The words you are searching are inside this book. To get more targeted content, please make full-text search by clicking here.
Discover the best professional documents and content resources in AnyFlip Document Base.
Search
Published by Thrive Magazine, 2021-11-11 19:24:18

Thrive Magazine Issue 16

Living Well with Limb Loss

Keywords: amputee,sports,healthy living,prosthetics

Joan Living Well
with Limb Loss
MacDonald
ISSUE #16
Talks Socks
Sockets Prosthetic
Care for
& Support Summer
Wear
Championing Back to
Wheelchair Tennis Bike
Riding
for Amputees
Adapted
www.thrivemag.ca • $4.95 Gardening

New Ways
to Toil in
the Soil



CONTENTS ISSUE#16

FEAT U R E S www.thrivemag.ca

22 18

Put a Sock on It Joan MacDonald Garden Variety Adaptive Ways to

Talks Sockets and Support Toil in the Soil

DEPARTMENTS

PUBLISHER’S NOTE 4

TAKE NOTE New Surgery Gives Better Feedback 6
MIND OVER MATTER Modified Mouse for Hook Users 6
ParaSport® Ontario Celebrates Five Amputees 7
75th Anniversary for The War Amps Key Tag Service 8
10
What it Means to be Strong
14
PEER SUPPORT Prosthetic Care for Summer Activities
28
SCIENCE & TECHNOLOGY A Show of Hands with Prosthetist Marcus Weber
34
HEALTHY LIVING Back on a Bike: Getting a Handle on a New Ride
38
INDUSTRY PROFILE Behind the Curtain at Naked Prosthetics
42
SPORTS & RECREATION Candice Combdon Champions Wheelchair Tennis
43
FORUM Fueling Against Osteoarthritis
49
THRIVE THROW-BACK “Mr. Veteran” 50

FINAL WORD

WELCOME Living Well
with Limb Loss
“A Rising Tide
Lifts All Boats.” DT Publishing Group, Inc.
– John F. Kennedy P.O. Box 327, Stn. Main, Grimsby, ON L3M 4G5
Tel: (416) 693-0032
Like fine wine, some things take email: [email protected]
www.thrivemag.ca
time. That certainly was the case
Managing Editor: Brenda McCarthy
with a three-year project that came email: [email protected]

to fruition this spring… one in Editor-in-Chief: Jeff Tiessen

which I was immersed very per- thrive founder and publisher, Jeff Tiessen Subscriptions: Emily Grace
THRIVEs-oAdn_a20l1ly6._cDmiysk.aqxbpi_laitryt 2T0o16d-0a1-y26P1u:2b7 PlisMhPinagge 1 [email protected]
www.thrivemag.ca
Group, the parent company of thrive magazine, just released The Power
Design & Layout: SJ Design Studio
of ParaSport – Celebrating Five Decades in Ontario for ParaSport® Ontario.
Art Director: Starr Hansen
The tabletop-style publication shGaresQ tUhOeTrEeSmarkable accounts of over
200 visionaries, pioneers and milestone-makers that led a Movement. Contributing Editor
The backdrop is sport for those with disabilities, but it’s so much more than Kimberley Barreda
that. It’s about a Movement. It’s about advocacy, uncharted waters and [email protected]
forging new pathways. Inspirational stories maybe; incredible stories for sure.
Advertising Sales:
I know the power of parasport. I’ve known it quite well in each of its five DT Publishing Group, Inc.
decades in Ontario. We found each other in the late 1970s. I was a teenager, Jeff Tiessen, publisher
a relatively new amputee, and when we first met, parasport in Ontario was email: [email protected]
even younger than me. Neither knew who or what we wanted to be really.
And neither had any inkling of who or what we would become someday. Legal Consultant:
Bernard Gluckstein, Q.C.
Decade by decade we both matured and evolved. We challenged
perceptions and made bold predictions about what we would accom- thrive magazine is published three times a year by
plish, together and independently. Reliably, new pathways emerged DT Publishing Group, Inc.
and milestones ensued. For me, it was the Paralympic Games and a DTPG accepts no responsibility for injury, damages or losses
lifelong passion for sport. For parasport, it was about opportunities arising out of the use or misuse of ideas, opinions, activities
for all – an ever-rising tide in the form of a Movement. or products contained in this publication. Where appropriate,
professional advice should be sought.
The publication, for me, is an extension of that passion. A nod to the bounty All material submitted to the magazine becomes the property
that parasport afforded me in our time together years ago and long thereafter! of thrive magazine.
Canadian Postmaster: Please send address changes to
Jeff Tiessen, publisher thrive magazine, P.O. Box 327, Stn. Main, Grimsby, ON
[email protected] L3M 4G5.
U.S. Postmaster: Please send address changes to thrive
Explore like a pro. magazine, P.O. Box 2660, Niagara Falls, NY 14302-2660.
Subscriptions: 1-year (3 issues) is $10.00 (orders outside
ABOUT THE PUBLISHER: Disability Today Publishing Group, a of Canada and the U.S. add $15.00 U.S.).
disability community leader for over 25 years, is known for its quality 2-year (6 issues) is $18.00 (orders outside of Canada and
publications, and compelling editorial. The publisher of Alignment for the U.S. add $30.00 U.S.).
Orthotics Prosthetics Canada, and a host of in-house magazine and © DT Publishing Group, 2021. All rights reserved.
book titles, the media firm is led by Jeff Tiessen, an amputee of 43 Reproduction, in whole or in part, without permission is
years. Tiessen, a three-time Paralympian, award-winning journalist and prohibited.
Canadian Disability Hall of Fame inductee, is a respected advocate
within the amputee community, the prosthetic profession, and other Made possible Ontario Interactive
healthcare fields as well. with the support of Digital Media Tax Credit
the Ontario Media

Development
Corporation.

Publications Mail Registration #10293
Canadian Mail Agreement #40069170

Printed in Canada

AllStar

Special Thanks to these Community Leaders for Supporting thrive as Valued Sponsors and Partners!

Meet the AllPro: the most naturally active, flexible, energy-returning foot

242 SISUSfrMoUmEMFil#lEauR1e6r.2Jo0in1t8he team on Instagram at @fillauerallproallstars.

PROVIDING THE HIGHEST
STANDARDS OF ADVOCACY

Gluckstein Lawyers has leading-edge practitioners with a wealth
of experience and the most innovative legal technology to serve
clients more effectively and efficiently. With offices in Toronto,
Niagara, Ottawa, Barrie, Collingwood, and Orillia, Gluckstein
Lawyers can handle the most complex litigation across the
province and beyond.

If you or a loved one has been seriously injured, please contact
us for an initial complimentary consultation, with no obligation,
at 416.408.4252 or toll-free at 1.866.308.7722.

TAKE NOTE

New Kind of Surgery Gives Good Feedback

By Cara Murez, HealthDay News

A new type of surgery is offer- doesn’t have its opposite activity,
ing amputees better control of and the brain gets confusing sig-
remaining muscles and prosthetic nals, explained Shriya Srinivasan,
limbs its inventors say. In their small post-doctoral researcher at Mas-
study, the new procedure also sachusetts Institute of Technology
helped curb pain and sensations and lead author of the study.
like the troubling “phantom limb”
syndrome. The team also developed a
modified version of the surgery
In most amputations, surgery for people who have already had
severs the muscle pairs (agonists/ a traditional amputation. Called
antagonists) that control affected regenerative AMI, it involves
joints. So, instead of the muscle on grafting small muscle segments
the front of the upper arm working to serve as the push-pull mus-
with the muscle on the back, that cles for the amputated joint. The
no longer happens. In this new surgery may also help ampu-
type of surgery – called agonist- tees maintain muscle bulk and
antagonist myoneural interface or volume in the remaining limb,
AMI – surgeons reconnect those muscle pairs so they retain allowing for better control of prosthetic limbs.
the push-pull relationship they’ve always had to improve “There’s been great progression of technology in the
sensory feedback. prosthetics field, but relatively little connection to the way they
interface with the human body,” Srinivasan said. The findings
Conventional amputation can make it harder for a person were published in the journal Proceedings of the National
to know where their limb is in space because of the loss of Academy of Sciences.
the sensory feedback. When one muscle contracts, the other

Modified Mouse for Hook Users

In yet another example of inge- using a standard mouse, Cooper
nuity on the part of the Human and his colleagues set out to work
Engineering Research Labora- on this problem.
tories (HERL), a collaborative
effort between the VA Pittsburgh “I had a prosthetic hook in my
Healthcare System and the Uni- office, so I started playing with it to
versity of Pittsburgh, there’s now a figure out how this would work,”
prosthetic hook mouse for those said Cooper. “A prosthetist made a
with upper-limb amputations. socket for it for me so I didn’t have
HERL researches, develops and to have a person with an ampu-
tests a variety of technologies for tation to try it. Then, we drew up
prostheses and other assistive devices. some shapes on the computer and
3D-printed them. One of the shapes worked reasonably well.”
The idea for the mouse dawned on HERL director Dr. One year after meeting Riley, Cooper and his team
Rory Cooper, a bioengineer, at the 2018 National Disabled unveiled their new invention. Shaped like a pyramid and
Veterans Winter Sports Clinic where he met Army and Coast elevated a few inches in the back, it provides a space where
Guard Veteran Dave Riley, a quadruple amputee who talked one can rest the wrist area of the prosthesis. In the front, the
about needing an adapted mouse to operate his computer. hook can drag a cursor and click right and left. Riley was
one of several Veterans who tested the new mouse.
Knowing that upper-limb amputees can face challenges

6 ISSUE #16

Five Amputees Honoured with
2020 ParaSport Awards

ParaSport® Ontario’s annual awards ceremony dates back to the organization’s inception over 40 years ago.
This year, the recipient of the organization’s coveted distinction, the Dr. Robert W. Jackson Award, has himself
presented this trophy to numerous winners over the years. Recipient Alan Dean, with five decades of volun-
teer service to parasport in Ontario, was joined by four other award-winning amputees celebrated for their
achievements as athletes and ambassadors.

JOLAN WONG ARISTOTLE DOMINGO 1992 – 2000. Coined the “Michael
Female Athlete of the Year Ambassador of the Year Jordan of Women’s Wheelchair
Basketball” she is one of the greatest
A 13-year-mem- Athlete, mentor, players to have ever played the wom-
ber of Canada’s media personali- en’s game. Together with husband
women’s sitting ty, advocate and Reg McClellan, also a highly-accom-
volleyball team, actor, Aristotle plished wheelchair basketball athlete
Jolan is looking approaches and co-recipient of the 2020 Bob
forward to Tokyo life with pur- Secord Award with Chantal, the couple
which will be her pose. He trains owns and operates 49 Bespoke, a
second Paralympics. She’s been a as a para-triathlete and is also an wheelchair company with an overarch-
key presenter at the Volleyball Cana- avid sitting volleyball competitor and ing mission of giving others the chance
da Coaching Symposium where she paragolfer. Founder of the Amputee to play too.
spoke about her sport to an interna- Coalition of Toronto, and host of his
tional assembly of elite coaches. She own successful podcast series The ALAN DEAN
also assists ParaSport Ontario with AmpTO Show, he celebrates limb loss Dr. Robert W. Jackson Award
grassroots development of the sport. with positivity. Constantly encourag-
When she isn’t on the court, she is ing other amputees to expand their As a founding
home-schooling her two children and comfort zones, his ability to motivate member of
running a brewery with her husband. makes him an effective ambassador. both the Ontario
and Canadian
CHRIS GARNER CHANTAL BENOIT Amputee
Male Athlete of the Year Bob Secord Award Sports Asso-
ciations and
A multi-sport Chantal was technical advisor for the Toronto
athlete com- honoured for Olympiad in 1976, Alan was an elite
peting at the her life-long parasport competitor himself. It was
provincial level in commitment his life mentor Dr. Robert Jackson,
para-ice hockey, to sport and the founding father of Canada’s
paragolf and contributing to Paralympic Movement, who intro-
sitting volleyball, the growth of duced Alan to the possibilities of
Chris is continuously raising the bar the ParaSport Movement in Ontario adaptive sport. Through competitive
for himself. The father of three also for others. Chantal competed in the sport, Alan discovered a passion for
coaches community soccer and most-ever Paralympic Games by athlete development, and organi-
facilitates ParaSport Ontario “Try Me” a Canadian wheelchair basketball zational growth. For five decades
programs. He’s the founder of the athlete with seven appearances. he has played an integral role in the
Amputee Coalition of Niagara and a She was a leading scorer during the development of parasport in Canada
director of the Amputee Coalition of team’s dynasty years which included and around the world.
Canada. three Paralympic gold medals from
ISSUE #16 7

The War Amps Key Tag Service LAST ISSUE
Celebrates 75 Years
“Wow! Sincerely, this is the
The War Amps Key Tag Service is celebrating a milestone best article ever written about
this year – its 75th anniversary. Since its inception, my story! I have done literally
the service has not only been reuniting thousands of interviews and
Canadians with their lost keys but they all capture the ‘story’ but
has been helping to make a differ- thrive captured the ‘essence.’”
ence in the lives of amputees. To date,
more than 1.5 million sets of lost – Alvin Law, CSP, HoF
keys have been returned to their
owners. A free service, and with no Also in the last issue: Disc
government funding, it is donations that enable the association to operate its Golf for Amputees, Returning
many programs for amputees, including veterans and children. Home After Amputation, and 5
Ways to Manage Hard Days…
Members of The War Amps Child Amputee (CHAMP) Program receive all available at www.thrive
financial assistance for prosthetic limbs and devices. They can also attend mag.ca (click Latest Issue).
regional seminars where Champs and their parents learn about the latest
in new limbs, how to deal with teasing and staring, and parenting an
amputee child.

The Key Tag Service was launched so that returning war amputee veterans
could not only work for competitive wages, but also provide a service to
Canadians that would generate funds for the association’s many programs.

Live Well with Limb Loss

SUBSCRIBE to

1-YEAR SUBSCRIPTION (3 Issues) $10.00
2-YEAR SUBSCRIPTION (6 Issues) $18.00

To Order visit www.thrivemag.ca
or call 1-800-725-7136.

8 ISSUE #16

Coyote Prosthetic
Locks

Dual Suspension

Air-tight Pin Lock

Water Resistant

3 sizes of
Air-Locks

New Robust Easy-Off Lock Design

Vacuum Compatable
Dual Suspension
Stronger Lever Release

www.coyote.us/easyoff Phone (208) 429-0026 | www.coyote.us

MIND OVER MATTER

What It Means

to be

ST RONG

By Andi Saitowitz

10 ISSUE #16

“S trength doesn’t come from what you can do. It comes
from overcoming the things you thought you couldn’t.”

~Rikki Rogers

A friend recently asked me: “Andi, where does your strength come from?” It took me a while
before I had a good enough answer for her. I sat contemplating the many roads I’ve travelled,
through my own transformational journey and the inspirational journeys of all my clients who
demonstrate incredible strength for me.

I moved to a different country, alone, at eighteen years share the secret sauce with you, and you could have
old and have changed careers, battled a complex pain di- full access to all the strength you’ll ever need to achieve
agnosis with my child, and lost loved ones. I am now living whatever it is that you really want… even the deeply chal-
through a global pandemic, like all of us, and most recently, lenging stuff and the tremendously scary stuff. All of it.
I am recovering from a traumatic, unexpected surgery. Life
has many surprises for us, indeed. I do know this: Strength is a personal measurement
for a truly unique, subjective experience. It’s entirely up
So where does strength really come from? I wish I to you to decide what strong means for you. And I also
knew the precise answer to this question so that I could know this…

Strength comes from doing hard things. It and are hopeful about an outcome, we feel
comes from showing up despite the pain or stronger. Even if we don’t know why.
fear and going through the struggle, the
endurance, and then building on that, Strength comes from without
to keep going forward and upward. — by surrounding ourselves
with people who lift us up and
Strength comes from taking see our worth, even when we
the time to acknowledge sometimes forget. It comes
what you have managed from choosing to envelop
to do and accomplish up yourself with kindness, inspira-
until now. So much of the time, tion, motivation, and gratitude.
we go through things without It comes from selecting role
realizing what massive effort models and learning from them.
something took, and we minimize It comes from seeing ourselves
the entire experience because we through others’ eyes — espe-
only focus on the end result and not cially those who see our greatness
the process.
and light when all we see is our
Strength comes from paying close flaws, weakness and shortcomings.
attention to the small but significant steps
and wins and incremental gains along the way. Strength comes from grabbing lessons and
Strength comes from tracking progress and celebrating it one blessings, often dressed up as really awful mistakes and
tiny bit at a time. painful failures.

Strength comes from within — from moments of acti- Strength comes from collecting moments that you are
vating your highest faith and belief. Knowing why you do genuinely proud of and taking the time to truly recognize
what you do, even when it’s not easy. these events for what they are and what they enabled you
to accomplish. Don’t overlook them. You get to use these
Strength comes from aligning with your core values and strengths in countless ways and in other areas of your life as
living with integrity even when no one is watching, and you much as you want to.
aren’t in the mood. When we connect to what truly matters
to us, we are stronger. When we believe there is a bigger plan Strength comes from knowing yourself. As you begin to
discover and unmask more of you, you get to make choices

ISSUE #16 11

The strongest people I know have incredible hearts that
expand wider with each hurdle. The strongest people I know
have endured so much and yet still find their smile to light up
the world for others.

The strongest people I know teach me every single day
how to try and be just a little bit stronger myself.

that honour more of you, and you get to live your purpose and ABOUT THE AUTHOR:
be more of who you really are. When we know better, we do Andi Saitowitz is a professional
better. life coach, global personal devel-
opment strategist and Lumina
The strongest people I know have had insurmountable practitioner, published author,
trials. They know what to say yes to and how to say no. They motivational speaker, mom of
know how to be proud of themselves with humility and hones- three children, and lover of books,
ty. They know how to pick their circles wisely and accept help, coffee, kindness and sports. In her spare time, she
compliments and advice. is involved in charity work and community. Andi’s
coaching practice incorporates techniques and tools
The strongest people I know cry a lot and feel everything. from the fields of behavioural science, organizational
The strongest people I know are the kindest. The strongest communications, psychology and mindfulness. Visit
people I know have wells of inner resources that are invisible her at andisaitowitz.com.
to the naked eye. The strongest people I know can say sorry
and forgive others. This article was reprinted with permission of
www.tinybuddha.com. Join the Tiny Buddha list
The strongest people I know can forgive themselves. or follow on Facebook, Twitter and Instagram.
The strongest people I know fall down hard, and slowly,
with every ounce of courage, bravery, and might, find a way
to get back up again — even if battered, bruised and aching.

The AmpuTO Show is available to be Live Streamed on
Voices4Ability Radio every Monday at 8 p.m. EST.

Missed a broadcast? Don’t worry.

You can also listen to The AmpuTO Show Podcast on demand from your
favourite podcast app.

Additional episodes including inspiring and motivational stories from the
limb loss and limb different community are available every Tuesday so make
sure to subscribe.

Check out the list of past shows at www.aristotledomingo.com

12 ISSUE #16



PEER SUPPORT

Ask Aristotle

You have questions. Q. What activities can I participate an activity is better than “sprinting” into
With the help of one and suffering for it.
Aristotle Domingo, in to enjoy the summer weather?
the founder of the Q. I want to get in the water this
Amputee Coalition A. There are many. Depending on your summer. Can I wear my prosthesis
of Toronto, and activity level, walks around your neigh- for water activities?
his peer network, bourhood, strolls through a park, riding
we have answers. your bike, and even enjoying the beach. A. There are many answers to this
You asked about Once COVID-19 restrictions are loos- question. My recommendation, and
summer activities ened, you could play golf, tennis, and best practice, is to check with your
and protecting other sports that are of interest to you. prosthetist to be sure that your pros-
your prosthesis. Maybe fishing, camping, hiking or other thetic components can be submerged
nature-inspired activities. The activities in water. Summertime is one of the
14 ISSUE #16 you can do are endless. But that all best times to check with your pros-
depends on your readiness to perform thetist about maintenance on your
those activity levels. Check with your prosthesis. They can help you clean
doctor about your physical health be- parts that you can’t easily get
fore taking on a long hike, for example. to when cleaning it on your own;
Remember, amputees expend more and check your fit. Check out the
energy during activities in comparison Amputee Coalition of Toronto blog
to our able-bodied counterparts. Make about understanding prosthesis
sure you are physically ready for the capabilities in the water: www.
activity. If you are not there yet, ask your amputeecoalitiontoronto.ca/blog-
physician where you can start… like a post/your-prosthetics-and-enjoying-
short walk and then adding on to build the-water-this-summer.
your stamina and strength. Easing into

Q. Have you experienced any Q. When I was in rehab, they kept Q. Do I need a specialized pros-
issues with your prosthesis from
telling me about “falling safely”. thesis for different activities?
summer activities?
What does that mean? A. Yes and No. In a perfect world,
A. That’s a question that has many we’d have a specialized prosthesis
answers too. We can experience all A. Falls are bound to happen, and for every activity we enjoy. They are
kinds of issues at different times of this applies not only during the winter available, but the reality is that they can
the year – some that we can manage months. Falling safely means to mini- be expensive and often not covered
ourselves and others that need our mize your injury when a fall happens. by provincial or private insurance. The
prosthetist or sometimes even medical The general idea is to fall with control. best recommendation I have is to really
help. However, there are ways in Let it happen smoothly. Do not panic. think about the activity you want to
which we can minimize issues when Stay relaxed. By keeping everything participate in the most and then invest
participating in any kind of activity in loose, you’ll likely have a softer fall. in a specialized prosthesis for that
the hotter months. When we panic, we stiffen up and are activity. For example, if you want to go
more likely to suffer injuries. back to running whether for main-
1. Check your fit. Whether you are a taining physical health or competing,
lower or upper limb amputee, ensuring Concentrate on falling on the meatiest investigate getting a running blade. An-
that your prosthesis fits comfortably part of your body – your butt, thighs or other example is a yoga hand adaptor
is priority one. You might have lost muscles on your back. Avoid reaching or a ‘shroom’ for your hand prosthe-
or gained weight in the past months out with your hands when falling. You sis if you are an avid yogi, or a golf
and because you’ve been mostly at can injure your hands, wrists, elbows adaptor to hold the club securely. But
home, maybe you haven’t noticed and shoulders quite severely. And most you don’t need a special prosthesis
that your socket isn’t fitting well. This of all, protect your head in a fall. Speak to participate in many activities. There
is very important, especially for lower to your physiotherapist or occupational are dynamic feet, for example, that
limb amputees who want to engage in therapist to learn techniques on how to
higher-level activities such as jogging, fall safely.
running or hiking. Skin issues on your
residual limb like blisters can develop “ Speak with your prosthetist about your
quickly from an ill-fitting socket. activity goals so that you can both
investigate the best solution for you.”
2. Prepare for the activity. Aside
from stretching and warming up,
which you should always do before
any physical activity, be aware of what
you need when participating in the
activity. For example, make sure you
have water to keep yourself hydrated.
Bring a towel to wipe down sweat col-
lected inside your socket or liner. Bring
extra ply socks (of various thickness
if you have them) should your socket
loosen or tighten. As our body hydra-
tion changes during physical activity,
it can affect the volume of our residual
limb and the fit of our prosthesis.

3. Change of liners, ply socks and
belts. If your activity involves water,
just like a change of clothes, make
sure you have extras of these items
on hand. Moisture is a hot bed for
bacteria and not keeping small cuts
and wounds clean after being in the
water, or not eliminating contact with
wet liners, ply socks, suspensions and
belts is asking for trouble. Change out
of a wet prosthesis and wipe it dry.

ISSUE #16 15



can be sufficient for hiking, jogging, or both the convenience and comfort
playing other sports. Speak with your of full-service accommodations in a
prosthetist about your activity goals so camp setting. You can find tents, or
that you can both investigate the best yurts, and even teepees, that come
solution for you. You can call on orga- equipped with its own shower, toilet,
nizations like ParaSport® Ontario and eco-friendly toiletries, comfortable
B.C. Wheelchair Sport Association that beds and linens, and some even
loan adaptive sports equipment – like offer breakfast service (like a Bed
a sports wheelchair for basketball or and Breakfast). Whatever your style,
tennis or road racing – for a small fee. I would recommend researching
Search out some of the adaptive sport what the campground offers so that
groups in your area to see if they have you can prepare for what you need.
similar equipment loan programs. Talk with other amputees and others
with disabilities who have visited that
Q. I’d love to go camping. Are campground if you can. Read online
there accessible camp sites? reviews. Something else that is worth
researching is the contact information
A. Camping is a great way to enjoy for the local prosthetist wherever you
nature. There are not many camping are travelling in case of a prosthetic
sites that are accessible. But don’t emergency. And make sure you pack
let that stop you. It will take some re- an extra battery, and prosthetic parts
search on your part and Parks Cana- if you have them. Have fun!
da (www.pc.gc.ca/en) is a great place
to start. Remember that camping More solutions for an active lifestyle
has also evolved. ‘Glamping’, which at www.amputeecoalitiontoronto.ca.
has become very popular, offers

ABOUT THE AUTHOR:
Para-athlete Aristotle Domingo is a double below-knee
amputee and an avid runner who also competes in
men’s seated field events – shot put, discus and jav-
elin. He also plays sitting volleyball and took home the
gold at the Niagara Penguins Sitting Volleyball Classic
in 2019. He also plays golf and is a member of PGA of
Canada’s Diversity and Inclusion Task Force. He is the
founder of the Amputee Coalition of Toronto.

FEATURE

Garden Adaptive
Ways to
Variety Toil in
the Soil

18 ISSUE #16

So as not to lead you down Photo courtesy of Ottobock
the garden path, after an
amputation you may need to 1. Our bodies change. That’s life. 4. Keep things interesting.
find some new ways to hoe Sometimes that comes with lim- Switch it up! Different garden
your row. So why not dig deep itations that prevent us from doing chores use different parts of
and put down some new roots. what we want to do. But look for the body. Repetitive move-
Touch wood, with a few adap- other ways to get the job done. ment causes pain, so switch-
tations you’ll be gilding the lily ing it up will help to keep you
and coming out smelling like 2. You can create a safe and from feeling sore the next day.
roses! comfortable garden to work in.
5. If you have a bad back, it
Adaptive gardening offers a 3. One of the best things you can is pure joy to stand up and
myriad of ways for gardeners do for your body is to stretch, garden. Find eye-level vertical
of all ages and abilities to stretch, stretch, before you start gardening opportunities. Then
identify what works for them gardening. Even dancing to some stand back to admire your
in their garden in keeping with upbeat music works to get you work. Good for your body and
personal goals and physical moving and warmed up. mind!
realities.

5

REASONS WHY

Adaptive Gardening

Could be Good

for You…

Contribution from Toni Gattone, author of The Lifelong Gardener,
Garden with Ease and Joy at any Age.

ADAPTIVE
GARDENING

Techniques

By Jeff Stafford Raised Beds. There are alterna- hoses instead. Not only are they
tives to getting down on your hands designed for better saturation for
Gardening is one of and knees and working the ground. the soil but your water bills will be
those hobbies that you Switch from garden plots to raised lower as a result. Soaker hoses only
can enjoy your entire beds. Have them built to a height of need to be set up once and you are
life. But after limb loss, 28 to 30 inches, or higher, with easy done.
or with ailments asso- access to the bed center so you can
ciated with aging, some water and tend to the plants from Plant Perennials. Reduce your
of the physical tasks re- any side. This greatly reduces bend- labour in the garden by planting
quired to manage your ing over and eliminates gardening on perennials over annuals. You can
garden can become your knees. always grow your favourite annuals
more strenuous and in containers or window boxes and
taxing on your body. Container Gardening. If trying to save your energy for your plants that
There are ways however, manage a large garden becomes too come back year after year.
to alleviate or reduce much work, scale back and grow
some of the physical plants and vegetables in contain- Weed Control. There are highly
strain that comes with ers that you can easily move from effective ergonomic tools for com-
the territory. outside to an inside sunroom as the bating weeds, but you can also be
seasons change. proactive and spend less. Put down
a layer of newspaper and then cover
Soaker Hoses. Manually watering a that with mulch or weed mats to
large garden on a regular basis can reduce the amount of weeding that
be a tiring task. Save your energy has to be done.
and use water conservative soaker

20 ISSUE #16

Adapted Tools. There are now a a seated position, or have difficulty Personal Care. Hydration – yours –
number of tools available for gar- bending, there are extender reach is important too. Drink plenty of water
deners with physical limitations from tools to help with gardening tasks. while gardening and avoid working
garden product manufacturers like DIY tools can often do the trick too. in the heat of the day. Early morning
Fiskars, Corona and Gripworks. In You can easily make improvements to or late afternoon and evening gar-
recent years, garden tools crafted from your current tools. For example, foam dening are best during the summer
lighter materials have become more sleeves sold for insulating pipes is an months. Another helpful suggestion is
customized to provide better support option for better grip on tool handles. to garden with a damp towel around
and functionality through ergonom- Hockey tape may add the cushioning your neck, which helps to keep you
ic design. Texas Assistive Devices needed to make gripping easier. cool. You can also buy cold packs to
(www.n-abler.org) has specific tools for keep in the freezer until you use them
upper extremity gardeners in the form Garden Aids. If you need support outdoors for heat relief. And, protect
of the Hand Hoe, Hand Cultivator and when bending over while gardening your skin from the sunlight with proper
Hand Spade. New tools like the Power why not consider investing in a garden attire. Wide-brim hats provide shade
Planter (www.disabilityworktools.com) stool or a rolling work seat that you can on your face, and the ones with neck
for gardeners struggling with arthritis or easily move around the yard? Foam veils are even better.
hand and arm strength is a soil auger knee pads are another inexpensive
for your electric or cordless drill to dig garden aid that offer great support. It is Gardening is good therapy for
holes to plant everything from flowers also efficient to keep the tools you need everyone. Do it smart and it can be
to bulbs. Less grip strength is need- with you, either in a portable wagon or as lovely as a bed of roses. Check
ed to hold the drill than to dig with a bucket or a handyman’s tote, to cut in with an occupational therapist
trowel. Whether you’re gardening from down on trips to the tool shed. for more good gardening advice.

Photo courtesy of Ottobock

Put a SOCK on It
FEATURE

22 ISSUE #16

JOAN MACDONALD

TALKS SOCKETS AND SUPPORT

By Diane Bracuk

Joan MacDonald enjoyed a successful career designing sportswear for competitive athletes. So when she
became an amputee, Socket Socks was a natural transition for her skills.

Like many fashionable people, Joan Moreover, her foot was collapsing, a procedure that would not guaran-
MacDonald enjoys mulling over her turning inward. As Joan bluntly puts tee pain relief but require repeated
wardrobe choices each morning. it, “my foot was done.” surgeries over her lifetime. The other
And along with the usual accessory option, amputation, still did not guar-
choices like scarves and earrings, Deciding on elective amputation is antee that she would be pain-free,
she also deliberates over the cover never easy, hinging on the extent of given the possibility of phantom pain
with which to adorn her prosthetic damage, and weighing the pros and that many amputees experience.
socket. The aqua mermaid print? cons of salvaging a limb through sur-
The camo classic? Or the “Ugly gery. Joan was given two options. “I had to decide whether I wanted
Christmas Sweater”?, which never The first was to fuse the ankle joint, to endure surgeries every five years
fails to get a laugh!

It helps of course that the former
sportswear designer is the founder
and CEO of Socket Socks, a Cana-
dian company that makes custom
and ready-to-wear covers for sock-
ets for both legs and arms. Started a
little over two years ago with Joan’s
mission to “empower others to stand
up with pride and style”, Socket
Socks has grown into a global
business. “I didn’t set out to build
this business,” she admits. “After
my amputation it found me, and to
be able to give back to the amputee
community has filled my soul.”

Osteoarthritis to Amputation
The Ottawa-based, married mother
of three grown daughters was raised
in Hawaii, enjoying an idyllic outdoor
lifestyle of running around barefoot
most of the time. A car accident at
the age of five left her with a limp,
and trauma-induced osteoarthritis.
For the next 45 years Joan endured
varying degrees of chronic pain until
it became so severe that she sought
out a series of specialists. After a few
misdiagnoses, an MRI revealed the
problem: her ankle bones were so
brittle that they looked like “sand on
the technician’s screen,” she recalls.

or take a gamble on getting rid of a rare and life-threatening side effect like a big Band Aid,” Joan remem-
burden that was with me since I was — a DVT (blood clot) running the bers. “It didn’t represent how I felt
a young child,” she shares. “What entire length of her sound leg. “We inside. Before my amputation, I did a
helped was writing down three were looking at a 50/50 chance of lot of research on being an amputee,
pages of questions for my doctor me surviving it,” Joan tells. After a and came across articles on female
just to be sure I had enough informa- harrowing two weeks her condition amputees wearing stylish prosthetic
tion in my toolbox to make the right improved and she was on the mend. covers, embracing their bodies and
decision.” She began her new journey armed looking proud to be an amputee.”
with a new conviction that life was
It was during her last appointment short, so make the most of it. With the proliferation of styl-
with her doctor that she asked the ish covers over the past decade,
definitive question that would cement Scratchy Fiberglass to finding one wasn’t difficult. Joan
her decision — would she be able to Stylish Sockets purchased one of the trendy — and
walk barefoot with a fused ankle? A longer recovery period than aver- pricey — laminated covers, but
age pushed back the start of Joan’s decided it wasn’t for her. And neither
While it might seem like a minor “Leg Day”, a term she uses to de- was a scratchy fiberglass socket
concern, for Joan, going barefoot is scribe the long-awaited first day that which snagged on her clothes and
one of her great joys in life, an es- she could try out her new prosthetic scratched her skin on her other leg.
sential part of who she is. “I still love limb with her prosthetist. And while “With my background, why couldn’t
to do that when I go back home to Joan was happy with her carefully I design a pattern for my socket
Hawaii. I’m barefoot in the house all selected prosthetist, she was not as and sew it up in a cool fabric?” she
year long. It’s just part of me, and to thrilled with her new socket. wondered.
take that away was not something I
could give up. When my doctor said “My prosthetist wrapped the plas- Her early prototype of what would
‘no’, I knew my answer. Amputate.” tic socket with fiberglass to protect eventually become a Socket Sock
it, which made it look too medical, was inspired by Canada Day. “In Ot-
Unfortunately, Joan’s below-the- tawa, people like to get dressed up
knee surgery in 2018 resulted in a in red and white clothing to celebrate
the festivities, so I thought ‘why not
make a Canada Day cover for my
socket?’ I made a red cover and
created a Maple Leaf out of rhine-
stones.”

The overwhelmingly positive
reaction from passersby was
transformative for Joan. “Instead of
looking at me with sympathy or pity,
people would exclaim, ‘Wow, that
is awesome!’ It made me want to
create something that was function-
al, affordable and made amputees
feel empowered and proud of who
they are.” And so, Socket Socks
was born.

“ I asked myself what was
the best way to use my
skills to help the world, and
I ended up sewing masks
and hospital gowns on
a volunteer basis for the

Ottawa community.”

Redefining Socket Covers Joan realized that there were basically to $75, a fraction of what you would
What makes Socket Socks so two sizes for all prosthetic devices. pay for a hard cover,” she promotes.
unique? According to Joan, the “I use a four-way stretch fabric which So, conceivably you could have a
covers look like they are painted gives me the flexibility to fit many whole collection of covers to go with
onto the socket, giving it a high- curves,” she says. “Small and medi- your wardrobe — just like Joan.
quality, professional look. “It doesn’t um fits 90 percent of my customers’
look like a pair of leggings that have sockets worldwide.” Moving Past Pause
been cut from the top and bottom When the pandemic hit last year,
and pulled over and tucked in,” she A peek at Joan’s website shows a many businesses that were roaring
explains. dazzling array of styles from casual to full speed ahead came to a sudden
super glam for both adults and chil- stop. Joan’s was no exception. But
With her in-depth experience de- dren. She also does custom printing after a good cry, the ever-resilient en-
signing form-fitting apparel for com- for those who already have a design trepreneur decided to shift her busi-
petitive athletes like body builders that they want on their cover. Covers ness. “I asked myself what was the
and gymnasts, Joan understands can also be made for Ankle Foot best way to use my skills to help the
body shapes and applies these Orthotics (AFOs) and wrist braces. world, and I ended up sewing masks
principles to Socket Socks. “They’re and hospital gowns on a volunteer
made from a custom pattern with a As fun and fashionable as her basis for the Ottawa community.”
Lycra fabric that fits snugly around covers are, Joan is quick to point
every curve. It actually looks like it’s out that they also have a functional The pandemic-induced pause has
part of the socket and is easy to side. “A Socket Sock can protect also given Joan an opportunity to
take on and off.” your prosthesis from sand and explore other design options, such as
debris when you’re doing an outdoor limb covers for osseointegration am-
Finding the right pattern size for activity like golfing, let’s say. Plus, putees. “It’s challenging in that I have
different sizes of sockets took a bit of they can protect your clothing from to make sure that the cover is com-
experimentation in the beginning. With getting snagged on your socket.” fortable and doesn’t irritate the skin,”
a little help from her friends, fellow am- Joan says. She is also experimenting
putees who became her test subjects, Then of course, there is the matter with pockets on the socket covers.
of price. “Our covers range from $27
With a post-pandemic future that
still looks uncertain, Joan is confident
that she has what it takes to survive
and thrive. “As amputees we learn
to adapt, which is what I had to do
in 2020. Now I’m ready to launch
again,” she says. And if she has her
way, more amputees will be stepping
out in style.

Check out her collection at
www.socketsocks.com.

ABOUT THE
AUTHOR:
Diane Bracuk is
a Toronto health-
care writer who
regularly reports
on the prosthet-
ics and orthotics
industry. She was a contributor to the
publication The Power of ParaSport –
Celebrating Five Decades in Ontario,
published in 2021. In her spare time
Diane writes short stories which focus
on women and self-esteem.

ISSUE #16 25

Joan’s Guide for New Amputees Along with creating a successful business after

her amputation, Joan has written a guide for new amputees based on her lived-experience, which is available for
free on her website: socketsocks.com/blog/new-amputee-guide. Some of her hard-won wisdom includes:

1. Take Time to Choose Your Prosthetist Because many trained peer support volunteer to talk to during the rough times.
people with limb loss have a life-long relationship with their Ask your prosthetist if he or she can recommend someone.
prosthetist, choosing the right one is essential. Although
one may be recommended to you, the decision is ultimate- 5. Online Physical Therapy A good physical therapist (PT) is
ly yours to make. When I spoke to my prosthetist the first essential for recovery. With lockdown, many have moved into
time, I let her know that I’m an outside-the-box kind of online therapy, including Cosi Belloso. Cosi is a PT specializing
person. “So when you think of stuff for me,” I said, “I need in supporting the amputee community. Every Wednesday she
you to think outside the box too.” That meant being a is on Facebook, either live or with submitted questions. It’s a
test subject and trying new and different approaches. wonderful forum for amputees, family members and even clini-
I wanted something that would work best for me. cians to ask questions about everything from gait and prosthetic
fit solutions to activities and skin care. Visit Cosi’s website at
2. Fit for Life Then there are socket fit issues, which often CosiTalks.com (facebook.com/cositalks).
require tweaking. I joke that my nickname at the clinic is Gold-
ilocks, because I’m always coming in for adjustments, saying 6. Humour Helps Losing a limb is no laughing matter, but I
that “it’s a little too big, or it’s a little too small,” a take-charge atti- found that keeping a sense of humour about my amputation
tude I urge for everyone. There are amputees using wheelchairs was healing. Believe it or not, we had a going-away party for my
because it’s difficult for them to tell their prosthetist that their foot. Yes, it’s a body part. Yes, I mourned its loss, but I turned
prosthesis isn’t working and it has to be made better. That’s why, it into humour, inviting my family and my friends to give it a
as an amputee, you have to advocate for yourself, stand up for send-off. I took all that energy to get through the healing
yourself, find out what you want in a leg or arm and ask about it. process.

3. Ask About Options The same proactive approach applies 7. Join a Private Amputee Group During my first year as
to prosthetic components. Although the latest advances in an amputee I joined every group that I was invited to, which
prosthetic technology have given amputees a wide range of lead to an unsettling discovery — there are people, both men
foot options, for example, many amputees — and even pros- and women, who are sexually attracted to disability specifi-
thetists — aren’t aware of all of them. Do your research and ask cally (and not the individual per se) and some even prey on
about the one that you think might be right for your lifestyle. I amputees. I was taken in by one of these people posing as
have an Ossur adjustable foot with a button that allows me to a new amputee. At first I was flattered when I was asked for
wear heels — but I don’t wear heels and that wasn’t my mo- advice, but soon after my spidey sense went off and I ended
tivation for requesting it. I chose it because the rotating ankle our exchanges. I still feel violated by the deception. Your first
allows me to walk barefoot, a must for a former line of defense against predators is making sure you’re join-
Hawaiian beach girl. ing a closed group. With a closed group, you usually have to
request to join and then answer a series of questions. I also
4. Be Patient Everyone’s timeline is different. There advise against joining too many groups and stretching your-
are so many things to learn, from standing up on your self too thin in chatroom conversations. Be selective. Keep
prosthesis, to walking, to how long you can wear your a list of the ones that give the best amputee tips for you. If a
prosthesis each day. Be patient. It can help to have a group doesn’t make you feel good about yourself, move on.

26 ISSUE #16

© Össur, 03.2021 PASO KNEE™

Pneumatics Reinvented

• Powerful, fluid movement - adapts
instantly and automatically to changes
in speed, for smooth walking/jogging
up to 7 km/h

• Up to 150° of flexion for comfort and
freedom of movement

• High degree of safety during stance
• Ready for use - works straight “out of

the box”
• Adjustable swing safety to suit user

requirements

Visit https://go.ossur.com/canada-paso-knee
or ask your prosthetist if Paso Knee is right for you.

CANADA (800) 663-5982
WWW.OSSUR.CA

SCIENCE & TECHNOLOGY

AShowof
HANDS

Talking Function and Fashion
with Prosthetist Marcus Weber

By Jeff Tiessen

After many years working in To that point still, Weber is disheart- the more effort that is needed to be
the field, prosthetist Marcus ened when watching someone invest put into learning how to use it.”
Weber is still fascinated by in the technology but never really opti-
things he sees. New technology mizing its functional ability. That speaks Funding is a reality as well and un-
continues to capture his imagi- to his point about those who will get fortunately has to factor into choice.
nation – especially myoelectric the same or even more out of a less “It can be a difficult discussion when
devices that no longer train the expensive option. a client discovered a wonderful hand
user how to operate them, but online that can do all sorts of things
allows users to tell the device To guide his clients to the best and wonders if they can have it, only
how they want to operate it. option Weber juggles a number to be told that there’s limited funding
There’s that, but even more of considerations. But first, for the for it,” Weber admits.
impressive to Weber are the uninitiated, Weber debunks several
amputees who operate their prevalent misconceptions. Despite “We talk about the pros and cons of
upper limb prostheses, be it a public opinion, “it’s not mindful different hands and I explain what I like
myoelectric hand or a conven- thoughts that control the hand; it still about one hand over another, or what I
tional terminal device, with the is muscle movement.” And second, might not like for them. It’s important to
skill and precision beyond the while each finger does move, it lay it all out there for the client... motor
imagination of most. doesn’t move independently or at noise, durability, and battery life. Once
will. Fingers all move in prescribed we understand the client’s goals, and
In speaking about myoelectric hands patterns. “You can’t direct the hand their capabilities, then we work from
specifically, Weber acknowledges that to move or gesture just the ring there to decide which way to go.”
despite the remarkable technology finger or pinky finger for example,”
available to his clients, at first it is rarely Weber says. Weber insists that it’s also important
predictable as to what is the best to consider what the device will be
option for them. Then come the considerations, used for and the expected life of the
beginning with an assessment of device, thinking about required main-
The “best in show” has its appeal what someone needs. “I start by tenance over that time too. “Clients
for many, new amputees in particular, asking what he or she plans on do- also have to understand that if they get
but the best technology is not always ing with it,” Weber shares. “If more really accustomed to the higher-end
the best for everyone, Weber cautions. concerned solely with functional technology, they need to be somewhat
“The most expensive devices might aspects, then I lean toward conven- farsighted in knowing that it will have
not be what works best for a certain tional prostheses. If there’s a cosme- to be replaced at some point. So, it’s
individual,” he notes. Weber explains sis desire as well, then we start to not just a one-time upfront cost. It’s a
that for someone who has been using look at myoelectric components. We long-term investment. There’s a lot to
a two-site myoelectric system for the talk about the product’s features and consider.”
past 30 years but wants to try some- that the more that the device has,
thing new with more function for them, So, who ultimately chooses the
learning everything that comes with final product? “We as prosthetists,”
that can be an unforeseen challenge.
“Learning how to use the new technol-
ogy efficiently takes effort,” he explains.
“This innovative technology works for
those who are willing to put in the work.
It takes a lot of training.”

ISSUE #16 29

“If you’re the type a number of reasons,” shares Weber,
of person who likes “including combatting stigmas that still
to have the latest cell exist. But when we get a chance to talk
phone, you’re probably one-on-one with the kids they often say
more likely to want that they don’t want one because their
the newest prosthetic friends accept them just as they are
and they’re getting along just fine. Most
technology.” of the kids are quite comfortable with
themselves. Congenital amputees are
Weber explains, “make suggestions but There are some commonalities with accustomed to working with what they
ultimately it’s up to the user. But users kids however. Weber finds that at his have which is very different from kids
have their own biases as well. Some clinic – Prosthetic Energy in Etobicoke who have lost a limb to trauma. Kids
will not accept anything that doesn’t and Scarborough – kids with congen- who have lost a limb want to replace it.”
look like a hand. Others are completely ital limb loss often come to them for
open to the functionality that comes the first time when they’re around 10 Weber goes on to say that even
with a conventional terminal device to 12 years old. A parental decision to when kids do agree to go through the
[hook]. We try and assess someone’s see a prosthetist, the child hasn’t worn process of a fitting and getting a new
potential with different technologies but a prosthesis at all up to this point and limb, he and his fellow practitioners
that’s really hard to do. And, add in the really isn’t interested in getting fitted for are not always sure how much they’re
fact that some are at a stage where one. “The parents feel it’s important for going to wear it. “But,” he assures, “it’s
they are still adjusting to the loss of a good to see them at that age and let
limb when we first see them.” them know what’s available and that
there are specific devices for bike riding
Weber’s experience has taught him or playing basketball and so many oth-
that a client’s personality often plays er things. Ultimately though, it comes
into the choice of a device and his down to their desire or decision to get
recommendations are often framed by fitted, which often comes later.”
character traits. “If you’re the type of
person who likes to have the latest cell When it comes to the various
phone, you’re probably more likely to myoelectric hands: “product to product
want the newest prosthetic technology. they all behave a little bit differently,”
While others – those who find some- Weber says. “But at the same time,
thing they like and are happy with it they all behave similarly. It often comes
regardless of age – typically stick with down to personal preference. For me
what works for them and don’t have a as the prosthetist, my preferences
need to explore new technology.” usually lie with the ones that I am more
familiar with – the ones that manufac-
Women versus men? “Not a lot of turers have educated me about.”
difference I find,” observes Weber. “It’s
a personality thing. I’ve worked with a
lot of women who put function before
fashion. I really can’t stereotype here.”

30 ISSUE #16



While myoelectric promised residual limbs. But with coapt grip can be done with pulsing. A quick
technology for upper you can work from almost nothing as pulse of the muscle gives a little bit tighter
extremity amputees has long as you make some sort of motion. squeeze for example. If something starts
been available for more Granted, it’s expensive technology and to slip in the hand, the user can give a
than four decades, a rel- that’s just the control part. You still need quick pulse for more grip. Some say it’s
atively new development to invest in a terminal device.” intuitive technology but really it’s still very
has been instrumental much a cognitive and a visual thing.”
in its evolution in recent Waterproof and water-resistant
years. It involves custom- myoelectric hands also represent big Other first-rate features include Blue-
ized pattern recognition contributions to advances in upper tooth grip chips that change the mode or
and serves hundreds of extremity componentry. And so does functionality of the hand with a swipe, so
prosthetic combinations. proportional control. “Terminal devices to speak. Referred to as gesture control,
The product of Coapt, have come a long way,” Weber states. with certain movements linked to preset
founded by a team of “You can still get digital technology that patterns, the hand can, for example,
myoelectric researchers at is either on or off, but proportional sys- switch from keyboard and mouse pat-
the Rehabilitation Institute tems give finer control. Users can open terns to kitchen cooking settings.
of Chicago, the system a hand just a little bit at a time, or at a
consists of a combination of preset slower rate, and also have more force- “Again, it takes a willingness to learn
electrode patterns that the user (and ful contraction. Controlling strength of how to manipulate these hands, and
prosthetist) assigns. With the coapt without that commitment it can be quite
system, eight muscle sites replace the frustrating for some,” Weber warns.
traditional two-site set-up which need- “Younger, savvy, computer game players
ed to correlate to specific muscles.
Now, control of the hand’s movements pick it up pretty quickly.
comes from distinct muscle patterns If you have a propensity
which are assigned to motions that the for learning new things, it
user determines for specific move- comes easier. For those
ments of the hand. Prosthetic wearers who have gone through life
usually work with their prosthetist and without this kind of technol-
occupational therapist to choose which ogy it can be much more
motions they want to employ. challenging to learn and
adapt to.”
“In the past,” Weber says, “you
needed some strength of muscle activ- And it takes deep
ity to operate a myoelectric prosthesis pockets, as some of these
which could exclude those with com- top-flight limbs can cost
upwards of $100,000.

“It’s hard to predict what
we will prescribe some-
times,” Weber sums. “Some
want function to get back
to doing what they used to
do. Others are more concerned about
aesthetics.” As for a show of hands, as
Weber says, it really comes down to
personality. Function and fashion.

ABOUT MARCUS
WEBER: Prior to
becoming a Certified
Prosthetist, Weber
graduated from the
University of Waterloo
(BSc. Hon Kin). He
worked at Sunnybrook
Centre for Independent Living
before joining Prosthetic Energy
West in 2017.

32 ISSUE #16



HEALTHY LIVING

Back on a BIKE

Getting a Handle
on a New Ride

By
Aristotle Domingo

34 ISSUE #16

With good weather upon us, riding a bicycle is an activity that amputees can enjoy. Cycling provides a good
cardio workout and a way to enjoy your neighbourhood. An easy ride around your community is a great
low-impact activity that is easy on your joints, helps increase muscle strength, and develops coordination
and balance. Here are a few tips to get you back on your bicycle this summer.

Check with your physician, overwork yourself on your first ride. get caught up on the fanciest bike. As
therapist or prosthetist. Ride the stationary bike at a moderate long as it is functional, light enough
pace, increasing gradually to a com- for you to carry, the right size and the
It’s always a good idea to check with fortable cadence. Do not go into a race right bike for the riding you want to
your primary care providers – physiat- speed as that is a tumble waiting for a do... a cheap bike can give you several
rist, physical therapist and prosthetist place to happen once you are on the seasons of riding. Once you get more
– before starting a new activity. They’ll road. Learn your safe pace to enjoy a comfortable riding a bike, and are riding
advise on possible medical conditions safe ride. more and could benefit from a custom
like joint health or heart and vascular bike, that’s the time to invest in an
issues that you should be aware of What you’ll need. expensive bike.
before starting the activity. Get an over-
all health check to make sure you are • Bike. If you had a bike prior to your • Helmet. Safety first! Whether or
healthy enough to ride a bike. amputation, you can likely ride the not it is regulated in your neighbour-
same one. If you don’t own a bike, hood to wear a helmet, wear one
Next, check with your prosthetist shop around. Ask biking friends about anyway for your own safety. You just
to make sure that your prosthesis can their bikes and their experiences with never know when a fall can happen,
handle the repetitive pedaling or cycling different ones. Bike costs vary from as especially during your first few times
motions. Ask your prosthetist about little as $200 for a low-end one (usually on the bike. In addition to learning
what you should watch out for during your department store brands) to thou- how to fall safely, a good bike helmet
or after cycling with regards to socket sands of dollars for specialty cycles. adds more security and protection.
fit, skin friction, redness, blisters and Decide on the type of riding you’ll do, Make sure the helmet fits well, and
so on, to make sure that your residual and where you’ll ride the bike before that it is easy to put on and take off.
limb stays healthy. He or she may also purchasing it. Visit a bike shop in your There are many options and many
check the alignment of your prosthesis neighbourhood and get measured for a styles. Pick one that both protects
to ensure that it is optimized for riding a bike. Many shops offer this service for and speaks
bike. For upper-limb riders, assess how free and can make recommendations to your
your straps fit in the riding position. on bikes and bike accessories that personality!
would be good for you. But don’t
Try a stationary bike.

Once you’ve been given a heathy “all
clear” to ride a bike, try out a stationary
bike at your local community centre or
your own gym if you belong to one. Or
ask your physiotherapist or prosthetist
if you can try a stationary bike at their
clinic or centre. This will give you an
opportunity to feel what it would be like
to pedal and more importantly, deter-
mine your riding pace so you don’t

• Comfortable clothing. You don’t
have to get fancy. Wear clothes that are
comfortable. Shorts will do but if you
prefer to wear pants, make sure that
your movement is not restricted while
pedaling, and that the fabric will not
get caught in the gears when pedaling.
Use a rubber band to secure your pant
leg near the ankle to prevent getting
caught in the gear or chain.

Pedals and pedaling. get frustrated. You will figure out how Handlebars and upper-limb
to position your foot on the pedal and attachments.
Lower-limb amputees may experi- you’ll become more aware of when
ence problems placing a prosthetic you are starting to slide off and adjust There are various cycling aids and
foot on the pedals at first. If you are your footing to avoid it. attachments available for upper-limb
not confident with where your pros- amputees depending on the type of
thetic foot is in relation to the pedal, One solution to consider is se- handlebar (visit www.trsprosthetics.
you may experience some difficulty curing your foot, or feet, with cycling com). Some upper-limb amputees
in starting to pedal the bike. Don’t shoes that clip into the pedal. This use special sockets, or semi-sock-
get frustrated if you don’t master this will allow you to ride more securely. ets, or even bar attachments directly
right away. Over time, with practice, But getting on and off of the bike on the bike’s handlebar to steer and
you’ll come to know where and how with toe clips requires time and balance the bike or use the breaking
far the bike pedal is in relation to practice. Practice in a safe area first devices. It is best to see your pros-
your foot. before going on the road with clip-on thetist to assess whether you need
shoes to make sure you can get in an attachment or modification of the
Another issue for lower-limb and out of the clip safely. bike’s handlebars for your use. You
amputees is keeping your prosthetic may need to take it to a bike shop to
foot/feet on the pedals. Prosthetic modify the handlebar.
feet tend to slip off. Sometimes,
because of your alignment, you may Key adaptations for upper-limb
hit the pedal crank with your heel amputees pertain to braking and
forcing your foot to slide. Again, don’t gear shifting. One recommendation
is re-cabling the brakes to oper-
ate both from one lever. For gear
shifting, there are a combination of
modes to operate the front and back
gears independently — a finger- or
thumb-trigger mechanism for the
front and a rotating handlebar grip to
shift the rear stack. You can also find
integrated gear shifters that combine
front and back controls into a single
package. There are also steering
dampers which reduce the bicycle’s
hair-trigger responsiveness and sim-
plifies shifting, braking and steering
with a single hand.

Stumps and Cranks

An Introduction to
Amputee Cycling

By Sonia Sanghani

Many amputees want to know
how it feels to be able to cycle,
and some even want to be
professional cyclists. The
disability market offers many
options for amputee cycling.
This book shows you how
to get started and take
those exciting first steps on
your way to a higher level
of mobility and indepen-
dence. It offers practical
tips and stories, imagery,
photographs, and much
more to help you or
a loved one firmly connect
with cycling as an activity
that can be done
despite an amputation.
www.amazon.ca.

Riding a bike can be very rewarding in many
ways. It’s an activity that you can enjoy with your
family and friends or one to change up your exer-
cise routine. It takes some practice and requires
some adapting to get comfortable, but it’s definitely
worth the effort. Riding a bike is a great way to
enjoy the outdoors. And as it is said: “It’s just like
riding a bike… you never really forget how.”

BE SAFE!

Disclaimer: By participating in any exercise you
understand that you do so at your own risk, are
voluntarily practicing these activities, assume all
risk of injury to yourself, and agree to release and
discharge thrive magazine and it’s author from
any and all claims or causes of action. Check with
your rehabilitation team before performing these
exercises.

ISSUE #16 37

INDUSTRY PROFILE

Naked
Prosthetics

The VISION
and the MISSION

Naked Prosthetics manufactures custom, high-quality finger prostheses specifically for partial hand amputation.
Restoring the ability to perform daily tasks, supporting job retention and encouraging an active lifestyle
are the pillars of its mission each day. In a conversation with Bob Thompson, CEO, and Dulcey Lamotte,
Chief Marketing Officer, thrive takes you behind the curtain of this innovative and visionary U.S. company.

thrive: Let’s start with need. for their family. Then there’s the loss of the presentation of the injury and the
some of their independence with re- prosthetic user, but for a hand, for
Naked Prosthetics would be spect to looking after themselves. When functional fingers, I think we are proba-
considered a relative newcomer that is lost, it’s devastating to them too. bly the most functional and robust
to the industry. And the partial- And then personal problems can devel- out there. We’ve built our devices
hand market it serves, historically, op. We see the psychological effects of specifically for swinging a hammer for
is one that is underserved. How finger amputation. It’s not just a finger. example, for getting back to work.
big is the need? They’re strong, sturdy and functional.
thrive: How do Naked We don’t try to cover it. It’s a naked
Bob: For starters, upper limb is prosthetic device and that’s where the
Prothetics’ products help? name comes from.
considered a niche segment in the
prosthetic industry. But that’s because Bob: We’re about restoration – func- thrive: On that front, a lot of
finger loss has not been included in
upper limb numbers. When talking tional and psychological. We’re not prosthetic components are the
about fingers you are talking about 94 about providing something to cover product of amputees themselves,
percent of all upper limb amputations. up an amputation. With our product first formed on kitchen tables or
It’s a huge number. And I’ve talked there is no elephant in the room. Our garage workbenches. Is this one
to ER doctors who contend that the products normalize life for our users. of them?
number of finger amputations far “Wow, that’s pretty cool,” is something
exceeds what is even reported. Doc- that our customers get a lot. Bob: Our founder Colin Macduff lost
umented as an “injury and closure”,
which most finger surgeries are, is not Dulcey: When you make a com- his finger to a mole trap. He’s a tinkerer
reported as an amputation. and likes to create stuff. He worked
ment to an amputee about how we for a bike company and built his first
thrive: Is it safe to say that love what we do because we are finger out of bike parts. He came to
changing lives and the amputee looks me and said, “Look at this thing! Let’s
there’s a lifestyle associated with back at you and says, “You aren’t patent it and sell it on the market.
the majority of lost digits? Can changing lives, you’re saving them,” There’s nothing like it.” But Colin didn’t
you characterize a typical Naked you know your product is helping. know how to run a business and he
Prosthetics customer? That’s why we do what we do. didn’t have the funds to start one.
With that enthusiasm we began.
Bob: Yes. 86 percent male. Guys thrive: Talking about functional
thrive: From there, how did you
who generally work with their hands or restoration, could your devices be
are active in that way. But dysvascular considered the most functional get to here… to where Naked
amputations have grown over the last prosthetic device on the market? Prosthetics is today? What was
20 years. Drugs used to keep organs the evolution?
alive are saving people who previously Bob: There isn’t one device that is
might not have lived, but bring blood
supply to the organs at the expense of suited for everyone. It depends on
the extremities.

thrive: As unsympathetic as it

sounds, are finger amputations
minimized by the prosthetic
industry?

Bob: It’s important to understand that

the loss of a finger or fingers can be
devastating. A lot of these guys are the
sole breadwinners for their family. One
day they have a job and then they lose
a couple of fingers and all of a sudden
they are out of work. A lot of these
workers aren’t able to go back to a job
that they are trained to do. They can’t
do a full day’s work because of pain
and then they lose their job. Many
people equate their self-worth with
what they do and how they provide

ISSUE #16 39

Bob: We started in 2010. We had a outcomes. Our clinicians work with Bob: We have seven engineers on
other clinicians and advise on the
prototype and knew we couldn’t build best fit for the end-user, so expec- staff right now and designers as well.
this thing out of bike parts every time. tations can be managed. We’ve be- All of our products are custom-made
Twenty-five years ago 3D printing was come innovators of not just prosthetic for the user, so engineering touches
coming to the forefront but it couldn’t devices but the process too. each one. The process starts with an
build an end-user product at that evaluation by our in-house clinical team.
point. But in 2010 it could. When we thrive: Share more about your After special features and concerns
started we didn’t know much about are written up, the design and produc-
prosthetics, but we were enthusiastic. approach to customer care. tion department takes over. We use a
We decided to go to trade shows combination of traditional machining,
to show it off. The first day we had Dulcey: Here is one example. Our injection molding, and 3D printing to
the attention of hand therapists who make the devices.
understand hand mapping very well. Finger and Partial Hand Amputee Peer
In 2016 we came out with the MCP + Support Group. Naked Prosthetics thrive: What’s the most common
Driver. created this forum because we under-
stand there has been a long-standing question you get from end-users?
It wasn’t until 2018 that we said, gap in peer support specifically for
“we’ve got this.” We released our finger and partial hand amputees. Our Bob: How do I get one?
thumb device, and did a significant intention is that this is a space where
manufacturing and industrial design finger and partial hand amputees thrive: Challenges?
push to better serve our customers. can share questions, concerns,
Then we started marketing beyond challenges, and triumphs related Bob: We are getting a lot more recog-
trade shows – social media work and to their amputation.
videos that went viral for us. Patients nition out there. And with that begins
started reaching out to us. thrive: Back to your products, the battle with insurance companies.
Some are starting to realize that fingers
Dulcey: We’ve always known that how are they manufactured? are a large volume in our health care
systems and of course are looking at
we have a superior product, engi- how this will be funded. Sometimes we
neered for function and strength. are rejected because insurance funders
Because of that and marketing don’t cover myoelectric devices. Since
efforts we’ve grown from a garage we are a new technology, there is a lot of
to a 20,000 sq ft facility and into an education to be done.
international company. We’ve grown
organically and learned from our thrive: What’s next for Naked
mistakes. We have a staff made up
of incredible people: Customer Care, Prosthetics?
Clinical, Engineering, Production,
Manufacturing, R&D, Administration Bob: We are always trying to get
and Marketing. We also changed our
philosophy and no longer have better, taking feedback very seriously
traditional salespeople. We have to drive innovation. What makes our
Educational Outreach Specialists. product even more functional and
We believe in growth through educa- more acceptable and appealing to
tion because we want better patient people? We are always looking at
industrial design – making it stronger.
40 ISSUE #16 It is never going to look like a finger
so we want it to look like a cool
accessory. We’re always working
on that next look.



SPORTS & RECREATION

TENNIS

Everyone!

By June Jang

Like a pair of skates or set
of skis, sports wheelchairs
are a piece of equipment for
a specific sport… like wheel-
chair basketball or wheelchair
tennis. While some amputees
are hesitant to give wheelchair
sports a whirl, others are not,
utilizing para ice sleds, racing
wheelchairs and court sport
chairs to their full advantage.
“In my experience,” offers
Katherine Hale of the Ontario
Para Network (ONPARA),
“the stigma around wheelchair
sports for amputees often
centers around an emphasis on
ambulatory sports. I emphasize
that wheelchair sports present
additional options for ampu-
tees. I encourage amputees to
try as many sports as possi-
ble – sitting and standing – for
strengthening different muscle
groups, for variety, and to meet
new people.” In fact, as Hale
explains: “lower-limb amputees
often have the upper body
strength and function to be
very competitive in fast-paced
sports like wheelchair basket-
ball and wheelchair tennis.”

42 ISSUE #16

Take Candice Combdon for example. Although her first introduction to Photo by Laura Joy Photography
The 33-year-old Team Ontario wheel- wheelchair tennis was over 12 years
chair tennis athlete grew up with spina ago at a ‘Have A Go’ day hosted by her confidence. “I came home and I was
bifida, a condition that prevents the ONPARA (then known as the Ontario like, ‘I can do this. Maybe Paralympics, if
spinal cord from forming properly, and Wheelchair Sports Association), the I really apply myself and work hard. I can
experienced life much differently than lack of readily-available resources in really do this.’ It was one thing to say,
most kids her age because of it. “I had her hometown of Newmarket at that ‘Oh, I’d like to go to the Paralympics,’ but
to fight for things I wanted to do,” she time prevented her from participating it’s another thing to really believe that I am
shares. “I had to push to be included more seriously. Combdon says the capable of doing it.”
and accepted by my peers.” most beneficial support she received
from ONPARA early on was through If there is one thing Combdon wants
Admittedly subdued and shy, its Wheelchair Loans Program which to share with amputees and all people
Combdon says that she only started enables participants to rent costly with disabilities looking for a way to get
living her life without fear after she had specialized sports equipment for a involved in parasports, it is simply to
her leg amputated three years ago. low monthly fee as a means of reduc- take a chance and try it. “I can’t stress
She had been living with chronic pain ing one of the barriers for those just enough how much taking that one
for seventeen years. “After my amputa- starting out in wheelchair sports. A new chance on wheelchair tennis twelve
tion I was a completely different person. sport wheelchair can cost upwards of years ago changed my life completely. I
I focused on following my heart and I $5,000, causing wheelchair sport to be am a completely different person. I am in
was so much happier, so much more inaccessible to many. a completely different place than I would
positive, and more willing to try different have ever been had I not discovered
things.” With the support of ONPARA, wheelchair tennis,” Combdon admits.
Combdon competed at the 2020 “It’s just been a monumental, crazy, pos-
One of those things was wheel- Indian Wells Tennis Garden Wheel- itive experience for me, and I will forever
chair tennis, a decision she took very chair Championship in California. She tell people: ‘if you’re not someone who
seriously. Never one to enjoy being says her exposure to an international plays sports, go and try one because it
in the spotlight, Combdon says she tournament and returning home with can make such a difference.’”
becomes a completely different a doubles trophy in her division fueled Follow @candice_combdon on her
person whenever she wheels onto the wheelchair tennis journey.
tennis court. “When I get out onto the
court, I’m an athlete. I feel good. I feel
confident. I can scream and get angry.
I can get excited. It’s a lot of fun for
me,” she adds.

Something that distinguishes Comb-
don from most other athletes is that
she grew up with little to no experience
in sports. Although she spent long
hours on weekends watching tennis
matches with her mom, the memory
of a careless but cruel comment from
one of her classmates when she was
just seven kept her away from sports
until much later in life. “I played T-ball
back when I was young, and I remem-
ber one kid who pointed at me and
literally said with a laugh, ‘Ha ha. You
can’t run.’ It stole my interest in playing
sports until I was in my twenties.”

Today, Combdon is very passionate
about sport – wheelchair tennis partic-
ularly – dedicated to improving her skills
every day. In fact, Combdon was on
the court – albeit on the bench – just
weeks after her amputation to watch a
wheelchair tennis session.

ISSUE #16 43

05 ACCIDENTALLY ACCESSIBLE

08AND INTENTIONALLY AWESOME PRODUCTS AND SERVICES FOR YOUR UNLIMBITED LIFE

“HOUSEWORK CAN’T KILL YOU, BUT WHY TAKE A CHANCE?” - PHYLLIS DILLER

06

07 10
09

01 03

04
02

ACCIDENTALLYACCESSIBLE.COM BY KIMBERLEY BARREDA

SPLASHPAD® Sink Splash Guards Litter-Robot 3 Connect Robotic Litter Box

SPLASHPAD mats have a soft, absorbent microfiber Never scoop litter again with the highest-rated
top layer that instantly soaks up moisture. Wash- WiFi-enabled, automatic, self-cleaning litter box for
able, available in multiple sizes. $29.95 https:// cats. By AutoPets. $499 https://www.litter-robot.
www.splashpadshop.com. com/.

05. Self Disinfecting Door Opener 06. Bob’s Butt Wipes

Refillable reservoir cleans 2000 cycles, eliminates 99.9% of Personal hygiene wipes. 100% biodegradable material,
viruses and bacterias. By CleanMotion. https://cleanmo- infused with all-natural, hypoallergenic formulas. From
tion.ch/en/self-disinfecting-door-handle/. $2.99 at https://sterlingglobalproducts.com/.

07. FrescheAir Portable Air Purifier 08. GoSpa Travel Bidet

HEPA filter keeps small spaces free from dust and aller- Stay clean no matter where you are with a portable easy
gens while keeping the air fresh and clean. $99.99 https:// to carry travel bidet. Comes in various colors and styles.
www.scosche.com/. $14.99 https://www.brondell.com/bidets/travel-bidets/.

09. Brondell Sanitizing Air Purifier 10. Pawz Dog Boots

Brondell Pro Air Sanitizer is proven to eliminate ≥99.9% of These natural, waterproof, disposable boots protect paws
COVID-19 virus (SARS-CoV-2) within 15 minutes. $649.99 against hot summer pavement, ice and snow, mud, and
from https://www.brondell.com/pro/. other dirt. From $15.00 at https://pawzdogboots.com.

01. Skadu 02. MagicFogger 03. Jax & Cali 04. Whoosh

Skadu is a 3 headed pow- MagicFog mist kills 99.94% Jax & Cali Paw and Body WHOOSH! screen and SPRING 2021
erful hand-held electric of microbes and is highly Wipes have a unique for- tech cleaners are the next
scrubber that easily cleans effective against viruses. mula to cleanse, nourish generation of clean. Wipes,
the most stubborn messes Safe for use in occupied and protect using vitamins sprays, and cloths make
with three scrubber disks spaces, around pets B3, E, and soothing aloe. it easy for you to practice
rotating in opposite direc- and children, and is FDA In convenient carry packs. good tech hygiene on the
tions. $69.00 from https:// approved. $79.99 https:// $8.95 from https://jaxand- go. From $9.99 at https://
www.hyperlychee.com. www.scosche.com/. cali.com/. whoosh.com.

SEND PRODUCT SUGGESTIONS TO [email protected]

FORUM

Presented by:

Össur Canada

Fueling Against Osteoarthritis

More amputees are living an active life with a prosthesis today than ever before. These numbers
continue to grow in parallel with the evolution of new and more advanced prosthetic tech-
nology and medical treatments.

With record numbers of pros- OA is also called degenerative
thetic users however, research- joint disease, degenerative arthri-
ers have noticed a troubling tis, and wear-and-tear arthritis.
trend: lower extremity amputees
who use a prosthesis are two For people with OA, treating
times1 more likely to experience your body kindly shouldn’t just
pain in their sound side – the mean keeping up with regular
side that has not been ampu- doctor’s appointments and buy-
tated – than individuals with two ing comfortable shoes. It should
biological legs. also include considering the
quality of fuel we choose to get
A typical scenario can happen us from one place to another.
like this: depending on various And it has been shown that the
factors, an amputee may be unbalanced in how he or she kinds of food may matter, even more than we might think.
bears their body weight, or their walking style or gait may be
uneven. They may consciously or unconsciously make ad- Yes-No-Maybe: Eating for Inflammation
justments every time they move. And while these adjustments Strictly speaking, no diet will cure OA. However, medical
or “compensations” might not seem to pose any issues at professionals, including dieticians and nutritionists, say
first, when repeated continually over time they can become some types of foods might actually improve the symptoms
problematic to the amputee’s long-term health and mobility. of the condition while other food types appear to have the
opposite effect by increasing pain and inflammation within
There is research that has found that 75 percent of lower limb the body.
amputees report feeling knee pain2 and that the rate of
osteoarthritis is 65 percent higher in amputees than in As a whole, medical professionals usually recommend a
non-amputees. Osteoarthritis (OA) is the most common combination of better food choices and regular exercise to
chronic (long-lasting) joint condition, where two bones come help anyone maintain a healthier weight overall.
together. The ends of these bones are covered with protective
tissue called cartilage. With OA, this cartilage breaks down, The good news? A massive transformation in weight
causing the bones within the joint to rub together resulting in and physical fitness is not required to reap the benefits of
pain, stiffness and other symptoms. OA occurs most often improved OA symptoms. Dropping as few as 10 pounds
in older people, although it can occur in adults of any age. can be the equivalent of losing 30 pounds in terms of
reduced pressure on the knees.

1 Delzell, Emily. “Knee OA in Amputees: Biomechanical and Technological Considerations: Lower Extremity Review Magazine.” Lower Extremity Review Magazine | Rehabilitation • Trauma •
Diabetes • Biomechanics • Sports Medicine, 26 Apr. 2017.

2 Gailey, Robert, et al. Review of Secondary Physical Conditions Associated with Lower-Limb Amputation and Long-Term Prosthesis Use. Journal of Rehabilitation Research & Development,
1 Nov. 2008.

412626 ISSUE #136

Visit www.ossur.ca for more information.

ISSUE #16 47

THE AMPUTEE COALITION OF CANADA

Improving quality of life for persons living with limb loss through:

• EDUCATION
• SKILL DEVELOPMENT
• CONNECTION

An Amputee-First Philosophy. Empowering one, empowers us all.

To learn more visit www.amputeecoalitioncanada.org.

Photo: Legion magazine THRIVE THROW-BACK

MR. VETERAN’S VISION
CELEBRATES
75 YEARS

The War Amps began its 2021 key
tag mailing to Canadian residents
with the theme “You Are a Part of
What We Do,” marking the 75th
anniversary of the association’s
Key Tag Service and paying tribute
to the public for helping make it a
success.

Cliff Chadderton, known to many
Canadians simply as “Mr. Veteran,”
was recognized nationally and inter-
nationally as an influential developer
of innovative programs and services
for war, civilian and child amputees.
He was also the founder of The
War Amps Child Amputee (CHAMP)
Program. Chadderton served as the
association’s Chief Executive Officer
until 2009. He passed away at 94,
in 2013.

Among his many accolades,
including Companion in the Order
of Canada, induction into the
Canada Veterans Hall of Valour
and the Canadian Disability Hall
of Fame, he was proudest of the
CHAMP Program which provides
child amputees with funding for
prosthetic limbs and education,
counselling and seminars. It remains
the only program of its kind in the
world.

ISSUE #16 49

FINAL WORD

“ Within you is
the strength,
the patience,
and the passion
to reach for the
stars to change
the world.”

– Harriet Tubman

Kayla
Crnecki

50 ISSUE #16


Click to View FlipBook Version
Previous Book
แบบรายงานผลการปฏิบัติงานIS
Next Book
5B0FB9F5-7C6A-4A40-B73D-7FFC53EF6CCA-converted