Cosi Talks with Special Guest Ahmad Najwa & Billy Lester – RevoSurface: How To Get Adjustability in Your Current Socket

Do you need a better-fitting socket now, but you are not eligible for a new device? Or are you simply interested in learning more about RevoSurface, then you don’t want to miss watching this recorded Cosi Talks.

On October 11th, 2023, Cosi Talks hosted an amazing show about RevoSurface and adding adjustability in an instant to your current socket. She had two special guests from Kenney Orthopedics, Ahmad Najwa, CPOA CTP and Billy Lester, CPO LPO talking about the benefits of adjustability and how RevoSurface is a great add-on to your existing device. It was a great discussion and we learned a lot from our friends at Kenney.

Tune in above, we hope you learn something new to empower yourself or others.

Full Transcript Below

0:00
I have two very special guests with me here this evening right up above I’ve got Billy Lester prosthetist and right
0:06
next to me I’ve got that way I’ve got a mod and they’re both protist from Kenny Orthopedics and they are on loan to me
0:13
tonight uh courtesy of Click medical my sponsor for this evening so guys those
0:18
of you who are watching the replay thank you again for watching the replay y’all are great about commenting hit Replay in
0:24
the section give me a shout out and if you have questions go ahead and put those in the comment section as well
0:30
after the show ends I always go back to check and see who’s watching the replay and to try to capture any questions um
0:37
so guys we’re going to give you a couple minutes to jump on board in the meantime gentlemen do you guys have anything interesting in your glasses this
0:43
evening anything H2O really maybe a little uh Don Julio ah
0:53
there we go cheers to you cheers to you guys I am drinking out of my click medical Yeti mug so the reason why I am
1:00
plugging this this evening is because we’re going to be giving a lot of these away this tonight Hey Kevin we got you on board Kevin listening in from the
1:07
YouTube channel all right and hopefully Jamie is going to be coming on board right now so Jamie we’re gonna give you
1:13
another minute to get yourself situated we’re going to do that picture that you’ve been wanting us to do so guys as
1:18
you come on board those of you who are new part of the initiation ritual to Coy talkes you got to let me know who you
1:24
are where you’re from and what is in your mug this evening we got Francis coming in from Orlando Rob coming in
1:31
from Indiana with Diet Mountain Dew all right guys don’t be shy I know sometimes
1:36
the responses come in just a little bit late but we’re gonna go and wait we got hey Scott there from West Virginia with
1:41
his cold water you’re a buddy of a mods right there and we got Denise there’s my tar heill from North Carolina go heels
1:48
water as well Richard on board with his Kaa coffee oh that’s the way to go that’s the way to go on the way to Texas
1:56
all right guys we got a really special show on board this evening uh click medical has been uh sponsoring this show
2:02
now for two years and it’s really been a joy working with the team I know many of you are users with Revo fit um but
2:09
tonight we’re going to change the angle just a little bit pun intended we got Emily here from Central PA she had her
2:15
appointment with her physiatrist OT evaluation on 17th might be in rehab by the end of next week and she’s got
2:21
Dunkin on as spiked iced tea tonight and that does sound delicious uh let’s see we’ve got Linda
2:26
here coming in from New York we’ve got Jean I’m seeing a lot of new name names here this evening guys so whether it’s
2:31
because this is your first time on the show or this is the first time maybe you’re commenting on the show uh welcome
2:38
uh my name is Coy boso I’m a physical therapist amputee specialist and like I said this evening I have Ahmad and Billy
2:44
two wonderful prosthetist from Kenny Orthopedics and I’m gonna let them introduce themselves um so we’re gonna
2:50
put um this way I gotta point this way Ahmad you’re up first so tell us a little bit about yourself please hey Coy
2:57
uh so my name is uh Ahmed I’m originally from Afghanistan I came to the states uh
3:04
for my bachelors to Kentucky H my bachelor is
3:09
in applied uh technology and applied design uh after I graduated um I wanted
3:16
to find work in the prosthetic field specifically because um Afghanistan has a large number of landmine victims um so
3:24
I kind of wanted to be in the field to hopefully at some point work with u Utes back home and I was fortunate enough to
3:30
find a position as a tech in keny Orthopedics in 2017 and U like the Drake song we
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started at the bottom now we’re here uh so I I’ll make one quick correction I am a a a cpoa so I’m a assistant Billy’s
3:47
the prosthetist uh but now um I’m leading our 3D lab doing a lot of um 3D brand
3:55
Diagnostics and other devices so it’s it’s been a fun ride no and thank you for being with us this
4:01
evening all right Billy you’re up I think ahad’s being modest he he he’s a
4:08
cpoa but he knows uh he knows a hell of a lot more about digital um OMP
4:15
fabrication that I do so he he runs all our digital side of kingom Orthopedics which is a significant uh amount of
4:22
business so don’t don’t be so modest a mods U my name is Billy Lester I’m a a
4:28
CPO out of Lexington Kentucky um I’ve been with Ken Orthopedics my whole life
4:33
my whole career so uh the owner and founder Mo Kenny gave me a job when I
4:39
was in college pouring plaster and and um being his Grant and um mentored me
4:45
along I eventually went to Northwestern University and um did my residency with Ken Orthopedics partnered in with Mo uh
4:54
back in 2009 and we’ve grown from to
4:59
practice location to now we just opened our 20 22nd location um in yeah Kentucky
5:06
Indiana and North Carolina so we’ve been fortunate to grow um the way we have and
5:11
and it’s because the people that we surround oursel with and um the technology that we use so I’m happy to
5:17
be here thanks for having us tonight cozy and um look forward to meeting everybody and trying to help answer some
5:22
questions that’s wonderful and thank you guys in advance again for for taking times from your lives to be with us here
5:27
this evening we’ve got already this sticker tape is is going crazy tonight uh so we got Chuck here from Wyoming we
5:33
got click medical guys we’re supposed to take a picture so ready guys’re we’re going to smile Bob’s gonna get in on the picture ready we’re gonna smile for
5:40
Jamie one two three Jamie I hope you got that picture
5:45
because Bob says he’s not doing that again all right we got Andrea on board she is my token occupational therapist
5:51
from Gatorland we got Gad on board Stephen says from New Jersey got my first prosthetic today pin lock and it
5:58
feels good to be vertical instead of on and on two instead of one congratulations to you we got Felicia on
6:04
board uh we got a lot of people we got Mark s is taking time away from watching his Sports to be with us here tonight
6:10
I’m always teasing you Mark we got harsh we got Susan now we got all the good regulars on here so guys tonight we are
6:16
gonna be reviewing revoit because it’s just I’ll just say it’s kind of one of my favorite products out there on the market right now but we’re gonna be
6:22
talking a lot about the revo surface okay so let’s talk a little bit about what is adjustability you know we hear
6:29
that term a lot we hear it you know in a lot of the Facebook amput support groups so for my newcomers here who have not
6:35
seen any of my click medical shows um adjustability basically means the the chance for you to adjust the fit of your
6:42
socket while you’re on the go okay so basically instead of having to take your socket on and off to put on socks or
6:50
take off socks there is some form of adjustability built into the socket so that you can either turn uh a click reel
6:57
or you can handle a ratchet in some cases and adjust the fit of the socket
7:02
itself and the size can be adjusted now click medical is one of the uh Solutions
7:09
out there for adjustability it is not the only option out there for adjustability and I always tell you guys
7:14
you need to be informed consumers so you need to take what it is that you learn on this show talk to your prosthetist
7:21
talk to your physical therapist and explore what the other options are and compare to see what is going to work
7:26
best for you so why is it important for us to have adjustability um so I know
7:33
you guys can probably Echo this sentiment but probably one of the biggest problems I run into with my new patients and even some of my veteran
7:39
patients is the frustration um with learning how to fit the socket properly
7:44
um when you have a new socket so with the limb volume fluctuations going on especially in those first year and a
7:51
half to two years after amputation the frustrations that people experience from
7:57
trying to figure out how to fit their socket so Billy I’m going to pick on you
8:02
first um how do you feel that plays a role when you see your patients in terms of the struggles that they might have
8:08
when they’re first learning to use their socket yeah I mean we spend a lot of time on education right I mean we
8:14
educate our patients how to manage sock ply um you know it’s like you know for
8:22
prior to an amputation right you try to use the reference you ever get up in the in the morning and try to put on your
8:28
ring or try to put on a watch sometimes it slides right on sometimes it’s it’s too tight right and it’s no different
8:34
than your leg it’s just a bigger feature that happens so your body fluctuates so
8:39
much um whether you realize it or not and so trying to spend time on the front
8:45
end on the education side is um I think invaluable and I think it’s a lot you know a lot of time we spend with
8:51
patients is educating on how we’re not with them right I mean they leave and they spending time with a physical
8:57
therapist or they go home and you know it’s like taking your car into a mechanic you know the times that
9:04
the car leaves and it it’s great but when you have issues you got to be able to self- diagnose and do some things on
9:10
your own so um you know we spend a lot of time on sock ply management
9:16
and with that you know in combination of sock ply Management on top of new technology like click it allows us to
9:24
educate and put the user you know put the put the adjustment back in the patient’s hand on the fly right and I
9:32
think that’s what’s so important about these newer Technologies are coming out is it’s allowing people to be more
9:39
independent um you know nobody likes to go in and have to take their leg off to adjust sock ply or pull their pants down
9:46
or try to figure out how to get their leg either get their pant leg up above and slide down their sleeve to be able
9:52
to put on another so right if you give somebody the adjustment to you live a normal life keep going and with a a
9:59
couple turns of a reel they can make an adjustment that makes them comfortable again and aad I’d love to hear your
10:06
comments on this as well yeah so I’m I’m gonna speak from like a fabrication
10:11
aspect uh whenever we fabricate um trans tibular transfemoral sockets we use
10:18
carbon fiber because you want the patient to be in a device that can U provide them with as much safety as
10:25
possible but that comes with the side effect of very rigid device and uh the human body uh needs something that’s
10:32
compliant so we need a device that is strong but at the same time that can be
10:39
adjusted and that’s where click I think gives us both features in the same device so it’s it’s a great
10:47
Innovation so we’ve got Benjamin saying he’s a bilateral BK and he says I’ve had my legs for about a year and they’re
10:53
starting to not fit well so this is very interesting for me yes so definitely stick around Benjamin uh collector’s
11:00
Edge is saying I’m excited to learn more about click and I will be getting it in my new socket then you are in the right place tonight to ask all of your
11:07
questions uh let’s see and Emily says I found out today that my limb has shrunk a little bit more since my first
11:13
appointment and I wouldn’t have noticed had they not taken measurements so guys let’s just talk a little bit about that
11:20
you know and those of you who have watched the show you know I talk a lot about limb volume management and skin
11:25
care management and everything that goes along with it um but you know in actual ity the the first up to two years guys
11:31
up to two years that limb is changing volume okay in the first few months it’s
11:36
basically all the edema all the swelling from the actual surgical amputation itself right so all of the soft tissues
11:42
are kind of trying to get rid of that edema and then over the course of time you’re also going to start seeing changes in the soft tissue in the muscle
11:50
how it was reconnected after surgery how it’s being shaped you know in different ways to prepare for the prosthesis and
11:58
then once you start using that prosthesis again you’re pumping fluid out of the limb everything is remodeling
12:04
right so everything is changing and then once you reach that two-year Mark and I
12:09
actually I’m going to be releasing a video of this pretty soon some of you will achieve stability with your limb
12:16
okay and stability with your limb can mean one of two things it either means that your limb stays exactly the same
12:22
all day for the rest of your life and I think I’ve met like two amputees right in my 23 years of
12:30
practice that that actually happens to um but for me stable limb volume also
12:36
means that it’s predictable okay so those of you who have stable limbs you
12:41
might wake up in the morning and you need five ply by noon you need 10 ply and by the time you go to bed you’re may
12:47
be up to 15 ply and then you start the morning off and it’s pretty much the same thing right so your limb will
12:53
change shape but it’s predictable for the most part throughout your day okay
12:58
and then there are some of you that you will not achieve a stable limb mainly because you have other issues some of
13:04
you might have lymphadema some of you might have issues with your diabetes and your blood pressure that’s causing a lot
13:09
of limb volume changes going on okay so these are all things to think about when
13:15
you’re talking to your prosthetist about the possibility of having an adjustable socket okay so what do you guys find in
13:21
your two years those first two years with your patients do you find that there’s a lot of instability going on
13:27
and and what do you see in your patients after those two years Amad I’m gon let you go first on this
13:37
one uh oh Ahmad we’re not hearing you that’s on
13:44
me um since I work at a cab um after a
13:50
while some of the patient names you kind of get familiar with them and uh where
13:56
you see most repeats are with new patients because the limb shape and volume changes so much so you they might
14:02
get a socket initially uh but once they’re distal end shrinks down once the
14:09
volume changes they’ll have to get a new socket unless it’s something that’s adjustable so it’s uh I’ll I’ll let
14:17
Billy speak more on that but it’s for new newer patients changes are pretty much
14:24
guaranteed yeah I mean for the first two years well for really for a your entire
14:29
life as an UT changes inevitable right for the first two years though dramatically and um you know I I’ve got
14:37
I’ve got cases where you know we’ve had to replace socket changes on on patients
14:43
every two to three months you know just super active patients that they get up
14:48
to 15 to 20 ply I mean you can’t you can’t be comfortable in something like
14:53
that right so um yeah I mean managing that and having expectations during
14:59
those first couple years is very important to know that you know there’s going to be change and to expect that
15:07
and to be okay with that and be you know in constant you know the follow-ups I think are the most important visits with
15:13
your prosti um because you know starting out a lot of people don’t understand it they
15:19
don’t know even though they’ve been educated on it it’s different when it’s you and so the constant follow-ups to
15:25
make sure that you’re staying on top of a proper fit and what the proper fit feels like within the first especially
15:31
in the first six months is you know is very important um you know just to
15:36
maintain and and protect the Lim from you know skin breakdown and other issues right absolutely if there’s one thing I
15:43
talk a lot about on this show it’s having that comfortable fit and we’re GNA pause for just a minute because I promised Jamie that we would post for
15:50
the first giveaway and I’m gonna do that right now so guys quick pause I just posted a link to the revo fit quiz now
15:57
guys you hear me talk a lot about my sponsors on the show and I’m not exaggerating when I say that I cannot do this show without the support of my
16:04
sponsors so in return I like to show my sponsors love and support the way you
16:09
guys can help with that is by participating in these quizzes and these giveaways that you guys have done over
16:14
the past couple of years um through Facebook and Instagram so here’s one of them right now if you can right click
16:20
don’t click out of the show rightclick on this link and just take the quiz some of you may have already taken the quiz
16:27
that’s okay take it again um and you’ll get a raffle entry and we’re going to announce a winner for the nice little
16:32
yeti mug that we have here which is really really really nice all right so pause going back okay so when it comes
16:39
to the fit and guys this was actually a question that came up on the show last week is how do you know when your sockets not fitting anymore how many ply
16:46
is too many ply and I answered by saying the textbook right will tell you that when you get to eight to 15 ply it’s
16:52
time to change the socket but the real world answer is when you start losing the connection with the socket right and
16:59
there are some folks and I’m sure Billy and Amad can can attest to this that they go up to six or seven ply and
17:04
they’re wigging out because they can’t feel their socket anymore and they’re losing that sense of proprioception and
17:10
then you have some people who are upwards of 20 to 25 ply which I don’t agree with by the way and they’re still
17:15
shuttling around in that socket that’s right okay but having something like the Click medical socket which we’re going
17:21
to get into a little more detail now can help prolong the life of your socket if you’re someone who’s going through a lot
17:27
of those changes right there um what’s your record I always like to ask Billy what is the record number of
17:32
ply that you’ve seen on a patient coming into your clinic 35 35 Holy
17:38
Cow just basically just walking in on a pillow there 35 up until now I heard 30 I think
17:47
you you’re the winner how about you do you have you got any higher than that that’s it that’s tough to be35 that’s
17:53
like a whole another leg they’re adding on with their socks right there another back stre boy yeah that they’re carrying
17:59
around there I mean that’s crazy needless to say he didn’t like coming in for his follow-ups he just managed he
18:05
just managed oh my goodness gracious uh let’s see Benjamin says my prostatus wants to use shimmy socks and inserts
18:12
before we go the new socket route and yeah you know I’ve seen I know I’ve seen prosus get all sorts of creative with
18:17
how they try to pad the socket and try to squeeze the life out of socket um the
18:23
most that they can um so what are some of the things that you try Billy on sockets when you
18:28
see that folks are really starting to to shrink too much what are some of the adjustments you might make including
18:35
click medical adjustability well I think it’s all patient dependent right like what you said the linkage of you know
18:41
what their expectation is on the linkage of of of their leg in the socket and you
18:48
know what type of activity the level they’re they’re you know they’re functioning at I think makes a big difference um you know but typically you
18:56
know we’ll we’ll add you know a pop teal pad or pre-tip pads or you know padding
19:01
in between the the flexible interface and the rigid frame if we’re using a flexible interface uh things like that
19:08
to prolong um if they’ve changed a lot so quickly um we’ll do things like that
19:13
um Tech pads um or some other things um and we use a lot of Willowwood liners so
19:19
we’ll use additional gel like distal gel cups and things of that nature um those
19:25
are typically my my go-tos on adjust ability um if I if I’m not in a click medical
19:31
socket so to try to kind of make things happen Scott’s trying to beat you out he said I had 28 within months of getting
19:37
my first that’s strong Scott I mean it’s a whole new word of meaning to bragging
19:44
rights right there yeah socks all right guys so let’s bust out
19:50
my Old Faithful model right here so you guys have seen this model a lot this is the revo fit okay so we’re just going to
19:56
go over the revo fit real quick and then we’re going to move on to the star of tonight’s show which is the revo surface so there’s a lot of action going on here
20:04
so just so you guys understand this is a model socket this is not how the sockets typically look okay they put everything
20:09
onto one socket for me so I could show off all the bells and whistles so they have three different ways of adding
20:15
adjustability they have something called The Gap design which it’s exactly that there’s a gap in the rigid part of the
20:20
socket um then we have the panel design which I’ll pull that out so you
20:26
can see here so they put the panel you click and it tightens up and then
20:31
they have a third way which is called the hinge design and that one is not in this particular model socket but it just
20:36
kind of hinges out just like that so there’s three different ways that you can put the adjustability in and that’s
20:42
kind of one of the big reasons I love these particular model um just because there’s so many different options um for
20:48
your prosthetist in terms of the kind of adjustability and where they can place it okay and now they
20:55
have I got all the toys tonight The Click reel which is their newer model
21:01
it’s lower profile you can twist it to tighten it and then the nice thing is is
21:06
that you can twist it in the opposite direction to loosen it so you’ve got those little micro adjustments which for
21:12
me I think is even more accurate than a sock ply right because with the sock ply you still got what like two to three
21:19
millimeters or something like that is that roughly it and then with this kind of adjustability you can fine-tune it
21:25
even more okay so if you guys been getting a lot of popular requests with the click reel in your clinic a lot yeah
21:33
yeah with the N click reel and if the if patients don’t know about it we suggest it right yeah yeah and it’s kind of nice
21:40
because again it’s it’s adjustable through the clothing it’s pretty low profile uh Rob says the revo fit was a
21:46
game changer for me very active and kept losing suction until I got this may look at the revo surface for my old socket as
21:52
a spare so Rob has already done his homework so he knows what the revo surface is for um so guys the revo fit
21:58
can adjust up to 10 ply okay uh oh all
22:04
right Stephen says that we can’t hear you I froze or you froze so I’m gonna give it just a
22:09
second just to make sure okay so it can adjust up to 10 ply so if you’re someone
22:15
who typically goes up to 15 ply in one day that means you would only have to
22:21
wear a five ply sock and that’s a pretty significant difference right that’s two less socks if you’re using three five
22:26
Plies that’s two less sock socks that you have to wear um so that’s something to definitely to think about um so let’s
22:33
talk about who’s the candidate so Ahad who do you think who is your perfect candidate for an adjustable
22:39
socket uh it’s one that I did recently and one I have a demo of that I can show
22:46
you as well you spoke about the hinge design so this is the hinge design so
22:52
you have a got it transtibial socket where where you have a back panel that
22:57
you can tighten to get compression or loosen
23:03
so in this case the patient’s distal and their AP is too big to fit through the
23:10
socket so in this case the revo surface and even in the diagnostic phase gives
23:16
you this adjustability and it’s great because previously if you wanted to do this with a diagnostic socket you’d have
23:22
to wrap it with fiberglass then you lose the ability to heat modify it or to even
23:28
um see any kind of contact through the socket so for me a patient with this uh
23:36
that presents with this limb would be a good candidate okay so we have that with some
23:41
of y’all who have like a little bit more of a bulbous end um those of you who are my siimes
23:46
amputations um some of you who wake up in the mornings and you say that the distal end the bottom part of your limb
23:51
is just a bit more swollen and you have to do the whole hopping to try to get yourself into that socket so having some
23:57
something like that hinge design really takes the abuse out of the limb and getting your limb into that socket that
24:04
is a really nice looking check socket there um is that one of the 3D printed
24:09
it it is show off please show off Now’s the Time so um the socket is printed
24:16
using petg it’s the same material as viac that normally is used conventionally so for our um in our
24:25
company basically the practitioners SC the patient they don’t cast uh everything is done
24:31
digitally um they Scan they Rectify it digitally then they send the file to us
24:37
and we uh prep it for 3D printer so this socket took around an hour and a half to
24:43
print which is crazy because something this size like five or six years ago
24:48
would take seven or eight hours and this is printed to the finished trim lines so
24:54
you don’t have to cut out anything um you SA material you save time you don’t
25:00
have to mess with plaster which is my main reason for doing it um plus it
25:07
uh allows you to um before you even print it prep it for something like this
25:13
where you know you’re going to cut it you’re basically introducing um you’re taking away from
25:18
the structural Integrity but you can plan for that by making it stronger in areas that need to be uh
25:26
beforehand and you can also o accommodate it for the dial beforehand by creating a flat surface in that area
25:34
that’s really nice that’s a nice looking socket um so Benjamin is asking is it
25:39
harder to get approv for your insurance than the standard socket um so definitely a lot of it involves uh
25:45
having the doctor and and Rob kind of responded quite nicely to that he said the doctor wrote fantastic notes documented the why we needed to switch
25:52
to the socket design and medical necessity always goes a very long way with insurance approval and guys I can
25:58
speak um I’m gonna put click Medical on the spot here and just say that there have been a couple of you as viewers who had some trouble with getting your
26:04
insurance um and click medical has offered their help to say you know hey we can talk to your proseus and just see
26:10
how we can help you get this approved um so again it’s it’s it’s a company that kind of puts puts their money where
26:16
their mouth is and helping out folks um with this issue uh what is the projected
26:22
life of the socket that’s a good question Billy I’m G to kick that one to you you know I don’t think it’s be
26:27
different than any other type of socket the material is the same material that we use in all sockets um you know have
26:35
with the older design I haven’t had to replace a new reel but with the older designs we would have to replace um we
26:42
would have to do some maintenance on the lock um on the dial but that’s really about it so the duration of the socket
26:49
is the same sounds good and guys I just got the winner in for our first part of the
26:55
giveaway for the quiz giveaway and it is Anita so Anita if you’re watching the
27:00
show right now I want you to whoops let me put my email on there guys that’s my email address so
27:07
Anita if you’re watching the show please email me your address so we can send you your click medical Yeti mug and guys for
27:14
those of you who are new to the show that is like I said my direct email address I’m the one who answers all those emails so if you do have any
27:20
questions about recovery from amputation in general about anything you hear on the show tonight if you think of a
27:26
question that comes up after the show ends don’t be shy send me the email that is the whole purpose of this show all right
27:33
so let’s see collector said or Linda says sorry Linda says I have a pin lock inst suction looking forward to adding my click to my system and someone
27:38
earlier had asked does the click medical Revo fit work with elevated vacuum and
27:44
the answer is yes and we actually guys if you go to my YouTube channel and yes that is totally a Shameless plug it’s
27:50
under Coy talks if you go to my YouTube channel I actually did a show with Joe Mayan he was he’s the creator of click
27:57
medical and Revo fit and we talked all about the different suspension systems including one that they have which is
28:03
called Revol lock um but yes the revo fit does in fact work with a lot of the
28:09
suspension all of them all of the suspension systems right yeah okay um Susan is asking are
28:16
they available in Canada Jamie your
28:21
turn I want to say yes but I’m always very careful I want to make sure uh Linda’s asking are these recommended for
28:28
bilateral above the knee amputees so Ahad you want to take that one so the
28:34
only limitation uh is patient weight um
28:39
The Click recommends u a dial per 100
28:45
100 kgs so that’s around 220 pounds so that’s the only limitation there’s no
28:50
you can be bilateral unilateral um and you can have the that the system so
28:56
there’s no limitation for from that perspective there we go all right guys
29:01
we’re going to go ahead and post our next Jamie I’m keeping you busy tonight we’re going to post our next giveaway So
29:08
Jamie is gonna post the link to the click medical Instagram and to The Click medical Facebook so we’re doing
29:14
Instagram and Facebook because I know some of y’all don’t do Instagram okay you need to go to the link it’s about
29:20
the post on Revo surface okay and I want you to like that post and then in the
29:25
comment section I want you to write what is a benefit of Revo surface and I know we haven’t gotten to that yet but you
29:31
guys can probably start to guess what some of the benefits would be all right so I’m gonna say that all again Jamie’s gonna post a couple of links follow
29:38
those links to the post like the post and tell us how can Revo surface benefit
29:43
you okay uh Louise is saying my last question was too long can you still see it Coy No Louise can you please repost
29:49
it sometimes with all the comments coming through they push some of the comments out of the way so please repost
29:54
your question uh let’s see click medical is saying yes you can add two systems to accommodate for higher weights as well
30:02
uh David glad you could join us no problem being late there all right so click medical post of those links guys
30:07
hay says I’d also love to know if these are available in Ontario Canada um it sounds like yes they are available in
30:12
Canada and I do believe that they said reach out to your provider and they
30:17
can order through ortoped and guys go to the click medal
30:22
website we’re going to post it up here as well if you go to the click Medical website they have direct iies of
30:27
providers and that that use click medical as well so you can look it up there um I think also for the United
30:33
States you can look it up by State uh Sean is asking what about the weight
30:40
limit on a below the Ute for Revo review fit I’m thinking he’s saying Revo fit or
30:46
Revo surface so it was just I think should I should clarify uh the point I made
30:53
earlier so it has a weight limit but if you’re above that weight limit you can just add a dial so it’s not like if
31:00
you’re above the weight limit you can’t get the system you just have to uh add
31:06
another dial so you can still have there is no upper ceiling for having the system okay so hopefully that answers
31:12
your question David uh Louise is asking I’m getting a whole new leg socket foot Hydra probably hydraulic foot is I think
31:18
what you meant to say to act as an ankle and the socket can adjust by a button to turn sound familiar will it help me walk
31:24
better um so Louise that’s a very big question to ask and a lot of it just depends on who you are as an ampuan I
31:31
know that sounds like a kind of a catch all answer um a lot of what depends on how you’re walking better number one yes
31:38
it is the fit of your socket for me it’s more important how your socket fits than what’s the componentry underneath the
31:44
socket you can have a $150,000 microprocessor knee but if your
31:50
socket is not fitting properly you’re going to walk around as if it were a peg leg and the converse is true when I
31:55
started working as a physical therapist we only had very simple door hinge knees
32:00
and wooden feet and we could teach our patients to walk beautifully because their prosus would make beautiful
32:06
fitting sockets so that’s the number one thing about walking well with your prosthesis the second thing is do you
32:12
have a physical therapist right are they working on teaching you gate mechanics how to walk again unfortunately it’s not
32:20
as easy as popping the leg on and going off about your day there’s a lot to be
32:25
relearned with gate mechanics and I have lots and lots and lots and lots of videos about that um that you can start
32:32
exploring on the YouTube channel all right Sean’s like I hate auto correct don’t worry Sean we got you uh let’s see
32:40
so Louise we’re gonna talk about that about how you can talk to your prosthetist a little bit later on in the show what I want to talk about now is
32:47
the revo surface because that’s kind of what we’ve been waiting for all evening and here it is so guys here’s the story
32:53
behind this socket a lot of you guys were teasing me because I would talk a lot about click medical and I didn’t have a socket so I sent them an old
33:01
socket that I had and it was a completely you know rigid socket and this is what they sent back to me which
33:07
is kind of cool so as you can see they put in the Gap design and they applied
33:12
the revo surface okay so let’s talk about the difference between the revo
33:17
fit and the revo surface if you look here this is the revo fit okay all the
33:25
wiring is in ins side and I probably shouldn’t say wiring cable is probably the better word to use is that a better
33:31
word I think they call it lace the lace thank you see this is what happens when the PT tries to talk I should let I
33:38
should let these guys because they’re the experts so am on I’m I’m gonna have you take over on this one so that one’s
33:43
a looks like a laminated socket that was probably done in two stages so they did a thin lamination then they laid all
33:49
that lace on there they had to pre-plan where the panels would be where the Gap would be and they laid all the lace on
33:56
there then they did the second lamination on top of it and then they cut out the panels and the Gap the area
34:03
that has the Gap in the posterior aspect there so I’ll just loosen this up so you guys can
34:13
see sorry my fingers are clumsy how it’s in between the lamination just like a mod said
34:20
right so for this kind you have to make the socket from scratch right this is this is a brand new socket that you have
34:27
to make versus you can see that the lacing is on
34:32
the outside so that is the biggest difference is those of you who have a socket right now um and you’re not
34:39
looking right now to get a new socket but you want to try out the system here
34:44
is the answer right um and then for your check sockets do you use you excuse me
34:51
you’re using basically the revo surface yes when sockets before we we uh because
34:57
this product wasn’t available we would use the fit and in that case you would U
35:03
do your lacing around the socket and then you would wrap it with fiberglass to hold everything in place and that
35:09
would kind of cover everything up and you couldn’t see the patient’s limb that’s where the surface is great you
35:15
can do your uh lace routing everything on the exterior um do your diagnostic fit um
35:23
and the system can be harvested so you can take off the socket once it’s done and reuse it if need be sounds pretty
35:33
good so let me get some of these questions that we’re getting in here uh lace thank you C click was like
35:40
aad you’re 100 per correct uh let’s see Susan’s asking do the cables or the lacing ever break if so could it cause
35:48
one to fall so Billy what’s been your experience with the wear and tear on the
35:53
lacing yeah I mean we’ve had some lacing break um you know really highly active
35:58
patients we had you know a UPS driver jump off the back of the truck and land and you know the force you know caused
36:05
it to the the laces to pop out it didn’t cause them to fall at all you’re still contained within the socket um but it it
36:14
was a loud popping sound and uh kind of scared him a little bit but we haven’t had those any of those
36:22
failures since moving into the new system so um yeah I mean I think they
36:28
can if they’re not manufactured correctly too by by your fabrication
36:33
facility whoever is doing them if they don’t you know follow the instructions and bevel the edges where the lace comes
36:41
out of the hole I mean I’ve think of Mod’s probably seen this in the past when we first started doing a lot of
36:47
Revo um you know we made the mistake as a fabrication facilities sometimes not
36:52
to not to do that um so that was more on on our end um but since then since we
36:59
perfected and done you know hundreds and hundreds of these sockets we our our failure rate is extremely extremely
37:07
small okay lace is made with Spectra it’s a type of plastic but it has like
37:14
500 pounds of force that it can withstand so so you’d have to try really hard really hard see for me my test is
37:22
giving this to my four kids and letting them play with it can survive my four kids messing
37:28
around with it um so here I’m just going to show you guys one more time so this one is the gap
37:35
design okay and you guys can hear that as I’m twisting it it’s getting a little bit louder that’s letting me know that
37:40
it’s going to release okay and that’s the Gap design so you can see the lacing
37:46
there and again as I start twisting it it gets a little bit quieter so that’s how I know the insides are kind of
37:52
catching on to everything and that’s where it really starts to tighten up um and again this is a feature that I
37:58
was really excited when they came out with the click reel um this past year because you can adjust for I call it
38:04
forward and backwards right so you can tighten or loosen it uh with the older boa dial you would have to you could
38:10
tighten it but then you’d have to release to loosen the whole thing and start again so this kind of micro
38:15
adjustment just kind of makes a little bit more elegant um in my opinion uh so let’s see I think the other the other
38:22
issue we had with with breakage is over like just kind of patient overtightening
38:28
trying to get too much adjustability cranking it down past where it’s supposed to really go putting too much
38:34
pressure on it so we’ve had maybe a couple failures like that but very few and far between and I understand my
38:41
understanding is that you know over time the cables will Fray a little bit and there’s a way to show the patient this is the time to come in and get it
38:48
relaced um so I know that click medical they have by the way guys those of you who are asking for your you know prosus
38:53
sake click medical has a lot of video videos and instructional courses on their website not only on how to
39:00
construct but how to troubleshoot everything they need to know about this device so there’s a lot of education for
39:05
them there uh Denise is asking how much bulk does the revo surface add to the
39:12
socket not a lot you can see it right here Janise that’s it that’s it um so you’re looking at
39:21
this is the only bulk that’s there and I’ve had stuff sorry let me get out so you guys can see it um as you can see
39:28
it’s pretty low profile and again this dial can be added in different places um
39:35
so again this is not where my area that’s you two to talk about um but I know I do have some patients that they
39:40
prefer to have it in a certain place because it’s a little easier for them to access or it won’t it’ll make their clothing fall a certain way um Ahad
39:48
where do you see like in the above the knee where do people typically like to have the dial usually it’s um anterior
39:55
medial distal um where right around where the valve would be U it it depends on the patient
40:04
Case by case because um some people ride motorcycles some people ride horsebacks so it just depends we we try to find out
40:11
what their lifestyle is what they want to do what they do throughout the day and try to put it in a in a area that
40:17
won’t kind of uh cause any issues for the system itself just be out of the way
40:22
and easy to reach there you go hence adjustable it’s it really kind of and
40:28
everybody shape or form right there uh let’s
40:33
see Louise is saying we’re making sure that if it’s perfectly before I leave with it I used to be very active just
40:40
came from Florida Hanger Clinic and seems to know her stuff and I stopped Physical Therapy do you recommend Louise I’m not sure what the
40:47
rest of your question is but in terms of do you recommend Physical Therapy yes to
40:52
me um that’s my little side side box right there is physical your relationship with your physical
40:58
therapist is just as important as your relationship with your prosthetist and with your doctor it’s a lifelong
41:03
relationship even if you’re not an ampute but especially more so um if you are an ampute our bodies continue to age
41:10
Unfortunately they also continue to break down along the way and that’s where the physical therapist can kind of help keep things running smoothly all
41:18
right uh let’s see Jamie would you be able to post those two links again for
41:23
the social media giveaway guys go ahead and try it again uh let’s see kaser is
41:30
asking how do the laces hold up in very cold temperatures minus
41:35
40 up here for at least three months of the year so I know in Kentucky and in
41:41
Florida we don’t get minus four yeah I’m gonna I’m gonna kick that to
41:48
click they’re up there in uh in Snow Country so we’ll yeah I’ve got my
41:54
Canucks on board that come listening every week so they’re going to be asking those questions uh click medical is
42:00
saying it’s the same lace used to catch alligators are you serious like I’m in Gator Country I
42:07
literally have like five Gators in my neighborhood that I have to keep an eye on so I’m just gonna get myself some
42:12
click medical lace and I’m gonna go you know hog tie them and [Laughter]
42:18
let’s yeah uh let’s see so David says I’ve had the lace
42:23
break but never fell when it happened um no Susan if the lace does break it’s
42:30
something that you take back to your prosthetist and then they relace it again uh let’s
42:36
see oh Jeran well I’m glad that you’re here and I’m glad that you got those drain tubes out because yes those are
42:42
exquisitely um painful can you walk with a broken
42:49
lace so guys have you seen it’s not really something that yeah I mean you can you can walk with a broken lace I
42:55
mean you can still utilize socks to to but I would recommend just getting into your process as soon as you can depends
43:02
on how where the panels are located and so forth so but yeah you can walk on a broken on a broken lay system okay uh so
43:10
the social media winner for our winner is Rob Samuel so Rob congratulations um you can go ahead and
43:16
email me I’ll put my email there up there again send me your
43:22
address all right um so if the LA do break guys um and you lose the
43:28
adjustability you can also just add the socks in until you get to your prosthetist just to kind of get you to the prosthetist office as well okay so
43:35
let’s uh one thing I do want to clarify is the kit because that’s something that sometimes confuses folks that they don’t
43:41
understand how this Revo is made um so a lot of folks think that they’re buying
43:46
the socket okay so let me just kind of clarify that if you talk to your protist and they say yes Revo fit or Revo
43:53
surface is the way for you your pro atist is still the one making the socket
43:59
okay what they will get from click medical is a little box and it has all the components that are needed to put
44:05
the adjustability into it okay so once again your prostatus is the one making the socket and they’re receiving a kit
44:12
to build the adjustability in ah look at him getting all fancy with the diagrams
44:18
and everything like that there we go that’s everything that’s contained in that Revo fit kit and one thing I also
44:24
want to add guys a lot of people will think that this is a magic cure for everything in a socket it is not the
44:31
magic cure okay it depends upon the skill of the prostatus and this is where I kind of put the onus on my prostatus
44:39
colleagues here right they still have to fit a well sitting socket the
44:45
adjustability is the icing on that cake okay if the socket is not well built it
44:51
doesn’t matter what adjustability it doesn’t matter what fancy elevated vacuum system you put into it or any
44:56
other bells and whistles it’s not going to fit well okay so the whole point of
45:01
adjustability again is just to give you that better fit to prevent you having to take your socket on and off 40 million
45:09
times a day yes okay that’s the co talk Soap Box I just had to get that one out of the way let’s see go ahead yeah okay
45:18
Amen to that okay so Sean is asking and this is a question that I always like to address on the show why is my process
45:26
determined to just keep me in a regular socket so guys what is your advice to
45:32
folks out there whose prosthetists may be a little hesitant to try adjustability what advice would you give
45:40
them well I mean so trying new technology is always tricky I mean I
45:46
think for everybody um not only for you guys as patients trying new technology
45:53
but for the process as well you know they I you know I assume your process probably has a system in which they take
46:01
care of people and they’ve been successful doing it a certain way for a long time so trying new technology is uh
46:09
can sometimes be problematic um in in anybody’s field right I mean if you look
46:15
at surgeons or attorneys or whatever profession you’re into trying something
46:20
new is always is always difficult um you know ultimately patient have a choice
46:27
too um you know and and it’s okay to get second and third opinions and talk to
46:33
other people about what’s important for you and that’s okay you know you have the choice to see whom you want to see
46:40
and not off fits are the right fit for you know the right people the right
46:47
person um so I think just keeping an open mind and open conversations with your process and those who taken care of
46:53
you and your physician that’s referring you as well absolutely and a mod I’d love to hear your opinion on this one I would just
47:00
direct them to click’s website really because U I think they’ve done a fantastic job of uh describing what what
47:07
these devices do along with like tutorials guides um you can chat with
47:13
them so there there’s a lot of resources available there for the patients as well as the
47:19
protists and Fabricators so they can kind of get some U knowledge about what
47:25
what this system offers and guys I’ll just kind of piggyback on those answers and saying
47:30
you know a lot of times I find a couple of different reasons why folks might be hesitant number one that they simply don’t know about the product um so I
47:37
know that before I met click medical like I said there’s other options out there in the community um I’ve seen a couple that are nice but I saw some that
47:44
I really just did not like um what I saw so when a patient would approach me about adjustability I’d always be like
47:50
hemming and Hauling about it right until I got out there and I started learning about the different options so that’s
47:55
usually the reason why I see hesitancy in some clinicians um the other thing that I see
48:02
is sometimes they think sometimes I think folks think that it’s going to be again the magic cure
48:08
for a socket right so what your pretus might be trying to tell you is maybe
48:13
this is not what we need to solve the problem with your socket right now right
48:19
what I encourage you is when your pretus says no to adjustable sockets ask them why and just just find out what is the
48:26
reasoning behind their thinking um guys I’ve said it a lot on the show there’s no one fit and Billy just mentioned it
48:32
there is no one fit no one solution for everybody so do I think that everybody should have an adjustable socket no but
48:40
do I think that everyone should be having a conversation with their prosthetist at some point in time yeah I
48:45
think it’s a it’s a great conversation just to have and just say hey is this an option for me and then from your part
48:52
okay what you need to let your prosthetist know is is this is what I would like adjustability for okay so if
49:00
your prostatus is hearing you say that yeah I’m having to take my leg off every hour every two hours that’s a lot okay
49:09
so if you present them with the arguments of this is why I want to consider adjustability and and goodness
49:15
knows we’ve given you guys lots of great talking points not just tonight but in a lot of previous shows I think that’s
49:22
also going to help with the communication with your prosthetist and then the other part which I’m going to tie this one in like a neat little bow
49:29
is if you have an existing socket and your predus is a little hesitant this is where the revo surface might be a really
49:36
great option because they don’t have to reinvent the wheel they don’t have to make you a brand new socket you can say
49:41
hey can we just try this out on my existing socket and see if it works yeah how did
49:48
I do with that one Jamie that one was good right that was good nail it okay let’s see let me scroll through
49:55
so Sean says I was told people don’t do good with adjustable sockets so again Sean my argument there with that one is
50:01
number one are you using the right kind um is the rest of the socket
50:07
constructed properly and are you using the adjustability properly right so Billy mentioned a little earlier in the
50:13
show that sometimes people might get overly aggressive right and have some problems with the
50:19
socket so um guys have you heard those comments and how would be your response to that
50:30
you’ll have to repeat their question I’m sorry to say so if somebody says I heard uh I was told people don’t do well with
50:36
adjustable sockets well you don’t know until you try it that’s where I think um click
50:44
adding Revo surface is such a big deal because now you can have adjustability in the diagnostic phase so you don’t
50:51
have you don’t have to go to a finished socket if your prosthetist is hesitant uh you can next time you’re doing a
50:58
diagnostic fitting you can ask them hey can we try this during the diagnostic stage um if if they’re unsure about
51:06
letting you go home with it let’s do it in a security of a the office setting the clinic setting so that’s where I
51:13
think the surface gives the processess an additional option if they’re not comfortable adding this to a definitive
51:20
device okay so guys I am posting the last question for the last giveaway
51:28
tonight okay and I’m posting it up just so you guys some of you guys like to read it what is the biggest difference
51:35
between Revo surface and Revo fit so this is for my smarty cats who’ve
51:41
hopefully been listening carefully to the show tonight so guys this is the last Yeti mug I am raffling off tonight
51:46
so in the comments section just a brief description what is the biggest difference between Revo fit and Revo
51:53
surface can I take or need to get some Yeti mugs I I will
51:59
say like come on we’re we’re gonna Jamie can we I’m like I’m like giving away the
52:04
mugs um let’s see uh oh I gotta give a shout out to
52:10
Greg there’s another wonderful prosus right there on board and another one Robert we got a lot of prosus on board
52:16
no pressure tonight guys um so Robert brings up a good point he says everything about Prosthetics is Custom
52:22
Custom to the person to the situation to the lifestyle Revo is awesome for the right person and should definitely be explored and discussed with your
52:28
prosthetist for different situations and that’s coming from another really wonderful prosthetist right there
52:34
guys proetus yeah I mean it’s dead on right I mean I don’t I don’t use we
52:39
don’t use you know a REO socket for every one of our patients but it’s an
52:45
option in the toolbox to take care of everybody and their individuality right it’s another it’s another tool in the
52:51
toolbox to make sure that we have all the tools to make sure that everybody’s taken care of yep and Mark is asking because of
52:57
adjustability shouldn’t it make sense for new amputees with the first socket yes it should make sense to have that is
53:03
a conversation yes absolutely um other factors are into play and again that’s
53:08
where the expert of the prosthetists who have a wide knowledge of all the different types of technology that are
53:15
out there but as Billy just said beautifully it’s another tool in the basket right there to
53:20
use um sorry trying to read you guys got a lot
53:27
of comment and guys after I close The Showdown I am going to go back through all the comments so if I missed your question if I missed your comment don’t
53:34
be shy about sending me an email and saying hey Coy you didn’t answer my question please answer it all right so
53:41
our last winner for the evening is Emily so Emily I know you know my email address so I want you to send me um your
53:48
address so we can get you your Yeti mug h Sean saying Coy talks I tried to
53:53
sh the show tonight because I knew click medic was going to be on the show thank you Sean appreciate that support very
53:59
very much um so David is saying laces in La is out so the answer guys the answer
54:06
guys the difference between the revo surface and the revo fit the revo fit you build into a new socket and yes
54:13
laces in somebody wrote in laces in laces out that’s a really quick way of putting it I like that Revo surface is
54:19
built onto your existing socket yes all right guys you guys did good
54:25
tonight you guys did good all right let’s see let make sure I got all these comments as much as I can I did see a
54:31
question uh I’m not sure who asked if if the system added weight to a socket it
54:38
shouldn’t other than the components that are on it which are just this dial it doesn’t weigh much um so there shouldn’t
54:45
be a a whole lot of added weight to this the socket itself yep it’s basically the
54:50
weight of the dial itself because the LA even though apparently you can wrestle an alligator with them they don’t I’m g
54:57
go try that um they don’t weigh very much all
55:02
right guys this has been a whirlwind evening we’ve put in I think we thrown everything in the kitchen sink at you
55:08
this evening um this is my last show of the year with click medical and I’m a little sad about that because it’s been
55:14
a wonderful second year so I again guys cannot say enough nice things um and
55:19
express my gratitude to click medical for being such a wonderful team Jamie Jen and Joe you guys have been a
55:25
wonderful support thank you um Ahad and Billy you guys got thrown into the hot seat tonight and then some so thank you
55:32
guys again thank you to Kenny Orthopedics those of yall who are in there goes the y’all again when those of
55:38
you all in uh Kentucky and in Indiana how many locations uh in North Carolina so we
55:45
have and North Carolina yeah 22 locations okay 22 locations um so guys
55:51
show these folks some love look them up follow them on Instagram and Facebook as well um so as always guys thank you for
55:59
letting us be a part of your lives this evening we will see you next week same B
56:04
Time same B Channel