Cosi Talks with Special Guest Joe Mahon, CP – Co-Founder & CCO of Click Medical FEB 9, 2022 – RevoFit Adjustable Kit
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Cosi Belloso on Cosi Talks features Click Medical’s Co-Founder and Certified Prosthetist, Joe Mahon as they discuss how adjustable prosthetic and orthotic devices increase patient comfort and mobility. Specifically Click Medical’s favorite product RevoFit®.
Joe will discuss all of the below and more.
What is RevoFit? RevoFit is a kit that your provider builds into your socket so that you can control the fit and comfort with a twist of a dial.
Why use it?
• Reduce sock ply changes
• Adjust through your clothing
• Control your fit and comfort by simply turning a dial
• Makes donning and doffing easy
• Reduce or even eliminate fitting
How does it work? With a simple twist forward and backward of the dial, you control the micro/macro fit of your device when and where you want. It’s that easy!
Who should use it? We have tested adjustable socket designs on adults, teenagers, top athletes, stay-at-home moms, professionals, outdoorsmen, and veterans. Whether you are an arm, a leg, or a joint disarticulation patient, adjustable sockets can increase your comfort and control. Great for new amputees that will change limb size over time.
Want to find out if RevoFit would work for you?
Full Transcript of Show Below – ENJOY!
Cosi Belloso 00:00
Good evening everybody. We have got a phenomenal show planned tonight and I brought my friend Joe Mahon with me. Say hi Joe. All right,
Joe Mahon 00:09
Hi, how are you?
Guys, we’re going to give you a few minutes to pop on board because this is definitely a show, I have been waiting to do for a long time and coming. Those of you, who are watching the replay right now, go ahead and post replay in the comments section.
I always like to go back to shows and see who’s been watching and also, if you have any questions and you weren’t able to catch the live show, I do try to go back and answer those questions. I see a lot of people popping on board. Justine, oh, I’m so glad you’re here. Justine and I have an update on your book.
So, we’re going to chat later harsh. Thank you for coming. Hey, handsome, how you doing Tom? We got Clarance on. No Clarance, you’re actually watching. You’re not watching the replay. You’re watching the live one, Clarance, ok. Joe, are you able to see the comments on the side of your screen?
Ok, wonderful. Ok, guys in there saying welcome Joe. Thank you guys, I’m seeing numbers pop up. I love hearing from my audience. So if this is your first time joining us this evening, don’t be shy. I like to know where people are from, and what is in their mugs? We’ll start off this evening properly. Cheers to all of you. Cheers to Click Medical. Thank you for being a part of the Cosi Talks.
Family in 2022, we got Karen on board. Carrie from Steamboat Springs, we got Brett on board from Kansas with his iced tea. It’s cold for iced tea for you, Brett. We got Abby excited to be here and we’ve got Mark on board. Awesome, guys. So, we’re going to go ahead and get started. We got a really nice group here on board, for those of you joining me for the first time, welcome oh, and Johnny V making his entrance into the Cosi Talks house.
My name is Cosi Bellose. I’m a Physical Therapist Amputee specialist here in Tampa, Florida. I have been a PT now for over 19 years and working with the Limb Loss community, is my passion, and with me tonight. I have Joe Mahon, the founder and creator of Click Medical and the Revo Systems. So, we’ve got a lot to talk about tonight, guys. Nanny you made it. Vicky you made it, wonderful. We’ve got Dana on board from North Carolina. There’s my fellow Tar Heel. She has a great kick start, nice.
Chris Evening from Southeast Iowa, there’s Barbara. Barbara, I’m glad you got in on time today. Thank you for being here. So guys, I have been so fortunate over the years to have several different companies in the OMP World, come to the show and talk about what they have to offer you as an Amputee, as a caregiver as a clinician, and probably one of the most commonly asked questions I got last year was about, Adjustable Sockets.
In the past, I’d say 10 years we’ve been seeing a nice boom in a bunch of options for Adjustable Sockets, right. I was excited to partner up with Click Medical. Tonight our focus is going to be on the Revo Systems and we’re going to be breaking it down. Guys, those of you who’ve been watching my show, you know that I like to put the responsibility on you, the viewer, right.
So, the same way that I encourage you to be an informed patient and do your research on your Prosthetist, do your research on your PT. Do your research on your surgeon. You also need to be an informed consumer when it comes to getting a new medical device. Ok, so if an Adjustable Socket is something that you’re thinking about for yourself or, you’re thinking about it in the future, tonight’s the night to start taking notes, right.
Take notes, learn everything you can from this man sitting next to me and then go out, and compare it with what’s out there, and start having these conversations with your Prosthetist to see what will work best for you. All right, Joe, I’m talking too much. I’m going to go ahead and zip it up for a few minutes. We got a lot of people. We got a lot of clinicians on board this evening. I’m really excited. Tom, what’s up Tom, Denise, and Ronnie onboard? So Joe, I’m going to let you tell us a little bit about yourself.
Ok, my name is Joe Mahon and I have been a Prosthetist now for, I think I’ve been in the industry for about 25 years, I would say 26 years. I started off as a technician back in the lab, grinding carbon and playing with plaster, and then wanted to do more, and got back into school and became a Prosthetist. That was back in 2000. I’ve been in private practice for 20 years, just about and we’ve got a small lab here, as well in Salt Lake City. But my main job is with Click Medical talking and teaching about Adjustability.
Excellent and we’ve got a few more people that popped on board as well. Susan from Canada’s here. Thank you for joining us, Susan. So Joe, what happened in 2014 when you went on a ski trip with your wife?
Actually, it happened a lot sooner than that—
— It actually happened back 2009, Click was created in 2014. But the idea came back in 2009. I’m the youngest of four and I come from a long line of talkers. I was as the youngest, I was forced to listen and observe all throughout my life, which actually has served me pretty well because I would notice patterns, with people and with different things.
One pattern I noticed with my patients is they constantly were having issues with volume. They struggled with, finding socks, wearing socks, having them with them, when they needed them, getting into see their Prosthetist. One time, I had a patient that called me and at the time, this is back in 2009, I was living at a Ski resort.
I was living up at solitude, with my wife and my two daughters. For some reason, we had a babysitter in the morning that was there. I’m not sure how that happened. But it gave my wife and I the opportunity to go, get a couple of runs in on the hill.
I was like, what I’m not going to work today. I’m skipping work. I’m just going to have some fun and ski with my wife. So I’m on the chairlift. It was I think, my second or, third run. It was a beautiful, bluebird powder day in Utah. I just couldn’t ask for much more. A patient called me. You know, I own my own clinic so I was like, I got to answer this or, should I answer it? I don’t know. But I answered the phone when I’m on the chairlift.
It was my patient, Tammy and she said, Joe, you know, I need to see you. I said, ok, what’s going on? She said I need to see you today and you can get an Adjustment. I’m leaving for DC tomorrow, and I’m going to be doing a bunch of walking. I need you to tighten up my Socket. I said, ok, I’m on a ski lift and I can’t see you probably today. But I could see you tomorrow, and she said, no, I can’t see you tomorrow. I got to see you day.
I said, ok, didn’t we already tighten up your Socket, just recently? She said, yes, it was great. I came in and you put in a couple of pads to tighten up the fit. After a couple of weeks, I didn’t need the pads anymore. So, I ripped them out. But I need you to put them back in.
I’m thinking myself now, if she could only adjust her own Socket, then I could keep skiing, right.
This is all really born out of selfishness about me wanting to ski. So I said, ok, Tammy, what I’ll come in and see you? Just give me a little bit of time to get off the mountain and get down to the valley. But I’ll come down and I’ll see you. Hung up the phone, I’m still in the chair. My wife’s like, what’s going on? I said, I got to go out and see Tammy. I got to tighten up her Socket. So, I’m just sitting there and I’m stewing over it, get to the top of the chairlift.
We’re sitting there and my wife’s, a snowboarder, and I’m a skier. I constantly have to wait for her at the top of the chairlift so that she can tie up her snowboarding boots. She had got some new boots and it had a little dial on it. I’m sitting there waiting for her and I’m like, let’s go, it’s my last run.
I got to get down and I’m waiting and watching her, play around with these new boots. She’s sitting there, cranking on the style. I’m like, wow, I hadn’t noticed it before really, but for some reason I have noticed it then. She just stood up and she started to snowboard. She went about 100 feet or, so.
As she was snowboarding, she reached down and she tightened it up some more, and off she goes. I’m right behind her. As I’m skiing down, great powder run, maybe that was some inspiration there. I don’t know. But as I’m skiing down, I thought, God, if Tammy could only adjust her own device. I could keep skiing and I’m thinking—
— God, maybe this little teeny dial could adjust a Prosthetist. Maybe that’s— then I’m thinking oh, how would I do it and [phonetic] I’m having this inner dialogue in my brain monologue about this problem, right. People are constantly changing volume, constantly losing—
— Daily hourly, by the minute. I went down. I saw Tammy Sure enough, I put the pads right back in the exact same spot, tightened up the fit, because she hated to wear socks. She just did not like to wear them and off she went. She was happy. On the way out, I grabbed a razor knife and I went back to our condo at solitude. I said, I know you just got these boots.
Oh, no. Oh,
I want to cut them up.
Oh, Jesus, How did that go Joe? Did that go over well? [laugh 10:28]
Yes, I mean, it not really because they’re pretty expensive snowboarding boots, right. I mean, she didn’t say no. She said, hell no [laugh 10:38] being the good husband that I was [phonetic]
You wait until she left for the grocery store and then you took her boots.
Yes, exactly [laugh 10:49]
I topped them up and I pulled the dial, and the lace and all the little bits, and pieces out. Then I, the next day went down to the lab and cut up a Prosthetist and made it adjust. I made it move. Then a couple days later, I had the patient come in and then try it. She put it on and I said ok, just walk around, and she said ok, she walked. It was fine. I said, All right, now turn that dial a couple clicks, and then see what happens. She turned it and—
— She just kept walking down the hall. I said, all right, keep turning it. See what happens and she turned it some more. Then she stopped, turned around and she said, Joe, I think you’re onto something here. I was able to instantly just tighten up the fit and that’s how it all started. It was really a selfish motivation to ski more and work less—
Well, you know—
— But in a wrong way.
— It’s working out for you. It’s necessity as the mother of invention there. That’s like the [phonetic]
That’s right, yes. So, from that we—
[phonetic] there. So, hopefully [phonetic] has forgiven you about the— folks give us a moment cuz I think we weren’t good. We’re good.
— I think we’re good.
Yes, sorry, guys we are having little internet glitches here and there this evening. So, thank you for being patient with us. Hopefully Joe’s wife has forgiven him by now and hopefully he’s gotten her a nice new pair of boots after that. So guys, who’s ready for the first giveaway? We have a lovely group onboard and Click Medical has generously, provided lots of giveaways for tonight.
Before I talk about the first giveaway, and Jen, if you want to go ahead and post that link that would be great right about now. Those of you who are on my email subscription list, I sent out an email yesterday or, the day before and there’s a special page on that email. That’s going to be one of our giveaways for tonight. So, those of you who are on my email list, go ahead and right click, and find the email that I sent yesterday. Kim says, I’m ready for the giveaway.
So, we are going to be giving away one of the Click Medical mugs and guys, these are yetis. These are really nice. I’m like, yes, there we go. Thank you, Joe, for modeling it so beautifully for us. Steven, we’re coming up with that one. That’s going to be one of the last giveaways we do this evening. So Jen, if you could please post the link for the Facebook OMP Adjustable Community by Click Medical. I have to give a shout out to Jen and Jamie. They have been working furiously behind the scenes.
They are part of the marketing team for Click Medical and they have been absolutely wonderful to work with. So, they’re going to be helping us out behind the scenes this evening [laugh 14:04] so Tio says, I showed the Revo Fit Flyer to my PT. He said it reminded him of his snowboard boots. So there you go. Now Tio, now you know that the connection there. All right, so Tom, thank you so much for posting that for us.
So guys, click on that link, ok, and for this particular giveaway, you need to join the group. It’s a public group. So all you got to do is, hit join and you have to comment on the post that they just posted. The last post that they just did, there’s a post on Cosi Talks. We’re going to give you guys a few minutes to go ahead and do that. All right, so once again, for that particular giveaway, you’re going to click on the link that Tom just provided. Ok and you’re going to go ahead and join the group, and comment on the post that says the Cosi talks post.
Oh, Mark is getting fitted for his Revo tomorrow. It looks like we got a lot of Revo fans here onboard this evening guys, wonderful guys, go ahead. Start commenting on that post in the OMP Adjustable Community. Not clickable. All right, Brett did it, good. All right, ok guys, we’re going to go ahead and move on.
So this evening, you guys know that I love to include education in all the talks that I do. So, we’re going to talk a little bit about the history of Sockets and the Shapes, and we’re also going to talk about, what happens in that first year, ok? The first year after Amputation, we’ve gone over this a little bit. That’s ok, Debbie. Glad to have you on board. Jen, could you post that link for us? All right, we’re going to give Jen just a minute.
All right guys, so with the history of Sockets, right, things unfortunately, have not changed too much in the past like, 40, 50, 60, 100 of years that Prosthetist device have been around. Joe’s hanging his head in shame right there. See, it’s not the PT’s fault. No, I’m kidding. Probably, one of the more original ones Modern Sockets is the Plug Fit Socket. I like to call it the Jell-O mold Socket. Abby, thank you so much for posting that for us.
Really appreciate that. Guys, once again, you can click on that link, join the group and comment on the post. So, with the Jell-O mold and the Plug Fit Socket, it’s exactly like, your leg got poured into a very rigid mold and that was basically it, there wasn’t a whole lot of contouring, a whole lot of shape to that Socket. It was pretty brutal on the residual limb and also, not very comfortable, right. So moving along into the 80’s—
— Right that, yes, Joe, do you remember those Plug Fits Sockets?
Yes, the plug fit, like those were the solid wood block, and they would carve them out, the inside out first. Then they would carve the outside to make the walls really thin and it was a plug fit. I mean, the artistry was amazing and the—
— Hand skills, phenomenal but the fit was horrible—
Not so much.
—But it’s the best thing. Yes, that goes way back 100 years or, more.
Shockingly, there’re still places I’ve visited in France and even in Ohio, where they still make Wood Sockets.
They still create them.
So then moving into the 80s, we started seeing the birth more of the Quadrilateral Socket. It was called that because it looked exactly like that. It looked like a rectangle and it was wider from the groin area to the outside of your thigh and this was hoping to provide a little bit more stability, a little bit more comfort to the socket. But they quickly realized that they were not allowing the patient to use the glutes with this particular design.
That many people were basically, their glute muscles were just completely atrophying and you all know, how much I love to use glute muscles for powering gait patterns, right. So moving along, they said, ok, let’s change up the shape a little bit more and here we have the issue rainbow containment, and many of you might be into this Socket right now.
Ok, so this Socket, where’s Bob. Come here Bob. Right, this is the Socket that goes pretty far up here, right into the groin area and it contains the Ischial tuberosity, the butt bone, back there. With this particular design, people started being able to activate their glutes more, so they started being able to utilize those glutes more during the gait, ok.
Now in recent years, we’ve also seen the Sub-Ischial Socket, meaning the trim lines are a lot lower on that Socket, ok. One thing I always to clarify on the show, because I see a lot of people get these terms mixed up. You have the shape of the Socket, which is the things that we just mentioned now and then you have the suspension of the Socket, meaning how it’s held on to your limb.
A lot of times folks will get those two confused. People will tell me, I have an Elevated Vacuum Socket and it’s like no, you have an Elevated Vacuum Suspension System added on to your Socket. Ok, so I always just go over that. Joe, is there anything else you want to add to that?
No, that’s absolutely right. Over the years, have not been a lot of changes in the Socket design. A lot of changes in technology and knees, and feet, and things but really, we’ve done a bit of a disservice on the Socket side, in terms of addressing Ischial. I really think that issue containment Socket was a huge leak for the above knee trans-femoral Amputation population.
That really helped with narrowing the gate, allowing people to have a more comfortable fit that locked the pelvis and the trochanter, and the distal femur. All in a triangular shape that really helps with biomechanics and adduction angles, and things like that, helped narrow the gate and create better walking patterns.
So that issue of containment going back to Ivan Long and John Savillich, and Chris Hoyt, those guys did make some great changes with that Socket. But since then, we haven’t seen a lot in terms of Socket technology. We’ve got Randy Alley and the Hi-Fi Socket, which is a fantastic option. We’ve got a few others, Marlowe Ortiz, also has a design that’s becoming more popular.
But there’s not a lot of focus on the Socket and in my opinion, if the Socket doesn’t fit, then nothing else really matters. It doesn’t matter how expensive or, fancy your knee or, your foot is? If you can’t wear it, if it sits in the closet and collects dust, then what good is it? So—
— It really comes down to the interface. In my opinion, the interface is everything.
Absolutely and one more time for the people in the back, if your Socket is not comfortable, you’re not going to go anywhere, regardless of what you have sitting underneath that Socket. So, Denise is asking, does pin-lock work with the Adjustable System? Yes, it does and we’re going to get a little bit more into that and later on in the show, Denise. Nanny said or, Vicky says, I have suction. Yes, that’s a Suspension form.
All right, so guys, let’s talk a little bit about what happens in that first year after Amputation? This is probably one of the most frustrating components of the recovery process for the patients that I see in my own clinic. Many of them obviously, that’s their first Amputation. Many of them have never met an Amputee before.
So, the issues associated with the recovery process is something completely new to them and the big one being, how much the limb changes in that first year, and then afterwards, right? Those first six to eight weeks, you spend basically, just trying to deal with the inflammation of surgery, right.
Your limb is probably two, three times the size of its normal size and that’s all that inflammation, that is sitting into that limb, and hopefully during that time you have the benefit of a Physical Therapist and a Prosthetist is coming in to fit you for a shrinker, to help start addressing that swelling and that inflammation there, ok.
So moving along, ok, those first few months after surgery, that swelling starts to resolve, ok, and your muscles also start to change shape. They also start to remodel, right. The muscles that are left to start to change shape and hopefully, will be accommodated into the Prosthetic Socket, ok but this can last up to a year and a half.
I’ve even had some patients two years, right. That have to have a lot of, revision or, excuse me, a lot of Socket adjustments done because of just how dramatically their limb starts to change. Especially, when they start Physical Therapy, right, they start becoming more active. So Joe, what would you say is about, the range that you see patients battling with this post-op, inflammation up and down?
Oh, God, in my 25 years, I mean, people will change inches in circumference. You can see easily one inch to two inches, not a problem, sometimes even more. So, it can take quite a long time to get the limb to mature in terms of shape. It could take easily up to a year and a half.
During that time you’re being fit with plastic check Sockets and temporary devices, and they’re being making them again. It’s a constant struggle because as soon as you get it, the new tighter fitting Socket, you are already starting to shrink even more. So, you’re just constantly chasing your tail for that first year. It can be quite maddening, a little frustrating.
Guys, I just got in the mug winners and actually they went ahead, and picked it. Oh my goodness, four winners for the mugs. So guys, thank you for participating in Click Medical. Thank you for doing that. So, Andrea, Scott Hager, Dana Glover and Kim Richards, congratulations, you won a Yeti Click Medical mug, which are so nice. I love these.
So folks, after the show is over so, once again, it’s Andrea Gilbert, Scott Hager, Deena Glover and Kim Richards. Please contact me. You can reach me through Facebook Messenger. You can reach me through my email and send me your address here. I’m going to go ahead and post my own email up there so you guys can email it to me. Email me your addresses and we will get those mugs, sent out to you.
Congratulations guys and these comments are flying in guys. I thank you so much for the participation. So here’s the interesting part. Joe and this is something I talk about a lot on the show is, once the swelling, right, is all done, that we think that the swelling from surgery revisions, everything is done.
A lot of people are still experiencing those volume changes, right. A lot of times, I have to remind my own patients, if they had diabetes, if they had blood pressure issues, autoimmune disease prior to their amputation, they still have those disease processes existing in their body, right. That’s certainly going to contribute a lot to limb volume fluctuation lifestyles. I’m very guilty with salt and vinegar, potato chips, right.
So, if you’re hitting those salty chips the night before, your limbs not going to figure your excuse me, you’re Sockets not going to fit the next morning, right. There are some people and again, I see it across the board. Actually, let me do a quick Cosi Pool. I haven’t done a Cosi Pool yet tonight. How many of you fluctuates volume during the day that you’ve been wearing a Socket now, for over a year and you’re still fluctuating in volume, and tell me how many socks you wear? How many socks a day?
For example, I had one gentleman fit in shape, Amputee for well over 30 years, and he fluctuates 15 ply a day. Like that’s just as normal. He wakes up wearing five ply in the morning. 10 by lunch and by the end of the day, he’s in 15 ply. Then the next morning, he starts all over again, right. I very rarely meet someone who is stable the whole time. That’s like a unicorn, right. Joe, is that? Ok, so Matthew is saying four years [crosstalk 26:41]
Absolutely, like I said yes, that’s a 10 year veteran, of being an Amputee, if they’re stable like that.
That’s very rare.
Yes and I think this is something that many patients, many viewers that send me emails, they are so frustrated because they’re wondering if they’re doing something wrong, and why is it that the Prosthesis can’t fit all the time, and it keeps changing on them? So yes, we’re getting a lot of comments on this one. Let’s see.
Matthew says, he’s been an Amputee for four years, and he’s up to nine ply. Kenny is five to 10. Tom says, all throughout the day, especially summer months, and Tom has been an Amputee for 60 years now, and he’s very active, right. Johnny says he starts with a five ply and he adds ply based on the activity level that day, Glenda with 10 ply, Pam says, I don’t do socks, all right.
So Joe says, I measure mine, I can fluctuate up to two inches in circumference multiple times a day. That’s a lot guys, and I can’t read all these comments because you guys are awesome. It looks like we lost Joe for a moment. But we’re going to go ahead and pop him back on board. Joe, are we good? Ok, I have a gremlin that lives in my computer and they might be jumping over to your computer, but that’s ok.
So guys, let’s go ahead and talk about the star of our show this evening, which is the Revo Systems. Ok, now when you look at Click Medical website, you’re going to see words like Revo Lock, Revo Surface and Revo Fit. I just want to explain a little bit about the three. The focus of tonight is going to be the Revo Fit, ok.
Revo lock is the Suspension System meaning, how this is held on to the leg? And we’re actually going to do an entire show dedicated to Suspension Systems on August 17th. Mark that one in your calendar, ok. We’re just going to give it a nice little asterisk and we’re going to save it for August 17th. Ok, the Revo Surface System, and Joe, you make sure I’m saying the right things.
The Revo Surface System is something that is going to be available later on this year. The reason why I really wanted to mention it this evening is because the Revo Surface System can be added to an existing Socket. Ok, this is the part where you guys take notes, ok.
Later on in the year keep watching ok, because once that comes out, this is a really fantastic way for those of you who are wondering, if this is going to be a good fit for you pun intended, right? The Revo Surface is something to take into consideration. Ok, so now, the star of the show tonight the Revo Fit. Ok, Joe, tell us about the Revo Fit? Who is it meant for? Joe, we can’t hear you darling. Ok, Joe, why don’t you log back out? That’s ok.
How about you log back out, restart your computer, log back in and I will start giving some of this information. Ok, here we go. Got to roll with the punches with live TV or, live shows, right guys? So basically, the Revo Fit is meant for, stay-at-home mom, outdoorsmen, athletes, adults, teens, veterans. Ok, pretty much everybody. Ok, this is a really great. All right, let’s see if we can get Joe back on board?
I’m back. Can you hear me?
Yes, we can hear you good because you’re way more of the expert on this, than I am. So no, I’m just telling folks, Joe, that this is meant for everyone, so everyone from the stay-at-home mom, everyone to the athlete, and everything in between outdoorsmen. Basically, you can take the Revo Fit Socket everywhere with you. No bars hold. Yes,
Right, correct. Yes, when I first started it was, I started it on athletes because they wanted to have a really tight fit, but they struggled to get it on. So, this allowed them to open it up, get their device on, and then I realized or, they realized that they wanted it for their everyday leg as well. Then I had other patients, moms and grandmas and said, hey, you know what? I want my leg to adjust as well.
Quite honestly, it can be just about for anybody that struggles with volume, struggles with levering, struggles with Socket instability, rotation. There’s a whole host of issues that can be resolved with Adjustability. We use it not only in the Prosthetic Field, but we also use it on the Orthotic Industry as well. So for Bracing, Spinal Bracing, AFOs, Fraps. We also have products and applications for the Orthotic Fields as well.
Excellent and Joe, we’re going to help you find a Prosthetist. Actually Abby, if you have a moment, can you please post the link to the Prosthetist Finder and we’re going to talk a little bit more about that towards the end of the show. But we can just go ahead and put that link in right there. So a couple of questions that rolled in. Andrea asked Adjustable Sockets appropriate for a first Socket? Yes, the Socket can adjust up to 10 ply. Correct Joe?
And sometimes more.
Sometimes even more, and then yes, Carrie the Revo Fit is meant for both Bk and AK, for above the knee and below the knee. So you were talking about fit issues. What you said about the athletes, about they want a snug fit, but obviously, they got to get into the Socket first. So having that Adjustability allows them to do that and also for people with the bulbous distal end.
So folks, for example, who are the signs Amputation, folks who still have their ankle bones, and they have a bulb on the end, right, that can make it challenging our knee disarticulation patients, right. That they still have— come here Bob, they still have these this part of their femur, which can create a bit of a bulb, and they’re making it challenge to put the fit into there.
Ok, hang on. I’m trying to keep up with all of these. Joe, can you show off a little bit and show us one of those Revo Fit that you have it back there, you have a lot of toys back there. We need to start playing with those toys.
I do, yes, and just on your point on the bulbous and any joint disarticulation could use the Revo Fit on post Amputation. Oftentimes, the distal end is much larger than the proximal portion of their leg. So they really struggle in their first Socket that they ever get struggled to get it on. They’ve been doing some research in New Zealand where they’ve shown, they’ve been able to fit people faster and sooner by having some Adjustability, to allow that to open and down, and then close it.
Ok, so Joe’s going to pull out an example and I have one here myself. I’ve had a lot of fun playing with this.
There’s a science, so very long tibia, a bulbous distal end here.
Then we’ve got one panel that opens and closes. So essentially, it just allows them to open this panel. There’s the dials on the back and they can turn the dial and essentially, close this panel. We put padding on the backside of the panel so that it gives them a little extra compression. This is used as a Suspension method. It’s also used as a volume adjustable control for the Socket. So there’s a dual purpose for the Revo Fit on this Socket here.
Ok, perfect. Bob, for those of you who are just joining us, we are with Click Medical this evening and they are the designers of the Revo System. So this is a particular type of Adjustable Socket, the Revo Fit to be more specific. They were so kind to outfit, one of a Socket with lots of different options. I’ve had a lot of fun playing with this. I’ve had a lot of fun playing with this.
We’re going to talk about I guess, one of the things I should backtrack a little bit. One of the things that really attracted me to Click Medical immediately was all the different options for creating the Adjustability within the Socket. For me, the more options that you can give someone, the better, because everybody is completely different. But before we get into all those differences, we are going to do our next giveaway.
So Abby, if you don’t mind, posting the landing page link. We’re going to put a link up there for you guys. Got a lot of questions and folks, if I don’t get to your questions this evening, I will go back, and answer them after the show is over. So don’t feel bad about putting the questions in there. If we don’t get to them tonight, we will be posting them, we will be answering them later on. Ok, so there is going to be a link posted. There we go.
I don’t know if you guys have checked out Joan McDonald Socket Socks Company, but she makes these beautiful prints and covers for the Sockets, for both above the knee and below the knee. All right, so we see some people coming in and we are going to pick at random. The team is going to pick at random, somebody to win the Socket Sock. All right, so in the meantime, Joe, we’ve got three different ways that this Socket can be the Adjustability, can be built in, right.
Thank you Abby, Abby just posted a link. I want you guys to go to that link. It’s a great informational page. Go ahead and right click, and you guys can take a nice look at it later on. Go to the link and tell me what color shirt am I wearing? And you’ll know when you get to that link what I’m talking about, what color shirt am I wearing? And start posting the answer in the comment section. We are giving away a Socket Sock.
We have panel designs, gap designs and hinge design. I know, I have a panel design here, right here. It’s exactly that. It’s a little panel that’s built in and I have another one on this side, and then it’s tightened. Right here, I have to push the dial in. Sorry, it’s hard with a camera to get it to go. So, I don’t know if you can appreciate that it’s already nice and tight, and it’s in there. And then to release it, I pull the dial out and it releases the tension on there. So Joe, can you tell us a little bit more about how the panel designs is used?
Yes, in that Socket that you have there, the Trans-Femoral Socket. You have panels and you also have a gap. So—
— You can talk about the gap now. On the panel side, we’re really targeting very specific areas on the limb, that are pressure tolerance. We learned about these areas in school and this goes back to my original story of seeing patterns where we’re constantly putting padding in the same spots.
What Revo Fit does essentially is, allows your Prosthetist to integrate this Adjustable System into any Prosthetic, doesn’t matter what Amputation level you are? You can integrate it into any device and basically, allows you to initiate or, engage those pads or, not with just the simple like, turn of the dial. So, we preemptively figure out, where are we going to adjust on this person?
We preemptively installed those pads into your Socket. Then you choose to engage those pads or, not, depending on you lost some volume. Have you lost some weight? Maybe, you went out and had sushi, and retained a bunch of fluids. Now, you can’t get your leg on. Well, if that’s the case, then you simply pull the dial, release those panels, open up your Socket, allow you to get it on completely. Then as you shrink throughout the day, you can slowly tighten.
It’s not all about compression. Sometimes it’s about expansion, and opening the Socket up so that you can actually get it on. One thing that really bugged me with patients is, they would get their leg on, maybe halfway. They would stand up. They would stomp on their limb.
Trying to jam it in there and I understand, they got to get to school. They got to get to work. They got stuff to do. They can’t sit and wait around for the leg to shrink, in order for them to get their leg on.
But, there was a safety issue. If you’re not fully seated in the Socket, that’s you have a lot of instability. So, this system is not just compressing and tightening, and eliminating sock usage, it’s also about expansion allowing for an easier donning process and doffing process, allows you to get it on a little bit faster. That might not be seemed such a big deal to some people, but it’s a really big deal for some people that’s getting your leg on.
Absolutely and this plays into the question Carrie just posted now, where she asks, do you pull into this like, a Suction Socket?
You can. This system can be used with a pin. It can be used with suction. It can be used with elevated vacuum. It can be used with knee sleeves, lanyards, really any type of Suspension System. The Revo Fit can be adapted to,
Any type of liners because Denise is asking do you wear your regular liner with the Sockets.
It’s just like your normal fit basically, your normal Socket. But we simply allow your Prosthetist to integrate these bits and pieces to make it adjust. Everything else is pretty much the same.
There you go.
Materials are the same. The weight is pretty much the same, everything was pretty much the same, it’s just one can adjust and one is rigid.
So that was the panel design, right, which is meant for the targeted compression, very specific areas. And here, so guys, I’m obviously carrying an above the knee Socket, and the back part of it, right here, has been fit. I cannot point very— I would make a terrible went to white. It has been fit with the gap design, ok.
As you can see, it’s just like the name says, it’s more of a gap back here. Ok and the same concept, you tighten and it narrows it down. This one is meant more, and you can see it already going in. This one is meant more for a global compression. So Joe, can you tell us a little bit more about this one?
Yes and I have a Gap Socket here. This is a transtibial. It’s got a gap. These two gaps in the back, basically, just provide some AP compression, ok. This is more of a global feel, not so precise. But this can really help in this instance, just by tightening the AP. We can reduce a lot of that distal tibia pressure that happens by tightening the mid shaft. We can eliminate a lot of that. We can do that with panels as well. Panels can also do that but gaps can do that with transtibials. The Socket that you have there as well, the Trans-Femoral
I have one year Trans-Femoral with a gap in the back. These systems have got panels and gap, but just like yours, this is really about adjusting the proximal brand. So, again, a lot opening it up for easier donning and doffing, cranking it down when you’re active, tightening up this brim. Ok, if you have to tighten up the mid shaft and you would engage the panels, ok. If you’re starting to lever and get distal femur pain, you would tighten the panels.
If you then sit down and you want to relax, you can open up the fit of the proximal brim. A lot of times the proximal brim can be uncomfortable when you’re seated. But if you can reduce some of that tension, that’s on the proximal area, you can have a little bit more of a seated comfort feel. So gaps are more global.
We also have gaps like, this is an Orthotic. This is also a gap that we’re closing. Okay, so again, gaps can accommodate for a lot of Adjustability. A gap design in this instance could accommodate for one or, two inches of volume change. So they can accommodate a lot, depending on the design.
Quite a bit.
Joe, I’m going to interrupt you for a moment just because we have our winner for the second, for the Socket Sock. Ashley Martin, congratulations, you’re the winner of the Socket Sock. So Ashley, send me your address after the show is over and we’ll be sure to get you hooked up with that order. A couple of questions that come in here that I just want to address. Let’s see.
Sorry guys, lots of really great questions. Susan says it replaces the Socket. No Susan, it is the Socket. So the Adjustability and you can see just the ridges here is, where the lacing and the cabling system is built into the actual Socket, to provide the Adjustability. Ok and guys, if you go to their website, clickmedical.co dot C-O, ok, you’ll be able to see a lot of nice clear pictures.
I know here it’s a little tough to demonstrate a little bit, what going on but you can sees they have a lot of nice clear pictures and videos there as well. So, here we go, let’s a couple more questions that were here. Yes, Brian, this is meant for below the knee and above the knee. Carrie, that’s actually a very good question. Carrie asked has the system triggered phantom pain for any users.
So Carrie, what I see is, if I see a patient coming in with phantom pain, and I suspect it’s because of compression, it’s usually because the patient put on too many socks or, perhaps the Socket is fitting too tightly. As with anything you use on your Prosthesis, you have whether it’s an elevated vacuum or, something like the Adjustability.
You have to understand how to use the device and you’re being taught by your clinicians to? Yes, make sure you’re not cranking it too hard to make sure you’re not over compressing. But that’s something again, that’s part of the training that you receive with any Prosthesis, that you’re issued by your Prosthetist or, you’re Physical Therapist. Good job Ashley. Go ahead Joe.
I would also add that having the ability to expand or, relieve that compression while you’re seated or, resting, is a great benefit for people with phantom pain allowing for some of that fluid to return back into the limb that you’ve been pushing out as you were walking throughout the day. So, that expansion mode can be beneficial for those phantom limb users as well.
Absolutely and then one person was asking you know about the comfort level, especially with the BOA dials and the bells, and whistles. Like I said, in this particular Socket, I’ve got three different Adjustability and this is basically a demo Socket. Your Socket’s not going to have three dials sitting on it like that, guys.
We’re going to talk a little bit about those dials and there goes Bob, in just a moment. But the whole point of this is to make the Socket more comfortable. Joe, we’re getting a lot of questions as far as insurance and reimbursement for these Sockets, what have you been seeing with your patients?
So, there is no code for it. In terms of Medicare reimbursement, there is not a code that can be used. That being said, we’ve had a handful of people go through the appeals process and get it paid for, through that process. It’s a little daunting and a little bit more work on the process side, but it has happened.
On the private insurance side, we see it being paid for all the time, vocational rehab, workers compensation, the VA, Blue Cross, numerous insurers will pay for some portions of this product.
It’s not a very expensive product. So, it’s a very minor, I guess, cost and the overall scheme of Prosthetic. It’s quite affordable.
Yes and I think, I saw someone here that his Medicare paid for it without a problem. Again guys, with everything that you’re trying to get reimbursed, documentation, justifying that this is a medically necessary device. Andrea, my Occupational Therapist just brought up a very good point that this would be an excellent device for someone,
For example, undergoing dialysis three times a week, I have one of those patients that they are up and down several times a week. So in that case, for certain, I would say, I would be the first one writing in capital letters. This is a medically necessary device.
Talking about the integrity of the skin, that’s another big one. You’re protecting the integrity of the skin when you maximize the fit of the Socket. Ok, there was a question on the weight I’m trying to get all these questions as much as I can. For my understanding, it’s a 220 pound weight limit per system and if it’s more than 220 pounds, Joe, how do you accommodate for that?
It really depends on the design, once you’re over 220, we can work with the Prosthetists and the fabricators in terms of, tailoring a design that would allow you to exceed that weight limit. A lot of my master that breaks all the stuff here for me, he’s around 275 and he’s been wearing this for upwards of 10 years. So, we can, you can go over the limit. Sometimes we may require a second system. But we have ways of designing devices to allow you to exceed that limit.
So Joe, if a person decides ok, I want to try this Adjustable Socket the Prosthetist puts the order in. The Prosthetist receives a kit. It’s not a Socket and guys, I want to clarify that because some people are like, is it the Socket that’s being sent? No. So another if you happen to have one of those kits with you Joe, but basically, your practice will receive a kit and within that kit, we’re going to see the straps, the cabling, the lacing and the particular dial. That’s it that is what your Prosthetist will receive. Tada! Right.
After which your Prosthetist will construct your Socket in the same way that they would construct any of your other Sockets. But they’re going to be using the tools in this kit to build the Adjustability in. Does that make sense Guys? Can you guys give me thumbs up if that makes sense? So Joe, I don’t know if you want to open up the box and show what’s in Pandora’s Box here?
Sure, yes, so basically, what you’re buying is, you’re getting the dial, ok. Then within the kit, there’s another box and we’ve got a nice little QR code. So we don’t have to print instructions and saving some paper. But within the box, we have the tubing that routes, the lace throughout the system. This gets integrated in between the layers of your Socket.
As they’re building your Socket, they’re integrating this tube, and sandwiching it in between the layers. So we obviously, teach how you do that. We have a course there’s —
— Multiple courses that you can, to learn how to do that. There’s a little receiving unit that receives the dial. So this gets embedded in the Socket and that’s where the dial will live is, where this little pieces is, and then we have the lace and the little wire that feeds the lace through the system.
In total, you’re only talking about a couple of pieces here, ok. That can really change a lot about your Socket. It can change the fit. It can change the suspension. It can change the volume. There’re a lot of things that you can do with this system and it is integrated into a new device. So currently, it has to be a new device.
It gets integrated into that.
Ok and like I said, questions keep flying in. So let me see if I can grab some of these questions. Joe, actually, can you grab one of the ones with the hinge panel, just folks can see. So we mentioned that there’s a panel design, right, this one, that there is a gap design in the back that can be placed in the back.
Then there’s the hinge design and the reason why I want to show you guys is because this really gives your Prosthetist a lot of things to play with, to see what is going to be the best way to adjust for you. Ok, and so he’s going to show us that hinge design. It’s exactly that it opened up.
Yes, it’s a very non-traditional Socket. This is a very simple just a bicycle Socket, only for riding a bike. But he had a larger calf and sometimes had a hard time getting through the Socket. So, this simply hinges and then you pop the dial, and it’s like a drawbridge. You basically, just close it.
Click it in.
And that’s it.
Ok, there you go.
You can do that or, someone that had a bulbous distal end, post-surgery, someone that’s got, in this example, this is for an upper limb, this is for an arm so, they’re basically—
There we go.
— Your elbow would fit in here.
Then this hinges behind the olecranon and provides the suspension for this, to stay on their on their arm. So again, it’s like a similar in a panel but a little bit different design, and that it hinges open and closes like a drawbridge.
There we go. Michael McCarthy to answer your question, you would be using two systems for the particular weight parameters there. Let’s see. I’m trying to scroll through here. So Bob, if you want to find out, ok, no, go ahead, sorry.
I was going to show you one more hinge and we do this for Orthotics. Depending, we have a dial and the lace, and the tube. This one gets sandwiched in between plastic instead of carbon.
We can run the lace behind the joint for dorsiflexion control. We can run it in front of the joint for flexion contractures, night splints, and things like that. But again, this is a hinge and we’re controlling that hinge, basically creating a rigid AFO.
Then as they progress through therapy and get stronger, they can start to increase their range of motion, to the point where they have full range. Then if they, maybe, encounter some stairs or, they’re getting tired or, it’s been a long day. They can simply lock this back down, lock that hinge and create that rigid AFO.
That’s pretty cool. Again I think so,
We’re using these kids for both Prosthetic and Orthotic.
And orthotic and I know there’s some folks out there who are watching that they have a Prosthesis on one leg and they do have an Orthotic on the opposite leg. So it’s good to know about this. Andrea asks, a new Socket is needed. Yes, Andrea. For the Revo Fit it’s built into the new Socket. But just keep in the back of your mind, right. I mentioned the Revo Surface and that’s coming out later this year. That is meant to be built into an existing Socket. Yes, awesome. Ok,
So let’s see. Sorry, I am just trying to get through this, all these lovely questions, ok.
Like how long the lace last? Yes. We change it every six months to a year. You have to look at it. You want to look at it at least every six months, but depending on the design. Some people can get it one year or, two years but it’s a strong lace. It’s what they use to fish Marlin with. So, it is a—
— 500 pound spec, yes, it’s very strong.
So Tom McIntyre, I know you asked earlier that you’re always getting dirty, and is it going to hold up to you. I think it’s going to hold up to you Tom. In fact, I almost want you to try it out. I want to see if you can put it through the loops there. So guys, let’s talk a little bit. So we talked a little bit about, how the panels or, the gaps are put into the Socket.
But let’s talk a little bit about the dials. There’s two different dials that can be ordered. I have the one that’s called the Boa dial. Sorry, I keep moving it into the wrong way. Basically, the way, the Boa dial works is, you push it in, hopefully you heard that click, and then you click right, and then to release the tension, you pull it out and the tension is released. Then Joe is going to show us the click reel, which is just a little bit different.
Yes, so we’re working on a new reel that is designed specifically for Orthotic and Prosthetic. So, that being said, we’ve been using these Boa dials for many years. Those were meant for shoes and outdoor gear. Not really for rigid carbon fiber Prosthetic devices that are weight-bearing and go under extreme loads. So, we went back to the drawing board and said, we need to make something that’s more robust, that’s got metal parts.
We need something that’s lower in terms of profile, so it doesn’t snag on the clothing account so far. We need something that has a safety feature in it because there are some people that have Neuropathy. They can’t feel. They don’t know what tight is? They can’t feel how tight their leg is? So, what we did is, we installed a clutch in the new Click reel and the clutch allows the Prosthetist to set the maximum tension in the system.
If they’re concerned about someone over tightening, maybe it’s for a pediatric and they’re concerned about their big brother getting a hold of it, cranking it and tighten it on their little brother or, something. You can set the tension. You can decrease the total maximum tension that the dial can deliver. So that’s a really great feature that we’re excited about. Let’s see what the other got with that? We’ve got a new lace that goes with this new Click dial. Yes,
Andrea was asking, do the dials rub on the clothing?
It depends on where they’re located. With this system, the really great thing about it is, we can put this dial anywhere. We can put it distally if we want to bury it above the attachment block and get it away from the clothing, so it doesn’t snag.
If you have a range of motion problem or, maybe it’s an obesity issue or, something, where you can’t bend over to get down to the bottom of your Socket, to adjust it, you can mount the dial proximal with a very proximal edge. All they have to do is, get to here and then they can adjust it. These dials can be put anywhere and if you’re concerned about clothing, obviously, you would want to talk to your Prosthetist.
Oh, and we lost. Poor Joe he gets keep getting kicked off the show. Here we go. There you are.
Yes, you just want to verify with your Prosthetist where you would prefer that dial to live, because once you make it, it’s permanent. If tight clothing as an issue, you’d want to find a place to hide it.
Absolutely and the fact is, it can also be adjusted from underneath the clothing, so the person doesn’t have to take their pants off or, roll their pant leg up. It can be adjusted through the clothing itself, which is a nice feature. Ok,
Yes, I was going to say, one of the biggest things that people say is, they don’t have to carry around so many socks and that are one of the biggest issues with volume control is, you having a sock when you need it, and most often you don’t have it with you. But with the system you can just simply reach down and you’re in the middle of Costco or, wherever. You can just reach down and tighten it or, loosen it. You don’t have to expose it. You don’t have to find a bathroom. You don’t have to take your leg off and put a sock on. You don’t have to do any of that. You just have to be able to grab it and turn it.
There you go. All right, with that, ok, this is the giveaway that I know many of you have been waiting for. So, on the Click Medical website, ok, you’re going to see when you look under Revo Fit and when you look under Revo Lock, which is their Suspension System, which is what we’re talking about in August, ok. There’s quizzes, and it’s basically just quizzes asking you, how are you happy with your current Socket fit and seeing, are you possibly a candidate for this?
So many of you were so gracious to help out and take that quiz, and hopefully learn a little bit more. We have two winners this evening. For that quiz, each one of our winners is going to receive a $50 gift card, courtesy of Click Medical. So hang on, I’m getting the first winner here is, Rhonda Jones. Did I get that right? Oh, please tell me I got that right. Rhonda Jones yes, you are the first winner.
So guys, I am scrolling through but I’m going to ask a few of my own questions. So Joe, one of the biggest things that people obviously have hesitancy for is, what if we buy the kitten? We’re not sure if it’s going to work out for us or, not? Do you have the diagnostic kit? Can you tell us a little bit about that?
So Rhonda, hopefully you’re listening in right now. Please send me your address and our second winner is Harsh Pirohitz. So congratulations, Harsh. You’ve been a longtime follower of this show and thank you for following, and thank you for taking the quiz. Thank you to Click Medical for providing all these wonderful giveaways.
Yes, we have a diagnostic kit, which is a less expensive kit. It allows the Prosthetist to really fine tune the design and really gets some user feedback. Get some buy-in from the patient. You can put this diagnostic kit on a plastic check Socket. They can do their original check Socket, verify the volume and the fit, and then they can put this diagnostic kit on it, and then chop off the Socket and make it adjust.
That way you can get some buy-in, in terms of, are we adjusting in the right spot? Is this providing enough Adjustability? Is the dial in the right spot? Are there any issues with nerves or, bone pressure or, is there anything? You can really fine tune, where that Adjustability happens and that diagnostic phase. So that way, if you do decide to go, yes, this this works. I’m a candidate. If you then take the next step to have it integrated in your definitive Socket, you know exactly what to expect.
So, it’s a great tool to really try and test out the system without committing because once you commit, we all know that you have to stuck with that device for three to five years. Make sure it’s going to work for you before you commit.
Yes, and you guys have heard me talk about it, you don’t just go and buy a car from the lot. I mean, I wish I were that wealthy to be able to just do that. You do your research. You do some test drives on the car and same thing with you’re going to wake up with this leg every morning. You want to make sure that all the components are something that you’ve tried out. You’ve had a chance to see if it’s going to work for you or, not.
So I’m really happy about that feature with the Click Medical systems. Ok guys, we’ve gone through a lot this evening and I do want to say thank you so much, Joe. Thank you so much to the Click Medical team. They’ve been working furiously behind the scenes, and have done a wonderful job of helping put together this show. Guys, there are questions that I know, that I missed. So what I’m going to do is, I’m going to go back. I’m going to try to get as many of these questions.
If you could help me though if there’s a question that you really want to make sure that I answer, send me an email and here I’m going to post my email right here, forgotten country to see right there. All right guys, if you have any questions about this system, I am happy to answer it and if I can’t answer it, I’m going to go send it straight to the team, to make sure we get all these answers for you.
Again guys, I hope that tonight, if anything, it just stimulates you to start asking questions, right. Start asking questions, start having this conversation with your Prosthetist. Once again, if we can post the link for the directors, oh, Greg’s on board. It’s a party. Oh, man, thanks for coming Greg. Ok guys, you can go to their website. You can find who are the providers in each state that have been trained to do this system, ok?
So, start having these conversations. Compare it to the other ones that are out there and see, what are the things that you like about this system and what are the things that you want to look for, in an Adjustable Socket? All right guys, for those of you who are my winners, congratulations again. Be sure that you send me your addresses, so we can get out your prizes to you.
All right guys, with that, I’m going to go ahead and sign off. Thank you for letting us be a part of your lives this evening. Thank you Click Medical again, for this wonderful opportunity. We’re going to see you guys next week. Same that time, same that channel. Check the calendar because Click Medical is going to be back on the show in 2022 once more. Bye guys.