Robert Poirier, Walking on Air
January 2018 Issue
Robert Poirier was struck by a drunk driver while riding a motorcycle to work at Big Bear Lake in Southern California one evening in late summer 1964.
Poirier, who was 17 at the time, remembers waking up on the side of the road knowing immediately his right leg had been badly damaged. "Some people had stopped to help us, and one lady was pressing hard on my femoral artery," he says.
Because of the severity of his leg injuries, he agreed with his physician's decision to have a transfemoral amputation. "There was a compound fracture above the femur about three inches above my knee, so that's where they would leave it," he says.
Poirier was released from the hospital three weeks after the accident. He had one arm in a cast, the other was heavily bandaged. "Using crutches was not an option," he says. "My parent's home was not designed for a wheelchair and getting back and forth from the bathroom was a challenge, but we made do as best we could."
Made From a Willow Tree
About three months after Poirier came home from the hospital, the teenager and his parents started making the nearly two-hour drive from their home in Barstow, California, to Los Angeles to begin the process of getting his first prosthesis. "I would wear the shrinker [the prosthetist] gave me, but since it took so long to get there, I usually had some swelling. So it took five or six visits before I finally had something I could walk with."
The prosthetist hand carved the lower portion of Poirier's prothesis from a willow tree. "The knee was nothing more than a hinge that had a leather pad that was supposed to lock up the knee when I put pressure on the foot," Poirier says. "The outside was covered in a plastic resin that was the color of a toy doll and the inside of the socket was painted with a clear lacquer."
When his residual limb would shrink, Poirier says his prosthetist would cut a piece of leather, skive the edges, and glue it into the socket before painting it with clear lacquer. The only prosthetic training Poirier received was walking while using the double bars a handful of times during appointments at his prosthetist's office. "Therapy? There wasn't any," Poirier says. "After I got my [prosthesis], he told me to go home and start off slow."
No More Wooden Legs
What Poirier remembers about most of the prostheses he had is primarily one thing: it was constantly too painful to walk.
He says that finding a qualified prosthetist is difficult. "I've never found a rating for them," Poirier says. "It's almost like trying to pierce a veil of secrecy like trying to find a physician. I struggled for years with a prosthetist shop mostly because [it was] covered by my medical insurance plans. I complained and argued that my prosthesis was unstable and painful even for short walks."
Poirier also visited consultants and physicians who specialized in rehabilitation for a second opinion with frustrating results. "Nobody would listen. When I inquired about a microprocessor knee, I was told that it was not available," says Poirier, who spent a small fortune on canes and walking sticks. "I never left home without one…"
When he joined the Amputee Connection in Redlands, California, in 2012, he met a woman who also had a transfemoral amputation—with one small difference. "She walked without pain and suffered no limitation to walking long distances," Poirier says.
It wasn't long before Poirier had his first appointment with the woman's prosthetist, Rick Myers, CP, who has operated Southern California Prosthetics (SCP), Irvine, California, since 2009. Poirier remembers his first visit to Myers. "I could barely walk to the front door," he says.
Myers expressed his belief that he could help immediately. "After we talked, and he had a chance to look at my residual limb, he boldly stated that he could make a better leg for me," Poirier says.
A Unique Setup
A few weeks after Poirier's initial appointment, Myers offered a foot and a Freedom Innovations Plié 2 knee from his office inventory for Poirier to try. "Before I met Bob, he was wearing a pin socket, a total knee, and a dynamic response foot, which he felt was inherently unstable. Without warning, it would fail on him, and he would fall," Myers says.
Poirier donned the prosthesis and walked around the office before asking to go outside. Myers agreed. By the time an exhausted Poirier returned to the building, he had tears in his eyes. "It was such a wonderful feeling to be tired from walking," he remembers. "I had just walked about 200 yards and never once had to stop for the pain to cease."
Falling, a Thing of the Past
Because he has a relatively short residual limb, Poirier's prosthesis has a unique setup that allows him "to have extremely robust suspension, while providing excellent support and comfort," Myers says.
The system is a double wall transfemoral socket system that utilizes an inner socket to suspend the socket with suction or vacuum (Poirier's is the latter) while the outer socket is focused on the proximal interface of the system between the socket and Poirier's body. The distal aspect of the outer socket connects to the microprocessor knee componentry and prosthetic foot. The inner socket is donned first and then slipped into the outer socket, and they are held together with a removable locking pin mechanism.
Poirier received his latest prosthesis at the beginning of 2017 and says he's been happy with the sockets Myers has designed for him over the years, which total about a half dozen. "I have a rotator between the socket and the lower portion, which allows me to unlock and rotate the lower portion at the knee level for easier dressing and getting in and out of vehicles," Poirier says.
In addition to the socket, the knee—Freedom Innovations' Plié 3 MPC—has made a big difference. "In the four years that I have worn the Plié MPC knee I have never fallen, which is saying a lot," he says. "Every other knee I have worn in the past 50 years has failed to support me and has given me much practice at falling on various hard surfaces."
Myers says the knees, the Plié 2 and Plié 3, work best for Poirier not only because they are lightweight, durable, and reliable, but they also allow his patient to carry multiple batteries. "He's an extremely active walker, over 2.8 million steps on his last knee over a three-year time period," Myers says.
Poirier also likes his Freedom Innovations' Maverick AT Foot. "This foot provides me with the predictability and flexibility I need to navigate rough and uneven ground," he says.
The Maverick AT Foot is flexible enough to accommodate uneven surfaces such as cobblestone. "Yet it is just solid enough to be predictable enough so that the Plié knee can operate as planned," Poirier says.
Myers says that since fiberglass has recently made a resurgence in prosthetic feet, there are several excellent foot options available in the K3 market (the original flexible feet were fiberglass and carbon), including the foot Poirier currently uses. "The benefit of a very flexible forefoot and keel provide Bob withexcellent ground compliance and rollover shape," Myers says. "Excellent technology, including the socket sys-tem, knee, and foot offer very good performance along with comfort and durability. These have allowed Bob to continue his activities of daily living for a long time at a very high level."
Poirier estimates he can now walk more than five miles per day. "Previously my limit was closer to a couple hundred feet," he says. "The knee and socket have been life changing. I can no longer look ahead and see the limit of how far I can walk, I can literally walk farther than I can see."
Walking on Air
With five decades of living with limb loss, Poirier can say with confidence he has witnessed the innovations of talented engineers. "If I don't notice it, then that's a wonderful thing, and that's the greatest compliment I can give," he says.
Poirier is happily retired, which means getting to travel in the new camper trailer he and his wife, Rosemarie, bought, and going to Disneyland with his children and grandchildren. Walking for hours at the theme park is not a problem, thanks to the socket from SCP, and the Plié and Maverick AT Foot from Freedom Innovations. "I hardly notice I'm wearing it," he says. "It doesn't enable me to jump high buildings, but I can walk and not think about it, not worry about falling down. I'm 70 years old now and falling down is not a good thing."
Betta Ferrendelli can be contacted at email@example.com.