Getting AFOs repaired
Several months after I moved to this facility (same state, different county), a rivet came out of the ankle strap on my right brace. The nurses held it together with stretchy tape. I went to an appointment with the same orthotic company (locally) that had made and maintained my ankle-foot orthoses (AFOs) at my former facility.
Since I usually had the ankle straps and Velcro replaced every two years, I asked about it. The orthotist said he did not like the design of my braces, and that he did not make ankle straps in his lab. He told me he could, however, replace the rivet and the Velcro toe strap.
When he returned, he put my braces on and I noticed the ankle straps were dramatically smaller. He told me he attached each ankle strap to one rivet instead of two at a different angle. Although he thought it was a better design, I was surprised he refashioned them without telling me. I was concerned that the straps were smaller and pushing my ankle at a different pressure point. He said there was no charge and I thanked him and left.
A year later I returned to the same orthotist because I needed a new Velcro toe strap. The orthotist did not charge me. I knew eventually I had to find a way to get new ankle straps made.
The next year, the smaller ankle straps looked even more worn. I talked with the facility therapist about my braces' ankle straps. I asked if getting a prescription would allow Medicare to pay for the new strapping. I did not get a definite answer. But the therapist suggested an orthotist ten miles away. I wondered if the orthotist (near my former facility) had refurbished them over the years because he made them initially.
At my appointment with the new orthotist, he asked if I had a prescription. I told him the facility had not given me one. He told me, quite directly, there is no funding to pay for brace repair. I offered to pay the fee myself, but he said he could not charge me. He did replace the Velcro and I thanked him, but I left feeling dejected.
My present braces were made in 2002. Therapy told me this year Medicare will not purchase braces unless I can walk 10 feet. The facility can purchase prefabricated plastic braces that will fit inside my shoes. I think that type of brace might work on my left leg. However, my right ankle flips outward and I am concerned about skin breakdown.
Therapy had another option for bracing—an open-toe (like a sandal) brace. It can be worn while sleeping or during the daytime. But I would not feel comfortable wearing an open toe brace outdoors—particularly during winter.
Two months ago, I asked the nurse manager if there was any way that my existing AFOs could be repaired. I explained I had lost weight and that the ankle straps were quite worn.
I went back to the same orthotic company whose branch had made my AFOs years ago. A different orthotist measured for new ankle straps, which would be made off-site. He also heated my plastic braces, made them smaller and attached new Velcro strapping.
The new ankle straps were made and attached a couple of weeks later. The braces fit better than before. I have some discomfort because the braces are stretching my muscles.
Since I wanted to know if the fee was paid for repairing my braces, I called and asked. The orthotic company told me there was no charge. I think it is ironic that I could not get the ankle straps replaced in the past five years, when I inquired myself.
Topics: Clinical , Rehabilitation