It's the start of a typical day for Grant Bush: wake up, hit the bathroom and put on the arm.
It's a simple cable-operated limb with a hook that can open and close on the end, he explains. "I can pick up an egg, control the sensitivity ... it's a pretty functional tool."
It's also great for opening beer bottles, he adds — it drives his friends nuts.
Bush, a St. Albert resident, is one of many Albertans that have a prosthetic limb. "I was born with a deformed wrist and hand," he explains from his living room couch, so doctors cut off his left forearm when he was young. "I was actually the youngest baby in Alberta to get a prosthetic at the time."
Since then, he's finished school, married and become owner of Construction Alberta News. "My life's pretty good."
He's also taken up golf thanks to an arm invented by Edmontonian Bob MacDermott.
MacDermott, a community homes manager with Alberta Seniors, has had a prosthetic leg and arm since 1988.
Back in 1987, he was getting pretty good at golf and was thinking about entering his first tournament. He decided to help out at the family farm in Saskatchewan instead.
"The decision literally tore me limb from limb," he says, with a laugh — his tractor ran over a power line and the resulting electrical burns cost him his left forearm and lower left leg.
MacDermott breezes over the months of painful skin grafts and recovery that preceded his first prosthetic limbs. "It was a trial of patience for me," he says, since he was in a hurry to get back to work, his family and golf. It took years of practice, but he's now the top amputee golfer in Alberta and Canada and regularly struts the fairways with his flame-emblazoned limbs.
Prosthetic limbs are about getting back what you've lost, MacDermott says. "With technology, passion, perseverance and hard work, I've found anything's possible. It's just a matter of how badly you want it."
Medical mechanics
Like most amputees in northern Alberta, MacDermott got his limbs from the Glenrose Rehabilitation Hospital.
St. Albert's Jim Moan has been a prosthetist there for five years and has been in the limb business for 17. He fell into the field after cutbacks cost him his job as a wildlife ranger, he says. Give him the chance, and he burbles on passionately about myoelectrics, computerized knees and other wonders.
Gary Tremblay, who works at Edmonton's Troppman Prosthetics, got his job 16 years ago through a friend. "It's pretty cool. Someone comes in [using] a wheelchair and goes walking out on the legs you've made them."
Most people who lose limbs lose them to diabetes, Moan says — accidents and war injuries are relatively rare. About 80 per cent are missing a leg below the knee while about 10 per cent need a full or partial arm.
"When someone loses a leg, they lose more than a leg. They lose a being," he says. The missing limb forever changes their self-image, family life and careers. It's his job to play medical mechanic and get them back on their feet.
The process starts with an assessment of the patient's condition, Moan says, followed by what they want to do. Military amputees are particularly challenging, he notes, due to their high-performance lifestyles.
Next they take a cast of the patient's stump. This is usually done with plaster, Moan says, but can also be done with a handheld laser scanner and computerized carver.
The mould then goes into the workshop — a messy place of plaster, clamps, T-wrenches and feet. Technicians melt a slab of plastic over the mould to create the limb socket, using a vacuum pump to ensure a perfect fit.
"This is the art part of it," Moan says — the joint must fit the person precisely for comfort and proper grip. Technicians will shave and add to a mould many times before they get the proper socket.
High tech, high cost
Once the socket is ready, technicians build the rest of the limb out of precision-made parts, most of which are imported from Germany. "Just to replace a foot can be $4,000," Moan says — a knee can be up to $40,000. Parts are often laser-aligned for proper balance.
There have been some amazing advances in leg technology, Tremblay says. "When I started 16 years ago you had a choice of, say, 15 different feet. Now, you've got a choice of about a thousand."
He and Moan both keep shelf-loads of them in the workshop, ready for new clients.
Today's legs are usually made of titanium, carbon fibre or Kevlar, Moan says. Many have rotator joints or shocks for better movement. (MacDermott's have both, which he says really helps his downswing.) The highest-tech legs are likely C-Legs — sleek futuristic limbs with computer-controlled hydraulics that regulate swing and respond to stumbles.
Advancements in arm technology have fallen behind that of legs, Tremblay and Moan say, and haven't changed much in the last 50 years. Bush says his arm has had the same basic design his whole life. There aren't as many arm amputees, so there isn't the demand for new parts.
Most arm advancements have come in myoelectrics, Moan says — electric hands controlled by muscles. The newest ones hook direct to your nerves so you can control them by thought. Temperature and touch-sensitive skins are also in development.
It's great technology, Tremblay says, but you have to be rich or a war vet to get them — top-of-the-line myoelectric arms run up to $75,000. "The things they're coming out with are great, but at the same time nobody can afford them."
Most regular limbs cost less than $12,000, most of which is covered by the province.
The whole process of getting a limb takes anywhere from one to 10 days, Moan says, depending on the client. Most people come back every few months for adjustments as their bodies change shape. "You'll see me more than you do your doctor."
Showing some leg
Bush says he used to try and hide his prosthetic when he was young. "I just wanted to be normal."
In high school though, he stopped caring about the limb. "If people didn't accept me for what I was, screw 'em." Nowadays, he's got no problems sporting a T-shirt in public.
Public acceptance of prosthetics has gone way up in recent years, Tremblay says, in part due to eye-catching limbs like the C-Leg. "Half the people I know will walk around in shorts showing off their leg because they think it's cool."
You also see a lot more people customizing their limbs. "It's kind of like a tattoo on your body," Tremblay says, "and you can get it changed every two years." He's made limbs covered in frogs, red roses, even "farm animals in compromising positions." One guy stuck a handicapped sticker on his leg, he laughs.
It's part of the recovery process, Tremblay says — a way of accepting your new limb. "This is a part of me now. Nothing I can do is going to get my leg to grow back, so I'm going to deal with it."
The new limbs have dramatic effects on people's lives, Tremblay says. "They come in happier and more upbeat because they're able to get up and do stuff."
Life with prosthetics is really about attitude, MacDermott says. "Things happen to us all the time and it's a matter of being able to put it in perspective and move forward with what you've got."
Bush says he's now so used to his arm that he'd have second thoughts if someone were to offer him a real one. "It doesn't define me," he says of the limb. "I don't think I have a handicap or that I should be treated different from anybody else."
He's glad when people forget about it altogether. "When I'm Grant, I'm Grant."
