My rookie year with a new prosthetic leg

Share

It was a warm afternoon in June, Angelena Dolezar finished work, teaching a Grade 5/6 class at Laurier Heights School in Edmonton, and drove herself to the Glenrose Rehabilitation Hospital. These 4 p.m. appointments had become routine since the 29-year-old substitute teacher's left leg was amputated after a water sporting accident the previous August.

Her prosthetist constantly needed to adjust her socket, the cup-shaped component that encases the remaining tissue of her thigh and serves as an anchor for a prosthetic. Dolezar hurried into his office on her temporary hydraulic limb – an energy-sapping piece of equipment that left her exhausted at the end of each day – thinking this appointment would be no different.

It was, in fact, the day she would fluidly walk out the door with a brand new leg – a state-of-the-art symbionic prosthetic with microchips in the knee and ankle that communicate with each other and learn the owner's movements to mimic a natural gait.

The new prosthetic is a slender piece of machinery that comprises the lower leg from the knee down: a grey plastic-encased calf, a metal shin, a plastic-encased ankle and a flat foot that resembles the tip of a ski. Her prosthetist bolted it all together and attached it to her existing socket.

Dolezar pushed her thigh into the socket and did a test walk, taking 30 continuous steps down a hospital corridor. She felt stable, confident, and in control. The difference was like switching to driving a car with power steering; her new leg didn't fight her. With each step, the microprocessors in the leg were programming themselves to respond to her gait and her walking speed. "It's neat to think ... you're going to own something that is going to learn you better so that you can use it better," she says. "There's this reciprocal relationship between me and the equipment."

Dolezar couldn't stop grinning. Her prosthetist said it was the first he'd seen her smile in a long time.

The past 10 months had been a struggle. On Aug. 7, 2013, she was riding on an inner tube, pulled by a Sea-Doo, on the Shuswap lakes of the B.C. Interior, when she fell off, dislocating her knee, fracturing her tibia, and severing the popliteal artery behind her knee. On Sept. 3, doctors amputated the limb.

Dolezar, who until the accident had been a competitive soccer player, has been trying to wrap her mind around it ever since. "Almost every day, I mourn the loss of my old life," she says. "On the good days, I welcome my new life, and on some sad days, I feel uncertain what my life is going to unfold for me."

By early October, she was walking on a hydraulic leg, covered by the government of Alberta.

Although the hydraulic leg was functional, it wasn't ideal. Dolezar is much more athletic and active than the leg allowed her to be. She couldn't walk down slopes or stairs easily; the knee moved far too quickly to give her much control. And because it has a soft foot, she'd feel her weight sink into the ground with each step. It required her to put a lot of pressure into the socket to get the leg to swing forward quickly enough to match her stride. When she stood in one place, she'd have to be careful about how she distributed her weight, so the leg wouldn't buckle under her.

Over the winter, she tried three different prosthetics. The first was too heavy and noisy, and since Dolezar was still early in her recovery when she tried it, she didn't feel strong enough to operate it. The second was much lighter, but its stance-control feature, which ensures the user doesn't accidentally engage the knee when standing still, allowed her to sway slightly. Dolezar found the sensation unsettling. "I found that scary 'cause I felt like I was kind of like a willow tree, like I was just like swaying around and I didn't know if the leg was going to bend or not."

Her week-long trials with each of these legs left her feeling deflated. "If I've worked a whole week at building skills on this product and I didn't get any better, that's very frustrating," she says.

When she tested the symbionic leg in March, she knew it was the right match. During her trial, she found she could walk longer with less effort. She could wear it for an entire workday, and still have energy to run a quick errand or visit with friends afterward before running out of steam. With her hydraulic leg, she would often go straight home after work, and go directly to bed, completely wiped.

The knee of the symbionic leg senses the amount of effort she puts into walking and responds with a reciprocal amount of resistance. So, when she's walking up a hill, the leg responds with less resistance. When she walks downhill, it increases the resistance. The foot, meanwhile, senses the plane of the ground and points the toes up or down, depending on whether she's going up a hill or down a hill. Those two systems, the knee and the ankle, operate in sync.

With the help of her friends' fundraising efforts and donations from generous strangers, Dolezar had enough money to afford the $65,000 prosthetic. In April, she agreed to purchase it from the company, thinking it wouldn't be ready for months.

Although Dolezar can no longer play soccer, she now has her sights on completing a triathlon. She's working slowly toward that goal, not setting any deadline to ensure she doesn't push herself too hard. "I just want to really honour my body and honour the rate of my recovery and not force myself to do something that maybe I'm not quite ready for," she says. "I just think, in time, it will happen. I will run a triathlon." She has already joined a para swim team, and is aiming to start incorporating running into her workouts in the spring.

Running requires her to use her old hydraulic leg, since her new symbionic limb is heavier and its built-in computer "overthinks" when she runs. Once she receives switches from her current socket, made of rigid fibreglass, to one made of flexible silicone, she'll also be able to get on a bike. "Being an athlete, I just wasn't prepared to sit around and do nothing," she explains.

At the end of June, she went alone to the West Edmonton Mall on her new leg for the first time. She stayed in one small area of the mall, but managed to wander around the shops. The short visit was, in fact, a big deal to her; navigating crowds on a prosthetic leg can be extremely daunting. It requires frequently and unpredictably changing one's pace. Until that point, Dolezar felt anxious about the possibility of being pushed over, and about having to constantly worry about where she parked her car and mentally calculate the distances she'd have to cover on foot. "I felt really good about it," she says of the milestone. "I was proud of myself."

In July, she also went hiking for the first time since the accident, walking five kilometres with a friend over steep and uneven terrain, an activity that wouldn't have been possible without her new prosthetic.

"It's starting to feel like my life is whole again, that I don't have to go searching for anything that I've lost, that my leg belongs to me."