Werner Herbst focuses on how to rehabilitate patients following an amputation through his work as an orthotist and prosthetist
The company I work for is called Opcare, which offers prosthetic and orthotic services. It is based in the National Rehabilitation Hospital in Dún Laoghaire. I see most of my clients there but I also travel to Galway, Castlebar and Waterford.
Orthotics involves braces and specialist footwear. Prosthetics involves fitting artificial limbs - legs or arms - to the body. The majority of clients we see are amputees who have suffered from peripheral vascular disease (PVD) or diabetes.
The next most common type of clients are those who have amputations as a result of tumours. Normally, when a medical professional (GP or consultant) decides that a patient needs a prosthesis they are sent to us.
I will see the patient and make a negative cast of the leg and take measurements. A technician will design the prosthesis. This normally takes a week or two. We will then have a fitting. Some people compare it to the fitting of false teeth. It is a very intimate fitting and a lot of different criteria need to be fulfilled.
If the patient is a primary patient - that is, they have never had a prosthesis before - they will be admitted to the hospital and receive rehabilitation with the new limb.
Here, they will learn how to use it, how to put it on, how to walk with it and how to balance with it. Learning how to walk on an artificial limb is like learning how to walk on stilts at the start.
Once the fitting is done and the both the patient and I are happy, the prosthesis is sent off and cosmesis is added. This foam type of material is used to make the leg look like the good leg.
Normally, the client is called back for a review to see if everything is going well. If it is the first time a leg has been fitted, the stump or residual limb will shrink and a new leg must be made between six and nine months after the first leg is fitted.
I see about four or five people every day or on clinic days between eight and 12 on review clients. I also attend multidisciplinary meetings with consultants and physiotherapists.
I get great satisfaction in this job helping people. Also, because every client is different, there is no sense of repetition in the job. Delays in the system, sometimes between four and six weeks to allow for a quotation to be sent to the health board, can be frustrating. This wait is not always a good idea.
Getting a prosthesis works for most people. However, some people, such as those with certain heart problems, may not be able to use them. When you have a prosthesis you use up more energy walking. That energy cost is sometimes too high for people with heart problems.
Because you see so many people you can't get emotionally involved by the work.
I focus on how to rehabilitate the patient and solve the problem to get them back to independent life.
Many people who have had amputations have suffered great pain for an extended length of time and amputation can be a relief after so much pain.
(In interview with Fiona Tyrrell)