Thursday 11 February 2010

Amputees have more bureaucratic legwork to do than bipods!

Not only does it seem ironic that I should have to work harder and walk further to have my mobility restored, sometimes it feels plain unfair and discriminatory. I don't know how it works in your country (but I'd love to hear about it), but here's an example of how the danish model can really make the amputee feel subhuman.

One beautiful Friday afternoon last summer, I was out with my children playing games on the grass. We decided to have a race. At 6, my youngest is almost able to overtake me now, and this time he got his lucky break, as my silicone total-contact socket split under the pressure of running, and other than causing a painful red mark on my stump, I was unable to keep the leg on and walk, let alone run, any further.

Now, I consider myself a normal human being, entitled to certain societal rights, like the right to medical help. Of course I recognize that I can't be treated for a broken leg in a orthopedic ward, so, having to work within normal office hours, I spent the rest of my weekend legless, and went to see my prosthetist the following Monday morning. On arrival, I apologized for turning up unannounced, but he told me I had done the right thing. He couldn't fix my leg on the spot, but it was ready to pick up the next day. As a lucky car owner, this meant simply hopping back in the car, going home and spending the rest of the day on crutches.

The next day my leg was repaired, and I was back on my foot again.

Six months later, I got a bill for around €700 for leg repairs. The bill had come from the prosthetist's practice, because they had been unable to get the local council to pay the bill. In Denmark, the prosthetics bill is paid for by your county council, but apparently you have to get approval first. To make it worse, I got one of those generic, computer generated letters, in bold print, that makes you feel like a national traitor for embezzlement.

So, I had to go to the local council, go through the normal procedure of being sent round to three irrelevant desks before ending back up at desk one, before finding someone to take quick look at the problem and understand the error - or at least the shortcomings of the system. No such luck: I got the bill sorted out - but empathy, even comprehension, were nowhere to be found. The secretary explained to me the correct procedure I should have followed when I first split my socket, and as she was sorting out what she could on her pc, I did my best to diplomatically introduce her to my perspective of the system protocol as an amputee.

"It's a bit like you falling and breaking your leg, having to drive yourself to the hospital, but being told by the doctor that you have to go and ask for permission from the council first, because they have to decide if it's necessary to help you"

"Yes," she told me as if I had so much to learn "because an artificial leg is an "assistance-device" (danish: hjælpemiddel)", putting it in the same category as crutches: assistance devices must be pre-aaproved..

"No, it's my leg. Just like you have two, I need two to get around."

Still a facial expression like it's something I haven't understood. I understand your protocol perspective, it is you that cannot see my injustice.

This pre-approval has to go on with everything to do with the building and maintenance of a prosthetic limb here. So, when I need a new leg, I have to ask permission from the council for the right to ask my prosthetist if he can propose a prosthetic solution back to the council, that they can then hopefully approve, and eventually I get the OK, "yes, you're allowed to walk again". This adds at least 2-4 weeks to the process of getting a new leg.

It's one of the very few times I'm made to feel subhuman as an amputee. What makes it even worse, is your prosthetist will tell you that he knows what's best for you, because he's done the 5 year degree in orthopedics, and the council will tell you they can't handle direct claims without a consultation from the prosthetist, because he is the expert, meaning I'm only allowed to beg, but not decide. So why am I involved at all? Why is it, that when I come in to a practice, with a clearly defect socket, my prosthetist's professional judgement is not enough? It's nonsensical, and feels discriminatory.

It's not the people themselves - my prosthetist told me I had done the right thing by going straight to him, and the secretary was just someone doing her strictly controlled job - but the system is full of flaws like this that I intend to shed light on and create a debate that might raise awareness for the amputee's perspective in this situation. Let me, and others, hear your story.

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