After one day of assessment and casting of the patients, another day of design and rectification of our Ankle Foot Orthotics, and yet another day for molding and fitting preparations we’ve reached the most rewarding part of all of this, patient fittings!
After a three day process of making the AFOs we finally got to see all of our hard work put into action. It was incredible, to say the least. We arrived to the Guiling Children Rehabilitation Center that morning and eagerly awaited the children. Once our patients arrived they came in two at a time for their fittings. Personally I find that interacting with the kids is the most exciting part about this entire trip. These are some of the happiest kids I’ve ever seen. They’re so amused by bubbles and stuffed animals and cry laughing at the smallest things. It’s a breath of fresh air to be surrounded by that kind of innocence. We are working in an under-resourced area so it’s nice to see that pure enjoyment of life regardless of their circumstances. I think at that point we also created relationships with some of these kids. There was one boy in particular who loved bubbles I think more than anything in the world, and this time around we knew to go straight for the bubbles to keep him entertained as we did the fittings. I think we were all a little bit more comfortable in that respect. We weren’t awkwardly trying to find our place in the clinic or figuring out how to entertain the kids. It was pretty great to see everyone so engaged with them.
The fitting process for each patient went pretty much the same. The patient came in and we tried on the orthotic and made note of any modifications that needed to be made. For example, the forefoot toe area of the orthotic may have been too long so we then had to fix it by cutting out that extra area and then polishing it. There were also cases of the lateral wall of the AFO being too tight or too wide so the plastic was heated up and then molded so that we could relieve any discomfort for the patient. My patient in particular needed two modifications to his AFO. He needed a third strap around his toe area to control forefoot movement along with extra padding around the tendon achilles area to release some pressure and redness we saw that he had during his first round of fitting. These modifications took some time so the other team members helped to keep the patients entertained until their AFO was ready.
There was a range of orthotics prescribed so being able to actually see a patient’s improvement wasn’t the same across the board. Those patients who had walking (hinge) AFOs and insoles tried them on and we could usually visibly see an improvement in their gait. The design of our AFOs aren’t particularly complex, so to see how this simple orthotic really did improve the gait of some of the children immediately, was really exciting. Those patients with resting AFOs only wear their orthotic while resting, so those will be improvements that we can observe over time.
Even if the patient didn’t show excitement, you could see how appreciative their parents were. Seeing the happy parents as they either got to witness their child walking a bit better or just be grateful to have something that will hopefully yield great results down the line is really reassuring. We sat on a 16 hour plane ride to serve and to learn, to use biomedical engineering to serve underserved and underprivileged communities, and we did just that. The journey to recovery is just starting for these patients, but it feels great to have been an important part of kick-starting that journey.