Well for heaven's sake it wasn't the foot drop at all! I got my referral to the orthotics place and hauled in all my devices: that is, the AFO, the bungee cord Dorsiflexion Assist, the Bioness L300. What I thought I wanted was the carbon fiber Allard device, possibly with the hyper-extension control that attaches to it, making it a combo device.
What I learned was that people with MS often progress into knee hyper-extension. Apparently it is a very stable position to have your knee locked like that, and we, being tippy and tippier as time goes on, just naturally want stability. Imagine that!
He was a great guy, this orthotic & prosthetic technician, and he laid out the usual order of foot drop devices that he might recommend as an MS client's foot drop and condition progressed:
1. Something like a Foot Up. There are a number of people who make such devices -- they goes inside a lace-up shoe and pull the end of your foot and toes upwards My bungee-cord device is probably in this category. 2. The Bioness or Walk-Aide might come next. 3. the AFO follows, and I admit, I had returned to it because it was the most stable thing I had, and then finally, an AFO with a knee brace. Hmmmm. I admitted I had returned to my AFO because it offered the best stability. But what about the Allard carbon fiber thingie, I asked?
The entire structure comes up the front of your leg, so it offers no help at all with the knee hyper-extension. "How about the combo--the knee brace part of it," I wanted to know. He hadn't used the Allard but he had taken the training for another company's similar device and used it with people and thought it didn't work well at all. Too flimsy, he said. Rats!
He held up my AFO and showed me the "stopper" at the back of the heel. Ahhhh, I get it--it stops my leg from tipping backward any more so my knee can't hyper-extend. Then he had me put it on and walk for him. "You're knee is still hyper-extending a little," he said, "and you are also pulling a bit to the side. The AFO isn't quite tall enough, and I can put in dorsiflex assists," (two stretchy strap things that pull the foot upward--I hadn't needed them 2-1/2 years ago when I first got the AFO.) He then delivered the final blow to my carbon-fiber dream: "You don't want to blow out your knee."
Ack! No, I don't want to blow out my knee. Sheesh, I'm trying to stay upright here. OK, it's an AFO after all.
After I took off the AFO so my leg could get cast for the new one, he pointed to the outside heel on mine. "See how rounded it is here? That creates more wobble. The new one will be flat on the outside, (round on the inside,) so it will be flat against the inside of your shoe--that will add stability too."
So the upshot of this is that I'm expecting a new AFO on Monday and then we'll see about a knee brace. I actually have a knee brace that I could use, as you may recall from my last post. I ordered a black plastic AFO with black straps this time, as I was tired of having to put an extra sock over the foot and translucent brace to make it match my other sock, which is usually black, brown or navy blue.
In the Wahoo, Ride 'em Cowboy Department. I've manged to get on my new recumbent bike 4-5 times a week and am up to 20 minutes. Watching something on TV has actually made me want to go longer. I admit it is sometimes 10 pm before the wheels see my approach, but oh boy, do I ever feel righteous!