Bouldering in Joshua Tree

Bouldering in Joshua Tree
Ronnie 15 feet off deck on the classic White Rastafarian.

Thursday, May 26, 2011

Amputee Profile - Maggi Pivovar

How is it going? New video up. This one is of our patient at Prosthetic and Orthotic Associates Maggi. She lost her legs below the knee to bacterial meningitis a few years ago but has not let any of that get in her way. She does phenomenal on her legs. Check out the video!

Things have been wild here, just keeping the ball rolling on a few different projects and getting ready for ACA National Conference coming up next week in Kansas City.

Take it easy!

Friday, May 20, 2011

Amputee Profiles - Mabio Costa

One of the coolest things about my job working as a prosthetic resident and being involved in the field has been the stories that people have to tell. I am always impressed by the challenges people have overcome and how anything is possible when you throw away all your excuses and just go for it. I am going to start sharing those stories with everybody via youtube and vimeo. Our first amputee profile is of Mabio Costa. He was the 2004 World Triathlon Champion in the PC division. He is a below the knee amputee of many years. Check it out!

Thursday, May 19, 2011

CAF Gait Clinic

Hey guys! So psyched! I am starting to do video posts on all of the events that I am a part of. Here is a clip that I filmed with Drew, and my buddy Ian Wald put it together. The Challenged Athletes Foundation hosts mobility clinics to learn how to run all across the country with Bob Gailey. I have been lucky enough to not only learn from these clinics but to be one of the instructors as well now. I highly recommend checking one of these out when you get a chance, it will do wonders for your running!

Tuesday, May 10, 2011

1st Annual Adaptive Climbing Clinic presented by Sanuk & Evolv

First video is up from the Joshua Tree Clinic. Sanuk recently added me as one of their athletes. They were also one of the sponsors of the clinic. I am really excited to collaborate with them on future projects. Check out their shoes as well, they make some killer stuff!


Challenged Athletes Mobility Clinic featuring Bob Gailey

The Florida Chapter of the Challenged Athletes Foundation was started about four years ago and is based out of Tarpon Springs. Meeting them back at the Gasparilla in 2007, I was one of the first athletes in the area they came in contact with. It has been really cool to see how much the organization has grown in the four years that I have known them.

Giving a talk at the end of the clinic

One of CAF California’s biggest events every year is the San Diego Triathlon Challenge, which is the event around which the national organization started. Challenged athletes fly in from all over the country to participate in this triathlon weekend that also features several adaptive clinics, including one held by Bob Gailey every year focused on teaching amputees how to run and increasing mobility. These clinics are one of a kind and have an amazing impact on the people that are able to attend. Every year amputees come in just barely able to walk and with the proper training and motivation leave not only running but with an increased self confidence as well.

Kids stopping to pose for a photo at the SDTC

Exchanging the chip as part of a relay team

These clinics were held once a year in San Diego, but recently have expanded to Chicago, Durham, New York City, and right in our backyard here in St. Petersburg, Florida as part of our St. Anthony’s Triathlon weekend.

Photo from St. Anthony's two years ago

Bob Gailey has been a big inspiration of mine and I have been lucky to call him a mentor as well. He is a mad scientist when working with people and leaves every clinic almost losing his voice. He is able to bring out the best in everybody that works around him and I hope to be able to do the same in the future as well. I have been really fortunate to have assisted in five of his clinics now to date.

The man himself

This year was the second year that the event has been held here. The first year blew all expectations out of the water, with huge attendance from the local community totaling to right around 20 amputees. The clinic held this year set the bar even higher and doubled in size. People came from all over the state of Florida and our furthest came from South Carolina. It was amazing to see not only small kids learn how to run better for the first time but also people in their seventies as well! One man I came in touch with had not run since his amputation in 1997. Here, 14 years later, he ran for the first time as a below the knee amputee.

Running can be such a daunting task as an amputee, with the challenges being both mental and physical. Sometimes it is just gaining that extra trust in the prosthesis, and other times it is learning to physically push past your comfort zone. Even the most minor tweaks like working on the rotation of your hips, pulling back into the socket, and swinging your arms can make drastic differences. The biggest thing that people are able to overcome is their fear of the unknown and of falling.

The group was very diverse, with some aspiring to become accomplished athletes, while others just wanted to be able to run around with their kids or just do the local 5k on Thanksgiving.  The mobility clinic caters to people of all ability levels, from kids, to people who need to work on the basics, to the advanced athletes looking to perfect their form. The best thing is the energy that is carried through the whole day. It is absolutely infectious and everybody leaves with a smile on their face riding the new high of their accomplishments. There is nothing like seeing everybody around you running and having an instructor believe you can run as well. Personal doubt soon turns into an “I can do this” attitude that can take people to new heights.

There has always been a really strong amputee community here in the Tampa Bay area and things seem to have come together perfectly with the addition of CAF Florida. I did my first Triathlon two years ago with only one other amputee doing the race as well. This year while doing the run I came across eight other people with disabilities competing as well. It is all because of the opportunities offered by the Challenged Athletes Foundation and other organizations that have given people with disabilities the possibility and encouragement to go out there and compete.
Me and Maria Katz after St. Anthony's 2008

Monday, May 9, 2011

Haiti: In Search of Solid Ground

Some of the video footage I took in Haiti was used by a Nature Coast Technical High School for a class project. I make a small appearance in the video when taking a break from filming. The video is a general piece on Haiti and its people.

Look for a more prosthetics specific piece coming soon!


Tuesday, May 3, 2011

Prosthetics of Hope - Haiti January 2011

In my March column, I mentioned that I had gone on a prosthetics mission to Haiti recently, which was organized by one of our patients, Kevin Valentine, a pastor at a local church. I was chosen to go along with my colleague, Michael Littles, CP, to make the week-long trip. We had no idea what we were getting ourselves into.

We arrived on Saturday, settled in on Sunday, and began seeing patients first thing on Monday. We worked 12-hour days, arriving at Prosthetics of Hope promptly at 8 a.m., breaking one hour for dinner at 5 or 6 p.m., and then coming back to complete our work until about 9 p.m.


Mike and I did not realize that our stay would coincide with the one-year anniversary of the earthquake. The media frenzy was tough to handle at times, disrupting our workflow the day before and the day of the anniversary.

The weather was another challenging factor. Living in Florida, I enjoy the comfort of air-conditioned indoor environments—I didn't realize just how much I took that for granted until spending a week in Haiti. It is hard to describe how oppressive the heat feels not only after working in it all day, but sleeping drenched in sweat all night. When I woke up in the morning, I never felt like I had gotten truly restorative sleep.
As a patient who, until about six months ago, was constantly going through volume fluctuations, I always felt like it was a matter of time before I would need a new socket. This has taken on new meaning in my short time as a practitioner. I have learned that there is no such thing as a finished patient. I like to think of their prostheses as works in progress—some are just more complete than others. People outgrow sockets, and some sockets just flat out don't fit anymore. This was the case when we arrived in Haiti.

All seven patients we worked with in Haiti were earthquake victims. Six of them had previously been fitted with a prosthesis; the seventh we fit from start to finish. There was no official patient list, but more like a running tab of who needed a replacement socket the most. We hit the ground running on our first day, casting four of the seven patients we would tend to that week. There were countless others who needed follow-up care, but in one week, seven is all that we could get to.

We used an infrared PDQ oven much like the one I used in school, but this one was a little quirkier. On our first transtibial patient we attempted to do a check socket, but several hours and failed sheets of plastic later, we realized that this would take more time than it was worth, and time was what we had the least of. The oven and the plastic seemed to have minds of their own. The oven heated slowly and unevenly, making the PETG bubble, so Mike and I left the plastic pulling to the two Haitian technicians, David and Nonue, who seemed to have learned the nuances through a lot of trial and error. David and Nonue worked their tails off while we were there but were still rough around the edges with their fabrication skills. It is hard for them to grow their skills consistently when they work only when a visiting practitioner is at the clinic. When there isn't a practitioner at the clinic, they work only on minor adjustments, as needed, with existing patients. They are waiting for the prosthetics school to open in Haiti and aspire to be two of its first students.

Learning to Simplify

After the first day, we decided we needed to simplify our processes. Patients with transtibial amputations were casted and after modifications the casts were turned straight into definitive sockets—brown polypro-copoly blend plastic with a pelite liner and neoprene sleeve. Each patient with a transfemoral amputation got a test socket, which was then mounted onto a plate with plaster and wrapped in fiberglass to get the alignment. We then did a second modification and made the final socket with the brown plastic, a distal end cap, and TES belt suspension. All sockets were fabricated with grace plates.

On one of my last days, I decided I needed to get some fresh air and went out for a five-minute walk. One of our older patients, Mary, was being carried to our facility piggy-back style by her son because she was unable to navigate the rough and rocky terrain. They both had huge smiles on their faces. Although she had lost her leg, she still had her son, her family. So many others have lost so much more.
Tent city 10 miles outside the city
Getting water inside the city
There is always hope

Beautiful sunset to close out the trip

Ronald Dickson is a graduate of the bachelor of science in orthotics and prosthetics program at St. Petersburg College, Florida. He is a resident at Prosthetic and Orthotic Associates, Orlando, Florida, and will be sharing his experiences as he completes his residency.

March Southeast Climbing Trip

Drew Johnson has been a friend of mine for a little over a year now. He is one of those guys that just likes to stay active and aside from his passion wakeboarding tries a lot of other sports on the side. He had been climbing with me a few different times, and finally I think the bug stuck and he got a gym membership to the climbing gym in Gainesville and started climbing a couple of times a week. When I heard this I told him that on my next outdoor climbing trip he had to come along.

The southeast can be really unpredictable in the spring time, and it is always best to have a couple of different weekends to work with because you might get rained out of your whole entire trip. The forecast was looking favorable at the beginning of the week, but dramatically changed by the middle of it. It was the only weekend we both had to work with so we just decided to go with it.

 The weather we did not get on Saturday.
We left after work on Friday and about seven hours into the drive to Horse Pens in Gadsden, Alabama we decided to just get a cheap hotel for the night at two a.m. and finish the drive in the morning since we were going to get rained out anyways.
Saturday was a complete washout! We managed to set up camp before the rain came it, but once it started it did not stop for about twenty hours straight. Thankfully it was the weekend of Horse Pens 40 rocks and there were some other people there to hang out with. It was still fairly miserable either way.
The rain stopped at about 4am and with the heavy wind all of the rock was dry and ready for the Sunday morning session. I am sure Drew hated me by this point because he slept in the car with the engine running because he almost froze to death in the tent (he neglected to bring a down sleeping bag).  Not having spent much time at Horse Pens, I used the day to get on some harder climbs and find some things that I was psyched on. Drew did a few of his first rock climbs, including a fun little V0 on the side of the Bumboy Boulder. My consolation prize for the day was a flash of Cuts like a knife (V5).

Scoping out all of the wet rock the day before.

We decided to move onto Chattanooga for the last day of our trip. I had unfinished business there that I could not wait to get back to and I know the area much better. My last trip in December I came agonizingly close to sending The Wave (V6). It is one of those climbs I thought I would never be able to do, but was really surprised when I was able to put it all together in one day. The hard part for me is spreading my body weight between both of my legs, compressing, and getting both hands on the arĂȘte. It is a move that never gets any easier and you just have to try really hard. It really made me use my prosthetic leg in ways that I never have before. After about twenty go’s I manage to link the move and make it on top! It really all just came down to executing and believing in myself. Drew had a good time climbing around and even did his first outdoor V3, Toucan Sam on the slice and dice boulder.

My hope this works/trying really hard face on the crux of The Wave.

Greenlife parking lot grabbing food on our way home.

We left the boulder field at 5pm on Monday and managed to get back into Orlando by 3 am. Work the next day was a blast! It is always worth it for climbing! It was really cool to get a chance to go climbing with Drew and he made this little video of our trip. Check it out!