Weight makes prosthetics cases difficult, Randall says

Name: Marcum Randall

Title: Prosthetist, orthotist, physical therapist

Location: The Amputee Clinic

First job: Sheet metal worker

Best part of the job: Seeing patients walk and smile after they've had a prosthesis put on them. "If you have a 300-pound plus person, the physical therapist gives up on them being able to walk again because of their weight, then they come in and I try to make a prosthesis and after many attempts, we get one that works, and the person is able to walk independently and that's very satisfying to both of us."

Worst part of the job: "Not understanding what the patient's needs are, usually due to a lack of communication skills, either on my part or their part. There's no one kind of prosthesis. You've got to talk and educate. It takes a year or two or three sometimes" to find an appropriate prosthesis. Patients, he said, can have more problems than limb loss, which can complicate making a prosthesis. "The pathology of the person is very complicated, and you have to constantly be aware of it." The peril of failure is this: A person in pain from a prosthesis can gain from that a whole host of problems, from loss of range of motion to agoraphobia, he said.

Best advice: "Anything is possible. The ones that I'm describing are the people who are usually very large, they have a lot of extra tissue and they've come in an electric wheelchair and more or less given up. Working with them for a day or sometimes two, we get them up and walking on the parallel bars, then with a walker, then without a walker - a cane maybe, or crutches. Somehow they get into (the clinic) and we make it despite all the complications."

How to make a career of it: The typical course of training, Randall said, is four years of college, one year of certification in prosthetics and orthotics and a yearlong internship.

- Compiled by staff writer Holly Leber

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