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My name is Brad Poziembo. I'm a prosthetist with Dayton Artificial Limb Clinic. A prosthetist evaluates and treats people with limb loss or amputees with artificial limbs. The majority of the amputations are due to a non-healing wound or from a traumatic injury. My key responsibilities are caring for my patients, making sure everything's in order, that we're able to provide a quality and safe product. That involves evaluating the patient. We work under the orders of a physician, mainly a rehab physician. I'm very hands-on in the process to maintain that the prosthesis is a proper-fitting device. Most of the products we use, like the feet, are off the shelf. They're ordered from other manufacturers. The main custom thing is the socket and the initial device that is attached to the limb. We use some special measuring devices, scanners to help digitize the limb into a computerized file. We use CAD/CAM to help modify molds and designs before we convert that over through the 3-D printer. Twenty, thirty years ago, the fabrication process was very tedious. It took about 130 different steps to make a final prosthesis. But with 3-D printing, it has significantly reduced the steps to three to five steps in order to make a prosthesis, allowing me to see and care for more patients. Typically, we'll get a referral from a surgeon, and sometimes it can be right before an amputation. We can provide a prosthesis in the operating room, and when they wake up from the anesthesia, psychologically, they see that they still have a foot. Healing takes one to two months. Then we'll take the impression of the limb, and we should have a test socket ready within 24 hours. Within two to three days, we should have them standing and walking. We like to see them at least once a year to make sure that everything is aligned correctly. Most of the alignment is through visual observation and getting feedback from the patient. I think it looks good. Let's walk back and forth one more time and we'll-- We can't see what's going on inside the prosthesis compared to what the patient can feel. They walk, and I'm watching the shoulders, hips, the knee, and how the prosthesis rolls over. Most adjustments can be done during the appointment. If they're feeling unstable, usually a couple turns of a screw can make a dramatic difference. Interpersonal skills is probably the biggest skill that I use. Hold on to the railing, and let's ride this knee down. We're the last people they see, in terms of their healthcare. They've already seen wound care doctors, vascular surgeons, rehab doctors, orthopedic surgeons-- everything they can do to save their limb. Try that again for me, J.D. When all that fails, I'm the last person that they see, which can be very frustrating for them. When I first meet them, they could be angry, depressed, upset, and I know that over time and with healing, that attitude's gonna change. I went to school at the University of Minnesota Duluth. I got my Bachelor's of Science in Biology, a minor in Chemistry and Psychology. I originally went to school to be a dentist. And it wasn't until I traveled abroad in Guatemala that I ran across a volunteer prosthetist. We started talking, and I'd never known a prosthetist. I'd never known an amputee. I didn't know the profession was out there. I started doing some research into it. All the challenges and problem-solving skills really intrigued me. I attended a technical school for prosthetics and orthotics, and then I went to practitioners' school. I went the long route. The normal route is a master's program. It's four years of undergrad, two years of master's, and then two years of residency. The occupation is not for the weak of heart, I should say. You see a lot of interesting things. We spend time in the operating room. If you can't handle blood, this is probably not the occupation for you. I'm not squeamish and nothing ever surprises me anymore. I like my job because of the challenge that it provides. Being able to see someone come into my clinic, either in a wheelchair or on crutches, and being able to leave, having the ability to stand, walk is very rewarding. It is good to know that I impact these individuals' lives. My services help impact the quality of life that they have going forward.

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