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Finding a good AFO vendor

June 18, 2012
by Kathleen Mears
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Last week the orthotist agreed to repair my right AFO (ankle-foot orthoses)strap, left the room and returned quickly. He said he reinforced it with nylon and felt it would hold.

He reminded me that during my 2011 visit he said he did not make straps with neoprene or vinyl, from which mine were made. I remembered that, but I wondered why he did not suggest remaking them with a different material. 

He said all braces are made at large, out-of-state labs. He did not say if repairs were sent to those same labs, but stated he does little in his lab. 

He did not say anything about what Medicare and Medicaid reimburse on new braces or repairs. But he also did not indicate any difficulty with payers. 

When I mentioned new braces, he suggested a different type. For better comfort he felt plastic braces with one upright—since I do not walk—would work best. Then specially made shoes would be permanently attached to them. 

When I questioned the change in design, he shared that he did not care much for my previous orthotists' work, even though they are employed by the same company.

I explained that those orthotists were very helpful assisting me to make the transition from metal to plastic, “inside the shoe” AFOs in 1996, when I moved to a nursing home. 

I told him I do not want a different brace design, or a specialized shoe attached to them. I have several pairs of shoes and I like the variety. Because of the spasticity in my right leg, I think AFOs go on and off without the shoe attached. Also, in my experience no brace is very comfortable.

I think new braces can be made offsite. But, I wonder how quick the turnaround time is and what happens if the AFOs do not fit correctly. I would hate to have to make many recurrent trips to the orthotist. 

So, I am back to square one with shabby looking AFOs. The straps this orthotist repaired have bits of material sticking out which makes me wonder about his work and how long the straps will actually last.

I am going to contact my former orthotists for their input. But, I may have to go to a different orthotic company to get the braces I want. 

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Comments

how frustrating! my own experience is that in the past several years the quality of customer service has declined quite a bit in lots of settings - including health care providers, store clerks, bank tellers - and general rudeness has increased - rude drivers, talking loudly on cell phones in public places, less eye contact and social conversation in places like a mall or train station, etc. Where i work i have been known to mutter "mediocrity is the new 'quality'". cynical, i know, and i try to keep turning a polite and friendly face to the world anyway. i admire your persistence in working on getting what you need. if you have had these devices for a while, can the MD or nurse practitioner arrange a new PT evaluation for you, for appropriate orthotics, etc. ? if Medicare is paying for creating of new orthotics, maybe the orthotist will get better reimbursement/be more interested in the work? i agree that it shouldn't make any difference, but it might. and lots changes in 5+ years, in terms of materials and design capabilities and latest thinking about pros and cons of different devices. so maybe you would benefit from a PT evaluation again for the devices, if you have not had one in several years?

Kathleen Mears

www.ltlmagazine.com/blog/kathleen-mears

Kathleen Mears has been a nursing home resident in Ohio for 20 years. She is an incomplete...