No slow day

The waiting room in William Yule’s office is full by the time he arrives each morning. Throughout the day, Yule sees dozens of patients, bouncing...

The waiting room in William Yule’s office is full by the time he arrives each morning. Throughout the day, Yule sees dozens of patients, bouncing between four sparsely decorated examining rooms on such a tight schedule he often has no time for lunch.

But Yule is no doctor. He’s a prosthetist who fits limbs on amputees, and business is booming for one reason: diabetes.
“There’s no such thing as a slow day,” says Yule, of Hanger Prosthetics & Orthotics Inc. in California, as he helps a client adjust her new right leg. “It can be hard, because you can’t help thinking a lot of these people don’t need to be here.”

As millions are diagnosed with diabetes each year, a growing number are confronting one of the most brutal consequences of the disease: amputation of a limb.

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Five years ago, Life-Like Prosthetics, a clinic in Torrance, California, that creates artificial limbs, saw two to three patients a day. Now it fits an average of eight patients daily, manager Carlos Sambrano said. Sambrano, who sold the shop to a larger San Diego company last fall, said up to 70 percent of his clientele was now made up of diabetics, as opposed to one-quarter when he entered the business three decades ago, when most amputations resulted from car accidents or cancer.

Peter Rosenstein, executive director of the American Academy of Orthotists and Prosthetists, said the industry’s labour shortage worsened in recent years. By some estimates, it will need 100 percent more workers over the next decade.

Diabetes is a metabolic disease in which the body doesn’t produce enough insulin or doesn’t process it well. Because diabetics have reduced circulation in their limbs, an estimated 5 of every 1,000 diabetics eventually requires an amputation, usually of a leg. Up to half of the amputees lose two limbs.

To capitalise on the market boom, manufacturers are introducing an unprecedented number of artificial sockets and limbs, many aimed at older and overweight users rather than the younger patients who traditionally have been the focus for new products.

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Some have sensors in the feet that clock how fast a user is moving, how much they weigh and if the foot is on an incline so it can adjust accordingly. Other products, such as the C-Leg and a bionic knee called the Rheo, are so advanced that some amputees use them to run marathons.

Typically patients weighing more than 90 kg have had a hard time getting prosthetics, but some newer models can accommodate patients up to 130 kg. Prices of artificial limbs typically range from $2,500 to $50,000, depending on how advanced they are.

“We joke that whenever they have a pill to cure diabetes we are all going to be out of business,” said Eric Robinson, president of Fraser, Mich.-based College Park Industries, which recently introduced an advanced foot called the TruStep.
-Daniel Costello (Los Angeles Times)