At age 17, Plano resident Nathan Sutti was in a motorcycle accident and lost his left leg above the knee. Having always thought he would go into farming, he suddenly found himself not only with a new prosthetic leg but also an interest in the mechanics of how his prosthesis worked. He already knew a bit about orthotic devices; his sister had used several after a car accident as a child paralyzed her from the waist down. Nathan credits these early personal experiences as sparking an interest in pursuing a profession in the field of orthotics and prosthetics.
As an amputee himself, Nathan had a unique advantage as he completed his education at UT Southwestern to become a prosthetist. He now works for Total Care Orthotics and Prosthetics located in Dallas, spending his Fridays at the Plano lab crafting artificial limbs or orthotics for his patients.
Becoming a prosthetist involves rigorous course work, clinical work and three board exams. It’s all worth it, though, as Nathan says the best part of his job is being able to help people get the best possible solution for their unique situation.
“Building and designing a life-changing product is the most rewarding aspect of my job,” Nathan said. “However, my job is not just simply building a prosthetic or orthotic device; it becomes much more than that as I tend to build lifelong relationships with my patients where we share stories, watch each other grow and become a support team for one another.”
With orthotics, Nathan’s job involves creating devices, such as braces or supports, to aid in the use of injured or deformed limbs. This may include anything from specialized casts to boots or slings designed to keep a limb in the correct position and allow it to be used the right way.
With prostheses, Nathan is responsible for creating a new limb to replace one that has been lost or damaged due to a number of reasons which may include traumatic injury, cancer or diabetes. These days 99 percent of the prostheses Nathan creates are lower extremities.
On a typical Monday and Tuesday, Nathan will check on orthotic patients at Children’s Medical Center in Dallas. On Wednesday and Thursday, he’s usually in the Total Care office seeing patients for both prosthetic and orthotic appointments. And he spend Fridays at the Plano lab putting together these devices, or “getting dirty,” as he calls it.
While Nathan now works mostly with children, he has experience fitting and helping patients of all ages, and says, “This truly does not feel like work but rather a blessing.”
While Nathan’s days are never the same, here is an example of a typical day in the life of a prosthetist.
A Day in the Life of a Prosthetist
8 a.m. Nathan arrives at the Total Care office to settle in before a morning of appointments with patients.
8 30 a.m. A typical first time evaluation for a new prosthesis can last as long as two hours. Nathan, his patient and the patient’s parents will go over all aspects of what is needed regarding the device Nathan will create. Together they set realistic goals. “We never want to sell a dream,” he says. Nathan will also take the patient’s height, weight, activity level and lifestyle into consideration. A young athlete would need a very different prosthesis than a senior citizen who is more sedentary, for example. At this appointment, Nathan will create a negative mold for the prosthesis by wrapping a plaster bandage around the patient’s residual limb and wetting it. Once this dries and hardens, he can remove it and take it back to the lab.
10 30 a.m. An appointment for a test fitting may last up to an hour and a half. When a patient comes in to try on an in-progress prosthetic limb, Nathan must observe it in action. A leg, for example, has so many facets to functioning properly. Many things must be taken into consideration for a proper fit: The way the socket of the prosthesis fits the residual limb, the gait of the patient, the weight of the prosthesis, the way the patient shifts his weight when standing still. Nathan will check the alignment of all components, making sure the knee is positioned correctly over the foot. Sometimes he will see patients for as many as three fittings to get the device just right.
12 p.m. Nathan breaks for lunch and answers emails and returns phone calls.
1 p.m. Sometimes Nathan will have a patient come in whose device worked just fine for many months, but is now rubbing uncomfortably. Because he works with children, he relies on their parents to call him when they’ve hit a growth spurt and might need to be re-evaluated for a new device.
2-5 p.m. On days when Nathan is working in the lab, he will be solely focused on assembling pieces to craft one-of-a-kind devices tailored to each patient. Individual components, such as a specific prosthetic foot, are ordered from a manufacturer. Nathan will create the socket that goes over the patient’s residual limb. This is where the mold he took at the evaluation appointment comes in. He fills that mold with plaster; once it dries, he has a plaster replica of the patient’s residual limb, or the positive mold. Each prosthetic limb is unique and one of a kind. In this business, there is no “one size fits all” model.