5 QUESTIONS FOR… Ralston C. Coleman, Jr.
Ralston C., aka Jim, Coleman Jr. is an ABC-registered prosthetic technician for Boas Surgical, Inc. in Allentown, Pennsylvania. He holds an associate’s degree in science and has worked in the O&P field for several decades.
O&P Almanac, JUNE 2009

1) How long have you been in the O&P field, and what inspires you to go to work each day?
I started employment in the O&P field at Boas Surgical on Nov. 24, 1975. I started in prosthetics under the V.A. on-the-job training, which was a two-year program. I tested for prosthetic technician in 1979 and my registration number is RTP 260. So, at the present time, I’ve been in the industry for more than 33 years and at the same place of employment since 1975.

I am so thankful to God for being in this field because it is so rewarding. I look forward to going to work every day to meet the new challenges in our field and to help amputees adjust and improve their new lifestyles.

There have been so many advancements since I have started in this field. Exoskeletal prosthesis have been mostly replaced with endoskeletal carbon-titanium lightweight prosthetics. It has been fascinating to see the transition from the old exo-knees to new high-tech, computerized functioning knees.

Although all these transitions are astounding, the most exciting and rewarding part of this field is to see an amputee start a new life of walking in a prosthesis that I have manufactured. Just to see their new motivation, smiles, progression, and hear their laughter and see their new attitudes and outlook on life is worth more than any money can buy. Just seeing and hearing these things in the new amputees lives is far more than enough reason to hold firm and keep my daily responsibilities and goals on top of my day’s work.


2) What do you think is the biggest challenge facing the O&P industry right now?
One of the biggest challenges facing our industry right now is the decisions of insurance companies versus patient needs. The majority of insurance companies seem to be doing entirely too much dictating in reference to patient needs. They seem to be concerned with keeping the costs down, rather than the patient. They should be looking at what type of knee, foot, etc. will mainly benefit that specific patient and make his or her life better.

A large percentage of insurance companies are not covering high-end microprocessors (knees), which is preventing those amputees from benefiting and experiencing the great advantages and special features of this new technology, which would greatly improve their quality of life. I also hear some of the practitioners at my company mention that some companies also carefully monitor feet that may be prescribed for a specific patient.

It doesn’t even matter what a patient’s abilities, age, or line of work, some insurance companies will only cover components that the amputee will use inside their home. I don’t agree with the insurance companies’ decisions. They are not dealing with used car parts being replaced; they are dealing with human lives and needs.

As our nation is freely spending our money on mortgage companies, banks, car companies, etc., I feel that we should have more concern for these amputees’ quality of life and help them obtain the best products to enhance their lives.


3) What fabrication project are you currently working on and why?
We are constantly working on different lamination layups and configurations to keep definitive prosthesis lightweight, but most importantly, strong. To accomplish this goal, we are experimenting with different carbon braid and nyglass materials in laminations. I also see the need to do this to try to keep a cost-effective platform for finished products.

One problem we are facing is that each patient has a special need in one area or another, and therefore several different layups may be needed. Some contrasts may be involved to achieve these variances. For a geriatric patient, I would try to make an extremely lightweight, but still strong, socket. In contrast, a socket for a very active, young, or heavy person would need more concentration on strength with still a concern for staying as light as possible.

Another challenge is to use the right materials for laminations that incorporate distal socket attachment units (rather than three- or four-prong attachment units) to maintain a good bond and extra strength to keep these units permanently set on the socket.

Also, having pelite liners on the casts for laminating should require a lesser amount of vacuum for the lamination, as the liners tend to compress under high settings of vacuum, therefore a lower setting on vacuum should be adjusted.

I am forever trying to resolve these concerns in fabrication of laminating sockets and definitives.


4) What are three tools that you cannot work without?
First and utmost would be a set of 4mm t-handle wrenches. I used these quite frequently during the day to adjust set screws on tube clamps attached to tubes on BK and AK prosthesis for production and also for numerous repairs that are required on walk-in patients throughout the day.

My second most-needed tool is my 2C100 tool for removing foot shells, also known here as the super iron clad shoehorn. Of course, beyond using my shoehorn to remove foot shells, it also is an immediate necessity to install artificial feet into patient shoes. I also keep it handy if a practitioner gives me a hard time.

My third required tool is my scissors. As simple as it sounds, I need scissors a great deal throughout the day. I use them to cut material for lamination, to trim and make pelite inserts, to cut and size buildup pads a practitioner may ask me to add to the inside of an existing socket, and for numerous other daily needs.

Actually a tool that is most important in my profession is a torque wrench, as different torques on clamps, adaptors, and other prosthetic components are required by individual manufacturer’s specifications. It is of the utmost importance to maintain these specifications for component safety for patients.


5) What is one aspect of your job that you would most like to outsource?
The one job I definitely would like to outsource is the chopart footplate bonded foot system, used for very minimal clearance for partial amputations with the bonding kit. The plate is available in three heel heights (0 mm, 9mm, and 19mm) is attached to the laminated socket with the bonding kit.

The two-part bonding agents have to be exact, in that the one can has to be in an oven for a required amount of time and then slowly poured into the other bonding agent can. It then has to set for numerous hours and then cured either at room temperature overnight or in an oven for a specified amount of time.

Now and then I can finish one that stays intact, but most of the time, after the patient wears the foot for a while, the bonding will slowly come loose. So, I prefer to send this out to the company that sells this and they will bond the foot on for a small fee. I don’t normally give up many challenges, but this is definitely one.