ACCORDING TO THE AMPUTEE COALITION, a non-profit organization headquartered in Washington D.C., and dedicated to the needs of people with limb loss, approximately 570 people in the United States experience the loss of a limb each year. The three most common causes are vascular disease (54%), trauma (45%), and cancer (27%). Thirty-five percent of people experience the loss of an upper limb; 65% experience the loss of a lower limb. Prosthetics refers to the science of creating artificial body parts; an artificial limb is called a prosthesis.
Orthotics are devices designed to support and comfort the feet, ankles and wrists. They may be used to treat foot pain caused by abnormal motion. They can also be used to treat injuries such as shin splints, tendinitis and carpal tunnel syndrome. Problems with alignment of the foot and ankle can not only cause problems but also knee, hip and even back problems. Orthotics designed to help a patient function are usually crafted of a semi-rigid material such as plastic or graphite. Depending on a patient’s needs, orthotics may also be constructed with softer materials so they can provide additional cushioning and support for conditions such as diabetic foot ulcers, painful calluses on the bottom of the foot, plantar fasciitis, bursitis, and foot, ankle and heel pain.
In order for patients to receive maximum support, comfort and function, prosthetics and orthotics are custom fitted. After a fitting, and especially in the case of prosthetics, patients may need occupational therapy to learn how to use the device. In addition, over time, as patients’ needs change, these devices may need adjustment, repair or replacement. And although the cost of prosthetics and orthotics are covered under most health insurance policies, patients sometimes need assistance navigating the perplexing and complicated procedures required for reimbursement in an increasingly fragmented U.S. health care system.
How does someone in the North Country live well with limb loss or limb difference? Enter the professionals at Mountain Orthotic & Prosthetic Services with offices in Lake Placid, Plattsburgh, and Malone.
Origins in Lake Placid
Founded in 2007 by Lake Placid native Jeff Erenstone, and joined by Quebec native Alex Trumper in 2015, Mountain Orthotic & Prosthetic Services offers personalized prosthetic care, custom and prefabricated orthotics, and therapeutic footwear. With a patient list in the many thousands comprised of an 80%-20% ratio of adults and children, Erenstone, Trumper, and their dedicated team, provide exceptional and empathic care for those facing challenging health issues that impact mobility and quality of life.
“I tell patients that this is where your recovery starts,” said Erenstone, speaking from the Lake Placid office. “It will be a lot of work, but we will be there for whatever they need, and for as long as they need it. We have people who come in with a wheelchair, and we develop a plan to fit them with the device they need and help them to pursue their full potential and best life.”
“Half of the job is treating the mind of the patients,” added Trumper. “Some folks who arrive here are at their lowest point. I reassure them that if they feel they are at ‘the bottom’, we can now work our way up. One of our employees is an amputee himself. Once patients meet him, they can see—firsthand—that there is hope and readjustment is possible.”
Common problems patients with limb loss and limb difference experience are intact limb pain, back pain, poor balance, reduced mobility and fatigue, irritation and skin issues, fit issues, and other discomforts. The team at Mountain Prosthetic & Orthotic Services has dedicated itself to finding the best option for each patient.
According to Erenstone, the business has grown steadily over the last 16 years, and continues to do so.
An Evolving Field
Like many aspects of health care, the training and practices in Prosthetics and Orthotics (O&P for short) is evolving to accommodate patient needs and maximize advances in technology. In the past, these two fields had separate educational paths and certifications. It is only in the last decade that they have been combined— a logical step. A constellation of training and skills in fields such as biomechanics, kinesiology and engineering are crucial to success in the field. In addition, problem-solving, creativity, compassion, hand skills and athletic training are also particularly important.
Head Clinicians Erenstone and Trumper both have extensive and varied educational backgrounds with degrees from the University of New Hampshire, McGill University and Northwestern University, and internships at Children’s Hospital in Boston. In addition, they have done work in places like Ecuador, Haiti and Nepal. Both are ABC (American Board Certified) Prosthetist/Orthodists.
An Effective Business Partnership
Trumper came into the business as the Practice Manager in the Plattsburgh office in 2015, and became co-owner with Erenstone in 2018. After leaving Quebec to continue his education at Northwestern University in Chicago, he and his family spent nine years there until he and his wife decided to relocate to the North Country to be closer to family. Through professional networking, Trumper reached out to Erenstone, and, after a couple of months of communicating, discovered they had similar interests and complimentary skill sets. “The timing was perfect,” said Erenstone. “I knew I was going to be shifting my focus to other things, and was looking to bring someone on who could move into an ownership role. Our values are the same even if our approaches are slightly different.”
Over the last decade, Erenstone has specialized in custom and small production designs for adaptive athletes of all skill levels—from Paralympians to amputees trying new sports. In 2018, he founded Operation Namaste, a not-for-profit organization devoted to improving prosthetic care around the world. A world expert in the use of 3D printers to make orthotic devices, Erenstone is currently writing an instruction manual, and is a member of a team from the United Nations working to bring this affordable technology (3D printers can be purchased for $1,000) to Nepal as well as other developing countries.
With a nod to more local needs, Erenstone has designed what he calls an ADK Climbing Foot—a specially designed prosthetic for amputees who want to “hit the rock”. Erenstone and Trumper’s partnership has allowed them to broaden their perspective, share knowledge and expand health care services in the North Country. Not surprisingly, this professional approach has carried over to their staff.
Currently, Erenstone and Trumper employ 12 people: practitioners, assistants, technicians, pedorthists (a maker of therapeutic shoes), and fitters. “All our employees are fantastic,” said Trumper. “If you get good people, it goes a long way to what you can offer patients. Jeff and I are both extremely proud of our staff, and the fact that our ‘ shortest-term’ employee has been with us for four years.”
Describing their staff as a “tight-knit group of people whom they consider as family,” Trumper and Erenstone were able to keep their entire staff on the payroll during the COVID pandemic and continued to partner with physicians to offer patient care throughout the difficult days of 2020 and early 2021.
“We put our patients first,” explained Erenstone. “We understand the value of having long-term relationships with them, and partnering with physicians to create an effective treatment plan. We do not sacrifice the long-term for a short-term solution. We know these devices can be complicated, and we always also pay attention to the deeper needs.”
Mountain Orthotic and Prosthetic Services
106 West Bay Plaza
Plattsburgh, NY 12901
7 Old Military Road
Lake Placid, NY 12946
566 Main Street
Malone, NY 12953