Advanced Prosthetics - January 2021


Formerly known as Kormylo Orthopedic

My Journey Toward Becoming the ‘New Kari’ Moving Forward Instead of Going Back to Normal

I’ve always been an extremely active person. So, when a routine ankle surgery led me to develop compartment syndrome and lose 90% functionality of my left ankle, I was faced with a choice between the lesser of two evils: keep my ankle, go through six or seven more surgeries and maybe walk with a cane for the rest of my life, or undergo a below the knee amputation and continue with my active lifestyle. I chose to amputate. You might not think it was an easy decision, but when the alternative involved never doing many of the activities I loved ever again, it wasn’t that hard. I’m an athlete and a mother of three daughters. So, getting back to the full function I had before my amputation was my main motivation following the surgery. I just wanted to do all the things I used to do with my family before I lost my leg, like biking, hunting, fishing, and coaching my daughters’ sports teams. But, one of the most difficult realizations I made during my recovery was that my life was never going to be like it was before. I would say, “When I can walk again, then I’ll feel like myself,” then, “When I can run again, I’ll feel like myself,” and then finally, “When I can play sports again, I’ll feel like myself.” But no matter the progress I made, it never felt like enough. On top of that, I also thought my recovery was going painfully slow. I had consulted with physical therapists, prosthetists, and other members of the adaptive community, and it seemed like I wasn’t recovering nearly as quickly as I should. As I was explaining all of this to my counselor one day, he gave me some tough advice: The sooner I realized the old Kari was gone, never to return, the easier it was going to be for me to recover. That frustrated me, but it ultimately led to a breakthrough in my recovery. Once I realized my goal wasn’t to regain what I had lost, but instead to build something new, I finally turned a corner. Plus, as much as the athlete in me wanted to push the envelope on my recovery, I realized I couldn’t compare my recovery to the recovery of other members of the adaptive community. Comparison is the thief of joy.

My surgery happened in September 2018, and since

then, I’ve been able to get back to a good number of activities. Recently, I worked as a youth sports coordinator at the YMCA, coaching soccer for kids ages 4–6. They were all very fascinated with my

leg — they thought I was a cyborg or something! I enjoyed using my prosthesis to teach them about disabilities. I also coached basketball at the YMCA and

was gearing up to coach for my daughter’s Little League team before their season got canceled because of the pandemic. I played wheelchair basketball up in Spokane and threw shotput and discus for a local adaptive sports league before moving from there to Boise. In short, while I might not be doing the same athletics I did before my amputation, I’m still finding plenty of ways to remain an athlete. Getting back into some of my favorite sports was actually how I was introduced to Stephanie and Brit at Advanced Prosthetics & Orthotics. I was participating in a cross-country skiing biathlon, and they were there making adjustments to participants’ prosthetics for both cross-country and downhill skiing. They kind of won me over for that. Since I’ve made them my prosthetists of choice, their customer service has blown me away. Brit once guided me through adjusting my prosthetic over video on her day off so I wouldn’t have discomfort walking around on Thanksgiving weekend! They’re by far the best prosthetics place I’ve worked with. Plus, it’s encouraging to see women working in the prosthetics industry. The journey toward the new Kari hasn’t always been easy, but looking back, I’m thankful for the progress and connections I’ve made along the way.

“The sooner I realized the old Kari was gone, never to return, the easier it was going to be for me to recover.”

– Kari Smith

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During the Cold, Dry Winter Months


As we dive into the winter season in the Treasure Valley, you should know a few things about caring for your residual limb in the cold weather. You’ll have to account for a different set of challenges in the colder temperatures, but if you know what to expect, taking care of your residual limb in the winter will be a cinch. Here are three important tips for how to do that.

IN 2021

Moisturize your residual limb.

Have you ever started working on an important project and looked up at the clock

after what felt like minutes only to find that hours had passed? If you have, you’ve probably experienced “flow state,” aka the Holy Grail of concentration and achievement.

Boise’s cold and dry winters leave many people’s skin feeling dry and itchy. This problem can be exacerbated on residual limbs, where the skin might be more sensitive. Dryness and itchiness on your residual limb can also occur when your prosthesis rubs against it as you walk. Remember to apply unscented lotion morning and evening to your residual limb during the winter. It also helps to apply it after you take a bath or shower. Additionally, drinking plenty of water and staying hydrated can decrease your problems with dry skin to begin with.

What is a flow state?

Psychologist Mihaly Csikszentmihalyi describes a flow state as a "focus that, once it becomes intense, leads to a sense of ecstasy, a sense of clarity: you know exactly what you want to do from one moment to the other; you get immediate feedback.” That sounds complex, but you can also think of flow as being “in the zone.” And it might be the key to achieving your New Year's goals. That’s because a flow state almost always coincides with tackling a difficult task, and when you’re in a flow state, even the most challenging things feel relatively easy.

Plan ahead for joint pain.

Many people suffer from joint pain during cold months, and that can be especially the case for amputees. The fat and muscles around a residual limb aren’t as prepared to protect against the cold, making joint pain a common problem. A few solutions could be some gentle exercises in the morning to get the blood flowing in the area around your residual limb, or a heating pad to do the same thing, for 15–20 minutes before going outside.

Why are high achievers obsessed with flow?

Account for residual limb shrinkage.

Flow state doesn’t only happen for people with desk jobs. You can get it while running, playing chess, dancing, or climbing a mountain, and it’s considered the Holy Grail because it has a host of benefits. According to the meditation app Headspace, those perks include heightened focus (goodbye, distractions!), a sense of clarity, feelings of happiness and pleasure, and the impression that all obstacles ahead of you have disappeared. That makes accomplishing your goals feel like less of a struggle. It's no wonder high-achieving hobbyists, workers, and creatives crave the feeling!

Cold weather decreases blood flow throughout the body, causing extremities to shrink slightly. This can be a problem for amputees because residual limb shrinkage can cause your prosthesis to not fit properly. The easiest solution to this problem is to wear a slightly thicker sock, but if the changes are too drastic for that to work, then you should talk to your prosthetist about other potential solutions or adjustments.

For any other questions or concerns about caring for your residual limb or prosthesis in the cold weather, give our office a call today at (208) 377-4024.

How can you get in a flow?

Usually, a flow state isn’t planned — it just happens. In a BBC article, author Steven Kotler describes flow as “a happy accident.” But he also notes that we can make ourselves “more accident-prone.” To set yourself up for a flow state, find a quiet place to work and choose an activity that’s difficult but meaningful for you. Ideally, it should be something you’ve already put work into perfecting. If you’ve never tried painting before, you probably won’t find flow on your first attempt, but an experienced painter could achieve it while mastering a new technique. Some people claim that being in a flow state is a form of meditation and that learning how to meditate can help you reach it. To that end, apps like Headspace and Evenflow (for iPhones only) are great places to start! Before you know it, you’ll be finding the flow like a pro.


Interesting Trivia About Prosthetics and Amputations

Over 2 million people in the U.S. are living without a limb. This is, of course, a rough estimate, and similar statistics say that roughly 1 out of every 200 people in the United States has lost a limb. The Amputee Coalition estimates that around 185,000 lower extremity amputations happen every year. Across the world, 300–500 amputations are estimated to happen every day. A majority of amputations are performed on males. The reasons for this trend aren’t entirely clear, but various studies have all reached the conclusion that men are more likely to become amputees than women. Regardless of gender, however, the most common reasons for amputation are cardiovascular disease and Type 2 diabetes. Prosthetics are still changing and developing. Late last year, army captain Carey DuVal helped test a new robotic prosthetic hand, with which he can control his gestures by simply flexing his arm inside the cuff. Because of this new prosthetic, he was able to return to his job in the infantry — the first amputee to have passed the Special Forces assessment selection. It just goes to show that as prosthetics continue to become more advanced, the chances of amputees returning to life as they knew it only become better and better.

Jan. 4 was National Trivia Day — a day to celebrate all the random, unrelated facts you’ve stored away in your brain. They might be related

to something you enjoy, whether that’s baseball, biology, or blockbuster

movies, but they might also be little tidbits of information related to nothing in particular you’ve accumulated over your life.

In honor of this holiday, we thought we’d share some interesting facts with you about prosthetics that you might not have known. Feel free to share them with family and friends, whether they’re related to the topic of conversation or not! Did you know that … The oldest prosthetic ever discovered is over 3,000 years old? It was found in the year 2000 in Cairo, Egypt, and its creation and use dates back to the days of the pharaohs. It wasn’t anything super extensive — just a prosthetic toe made from wood and leather — but it’s incredible to think that the Ancient Egyptians had the technological savvy to create any sort of prosthesis thousands of years ago.




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8 chicken thighs or drumsticks, lightly salted

1 tbsp olive oil

1 tbsp all-purpose flour 1 onion, finely sliced 2 celery sticks, thickly sliced

2 carrots, thickly sliced 1 leek, thickly sliced

1 lb potatoes, peeled and cut in large chunks

2 garlic cloves, sliced 14 oz chicken stock

1 sprig rosemary

Finely grated zest and juice of 1/2 lemon 1/4 cup fresh parsley, finely chopped


1. In a large frying pan, heat oil and fry salted chicken on high until brown. 2. Transfer chicken to the slow cooker. Add flour and stir. 3. In the frying pan on high heat, fry the onion, celery, carrots, leeks, and potatoes until lightly browned. Add garlic and fry for 30 seconds. 4. Transfer vegetables to the slow cooker and add the stock, rosemary, and lemon zest. 5. Cook on high for 2.5–3 hours or until chicken is tender. 6. Check seasoning and add lemon juice to taste. Top with parsley before serving.

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175 N. Benjamin Lane Boise, ID 83704 208-377-4024

3906 E. Flamingo Ave. Nampa, ID 83687 208-466-4360

Formerly known as Kormylo Orthopedic

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1 Kari Smith’s Journey Forward

2 How to Find Your Flow in 2021 2 Tips for Caring for Residual Limbs in the Winter 3 Interesting Trivia About Prosthetics and Amputations 3 Slow Cooker Chicken Casserole

4 Give Yourself the Boost of Getting Outside


2. Use mornings effectively. Waking up and getting the day started can be hard. But studies have shown that natural light helps decrease your melatonin production, which means you feel ready to face the day sooner. So, set yourself a second alarm to head outside and take a quick walk around the block just after waking. Don’t even wash your face or grab coffee. Just get out there. 3. Take your work outside. If you’re working from home, take some work outdoors. Phone and virtual meetings are a great outdoor option, especially if you’ll just be an active listener and aren’t required to do any work simultaneously. Attach a note to your meeting reminders to get yourself set up outside five minutes before you start. 4. Create a schedule. It might feel strange to set reminders throughout the day to step outside, but you easily get wrapped up in activities and overlook breaks, and these reminders are exactly what you need. Start with 10-minute blocks three times a day. If you stick to them, soon you won’t need a schedule to get outside anymore. Winter weather may be cold, but even when you’re bundled up under a jacket and scarf, just 5–10 minutes outside can do wonders for your mood and energy for hours.

Hunkering down and waiting for the dark and chilly winter season to pass sounds pretty nice. But the reality is, if we deprive ourselves of time outside, we do ourselves a big disservice both mentally and physically. Staying indoors all day affects your energy

and mood, which makes it hard to get anything done, so here are four easy tips to make it easier to get a little

fresh air.

1. Make it a priority. Getting outside means making the conscious effort to do so. If you want to reap its benefits, you have to decide to make it a priority in your day-to-day schedule. If you make the act important to you, you have more motivation to actually do it.


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