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Certified prosthetist orthotists (CPOs) are specialists in the design and fitting of prosthetic and orthotic devices. They customize devices specific to a patient¡¯²õ needs and goals ¡ª  whether it¡¯²õ providing an orthosis (brace) to help a patient with alignment or support of a weak part of their body or designing a prosthetic limb for a patient who has experienced lower- or upper-limb amputation.

Follow along for a day in the life of Jessica Smit, a CPO at Shirley Ryan С¶÷ÑÅ. She has a range of clinical interests in prosthetics, from working with pediatric patients to helping patients get back to sports.

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The alarm goes off, and I get ready for the day. I bike to work ¡­ rain or shine!

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I start work by checking my messages and completing any new administrative to-dos.

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My first patient arrives for an adjustment to her prosthesis. I take the prosthesis to our lab where I thin out an area of the socket that is irritating her. I make pads to offload the bony prominence ¡ª an area of the bone close to the skin¡¯²õ surface ¡ª that has been causing her some pain as she is walking more. She tries walking with the new adjustments and feels much better!

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Then, I cover Dr. Mark Huang¡¯²õ clinic for patients with limb loss. Today, one patient gets cleared to start the prosthetic-fitting process, another receives an order for physical therapy and another requires a socket replacement due to limb atrophy.

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My next appointment is a diagnostic fitting for a test socket. This patient is a new prosthesis user, so I educate him on how to put on the prosthesis. The patient is able to stand and start walking in the parallel bars. While he walks, I make adjustments to the alignment of the prosthesis to help achieve smooth gait mechanics. This is the first time he has walked since his amputation! I usually find that my patients are very excited for their first walking appointments. They say they feel like they are finally getting part of their lives back that they lost due to amputation.

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I enjoy a break for lunch in the staff breakroom and socialize with my coworkers.

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My next patient appointment is a delivery of a new transtibial prosthesis, also known as a below-the-knee prosthesis. These appointments are among my favorites because patients finally get to bring their prostheses home and start using them in their daily lives.

At this appointment, the patient required a few adjustments to the socket to get him fully comfortable, so I had to grind some of the carbon fiber away. This involves putting on a lab coat, arm sleeves, gloves, goggles and a respirator to protect myself from the itchy carbon fiber particles that I am grinding off the socket.

Once he is comfortable walking in the hallway, I go over ¡°use and care¡± education with the patient, and Shirley Ryan С¶÷ÑÅ releases another prosthesis into the world that gives the gift of mobility!

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My next patient is an initial evaluation and casting appointment for a new transfemoral prosthesis, also referred to as an above-the-knee prosthesis. This appointment involves a lot of education and expectation-setting as I discuss the process to get a prosthesis. I do an in-depth interview about the patient¡¯²õ living conditions, activities and goals, as well as a physical evaluation to determine the best prosthesis. I then prep the room to take a cast of the residual limb while the patient stands in the parallel bars. This process can get very messy as we use plaster to wrap about the leg.

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After my last patient leaves, I spend time doing lab work. This includes putting a prosthesis together with all the appropriate components so it will be ready for a fitting appointment tomorrow. I also have to work in the plaster room to modify a mold of a transradial (below-elbow) amputation I took the day before; it needs to be fabricated by one of our technicians. I discuss with the technician what technique we want to try for this patient¡¯²õ next test socket. Our technician team here is super-creative, and it is fun to try new things like custom-rolled silicone and 3D printing.

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I use my last hour at work to finish up notes from today¡¯²õ appointments. I also check on insurance authorization status for all my patients and begin putting the next steps in motion. This includes ordering new prosthetic parts and scheduling patients. I try to end my day by making notes about what I need to complete tomorrow, and I make sure I have everything prepped for the rest of the week¡¯²õ scheduled appointments.

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I log off for the day and jump back on my bike to head home.