While visiting family in Lismore, I recorded a series of conversations exploring the personal and clinical sides of limb loss.
For this conversation, we gathered down the road at the office of SPAO (formerly Northern Prosthetics) in Ballina to sit down with prosthetist and orthotist Lauren Ljiljak. Lauren holds a Bachelor of Prosthetics and Orthotics from La Trobe University and a Master of Public Health, bringing extensive expertise in both paediatric and adult orthotic management, tertiary teaching, and regional healthcare advocacy.
Lauren and I, along with Bob, a recent amputee from nearby Casino, sat down for a memorable interview which will feature in a future episode of The Limb Shift.
At its core, a prosthetist’s work balances precise physical technicalities with deep interpersonal understanding. Creating a functional prosthesis demands technical craftsmanship, but the success of the device depends heavily on client trust and communication. As Lauren explains, the clinical role involves a rich blend of practical skill and individual connection:
“It’s part art, part science. It’s a really interesting blend because you have engineering principles and biomechanics principles, and then you’got all the physiology and anatomy.
The partnership between clinician and patient often begins during a deeply vulnerable period following surgery.
After enduring five years of agonizing, open leg ulcers and multiple hospitalizations, Bob made the difficult personal choice to amputate:
“The pain and the constant lack of healing. And then I talked it over with him (his doctor) and the plans were made… I couldn’t live in and out of hospital. I couldn’t live with the pain.”
When Bob was transferred to rehabilitation in Ballina, the regional team acted swiftly to start his fitting process.
Lauren recalls their initial meeting and how Bob’s preparation allowed them to move forward immediately:
“Looking at Bob, we could tell he was very motivated, with a really pleasant disposition, very amicable… and I think the fact that he’d had a bit of a delay meant his stump was actually ready… for Bob, we could really just say you’re healed. You’re ready. Let’s go. So we were able to take a cast the first day that we met.”
Bob says he was amazed by how quickly the team converted measurements into a functional check socket:
“I met Lauren there then, and Lauren took all my measurements and I, it was all happening so quickly and, uh, but Lauren knew what she was doing. She turned up with the goods… I had something to use… check sockets… and it was so quick. It was extraordinary.”
A major component of managing this clinical relationship involves guiding patient expectations and tailoring equipment to individual needs. In regional areas, environmental factors play a massive role in prescribing the right components:
“In this area, it’s a very humid environment. It’s very coastal. There is a lot of salt in the air. So we have to be really aware of things like corrosion, and water, with sweat and heat… When I met Bob, I was thinking about his skin, the cause of his amputation, what’s going to be a good fit to keep his skin safe and him on his leg for the longest amount of time.”
For Bob, the chosen pin-lock silicone suspension system offered immediate security and confidence, as Lauren explained:
“A lot of people up here choose a pin lock system because there’s less material around their leg, less heat, less sweating. And it’s a really direct system for suspension. You know, if you’re clicked in, you know, you’re in… it’s a really good way to get people from the very beginning. You’re learning and they feel pretty safe on a system like that, which is really important.”
Bob likes the “invisibility” of it all.
“I walk around and unless I’ve got my trouser leg pulled up, most people are not even aware that I’ve had a problem, that I’ve got a prosthetic and I wear it all day…”
The ongoing bond requires continuous maintenance as the body adapts over time. Lauren notes that the first year involves major physical changes that necessitate regular clinical oversight:
“The first twelve months is the biggest adjustment period, both psychologically, practically and physically. The stump itself changes a lot. There’s a lot of muscle atrophy that occurs in the first year to two years because your body’s not using that muscle tissue anymore… you end up shrinking down.”
Ultimately, a successful rehabilitation outcome relies on mutual trust, active participation, and positive client attitude.
Bob advises others facing similar life changes to maintain perspective and rely on their clinical team:
“It’s the attitude… if you’ve got a good attitude like, I can do this, this is okay. It’s not the end of the world. I’m alive and I’m happy to be alive. Let’s get on with it. And, and just allow people like Lauren to direct you… don’t brood about the situation, but try and look ahead because it does get better. Absolutely gets better.”
Lauren echoes this, emphasizing that the quiet, everyday triumphs shared between clinician and patient are what make the lifelong relationship so rewarding:
“I think setting realistic expectations is one of the, the big, important things… I think what Bob has done, where he’s really reached out to other people and been of service and supported has made a huge difference in his experience… that same moment that he gets to stand up for the first time is one of the highlights of our day, of our week, of our year, because it’s such a special moment.”
