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ECU alumnus Shane Coltrain, left, measures patient Carrie Allen for a brace at his orthotics and prosthetics practice in Greenville. Coltrain was drawn to the career following his own experience with an above-the-knee amputation in the early 1990s. (Photos by Cliff Hollis)


SPECIAL BONDS
ECU grad uses personal experience to help patients

Oct. 9, 2014

By Steve Tuttle
ECU News Services


Shane Coltrain’s orthotics practice is seeing an increase of a particular type of patient, and he’s not happy about it.

His eight-year-old Greenville company, Orthotics and Prosthetics East, fits individuals who have lost limbs with prosthetic devices. In recent years he says he’s seen an uptick in patients with diabetes who have lost a foot.

“There are many things in life where the health care outcome is unavoidable—accidents, birth defects. But people with diabetes should not have to lose their feet,” he said.
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Coltrain adjusts a prosthetic device that can help his patients regain mobility following an amputation.

He gives those patients special attention. “My diabetic patients, we see every four months” to be sure their prosthetic foot continues to fit and wear well, he said.

Coltrain’s specialty is treating patients who have lost a leg up to and including part of the hip. That’s called a hip disarticulation.

“If there’s a hip disarticulation amputation in this area, typically I see them because I am one. That’s how I am fit.”

That’s one reason why Coltrain and his patients often develop special bonds. He knows what they’re going through.

He was active in sports growing up in Jamesville in Martin County. He especially loved baseball. In 1991 he developed an infection from a cut on his right leg, probably from sliding into second base, he said.

The infection got worse. Eventually the leg had to be amputated above the knee.

That was a personal tragedy, he said, but from it grew a rewarding career.

“I do things differently than most practitioners simply because I know exactly what the patient is experiencing. A lot of the difficult fits in this area are referred to me.”

His career path has been long and winding.

After graduating from high school in 1993, he got a job working for a prosthetics and orthotics firm in New Bern while attending Craven Community College. Four years later he transferred to ECU. He completed a degree in rehabilitation studies in December 2000.

Then he transferred to Northwestern University Medical School in Chicago to study prosthetics and orthotics.

He returned to Greenville two years later and completed a residency at Hanger Prosthetics & Orthotics, a national leader in developing and fitting artificial limbs. He opened his Greenville practice in 2006.

His field is growing and evolving. Practitioners once depended on internships and residences to learn their craft, he says. Recently, a more rigorous academic discipline has emerged.

“There still are maybe just 10 or 12 schools throughout the country that have a prosthetics and orthotics discipline,” he said.

He believes in a team approach that connects his therapy with the patient’s primary care physician and local support groups.

“We fit some of our patients with the C-leg, which has a microprocessor controlled knee. It's a mechanical device so you have to come in and get routine maintenance.
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Scanning equipment gathers information to be used in ensuring the best fit for orthotic or prosthetic devices.

“Plus, as people learn to walk better – if they go from a walker to a crutch to a cane – the alignment of the prosthetic needs to change because their gait changes,” he said.

Coltrain’s practice usually sees 100 or so patients each week.

He said the key to success in his medical field is keeping up with technology and mastering the Medicare system.

“We situated ourselves from the beginning with electronic medical records. It actually made my life easier. We embraced new technology; I have a 3-D scanner here that I use to get the exact shape and dimension of the area above the amputation, because we have to tailor the socket—the part of the device that connects to their body-- to fit them perfectly.

“The reimbursement issues around Medicare have become more complex. They are doing more audits into patient outcomes, which actually was needed but it’s causing a lot of small practices to go out of business,” said Coltrain.

He connects his patients with local support groups and the Amputee Coalition, the nation’s largest organization serving patients with limb loss. He believes in the coalition’s approach to enhancing the quality of life for amputees and their families.

He hopes that technology will soon deliver a mechanical arm as rugged and natural as the C-leg.

“We aren’t there yet because with the hand, you often use that outdoors, in wet weather. And that isn’t a good environment for a complicated device,” he said. “But the Navy has technology where devices like that operate on ships on the ocean, so surely we can adapt that to making a hand that can pick up a cup of coffee and won’t fry if hot coffee spills on it.”