Q&A with Shea Stokesbary, CPO
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Shea Stokesbary is a certified orthotist prosthetist who specializes in pediatric orthotics among other things at the Boston O&P clinic in Richmond, VA. In this Q&A, Shea shares how she got into the field, her love for mixing biomechanics, art, and patient care and how she continues to grow her expertise.
How did you become interested in the field of orthotics and prosthetics?
I originally thought I wanted to be a physical therapist. While shadowing in pediatric physical therapy, I saw a kiddo that had a Van Nes rotationplasty procedure and thought it was very interesting. After researching the field of orthotics and prosthetics, I found Austin Prosthetics Center and started shadowing there post undergrad. They taught me how to make my own foot orthotics, use the Trautman machine and pull check sockets. I fell in love with the mix of biomechanics, art, and patient care, as I watched patient castings and dynamic alignment of prosthetics.
What are your specialties, and why were you drawn to those particular areas?
I feel like I am still too young in the field to claim a true specialty. I enjoy treating patients with scoliosis as well as patients with conditions requiring lower limb orthotics. I'm also trying to expand my experience with the prosthetic user population and help build Boston O&P’s program here in Richmond. I'm drawn to understanding biomechanics and how the devices we fit work together with each patient’s unique biomechanics. I'm also drawn to problem solving. I have learned working in pediatrics that sometimes biomechanics of gait or anatomical presentation do not fit the ‘standard’ presentation and can make fitting challenging. I enjoy problem solving the nuances of adjustments or even brace design to reach an optimal outcome for the patient.
You like to explain the function of the device to your patients during evaluation and fitting. How does this help the process?
I believe explaining the function of the devices, including the casting method, helps improve patients' and families' knowledge in their care. It helps provide reasoning as to why a specific style of device is being used over another one. I think it also helps instill confidence for my patients and their families that I am putting thought and consideration into what the treatment plan is for them.
What is your personal philosophy of care?
My personal philosophy of care is to always do my best and to include my patients in their care plan. I try to consider if it were me wearing the brace would I find it acceptable to wear.
How does Boston O&P’s philosophy of care compare with your own?
I think sharing knowledge, whether it's with patients or coworkers, is important for growth. We have a big network of practitioners with vast knowledge who are available and willing to share their experience with you. Boston O&P has put programs in place, such as mentors and research studies, to help foster growth and education for practitioners in the field.
What has been your most rewarding experience working in your field and at Boston O&P?
My most rewarding experience in the field was while volunteering in Cambodia. I made a new prosthetic leg for a lady who had not had a new prosthesis in 24 years. The rubber foot she had when she walked into the clinic was held together with electrical tape. Her new prosthesis included a polypropylene socket, polypropylene pylon, and a new rubber foot fabricated in the O&P clinic. She was beyond thankful and excited about her new leg, which is incomparable to what a new prosthetic leg in the U.S. would be, and I was beyond humbled.
Also rewarding at Boston O&P is a combination of experiences with families and their children. Each child is unique in their own way, which brings its own set of joys and challenges in providing the best care possible for them.
What do you see as the most exciting advancement in scoliosis treatment?
As Boston O&P continues to focus on clinical outcomes of bracing treatment, I think it will shift the current standards of scoliosis treatment towards improved outcomes. This will drive how we, as a multidisciplinary team, approach the treatment of scoliosis in the future.
What do you think makes Boston O&P’s treatment of scoliosis different than other approaches, including the types of braces they manufacture, how fitting is done, and the quality and type of care provided by Boston O&P clinics and clinicians?
Boston O&P’s treatment of scoliosis is very technical and precise. Having worked at a different practice and seen TLSO (thoracic lumbar sacral orthosis) braces made by other companies, the Boston TLSOs are truly custom braces that strive for an intimate fit with calculated correction. Boston braces are a low profile fit and I have been told by patients that it is more comfortable than other braces they have worn, which helps increase compliance.
What is the most remarkable outcome you’ve experienced for an orthotics or prosthetics patient being treated by Boston O&P?
The most exciting outcome I've had at Boston O&P was with a scoliosis patient. Initially, she did not have optimal correction in her first TLSO brace. I worked with a colleague on adjustments to the brace, with marginal improvement. The mother was concerned after the 1 year out of brace X-ray. The orthopedic doctor requested a new anterior opening TLSO. I reached out to the doctor suggesting we try posterior opening, confident we would get better results, she gave the OK. The next in-brace X-ray showed phenomenal correction. Not everything works the same for every patient. This is just one example of how working as a team we can achieve better results for patients.
What experiences have done the most to expand your skillset and improve your ability to treat your patients?
Volunteering has had a huge impact on how I view my job and allowed me to grow as a practitioner.
I think working with Ksenia Major and the scoliosis mentor/mentee program allowed me to build confidence and competence in treating lower limb orthotics and scoliosis patients. Growth in education and understanding is challenged here. As well as the ability to discuss clinical findings with someone more experienced helps reduce a lot of trial and error, as well as learn from their years of experience.