HERRIN - Tim Cheatham understands the pain and frustration of amputation. As an 18-year-old, he was on the wrong end of a hunting mishap that cost him his left leg below the knee. So he speaks from experience when he greets patients at Hanger Prosthetics and Orthotics at Logan Primary Park in Herrin.

Today, Cheatham, now in his early thirties, is an experienced pedorthotist whose mission is to help improve the quality of life for his patients.

At Hanger, Cheatham and Darla Cislaghi, practice manager, who is certified in prosthetics and orthotics, use new technologies to evaluate the needs of their patients and custom fit them for an artificial limb or orthotic device.

One of those new technologies is laser scanning. Hanger is the only prosthetic and orthotic company in the region to have access to the scanner.

Known as the Insignia, the scanner is an alternative to traditional casting methods of prosthetics and orthotics. The machine employs a three-dimensional motion-tracking laser scanner and proprietary Computer-Aided Design software to provide patients with a faster, cleaner and less invasive casting experience.

Cislaghi explained that the most common prosthetics are transtibial or those below the knee. Many are the result of diabetes. The less common prosthetic is the upper extremity. The far more expensive replacements are transfemoral or above-knee prosthetics.

"The transfemoral replacements can run anywhere from $8,000 to $50,000 depending upon the amount of computer components that are used," Cislaghi said. "The good news is that most are now covered by insurance with a letter of medical necessity and a physician's prescription."

Cislaghi said perhaps the patient's biggest fear with the acquisition of a new limb is falling.

"If you trip, many of these new prosthetics are designed to ease you down, giving you a chance to catch yourself," she said. "Patients can now walk down steps foot-over-foot with more of a natural gait. And the new prosthesis will analyze your gait up to 50 times per second."

Cislaghi, who earned her bachelor's degree in industrial design from the University of Illinois and completed a prosthetics certificate program at Northwestern, said all of her work at Hanger is not about manufacturing new limbs.

The company also makes extra-depth diabetic shoes to help prevent ulcers from developing. There are also braces made mostly of plastic for stroke or scoliosis patients, for example.

Amputees, Cislaghi said, have a wide range of capabilities, more so now than ever before. There are literally hundreds of stories of amputees competing once again in athletics, running and bicycling, rock climbing, golfing, even sky diving. Whatever they could do before, they often are able to do again with the aid of the proper prosthesis.

Of course, there are also some patients who are confined to a wheelchair or bed because of their general health.

When building the prosthesis, Cislaghi said she encourages patients to customize the piece They may provide her with a variety of different fabrics to adorn the limb. Hunters may choose camouflage colors. Children may choose cartoon characters or animals.

Cislaghi added that periodic checks are made on the prosthetics to ensure quality results.

"We're going to check for pressure points," she said. "As time passes, the body changes, so sometimes, the prosthetics need to be changed or adjusted."

Cheatham said educating his patients is a must.

"For those with diabetes, for example, they need to know about proper foot care and about getting the pressure on their feet evenly distributed. The idea is to prevent ulcers, which can lead to further medical problems."

Cheatham said the most rewarding aspect of the business for him is watching a child adapt to his new surroundings.

"Some, who may wear braces for various reasons, are able to graduate from a walker to a cane and some are even able to get rid of the cane in time," he said. "The new technologies we have today are really cool. It's much easier to get a good, intimate fit of a prosthesis for our patients."

Cislaghi said it is not only stressful for patients to have to deal with prosthetics, but the work can be equally stressful for her three-member staff, which also includes office administrator Tracey Mofield.

"I love to paint and that helps relieve my stress," Cislaghi said. "I enjoy my work, though. If I didn't, I wouldn't have stayed with the business the last 14 years. The key is to be there for the patient " take the time to explain everything very carefully and with compassion."

john.homan@thesouthern.com

(618) 351-5056