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Q: What is a Prosthesis?
A: A prosthesis is an externally applied device designed to replace a missing part of the body or to make a part of the body work better. Diseased or missing eyes, arms, hands, and legs are commonly replaced by prosthetic devices. Generally, most people view a prosthesis as an artificial limb.
Q: How soon after surgery am I ready to be fit?
A: Your doctor will determine when you are ready to be fit. Our evaluations and consultations are always free of charge and we will consult with your physician regarding your amputation, any medical precautions, and issues that may affect your options or expected outcome. The surgery needs to be well healed and typically a person will receive their prosthesis from 2-3 weeks post surgery. Persons who have other medical complications or problems healing may take longer.
Q: How do I get a Prosthesis?
A: As a new amputee, you will begin the fitting process following a series of rigid casts and application of a compression sock “shrinker” which will help shape your limb in preparation for a prosthetic. This takes an average of 6-8 weeks following surgery. Once your surgeon has given their blessing, we will proceed with making your customized limb. You will then see one of our practitioners, known as prosthetists, who are professionally trained to fit, adjust, recommend and modify a prosthetic device. Several visits to your prosthetist are required and involve casting, measuring, diagnostic fittings and training in how to use and care for your prosthesis. If you are a new prosthetic user, you will visit a physical therapist upon delivery of your prosthesis. The therapist will train you on the functions of the newly acquired device as well as how to obtain good performance and maximum comfort in everyday life while using the device. The time from casting to delivery typically takes 4-5 visits over the course of about a month.
Q: I have been told that I am “difficult to fit”. Can you make a prosthesis that will work for me?
A: Sometimes patients are categorized as “difficult to fit” – this group may include hemi-pelvectomy or hip disarticulation patients as well as those with high-level above the knee or above the elbow amputations. There are numerous unique conditions that may result in the need for unique, individualized prosthetic solutions. One of the things that we do best is working with patients who face these unique challenges. If you are faced with a challenging fit, we want to face it with you. Our experienced practitioners have a solid record of fabricating a comfortable prosthesis for even the most challenging patients.
Q: Do all prostheses look alike? Can I get one that lets me express my individuality?
A: An advantage of our on-site state-of-the-art fabrication lab is the ability to produce a prosthesis that can reflect each patient’s unique personality or interest. Sockets can be fabricated incorporating a wide variety of distinctive designs or logos. If it is printed on fabric, there is a good chance we can incorporate it into your final socket.
Q: How do I determine the amount of prosthetic socks I should wear?
A: Many amputees wear prosthetic socks over their residual limb. These prosthetic socks come in a variety of thicknesses and materials. There are many benefits and uses for these socks. They provide cushion, reduce and absorb friction, protect the skin, absorb perspiration and compensate for shrinkage and/or swelling of the residual limb. As the residual limb matures, it will begin to change size and shape.
To maintain an appropriate fit of the prosthetic, different thicknesses of socks are added to compensate volumetrically for any loss or gain that has occurred. Typically, you need to add a sock after the first hour after donning your prosthetic in the morning due to volume loss of as much as 10%.
A prosthetic sock thickness and weight is represented with the term “Ply”. As you increase in ply, you increase in thickness. Below is a reference guide to sock ply and their thicknesses. 1-Ply (White)- all white sock 3-Ply (Yellow)- all white sock with yellow number 3 5-Ply (Green)- all white sock with green number 5 You will receive several socks with your prosthesis. With this supply of socks, you will be able to better manage your fit.
Every time you put on the prosthesis, it is important that you are aware of how many ply you have on. If the socket is loose and your limb slides in too easily, you need to add a sock; if the socket is feeling tight then reduce your fit by a ply. This process may need to be repeated throughout the day as your limb will change in volume. It is ideal to have the best fit possible with the least amount of socks. For example, it is preferable to have on one 5-ply sock rather than one 3-ply sock with two 1-ply’s.
Understanding prosthetic sock management is key to avoiding skin breakdown and irritation. With the proper fit and follow-up the chances of having a healthier residuum will increase.
Q: Can my prosthesis get wet?
A: We strongly encourage that you keep your prosthesis as dry as possible. Certain componentry will rust and is not meant to get wet. There are, however, covers that go over your prosthesis that help prevent water from entering. We are also able to fabricate a special prosthesis designed for water activities including swimming, fishing and showering.
Q: Can I go back to work with my prosthesis?
A: Depending on your activity, you can go back to work with your prosthesis. If you pursue an activity which is very physically demanding, then you should inform your prosthetist before your prosthesis is made, since the type of loading affects the specification of the socket and the selection of components.
Q: How long will it last?
A: Depending on your age, activity level and growth, the prosthesis can last anywhere from several months to several years. In the early stages after limb loss, many changes occur in the residual limb that can lead to shrinking of the limb. The greatest amount of volume loss occurs within the first six months following amputation. This may require socket changes, the addition of socks, or changes in the alignment and/or replacement of the socket.
Later on, increased activity level and desire for additional function can necessitate a change in the prosthetic or its parts. Once the prosthesis is comfortably adjusted and you are functioning at the desired level of activity, the prosthesis needs only minor repairs or maintenance and can last for an average of three to four years.
Q: Can I expect to drive as before or will I need special equipment?
A: Although a few below knee amputees can effectively drive using their prosthetic, in most cases, an easily operated left-foot gas pedal can be installed. These are inexpensive and fold out of the way for general use. In some cases, hand-controls may be a more realistic option.
Q: Can I speak to someone in my situation? Can you recommend a support group for me?
A: Yes, definitely. We often arrange for new amputees to speak with others who have been though a similar process. Speaking with someone who has been down the same path, can be extremely valuable.
Q: What is phantom pain?
A: Phantom pain is the term used to describe sensations felt by amputees, which may include cramping, tingling, itching, pins-and-needles, stabbing pains, pressure, a sense of fullness (as if the limb was still there, but slightly swollen). The majority of amputees experience these sensations, however the degree to which it is felt will vary. The phantom sensations are intermittent and come and go, unpredictably. New amputees tend to have frequent and intense sensations several times every day, often continuously for a few hours at a time. As the years pass after an amputation, the sensations will generally become less frequent, and less intense, and bouts of pain last for a shorter amount of time. Talk to your physician about the different options for helping to reduce the phantom pain.
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