Prosthetics //

Journey of an Amputee

Real Life Prosthetics - Journey of an Amputee

 

Please note that this information is generalized, based on optimum healing conditions, prompt responses from insurance companies and other medical providers, etc.  Every situation is unique and has their own highs and lows. 

PRE-PROSTHETIC CONSULTATION (ASAP)

You should contact a Prosthetist as soon as possible when amputation surgery is inevitable.  Make sure to choose wisely when determining YOUR Prosthetist as this relationship should be lifelong.

Questions that you can ask when interviewing Prosthetists:

  • Where did you receive your degree in Prosthetics & Orthotics?

  • Where did you complete your residency?

  • When did you receive certification/licensure?

  • What do you consider your areas of specialization

  • Where will my device be fabricated?  Onsite by your company's certified technicians or central fabrication off-site?

PHYSICAL THERAPY

PRE-PROSTHETIC REHABILITATION (ASAP)

Pre-operative rehabilitation (also called 'pre-rehabilitation') is an increasingly common strategy used in multiple patient populations to improve patients' physical and mental condition prior to surgery, thus aiming at improving the post-operative patient outcomes.

With physical therapy for above-the-knee amputation and limb-loss patients, your physical therapist helps prevent contractures and improve range of motion. Physical therapy for bilateral amputee and limb-loss patients helps overcome residual limb challenges and develop muscular strength for transfer and motion.

 

You should contact a physical therapist as soon as possible when amputation surgery is inevitable.  Make sure to choose wisely when determining YOUR physical therapists as this relationship will help or hinder your transition back into your community as an amputee.

Questions that you can ask when interviewing physical therapists:

  • Where did you receive your degree in physical therapy?

  • Where did you rotate clinically as a physical therapy student?

  • When did you receive licensure?

  • What do you consider your areas of specialization?

  • What is your typical protocol for pre and post-prosthetic rehabilitation?

  • Do you work closely with any particular Prosthetist or prosthetic company?

AMPUTATION AND HEALING

4 - 6 WEEKS

What to expect during your hospital stay when you come home.

  • Keep your limb protected and covered while healing (staples/sutures in place)

  • Keep your limb very clean while healing

  • Keep your knee straight while healing (below-the-knee amputation) or keep your hip stretched out while healing (above-the-knee amputation)

  • Ask your Prosthetist about protective devices (removable rigid dressings, post-op devices, etc.)

  • Continuing exercises learned in the hospital

  • Moving safely at all times to prevent falls

  • Keeping all follow-up appointments.

WHILE GOING TO PHYSICAL THERAPY...

Work with your physical therapist on desensitization techniques as hypersensitivity is normal.  In addition, also work with your physical therapist on phantom limb sensation/phantom limb pain reduction as this occurs with most amputees.

 

Also happening in during the healing process...

COMPRESSION THERAPY (2 - 3 WEEKS)

After healing specifically when sutures have been removed.  Talk with your Prosthetist about using shrinker socks for compression therapy when sutures/staples have been removed.

 

WHILE GOING TO PHYSICAL THERAPY...

Talk to your inpatient physical therapist about using ace bandage for compression therapy while sutures/staples are still in your residual limb.

PREPARATORY PROSTHESIS

3 - 5 MONTHS

Your preparatory prosthesis is most likely the first device that you will receive.  The prosthesis has three main components (socket, pylon and foot).  This device has no foam covering or skin covering because it is designed for short-term use and your Prosthetist needs access to components for quick alignment changes.

The goal with using this device is to shape your residual limb as it shrinks, improve your balance (double limb support), mobility skills, and cardiovascular efficiency in preparation for your definitive prosthesis.  This prosthesis is typically used for 3 - 5 months as your residual limb shrinks in size.

DEFINITIVE PROSTHESIS

5+ MONTHS

Your definitive prosthesis is the device you receive after preparatory training.  This prosthesis generally has up to five main components (socket, pylon, foot, foam covering and skin covering).  This device does not require as much adjustment so the foam cover can be installed to restore leg symmetry and a skin covering installed to protect foam from mositure, mold and mildew.

The goal with using this device is to continue shapingyour residual limb as it shrinks, continue improving your balance (double limb support), mobility skills, and cardiovascular efficientcy with advanced gait training.  This prosthesis is provided at the 4 - 6 months mark as your residual limb matures.

One or two replacement sockets may be required within the first 24-months of being an amputee to track anatomical change.  Your socket fit may become dangerous when using 10+ sock ply; excessive pistoning can result in skin trauma and breakdown.

Your Prosthetist should follow up with you routinely and determine when a new socket or prosthesis is required.

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RESIDUAL LIMB SIZE STABILIZATION

24 MONTHS

Your residual limb should reach a point where it does not constantly change size on a daily basis.  Life gets much better at this point, when you don't have to constantly contend with various sock ply combinations to achieve a comfortable fit.  You should also reach a point where you follow-up with your Prosthetist every 6-months to make ensure that your prosthesis continues fitting/functioning optimally.

 

SIGNS OF DEPRESSION

Clinical depression is common in people with amputation and it is very treatable.  It is important to watch for such problems as:

  • Ongoing sadness, irritability, fear or nervousness

  • Difficulty in sleeping

  • Loss of appetite

  • Loss of interest in life

  • Ongoing preoccupation with the cause amputation

  • Withdrawal and isolation

  • Use of alcohol or drugs to escape or manage your feelings

  • Difficulty following therapy recommendations.

If you notice that any of these feelings persist, talk with your physician; they should be happy to arrange a mental health consultation.

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PHANTOM LIMB SENSATION

When people have an amputation,they usually have feelings in the limb that is missing.  There may be tingling, a prickly sensation or a numb feeling.  The missing limb may feel hot or cold.  It may feel as if the toes or fingers are moving, that the limb is in a funny position or there may just be a feeling that the limb is still there.  These feelings are called "phantom limb sensations."  The sensations are very real; "phantom" refers to the fact that the limb is missing.  The important thing to know is that phantom limb sensations re perfectly normal and almost all people with amputations experience them to some degree.

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SKIN PROBLEMS

Skin problems are fairly common on the residual limbs of amputees.  They may develop for a variety of reasons, including poor socket fit, incorrect alignment of the prosthesis, poor skin care or allergic reactions.  Skim problems in the amputee often take on one of the following forms:

  • rashes,

  • blisters

  • ulcers

  • verrucous hyperplasia

  • epidermoid cysts or infections

Controlling order when you wear a prosthesis, your leg will be enclosed much like your foot used to be.  If you develop an unpleasant order on your residual limb, much like that of a sock or shoe, you should not be alarmed.  The bet way to control the small is to take good care of your skin and to keep your socket clean.  If excessive perspiration is a problem, you can use a spray-on antiperspirant that does not contain a deodorant (deodorants can cause rashes in a prosthesis).  If needed, a very strong antiperspirant can be prescribed by your doctor.

 

PHYSICAL THERAPY

​Your physical therapist is another very imporant member of your rehabilitation team.  They will help you learn how to use your prosthesis.  Therapy may occure in an outpatient setting or in the home.  Physical therapy in an outpatient clinic is recommended.  This is because there is more equipment available to use, your therapist has additional help if needed, and therapists generally have more time to give to their patients in a clinic.

Physical Therapy Goals

  • learning to put on your prosthesis correctly

  • transferring in and out of wheelchair

  • transferring on and off of a toilet

  • transferring in and out of a bathrup

  • walking with a prosthesis

  • walking up and down a ramp

  • stepping over curbs

  • walking up and down stairs

  • getting off the floor.

Your therapy does not need to be limited to these basic skills.  You should strive to return to as active a lifestyle as you had before your amputation.  Once you have mastered the basics, discuss resuming more challenging activities with your rehabilitation team.

 

Support Groups

Amputee Coalition In 1986, a small group of amputee support group leaders recognized the need for an organization dedicated to the needs of people with limb loss, their families and healthcare providers. Working entirely as volunteers, they laid the foundation for what the Amputee Coalition is today, the leading national non-profit organization that empowers individuals with limb loss through education, support and advocacy.

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