How do I care for my residual limb?
Always take care of your limb. Make sure you wash your residual limb at least once per day with
anti-bacterial soap (the soap should be unscented and unpigmented).
If you sweat excessively, or are prone to rashes or infections, wash more frequently. Never use spirit or talc on your residual limb as this will act as an irritant when you wear your limb. A small amount of baby oil, on the other hand, maintains moist, soft skin.
Whichever part of the prosthesis is in contact with your skin – the inner socket or liner – should also be washed with hot water and antibacterial soap on a daily basis.
How do I care for liners?
If you wear liners, it is imperative to always have a pair for each residual limb. You must alternate the liners every day to permit them to maintain their elasticity and shape, and to ensure that they dry out completely before you put them back on. Liners should be cleaned with the side that touches your skin turned IN, using the following process:
a) Wash the liners with hot water and antibacterial soap, shaking the water-soap mixture inside the liner for 30 seconds.
b) Dump the mixture out of the liner and rinse again with hot water until no soap remains (at least three times).
c) While the liner is still wet, add 4 drops of baby oil to the inside and rub it around thoroughly.
d) Allow the liner to air dry. Putting the liner in the dryer will damage it. Washing the liner also prevents bacteria causing milia. These are tiny spots of hardened material that can become painful and infected.
Once a week, after rinsing the liner but before adding the baby oil, apply isopropyl rubbing alcohol to the inside of the liner and rinse with hot water. Sticking to a daily cleaning routine and overall good hygiene is vital.
If you are a below-knee amputee, carefully monitor your sock ply throughout the day and adjust it whenever necessary. If you begin to experience pressure and pain in a particular area, make sure to make any adjustments you can (e.g., adding or removing socks), and if that does not help, contact Precision Prosthetics & Orthotics for a prosthesis adjustment.
How to maintain the benefits of my well-fitting prosthesis?
The best way to prevent your fit from worsening is to maintain your body weight. Stability of body weight is the number one key to avoiding fit issues. The following are guidelines for weight fluctuations and how they will affect your socket fit:
3-5 lbs. – noticeable difference that may require minor socket adjustments
5-10 lbs. – requires major socket adjustments
10-15 lbs. – may require complete reevaluation of socket and residual limb and probable casting for new socket
15-20 lbs. – may need new entire new prosthesis and re-categorization of prosthetic components
Similarly, the wrong prosthetic alignment can cause pressure, swelling, and breakdown. Make sure to wear the correct heel – both in terms of its hardness/softness and its height – for your prosthetic foot. Discuss heel height issues with your prosthetist.
If you like to change your heel height, your prosthetist can create a leg with an adjustable ankle. Keep your residual limb dry. If you sweat a great deal, take your limb and liner off several times a day and dry it with a clean towel. Do not use an antiperspirant unless it is one of the brands suggested by your prosthetist. If you suffer from decreased sensation in your residual limb, make sure to remove your prosthesis several times a day to check for signs of abnormal pressure areas. Otherwise, you can experience significant breakdown before you are even aware there’s a problem.
When should I add socks?
Socks are needed when your limb changes volume. Here are some signs that indicated socks are needed:
- Socket feels loose
- Pain on bottom of limb
- Socket spins when walking
How should I treat skin problems when they do occur?
If you develop a mild rash, use an over-the-counter steroid cream. Also, make sure that your socket or liners are completely rinsed free of soap after washing. Keep your residual limb dry. Seek medical advice if these steps do not work.
If you experience an itchy, burning rash akin to athlete’s foot, use a topical anti-fungal cream and make sure your residual limb is dry. Seek medical advice if this treatment does not work.
This is a condition caused by poor socket fit and is haracterized by the development of a wart-like skin growth at the far (distal) end of the residual limb. If untreated, it can lead to an infection that could require revision surgery. Seek immediate prosthetic treatment to remedy the fit issue and seek medical advice to treat your skin.
Use ichthymal, a drawing salve. Never shave or use depilatory on your residual limb.
If you experience any of the following symptoms, emergency attention is required to prevent the infection from becoming life-threatening:
- Your residual limb feels cold, turns blue, or you develop persistent pain deep in the muscles. These signs may indicate that your circulation has become impaired.
- An area of your residual limb emits a bad smell.
- The glands in your groin or armpits swell or become painful.
- Pus/thick discharge seeps from any area of your residual limb.
- An ulcer develops anywhere on your residual limb.
- Skin becomes black/gangrenous.
What if I find it difficult to use a prosthesis?
On some days, you may have a great deal of difficulty donning (putting on) your prosthesis. Wearing a shrinker or a bandage while you sleep and up until you put on your prosthesis in the morning can help prevent swelling overnight. If you are a new amputee, you should wear a shrinker and/or bandage whenever the prosthesis is off. Wearing shrinkers itionally helps shape the leg and prevents “dog-ears” or other shape irregularities that can complicate your fit in the socket.
Another potential cause of difficulty putting the prosthesis on is hot and humid weather. These conditions can cause your residual limb to swell and sweat, making it difficult to don the prosthesis. If this is the case, try (if possible) to get into an air-conditioned room or vehicle. After five to ten minutes, attempt to don the prosthesis again. If you are not diabetic and do not have a circulatory condition, you can also try applying a bag of ice over your residual limb, but make sure that you place a towel between the ice-filled bag and your skin. After 5 minutes, remove the ice and try to don your prosthesis again.
What does it mean if your prosthesis keeps slipping off when you walk?
If your prosthesis has an air valve, one possible explanation is that you have a leaky valve that is letting air into the socket, breaking the vacuum required to keep the prosthesis on. Another possibility is that the prosthesis was not fully on to start with. Finally, the socket may have become too loose. If you continue to have this problem after donning the prosthesis and verifying that it is on your body correctly, you should call the prosthetist and expect to make a visit to solve the problem.
What are K-Levels?
K-levels are a rating system used by Medicare and other insurance companies to indicate a person’s rehabilitation potential. The system is a rating from 0 through 4 and it indicates a person’s potential to use a prosthetic device. Your K-level designation is important because it is the driving factor in the decision on what prosthetic device to provide to you and the payment for that prosthetic device. Below are Medicare descriptions of the five (0-4) K-Levels
Does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.
Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. Typical of the limited and unlimited household ambulator.
Has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulator.
Has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
Has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. Typical of the prosthetic demands of the child, active adult, or athlete.
How often should I come for a regular maintenace?
Even when you are not confronted with an emergency, regular care and treatment is necessary to achieve a successful outcome. Follow-up allows us to make sure that your prosthetic components are functioning properly and are not showing excessive wear, that all attachment points are secure, and that your socket fits comfortably. Failing to come in for this regular treatment can lead to more serious health problems, and we strongly advise all clients to stop by at the recommended intervals for their own benefit.
What is an orthosis? What is a prosthesis?
An orthosis (plural is orthoses) acts to control weakened or deformed regions of the body of a physically challenged person. Orthoses may be used on various areas of the body including the upper and lower limbs, cranium, or spine. A prosthesis (plural is prostheses) is an artificial limb that replaces a missing extremity: leg, foot, toes, arm, hand or fingers.
Why do people have amputations?
Amputations may be the result of diabetes, bacterial infections, circulatory diseases, trauma and accidents. Some people may be born with congenital birth defects which leave them with non-functioning limbs that may become more useful once removed and replaced with prostheses.
I am facing an amputation. What should I do first?
Information is extremely important for new amputees. Many people do not know what to expect or what to do before or after having an amputation. We have found an informed patient has a much easier time adjusting and their recovery is smoother.
For these reasons, we believe pre-prosthetic care should begin prior to amputation whenever possible. It is important to discuss the ideal amputation level, both medical and prosthetic, with your doctor. The sooner we get involved, the sooner we can fit you with your prosthesis. We are happy to discuss, in detail, the process of prosthetic rehabilitation.
How soon after my amputation will I be able to get a prosthesis and start walking?
While it differs depending on how quickly you heal, a healthy person with good circulation and no post-operative complications might be ready to use a temporary prosthesis as soon as 2 to 3 weeks after surgery. If possible, it is always beneficial to consult with a Prosthetist prior to amputation.
Will my prosthesis let me do everything I could do before my amputation?
A well fitting prosthesis will allow you to regain much of the function you have lost. There are limitations depending on the type of prosthesis, your health and abilities. Your prosthetist, physical therapist, and doctor, will work with you to ensure you get the most from your prosthesis.
Is there anything I can do to speed up the rehabilitation process post-amputation?
We recommend wrapping your residual limb at all times and keeping it elevated whenever possible to reduce the edema (swelling).
When do I need a prescription?
A prescription is not required for consultation or initial evaluation. However, a prescription is required in order for us to provide a device to a patient. We will be happy to assist patients in this process. If requested, we will give a written plan outlining our course of treatment free of charge.
How do I get a prosthesis?
With a prescription from your doctor, we will make the necessary measurements of your residual limb. We will discuss various types of prostheses with you, including your lifestyle, then design the best device for your needs. We will custom fit it, make it, instruct you on the use and care of it and also make any needed repairs and adjustments. Making the prosthesis takes on average 3-4 weeks.
Do I need any help in learning to wear the prosthesis?
We can help you find other health professionals such a physical or occupational therapists for additional instruction and training on using your prosthesis as well as necessary strengthening programs. We can also get you products needed to wear and care for your prosthesis, including socks and liners.
How will my prosthesis stay on?
There are many different suspension methods - you should discuss the best for your needs with your Prosthetist. Some limbs are suspended using suction, some using vacuum-assisted socket design, some using pin liners, etc. Feel free to contact us for additional information regarding the different socket designs.
Will it hurt to walk on a prosthetic leg?
Once your residual limb, your stump, has healed and swelling has gone down and it is wrapped properly, you should be able to use your prosthetic leg with little to no pain. You may feel some pressure but pain should be minimal. Your prosthetist will give you a specific schedule for using your new prosthesis which will allow the residual limb to gradually adjust. If you do feel pain while wearing your prosthetic leg, you should let your prosthetist know right away.
What is phantom pain?
Phantom pain describes the sensations felt by amputees which may include itching, pins and needle feelings, stabbing pains, pressure, tingling, cramping, a sense of swelling – all in the area of the missing limb. Most amputees experience these sensations althouigh the degree to which they are felt will vary. The sensations come and go. They may occur several times a day, for a few hours at a time. After time passes after the amputation, they will become less frequent and intense and short lasting. Your prosthetist will discuss options for helping reduce the pain.
How do I decide which foot is for me the most suitable?
Feet are recommended based on multiple factors that are specific to the patient. Considerations include activities the patient does on a daily basis, recreational activities, work environment and home environment. Each foot is then specifically categorized based on the weight of the patient and the amount of forces that will be put through the foot according to the above listed factors.
How heavy is a prosthetic leg?
The weight of the prosthetic depends on the type and the components. The average weight of a typical below the knee prosthetic is about 4 lbs. The average weight of an above the knee prosthetic is about 8 lbs. Your natural leg is usually about 1/6 of your bodyweight.
Can I drive with a right leg prosthesis?
Some below-the-knee right leg amputees can drive effectively with their prosthetic; others may find a left-foot gas pedal installation better suited for their needs. Other amputees might find hand controls a better option.
Can I get my prosthesis wet?
It depends on the type of prosthesis. We can create water legs that are completely submersible in water. Some microprocessor knee units are waterproof, although many are not.
What is the average cost of a prosthesis?
All prostheses made Precision Prosthetics & Orthotics are customized for each individual patient based on anatomy, needs, functional lifestyle, and cosmetic preferences. In order to provide you with an accurate cost estimate, please contact our office so that we can set up an in-person or phone consultation.
How much will my insurance cover for a prosthesis?
Every insurance policy is different. Our staff will work with you to ensure that you are informed of all of the details of your prosthetic coverage.
How long does a prosthethic leg last?
This depends on changes in the residual limb size, activity levels, body weight/height and general wear and tear on the components. In early stages, residual limbs frequently change size and shape, most often within the first 6 months after amputation. This may require socket changes or adjustments. We recommend an evaluation at least every 6 months by a certified prosthetist. Early detection of a problem can prevent major problems.
How often can I return for adjustments?
There is no limit to the number of visits a patient can request. We are here to help.