1. What is a Prosthesis?
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.
2. How do I get a Prosthesis?
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.
3. What if the prosthesis doesn’t fit right?
Follow-up is as important as the initial fitting. You will need to make several visits for adjustments with the prosthetist as well as training with a therapist. They can help you ease pressure areas, adjust alignment, work out any problems, and regain the skills you need to adapt to life after limb loss. Tell your prosthetist if the prosthesis is uncomfortable, too loose or too tight, or causing any skin issues such as blisters. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you communicate with your prosthetist and therapist, the better you will be able to succeed with a prosthesis.
4. How much does an artificial leg weigh?
The weight of your artificial limb will depend on the type of limb and the components, but on average a below knee prosthetic weighs 4 lbs and an above knee prosthetic weighs 8 lbs. A natural leg is approximately 1/6 of your bodyweight.
5. How long will it last?
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 years.
6. What is phantom pain?
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 prosthetist about the different options for helping to reduce the pain which may include a special sock made with a metallic material, massage, mirror therapy or medications.
7. Can my prosthesis get wet?
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.
8. How do I determine the amount of prosthetic socks I should wear?
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 ½ 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.
Sheaths are also available for the prosthetic wearer. They are used to reduce friction caused by excessive rubbing and help wick away perspiration.
9. Can I expect to drive as before or will I need special equipment?
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.
10. Can I speak to someone in my situation? Can you recommend a support group for me?
Yes, definitely. We often arrange for new amputees to speak with others who have been though a similar process. We can direct you to support groups in your area and also to organizations such as the ACA (Amputee Coalition of America).