The Rehabilitation Team
It is important to understand the role the rehab team plays in your recovery. The team consists of a physiatrist, your physical therapists, your prosthetist, and yourself and family. Not every amputee has this team of professionals assisting them, but we encourage you to try to establish one.
A physiatrist is a doctor who specializes in rehabilitation medicine, which includes prosthetic care. They are instrumental in prescribing your prosthesis and guiding you through gait training, the process of learning to use your prosthesis. Gait training can occur as an inpatient in a rehabilitation hospital, skilled nursing facility, or on an outpatient basis, through a local physical therapy group. The physiatrist provides us with proper and necessary documentation for insurance purposes. They will follow up with you routinely to make sure you are progressing according to the treatment plan. At times they will need to prescribe adjustments or supplies for your prosthesis. Some physiatrists hold weekly or monthly amputee clinics where all members of the rehab team are present to provide a group evaluation of you and your status.
A prosthetists is a person who measures, designs, fabricates, fits, or services a prosthesis as prescribed by a physician. Your prosthetist will help determine what type of prosthesis would be appropriate for you based on your activity level, health status, hobbies and occupation. We provide all services related to the prosthesis and supplies needed to make it fit well and function properly. It is relationship that can last many years, as a prosthesis is a tool that periodically needs to be adjusted and replaced.
Physical Therapists are instrumental in teaching a new amputee how to walk with their prosthesis. This usually occurs during a short stay in a local hospital or skilled nursing facility for what we call “gait training”. There, you will have therapy several times a day to teach you how to walk with your prosthesis. You will learn how to care for your prosthesis and what’s involved in maintaining it on a daily basis. One thing we preach for every amputee while in gait training, is quality over quantity. There are habits that an amputee can develop that make it more noticeable and use up more energy to walk. We want every amputee to perform to the best of their ability and we don’t want this process to be a race.
The more you know about the rehabilitation process and your prosthesis, the more successful you will be with your new prosthesis. Remember to ask questions, Union Orthotics & Prosthetics Co. is here to help you.
Caring for Your Residual Limb
The earlier a prosthesis is fitted, the better. One of the most difficult problems facing a new amputee is edema, or swelling of the residual limb. The care you give your residual limb initially will directly affect your success with your new prosthesis.
To help reduce swelling in your residual limb, new amputees wear an elastic bandage or shrinker sock. It is normal for your residual limb to atrophy and shrink with time. Wearing a shrinker sock or wrapping your residual limb will help to shrink the limb as much as possible to allow for a more accurate fitting of your prosthesis. Wear your elastic bandage or shrinker sock 24 hours a day, except when exercising, until you receive your new prosthesis. Proper hygiene is essential. Wash your limb thoroughly with soap and water every day, unless your doctor has instructed you otherwise.
Sometime, people have sensitive or painful spots on their residual limb or along the suture line. We recommend to massage your residual limb to desensitize it. By getting it used to being touched, helps decrease this sensitivity and sometimes reduces the feelings of “Phantom Sensation or Pain”. This is when the amputee can still feel the missing limb move or have symptoms of itching or pain.
Preparing for Your New Prosthesis
Physical therapy to regain strength and agility is an important step in your preparation to use your new prosthesis. You may have had some therapy while you were in the hospital, and chances are your doctor will want you to continue with it, both now and after you receive your new prosthesis. The strength you develop now will help you to walk as normally as possible in the future.
Your New Prosthesis
Your Union O&P prosthetist will work with you, your physician and/or physical therapist to design a prosthesis that is right for you. Our goal is to fabricate a custom prosthesis as close to your natural limb as possible in appearance and function. We use high strength, lightweight materials which will be designed to match your leg in size, shape, and even skin tone. Your prosthetic foot will be responsive enough to provide motion for a natural-looking gait.
Your First Fitting
Your prosthesis is custom made especially for you. Detailed measurements and possibly a cast will be taken at your first fitting in order to make your custom socket. The emphasis at the first fitting will be on you and your lifestyle taking into consideration your activities of daily living, your work, your physical size and agility. Your prosthetist will assess your functional ability and design a prosthesis optimally suited for you at this point in time.
Your prosthetist will spend a lot of time working with you during this fitting to make sure your prosthesis is adjusted perfectly to your needs and comfort. The alignment fitting will take into account every aspect of your prosthesis’ fit and function. A lot of attention will be focused on the socket shape because it needs to spread out the pressures on your residual limb evenly and comfortably when you walk on it. The alignment is important to make sure your knee and hip are straight when you stand and walk, and the height of the prosthesis is not too tall or short.
Delivery of the Prosthesis
When the prosthesis is finished, a final delivery appointment will be scheduled. It is common for this final fitting to occur at a physiatrist’s office, a rehabilitation facility, or in the office. The prosthesis will be evaluated one final time for comfort and alignment.
It is important that you learn to walk properly with your new prosthesis from the day you receive it. Your physical therapist will work with you and make recommendations regarding any additional support you may need to walk your best - such as a walker, crutches, or a cane. With your therapist’s help, you will soon be accomplishing many of your daily activities. We will be counting on you to call us whenever you have any questions about the fit, alignment, or general performance of your prosthesis. We are members of your team, and want to help you do your best now and in the future.
Adjustments and Prosthetic Socks
Most new amputees experience atrophy and shrinking of the residual limb. This is perfectly natural, but it does affect the fit of your prosthesis. You can make adjustments by using prosthetic socks of varying ply and thicknesses. When your limb goes through a certain amount of change, the socket of the prosthesis will need to be adjusted. It is normal to have several adjustments’ made to a prosthesis.
Prosthetic socks come in varying thicknesses (1 ply, 3 ply, or 5 ply). If your prosthesis feels tight with one sock, try a thinner sock. If it feels too loose, try a thicker sock or wear two or more socks at the same time. Experiment until you feel comfortable. Remember to wear a clean sock each day, and continue to wash your residual limb daily as well. If you find that changing your socks does not comfortably adjust the fit of your prosthesis, make an appointment to see us and we will modify the socket of your prosthesis appropriately.
Union Orthotics & Prosthetics Co. provides long-term follow-up care for our amputees and we are always eager to help you through any prosthetic obstacles or opportunities life brings.