The loss of a limb, whether through trauma or illness, is a very permanent condition that can initially feel like you have lost a loved one. You should take heart, though, in knowing that most amputees are eventually able to return to their prior functional level and enjoy life to its fullest. To achieve this it is important that you receive the best care and treatment available. Your artificial limb, called a prosthesis, is a finely crafted blend of art and science, and should only be provided by a highly-trained and experienced practitioner called a prosthetist. Prosthetists credentialed by the American Board for Certification in Prosthetics and Orthotics (www.abcop.org) are designated by the initials CP or CPO after their name. At Bio-Medic Appliances, Inc. we employ only ABC certified or board-eligible practitioners.
At Bio-Medic Appliances, Inc., many hours are spent ensuring that your prosthesis is carefully designed, crafted, adjusted and maintained for the best results. Even the tiniest of details can mean the difference between disappointment and success. We listen carefully to your comments and questions to make sure we are meeting your unique needs, so that your prosthesis truly becomes an extension of your natural body, or as close as technology permits.
Choosing a Prosthetist
Choosing the right prosthetist is probably your most important step in achieving a full recovery and returning to your prior life, as your prosthetist will be instrumental in restoring the function of your missing limb. Ensuring that your prosthesis is comfortable to wear, securely attached to your body and provides the ideal function and appearance is all up to the prosthetist. Be sure to interview more than one prosthetist and ask plenty of questions so that you can make the right choice to get the best possible results. Your amputation is a permanent condition, and you will be working with a prosthetist for the rest of your life, spending many long hours together. Consider these aspects of the prosthetist – education, credentials, experience, reputation and personality. All of these should outweigh the location of a facility, as they have much more to do with getting the right outcome. If access if a problem for you, ask if the prosthetist can make house calls or see you at a more convenient location for some of your visits.
What To Expect
At your first visit, you will be evaluated for your device. The evaluation consists of a physical examination, motion and muscle testing and a thorough discussion of your physical needs, environment and lifestyle.
Here are some questions that you may be asked at your first appointment:
- What kind of work do you do?
- What kinds of leisure activities do you participate in?
- What other devices, if any have you tried in the past?
- What did you like or dislike about your previous device (s)?
- What are your goals and expectations from us at Bio-Medic Appliances?
After your initial consultation, we will recommend the options that are most likely to meet your needs and we will discuss the effectiveness and possible outcomes of each option. With your input, we will select a course of treatment. If needed, we will confer with your doctor and/or physical therapist to help make the best decision.
This initial consultation can be quite lengthy, taking all aspects of your residual limb and life into consideration may require a rather long appointment. We devote ourselves to each patient when they are in our office, so please come prepared with any and all questions you might have so that we can best evaluate your needs. Initial consultations and evaluations are always a free service we offer to all prosthetic patients.
Depending on the outcome of the initial consultation, you may or may not be measured or cast for new items. Because the consultation can be rather long and there are numerous products/items that may be decided, it may not be possible to measure or cast at this initial visit. If so, we will schedule a second visit for measuring or casting. If you are traveling from a far distance, we do everything possible to maximize the services we provide at each visit.
Diagnostic Socket Fittings
Once we have taken casts, impressions and measurements, we will order the components (feet, pylons, knees, attachment pieces) for your device. The most important of these items is the custom diagnostic socket. The diagnostic socket is usually made of a transparent thermoplastic. This temporary testing socket serves as a starting point for the fitting process. Once we have made the necessary adjustments for fit, function and comfort, the finalized socket will be fabricated from stronger more durable yet light materials here in our lab. The materials we use for finished prostheses are: Carbon fiber, Kevlar, fiberglass, cosmetic outer designs. These materials are designed to hold up over a longer period of time and are chosen for activity level, and patient weight. The final device ,may also have a cosmetic shell or finish applied to help it look more “real.”
The number of appointments needed to adjust and finalize the diagnostic socket varies with every patient. We will meet with you as many times as is needed to get the right fit.
Depending on your experience level and health, we may send you home with the diagnostic device for a one week “walking trial.” This gives you the opportunity to test your new prosthesis in the environment with which you are in and around every day, notjust the sterile, flat surfaced environment of our office. You will be able to test the fit not only in your own environment with it’s individualized environmental barriers, but also during activities that you normally do day to day. This gives all of us the best feedback on fit, function and comfort.
Alignment Of Components
The next step is to make sure that all of your components of your prosthesis are properly aligned to optimize your function. We will try different combinations of parts and biomechanical alignments in order to best address your functional goals as well as to help eliminate or prevent pain and discomfort.
One of the most difficult aspects of the fitting process is limb shrinkage. Your residual limb will shrink after your amputation surgery or with weight loss. You limb volume may also increase with weight gain. Limb volume is constantly changing throughout the healing process and some people struggle with fluid retention more than others. The best way to cope with this issue is to anticipate what changes your body is likely to go through as you learn to use your new device and to build these changes into the fitting process. Compression stockings and adjustable volume sockets can make the new amputees changes more comfortable and patients who are particularly prone to edema may be better suited to certain styles of devices than others.
Bringing Others With You
Doctors, physical therapists and family members, even friends are welcome to attend any visit expecially the first appointment. If necessary, appointments can be scheduled at a physicians or therapists office.