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Generally you will be assessed as to your suitability for a prosthesis (the artificial replacement for the missing limb or part of the limb). Although a prosthesis is never as natural as your own limb it can help you do many things quite effectively if you are willing to combine your energy and willpower into learning how to use it. It is important for you to work with your doctor, prosthetist and therapists; these people can address all of your concerns. They will work with you on the design and function of your prosthesis and training on how to use it.
Each device will be different, depending on the level of your amputation, physical ability and needs. Your prosthetist will create a device that is custom-made to fit you. Your prosthetist will make suggestions based on the type of amputation and your activity level. A prosthetic is basically an extension of your body. A standard prosthesis is made of conventional component parts that create the leg and prosthetic foot. These parts are connected to a socket that fits over your residual limb.
Depending on the type and level of amputation, physical ability and functional needs of each person, every prosthesis will differ. Prosthetic components are available if you desire a “cosmetic look” however, most standard prosthetics provided are comprised of conventional component parts attached to a socket that fits over your residual limb. There are a number of ways that the prosthesis is held on, some use strapping, some suction; your prosthetist will advise you of what will be suitable for you.
Generally you should be ready for a prosthetic measuring and fitting within a few weeks after surgery, when the wound is healed and tissue swelling has decreased. During this stage of rehabilitation your medical team will be concerned with maintaining proper shape of the residual limb as well as increasing your overall strength and function. Fitting will usually involve several steps to create a prosthesis that is unique for you.
Some amputees find a wheelchair or crutches to be helpful in reaching their goals. The type of assistive device you use is your choice. You should use the device that will help you live the life you want to live. This may mean using a wheelchair or crutches for some activities. Many amputees have a wheelchair or pair of crutches that they use at least part of the time. They may use them for nighttime trips to the bathroom, showering, traveling long distances, or if problems arise that require leaving the prosthesis off for a period of time. This is an individual decision, based on your needs and comfort level.
A prosthesis can range widely in price, depending on your amputation level and the type of device you are looking for. Typically, your prosthetic device will be partially covered by your insurance plan. Some insurance plans may even cover the entire cost of the device. You will need to work closely with your insurance company to understand the types of devices and services that will be covered under your policy. Be prepared to make several phone calls, provide documentation and be your own advocate. Check that your policy includes prosthetic coverage. Know the limitations and exclusions in your policy. It is important to know that working with your prosthetist on fit and alignment of your prosthesis should be bundled with the total cost of your device. Your prosthetist should continue to work with you until you reach a comfortable fit and alignment.
A K-level is a scale used by Medicare to rate your rehabilitation potential. Many private insurance companies follow Medicare’s example to establish coverage guidelines. The K-level is a rating from 0 to 4 to predict your potential success with your prosthesis. Basically, if you had a device and training to learn how to use it, would it work for you? Would you be able to use it well? The K-level is important because it is used by your insurance company to figure out what type of prosthetic they will cover for you. Insurance companies want to know that the prosthesis you receive will be realistic and functional. Your doctor will complete an assessment of your physical and cognitive abilities to determine your K-level. The Amputee Coalition’s National Resource Center can connect you with additional information and tools to help you understand what your K-level means and how it might impact your prosthetic options.
The timing depends on how quickly your residual limb fully heals from the surgery. Some individuals receive a temporary prosthesis immediately following amputation or within two to three weeks after surgery. Usually, a prosthetic fitting begins two to six months after surgery. This will be when the surgical incision has healed, the swelling has gone down, and your physical condition improves.
The process of being fit for your prosthesis will involve several visits to create a device that fits you and your needs. Follow-up visits with your prosthetist are as important as the initial fitting. You will need to make several visits for adjustments with the prosthetist as your residual limb changes and continues to heal. Tell your prosthetist if the prosthesis is uncomfortable in any way. They can help you ease pressure areas, adjust alignment and work out any problems you may experience. Using your prosthesis should not be painful. The more comfortable the fit, the more likely you are to use it. Talk honestly with your prosthetist about your needs and goals. Discuss the things you want and need to do in your life after surgery.
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. This may require socket changes, liners, or even a different device. Increased activity level and a desire to do more activities can create a need for a change in the prosthesis or its parts. Once you are comfortable with the fit of your device, the prosthesis needs only minor repairs or maintenance and can last an average of three years. Your prosthesis should be regularly checked by your prosthetist to avoid any major problems.
There is a lot you can and must do to be able to use a prosthetic, beginning with these top priorities.
Yes, things can happen that will require repair or replacement, so it’s a good idea to know about warranties and what to expect from your prosthetist. Get small problems with your prosthesis taken care of promptly. There is no benefit to waiting until your prosthesis falls apart or causes serious skin breakdown. If you wear a prosthesis too long when it needs repair or replacement, you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back, shoulders and hips will affect posture in addition to performance of the device and the energy needed to use it. Early prevention is much better than long term treatment.