Tuesday, February 26, 2013

The Prosthesis Arrived Today!

My prosthetist turned it over to me at today's appointment. He had completed the socket, and with a suitable liner and other miscellany, it was ready to go. Not me; I'm exhausted (don't ask). And I have an appointment with the hospital case manager tomorrow, so I can't stay up tweaking the "new" computer as I would prefer, so I'll have to write more later. Thanks as always to friend and neighbor George, who prevented this day from ending before it began because of transportation obstacles.

"Tomorrow, tomorrow [evening], there's always... tomorrow..."


  1. Good luck with the prosthesis Steve!

    1. Thanks, jams. So far, so good... I "modeled" it for the case manager (who is a specialist in this kind of medicine) and her team this morning over at TIRR in the Texas Medical Center. They had some questions, but nothing but praise for the device itself. Twice more since delivery I have donned and doffed it; it's getting easier and more natural each time. I walked only a few steps on it today, but those steps felt better than yesterday's. I think this thing is going to work. Now all I need is training in its proper use, and that began yesterday and continues Friday. I'll continue to have two therapy sessions a week, focusing on use of the prosthesis. Yesterday's session was on balance and on shifting weight, left to right and back and forth; that was done on a PPAM (a sort of prosthesis trainer), but the Friday session will be on the actual prosthesis. Watch me goooooo... :-)

  2. How do you keep the foot on? Tape? Sticky paste? Heavy sock? I never thought this process would be so involved. You are educating all of us.

    1. ellroon, it's almost that bad, but not quite. The device involves several layers...

      Next to the skin of the stump is a liner; that is big enough to hold the stump and extends to just below the knee. It is made of a soft, rubbery-feeling synthetic, very deliberately as non-irritating as possible. One end of it is fitted with a metal pin, which points downward; I'll describe it below. One dons it by turning it inside out, centering it carefully on the end of the stump, and rolling it on. The liner grips the stump very firmly, so that the leg doesn't remove itself except when the wearer wants to take it off.

      Atop the liner is a sock. Or two socks, or a two-ply sock. Or a half dozen socks. (For the process of fitting these moment-to-moment, my prosthetist coined the term... and the industry adopted it... "sockology". Ahem.) The socks are made out of a material a lot like a man's undershirt, only perhaps thinner, and their purpose is to fill the gap (or not) as the stump expands or shrinks in the course of activity. I'm told such a thing is essential in a Houston summer. The sock (socks) has (have) holes in the end to fit over the pin.

      Back to that pin. It's about 2 inches long, perhaps 1/4 inch in core diameter, with flat cone-shaped flares along its length. These work as a sort of ratchet: the pin goes into the leg in one direction, with a lot of clicks, and doesn't come back out until you push a button on the side of the leg. This secures the "soft" part of the mechanism (stump, liner, socks) to the hard part. It can't accidentally come off, but it leaves some flexibility at the knee, and it comes off pretty easily when you pull on it while holding the button in.

      Now we come to the hard part. There's a hard plastic socket made of some sort of hi-tech material, shaped and colored like one's calf on the outside and slightly bigger than the stump (it was made form-fitted using a plaster cast) on the inside. The other end of the ratchet (into which the pin fits) is mounted at the inside bottom of this cavity. With all the soft parts on the stump, one pulls the whole "leg" (I'm pulling my own in this case) over the stump and tries to align it exactly with the pin. If it's close enough, one can stand on it; the pin ratchets itself into the hole (click-click-click, maybe 5 or 6 times), and the leg is quite securely attached to the stump. Take a couple of steps, and you may hear a couple more clicks. The attachment is secure, but the joints are still flexible at the right places in the right amounts.

      Below the fitted socket (artificial leg; it's color-matched to one's ethnicity) is a hi-tech foot that looks like what one imagines is beneath Cmdr Data's "skin"... a mechanism for the ankle and a cast-plastic (?) foot made from one's own remaining real foot, so they match.

      To take it off, one reverses the process. There's a metal button poking through the inside heel of the prosthesis almost flush with the serface; hold it in, and the pin-ratchet releases, and one can pull the leg off the stump. Once it's off, I wear the "shrinker" most of the time I spend out of the prosthesis.

      And that's it!

  3. I've always wondered why the stump does not get massively irritated by the wearing of the prosthesis. It sounds like they are getting better and better at creating things to help.

    Appreciate the clear description. Thanks.

    1. ellroon, mine is only one of dozens of kinds of prostheses for amputees. As surely as they are hi-tech, they are also a product of art and craft. I regard my prosthetist as a very specialized sculptor; I told him so, and he shrugged... it's his work, he says. But I believe he does it superbly, and has gained a good reputation at least at TIRR.

      I just spent a half hour in the prosthesis... donning and doffing it myself, standing a while, sitting a while. Notwithstanding the exhilaration of walking, my first lessons are in balance and weight-shifting, left-right and front-back. They say you have to learn to crawl before you learn to walk; I say I have to learn to walk all over again.



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