A: Preparing yourself for a prosthesis can be as much of a mental process as it is a physical one. It is important to prepare yourself for an unfamiliar experience and be willing to embrace the unknown. Anxiety and self doubt are completely normal feelings to have, but if left unchecked they can quickly grow out of control and be responsible for keeping you off of your feet for longer than necessary. Our goal is to help you get back on your feet and assist you in returning to the lifestyle that you once enjoyed. A little adaptability, patience and a can-do attitude on your part will ensure that you get the most out of your device.
As for the physical preparations for a prosthesis, our best advice is to trust in the guidance of your physical therapist and stick to their program. All of the work that you put in before you receive your first prosthesis can greatly affect the amount of time it takes you to learn how to use your device. Regardless of the level of amputation you have, or the condition that you were in prior to losing a limb, you can expect to do a lot of hard work in order to reach your goals. As long as you work your hardest to build your strength and improve your skills with the prosthesis, you will eventually get there.
The Recipe to Prosthetic Success:
-A Good Attitude
-Listening to your Physical Therapist!!!
A: We can begin the process of getting a prosthesis immediately after your surgery is completed. This will allow us to handle much of the paperwork while you are waiting to heal. After your incision has healed and your sutures have been removed, you will be ready to start wearing a shrinker in preparation for your casting. By starting the process as early as possible we aim to get you back up on your feet in as short of a time as we can.
On a related note, patience is one of the most important things for you to have during this period of healing. The limited benefits of beginning the fitting process any earlier are greatly outweighed by the risk of injury and even greater setbacks associated with waiting for secondary wounds to heal. You can still make progress before your fitting by doing reading on different prosthetic topics or participating in a physical therapy program. Doing things the right way is well worth the wait.
A: A shrinker is a tubular piece of compression bandage that is used to control the amount of swelling in your residual limb. Shrinkers come in every shape, size and style imaginable, but they all serve the same purpose. We recommend that all new amputees wear a shrinker, AT MINIMUM, from the period of time that they have fully healed, to the time they receive their first prosthesis. We also recommend wearing a shrinker whenever the prosthesis is not being used. This will ensure the prosthesis can be donned consistently and will help in keeping a perfect fit for a longer period of time.
The need for a shrinker may gradually decrease over time as your residual limb continues to mature and stabilize in volume. It is always a good idea to keep at least one shrinker handy in the event you swell more than anticipated and have a difficult time donning your prosthesis.
If you are a new amputee, you will greatly benefit from the proper and regular use of a shrinker. Wearing a shrinker is one of the best ways to ensure your prosthesis continues to fit as well as when you first received it.
A: The specific appearance of your prosthesis will vary based on multiple factors. The level of amputation you have will determine the number and type of components that you receive. Your activity level will affect the class of components that will be available for use on your prosthesis. Generally speaking, lower-activity level components will have a more modest appearance and the higher-level components will look more high-tech and are often made of exotic materials. The third factor that will affect the appearance of your prosthesis is the branding the manufacturer chooses to put on their components. This is largely out of our control, as we generally make decisions on components based on their functional benefits rather than their aesthetic appearance.
If you do not like the appearance of the exposed components, we can offer you a cosmetic cover for your prosthesis. This will give your prosthesis a greater resemblance to your other limb and can help you to adjust to seeing yourself with a prosthesis. We will generally wait for a couple of months after your prosthesis is delivered to begin making a cosmetic cover. It is important for our practitioners to have easy access to the device in the first months in order to allow for adjustments to be made.
A: A cosmetic cover is created by covering your prosthetic components in a foam, which is then shaped to resemble your other limb. After the shaping is completed a textured skin that matches your skin tone will be applied to the outside of the foam to create a more realistic-looking prosthesis.
It is important to carefully weigh the benefits of a cosmetic cover against the potential compromises in performance that may have to be made. For example, while a cosmetic cover may make an above-knee prosthesis look more realistic, the foam will also inhibit the motion of the knee to some extent. If you require assistance in determining whether or not a cosmetic cover is the right thing for you, consult one of our prosthetists for advice. They will be able to clearly explain the advantages and disadvantages of using a cover with your specific prosthetic solution.
Q: What are some of the challenges I may face in adjusting to my new prosthesis? What can I do to overcome those challenges?
A: The thing we hear most often from our patients is that the process of developing a sense of balance on their prosthesis is very difficult. Balance is a fairly complicated skill to teach, as it consists of both mental and physical components. It is fairly easy to identify when somebody has good balance, however, nobody will be able to “tell” you exactly how to balance yourself on your new prosthesis. Your physical therapist will help you to increase your physical ability to balance yourself, but putting the strength together along with the other pieces is entirely up to you. Our advice is to take it slow and practice frequently, with practice you will eventually improve your balance, which will translate into a much better experience in using a prosthesis.
Most patients experience some sort of emotional difficulty in adjusting to the loss of a limb as well. It is completely normal to feel like less of a person after undergoing an amputation. You have a reminder of your loss every time you look down at your residual limb or feel a phantom sensation. While everybody finds their own way to deal with these feelings, it is important to understand that if you are having a difficult time figuring it out, there are groups and professionals out there who can help. Whether you speak to a family member, a support group, or a mental health professional, it is important that you find somebody that you are comfortable opening up to.
Above all else, remember this. It is normal to experience difficulty in the journey back to your life. By utilizing the support of family, friends, and your healthcare team, you will feel empowered and more motivated to continue through the difficult days. Once you start to reach your goals, you will find the process will go by faster and faster. Before you know it you will be back to your normal life.
Q: What are some of the different prosthetic devices that are available? How do I know which one I need?
A: A given prosthesis consists of three basic parts. Your socket is the custom made piece that will fit your residual limb perfectly and provides control, support, and suspension for the prosthesis. The fit of the socket is arguably the most important part of any prosthetic solution. The components on your prosthesis consist of adapters, tubes, screws, and level-specific components. (Feet, Knees, Hands, Elbows) Most of these components are modular and will be usable with just about any other types. The final part of a prosthesis is the suspension, or the mechanism that is responsible for keeping your prosthesis “attached” to your residual limb. A perfect fit along with the right suspension system can make your prosthesis feel lighter, more responsive, and more comfortable.
Sockets are always custom made and based off a mold created of your residual limb. Their features will vary based on your individual situation, as well as the components and suspension system you are using.
The basic types of suspension are mechanical locks, lanyards, suction and elevated vacuum. Different systems have their own advantages and disadvantages, however we generally prefer to use either suction or elevated vacuum whenever possible. Those two systems are scientifically proven to provide the most benefit to an amputee when compared to the other two.
Finally the components you receive will primarily be determined by your functional ability. Your functional ability will grant you access to different “levels” of components. Within each category of components are many different options that are available for you to try. Your prosthetist will likely have a recommendation based on their experience, but if you do not like what you receive, nearly all components have generous return policies that will allow you to try a different component within the same category. To read more on the functional levels, see our blog posts or resources page.
A: You will need a new prosthesis whenever your current system is not serving your needs. This can be simplified down to two important questions. The first is whether or not your socket fits well. A poorly fitting socket can turn even the most expensive components into fancy paperweights. If your socket is causing you pain or feels loose, we will immediately begin the process of creating a new one for you. In the meantime, we will give you some supplies and instruct you on how to temporarily compensate for any changes in fit. It is important that you make an effort to reduce your activity when utilizing these temporary solutions as they will not provide the same stability and control as a properly fitting socket. The most common reason we see for changes in fit are due to a decrease in volume of your residual limb. This most frequently occurs in the few years immediately following your surgery.
The second question is whether or not your components are appropriate for your needs. The most common time that we see this is during the initial period of rehabilitation after receiving your prosthesis. The next most common cause is broken, out of warranty, or malfunctioning components that you have had for a long time. Either way, your prosthesis should always serve as a tool to make your life easier. If your prosthesis is no longer fulfilling that purpose it is time to look at getting a new one made. We are always available to answer any questions or concerns you may have about your particular prosthesis.
A: Medicare will typically always cover a large portion of the cost of a prosthesis. They require medical justification for the prosthesis that is supported by evidence found in your medical record. If you are a new amputee, simply not having a prosthesis is usually a sufficient reason for them to pay. If you already have a prosthesis and are looking at getting a new one, it is critical that you arrange to see your primary care physician to get your issues with the prosthesis documented in your medical record. By doing this you will greatly speed up the approval process and will shorten your wait for a new device.
A: The cost of a prosthetic device varies greatly depending on the type and quality of components that are being used to create it. Think of in terms of automobiles, you wouldn’t expect an affordable family sedan to cost the same amount of money as a sports car. The good news is: as long as your need for advanced components can be medically justified and supported with evidence from your medical record, most insurance companies will pay for them.
Since the financials of a prosthesis vary so wildly with the specific device that is being proposed for you, the best way to learn more about the cost of your device is to call one of our Administrators. They will be able to assist you in determining the overall cost of the device, how much will be covered by insurance, and what, if any, financial responsibilities you may have.
A: The answer to this depends largely on the specifics of your plan, as well as the amount of contributions you have made to your yearly deductible (if applicable). Generally speaking, Medicare will usually cover 80% of the cost of a prosthesis if there is a proven medical necessity for the device. Most of the private insurance plans will pay anywhere between 20-80% of the cost of the device, depending on the amount of your deductible as well as aspects of your specific policy.
The simplest way to estimate how much your insurance plan will cover is to let our Insurance Specialists do some research on your plan and the other factors that influence how much is covered. They will be able to get you as accurate of an idea as possible of what your insurance company may expect you to be able to cover.
A: If you lack sufficient coverage for prosthetic services you may feel like you do not have a shot at getting a prosthesis. Fortunately there are a wide variety of ways to go about getting a prosthesis in the event your plan does not include coverage for a prosthesis, or even if you have no insurance coverage at all.
There are charity based programs like Limbs for Life, that offer free prosthetic devices to people who do not have coverage for them. For these types of funding sources, you will be required to fill out paperwork in conjunction with your prosthetist and join a waiting list. These options are generally no strings attached arrangements, however you will often end up waiting quite a while as many people sign up for these services.
In addition to charity based programs, there are also workforce rehabilitation programs that are organized and maintained by a branch of your State government. These programs will be able to provide you a prosthetic device free of charge as well. In exchange however, you must create a rehabilitation plan that will help you get back to work and return to a productive lifestyle. These kinds of programs are generally the best option for younger amputees who need a prosthesis to start, or continue working.
A: The most straightforward way to figure this out is to call the number on the back of your insurance card and ask. While some Insurance Providers are more generous with prosthetic coverage than others, your specific coverage is still usually defined on a plan-by-plan basis.
If you do not wish to speak with your insurance company, we can also have our Insurance Specialists call and find out for you.
A: The map is intended to be used as a guideline for the approximate area of where we provide our services. You are not automatically disqualified from being a patient of ours if you live outside of the defined areas. We ask that you contact us so we can take your individual situation into account when making our decision.
A: That is absolutely not a problem! We offer our mobile services to patients who find the process of travelling to be too difficult, or are too far away to make the trip to our office. If you do not have a problem with travel, we will be more than happy to schedule your appointments in-office. For more specific information on how we handle in-office scheduling, give us a call!
A: Absolutely not. We believe that making the process of getting a new prosthesis as easy as possible is one of our most important responsibilities. By simplifying things as much as possible, we hope to give all of our patients the best possible chance at success.
A: When we schedule appointments for house-calls we generally will give you a 2 hour window in which a practitioner will arrive. We will call you the day before to confirm the time of the appointment so you can make the necessary arrangements to be available. The 2 hour window relates specifically to when your practitioner will be arriving and does not necessarily reflect the total time of the appointment.