Harmony P4 socket fit

[shanebritz]

Hi all.
I’ve been a below knee amputee for approx 20years. Did my ‘appy-ship’ with pin systems for a long time, and around 5 years ago changed to the harmony e2 electronic pump.
My big issue is that I have practically zero sensation in my stump, so battle to offer meaningful feedback to my prosthetist, so getting a good fit is a time consuming and slow exercise.
My very patient prosthetist did eventually make the perfect socket and I had 3 very trouble free and very active years on my socket! 😄
Time for a refit, and I have now moved to the P4 pump.
A reminder: I have practically zero sensation in my stump. My stump is fairly thin, with quite a soft fleshy end.
We have been experimenting with a test socket for a month now. The fit generally is great with one exception. The skin at the end of my stump(and slightly towards the back) gets really hard by the end of the day, with a general feeling of discomfort. After a day or so of rest I try again with spots and half socks etc. Still, the end of my stump keeps getting hard and sore.
Any opinions out there please?
Too much weight bearing at end?
Too much space at the bottom of the socket, with vacuum hurting my stump?

[bodrum]

Hi Shane, I know it's been ages since your post but I'm struggling with a very similar problem right now. I really hope you managed to find a comfortable solution in the end. Perhaps we could compare notes? I have a Harmony P3 with uneo 3d liner and am on the third socket attempting to solve the problem of hard skin buildup and tendancy to crack open into painful sore bit on distal end of stump. Never had this particular problem with passive vacuum or pin system with silicone liners...
Best regards

[marke1]

Hello. My first post/response here and I just registered 5 minutes ago🥸. BKR here 21 years and 3 months. I too had DE issues. I’m super fortunate to have been 1 of the 60 amputees invited to Carl Caspers TEC office in St. Cloud Minnesota. Carl (if you don’t know) is the inventor of the Harmony system along with UR liners and a few other items that most of us use. Anyway, to the issue at hand. The front of your stump from the knee down (your stump) is in charge of your basic balance when walking/running. During the casting, my prosthetist followed Carl’s example of molding cast as it cured to push as much soft tissue towards the back of the stump when you slide your stump into the socket. Not only did it solve my control issues with PL but stopped the skin issues at DE. Only a slight amount of DE blistering happened and a tech spot cured that instantly. So, if you look at my socket either outside or inside you can see how the shape was molded. Socket is not rounded as most are but looks oblong or shaped clearly so that soft tissue is forced to the rear. I’m terrible at explaining things with words. Wished I could put up a photo.
Anyway, I’m here for a different reason but thought I’d share what works for me. I’m also participating in a new surgery to address nerve pains and once it’s done, I plan on posting the results here and everywhere I can especially if it’s successful.
Now to figure out where to post my original request on this site. I’m in Arizona and desperately looking for a physical fitness partner because I’m such a fantastic cheater and will always find a reason not to exercise.
Cheers and I will be on here plenty now that I’ve found y’all 👍