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Post by cherylm on Apr 16, 2013 23:10:59 GMT -7
I had an interesting day today...I got to serve as a "model" for an Otto Bock seminar on "how to cast and fit a Harmony System socket for a below-knee amputee," which was being given in a nearby city. It was a very long, but fascinating, day...and it was a chance for me to have a full trial socket built for me on the spot!
I've never worn anything in the line of a suction or vacuum-assisted system before...I've been in a pin-lock suspension system for my entire amp-life and have not had any major problems with it. However, this new test socket feels better than anything I've experienced before. My CPO says that he has been able to justify this elevated vacuum system to my insurance in the past, so I'm very, very seriously considering giving this a go.
Soooo...here's my question: Has anyone else here used a vacuum-assisted system? If so, was your pump electronic or mechanical? And what were/are the advantages or disadvantages of such a system? They're currently suggesting an electronic pump for me...something relatively new and very quiet and lightweight, supposedly dependable. They say it's the easiest pump to integrate with my current foot and ankle. There is also a mechanical unit small enough to fit into my current foot/ankle assembly, but I've been told that it's "somewhat more troublesome" to establish the vacuum with this unit.
I'm interested in anyone's experiences! Thanks!
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Post by allenuk on Apr 16, 2013 23:49:30 GMT -7
Tried a vacuum system a year or two back. Didn't like it. Took AGES to get on. The liner next to your leg had to be very tight, and even with big strong hands I just couldn't get it on. Prosthetist said 'lubricate it with jelly' which we did, but then your big strong hands are ALSO covered with jelly = no grip at all!
It was mechanical, and often after 100-200 yards, the vacuum had failed.
I like to be able to get 'legged-up' in the shortest time possible, which is about a minute in the pin lock. In the suction it was going to be more than 5 minutes, on a good day.
Oh, a spin-off criticism: the nature of the liners meant that there was loads of rubber/silicone behind your knee, making bike-riding v.difficult if not impossible.
Other people wear them all the time, so maybe it's just me!
Allen.
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Post by ann- on Apr 17, 2013 9:08:24 GMT -7
yep .... I had a similar experience to Allen and it didn't work out, I did the jelly system with the initial Tec system and the liners were a nightmare to clean, though I don't think they have moved on further with this nowadays.
I had a brief try with the Harmony system and like Allen the vacuum didn't work too well, though think it was the way things were set up, not the system itself. I know a couple of people who use it and it works very well for them, so again its very individual.
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Post by cherylm on Apr 18, 2013 1:09:51 GMT -7
Thanks for the input! I've not yet had the chance to try walking in it -- just stood in it without foot attached -- so I'll make a point of seeing how the vacuum holds when I get my trial version to take home on Monday. I gather that the electronic pump is supposed to make it easier to establish and hold the vacuum, but I have a tendency to want the smallest of the mechanical pumps they showed me, even though they're recommending the electronic one. Just seems like one less thing to go wrong....
I actually liked the liner very much, and I was able to put it on fairly easily, with little mess from the moisturizing treatment. (However, they just sprayed the outside of the liner with water, no "jelly"..."jelly" does sound messy!) Since I already wear both a liner and a suspension sleeve, I don't think I'd have a problem with the amount of "gear" that's involved, at least not as far as my knee is concerned. During my little trial of the test socket at the seminar, I was able to get slightly more than 90 degrees of flex in the knee. (I've always been good at flexing the knee...it's one of the few strong and flexible things about me!)
Allen, one of my concerns is also how long it takes to get the leg on. I can slap my pin-lock on in total darkness in possibly slightly less than a minute (at least well enough to walk short distances), which is very, very convenient for middle-of-the-night activities. I know that would not be the case with all the gear for the vacuum-assist leg but am "kind of hoping" that the improved fit and stability during the day would make it worth having to use my wheelchair to get around in the middle of the night. Oh, the things an amp has to think about..........
Anyone else have any experience or opinions???
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Post by allenuk on Apr 18, 2013 4:56:05 GMT -7
Do you have to give up your pinlock if you go vacuum? Just a thought - if you could keep it as a spare, it might solve the 2 a.m. problems.
A
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Post by cherylm on Apr 19, 2013 0:31:34 GMT -7
Allen, I think there might be a way that I could keep "some sort" of pin-lock as a spare. It would entail a couple of "foot swaps"...they're planning on putting my current foot and ankle on the vacuum-assisted socket...but I have another leg, with an ill-fitting socket but a reasonably decent foot, so they might be able to move that foot to my current socket. I'm certainly planning on asking about it!
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ann58
Female Member
Posts: 278
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Post by ann58 on Apr 19, 2013 6:47:32 GMT -7
Cherylm, I, for one really like the vacuum socket...{Like Allen}, hate the fact it takes much longer to put on. Mine is fashioned like the Stan Patterson sockets {Prosthetic & Orthotlic Assoc. in Orlando, Fl}. U use alcohol & water mixture so it slides on with ease. I had to stop wearing the pin system due the piston action & how it was affecting my leg. {Not good} The only talk I have heard about the Harmony System was it made alot of noise. This was when it just came out. I am sure it has been improved., and think U will like it. I have a very short way to bathroom., and get there on my "tush"., no-one watching but my little dog & she doesn't care }
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Post by cherylm on Apr 20, 2013 0:58:00 GMT -7
Thanks, Ann...it's good to get another perspective! I've been reading the info they gave me at the seminar, and that also recommends an alcohol/water blend for donning. I know so many people who really like working with Stan...I just can't quite see going clear to Florida for a socket, although a good number of folks seem willing to do exactly that for the experience!
The electronic pump they showed me was the "latest and greatest" model, and it was VERY quiet...I had to hold it right up by my ear to tell it was running. So that does sound like an improvement.
And yeah, I could do the ever-popular "amputee butt-walk" if worse came to worst...and I wouldn't even have to worry about embarrassing a pet!
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Post by barclay on Apr 21, 2013 20:40:16 GMT -7
My prosthestist has said that he wouldn't recommend one for me because, if they get a puncture (which can happen apparently easily if you are active), then you are stuck where you are as the vacuum is gone and the leg falls off. For some of his amputees though he says they are great.
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Post by cherylm on Apr 23, 2013 0:25:34 GMT -7
Thanks for the info, barclay. I had heard about the possibility of leaks and losing vacuum. I think, from my experience at the seminar, that there's now a sort of "safety net" for that. The suspension sleeve is making sleeve-to-skin contact, so a leak will result in the leg feeling heavy and uncomfortable, but it's not supposed to fall off.
Considering how active you are, I think I'd probably agree with your prosthetist...you're already breaking FEET, after all!
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Post by cherylm on Apr 28, 2013 19:09:06 GMT -7
Well, gang, I've been in my new harmony system leg since Wednesday...and I LOVE it...and I HATE it!
I absolutely adore the stability it gives me...I really do feel like I'm walking "normally" at a fairly "normal" speed for the first time in eight years. It's a wondrous thing.
HOWEVER...there is some sort of odd fit and/or suction problem that periodically causes my liner to eat me alive! I've developed two lovely little "hickey-like things" on my stump, one large water blister right at the distal end of the bone, and this dear liner has torn off two sizable pieces of skin (just the top layer of skin, but about 1/2" X 1.5" each) off the soft tissue at the very end of the stump.
If the leg would quit trying to eat me, I would be a happy camper!
Going back to prosthetist tomorrow to see if he can tell where the fit and/or suction problems lie. Wish me luck!
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Post by stonecutter on Apr 29, 2013 6:59:44 GMT -7
Uh... Wow... Even if it gave you the most stability an amputee has ever seen - OUCH! Hope they can gain some comfort for you in the problem areas. Recently I've made a discovery for areas that are sore BUT NOT BROKEN DOWN YET... I use these: CLICK ME
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Post by cherylm on Apr 29, 2013 22:27:06 GMT -7
Thanks for the tip, Trevor...once I'm healed up, I'll look into it.
Back at the prosthetist today...the latest theory is that I'm not fitting into the current "standard-size" liner and that a custom liner might fix the problem. So that's where we're headed next.
In the meantime, I'm out of all prosthetic limbs and back in the wheelchair until the stump is all healed.
sigh.....................
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Post by ann- on Apr 30, 2013 1:50:35 GMT -7
oh dear .... sorry to hear that Cheryl .... I had similar yesterday and had to get an emergency appointment as my new legs had done more the opposite instead of taking chunks out of me had caused bruising and swelling on a few boney parts .... so after four months of fittings and settling into this pair, I was not a happy bunny either.
In my case alignment was altered on one and it looks like a re-cast on the other. So am chilling today ... another sigh too from over here!
Good healing Cheryl.
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ann58
Female Member
Posts: 278
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Post by ann58 on Apr 30, 2013 9:27:01 GMT -7
Well, gang, I've been in my new harmony system leg since Wednesday...and I LOVE it...and I HATE it! I absolutely adore the stability it gives me...I really do feel like I'm walking "normally" at a fairly "normal" speed for the first time in eight years. It's a wondrous thing. HOWEVER...there is some sort of odd fit and/or suction problem that periodically causes my liner to eat me alive! I've developed two lovely little "hickey-like things" on my stump, one large water blister right at the distal end of the bone, and this dear liner has torn off two sizable pieces of skin (just the top layer of skin, but about 1/2" X 1.5" each) off the soft tissue at the very end of the stump. If the leg would quit trying to eat me, I would be a happy camper! Going back to prosthetist tomorrow to see if he can tell where the fit and/or suction problems lie. Wish me luck! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was this coming on automaticly....{the pump}. I know when they were first out, it would come on whenever u started to loose suction. AND something else, do u just pull your liner off fast? My skin is too sensitive to do that, I ease it off slowly. After reading ur post, I am glad u found out what was wrong with ur liner...I do hate the fact u are right back in your chair though. I would imagine u have time to do alot of reading {if u read much} and watching tv or movies.
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Post by cherylm on May 1, 2013 0:01:58 GMT -7
Thanks Ann(s)...it's good to have folks who understand what we go through sometimes! The pump has been very "quirky" but it seems more inclined to lose its charge and not come on at all than it does to turn on too often. And it's getting downright silly, just how cautious I am about "easing the liner ever-so-carefully off" at this point. (Skin tearing loose in extreme slow motion may be even LESS pleasant than skin being torn off rapidly!)
Anyway, it's back to the CPO tomorrow afternoon to cast for the new liner. I've always wondered if a custom liner would be more comfortable for me...but it's never been a big deal until now. Oh well...life goes on........
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Post by ann- on May 1, 2013 11:10:05 GMT -7
Don't like the sound of skin tearing loose Cheryl .... fast or slow! Good luck tomorrow with your appointment.
I have been back for a another appointment today and it looks like I have to have both remade .... so fingers x'd this time.
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ann58
Female Member
Posts: 278
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Post by ann58 on May 2, 2013 9:22:51 GMT -7
Most of my liners are custom made...seems if purchased off the shelf they are too tight @ bottom & just right on the top or the other way around. What can I say, guess I'm just out of line. I'm sure they will get it squared away.
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Post by stonecutter on May 8, 2013 14:57:48 GMT -7
Just on the subject of vacuum systems... Found this on Facebook this afternoon: www.ossur.com/?pageid=17800 Looks like it fits on my Reflex Shock with EVO foot. I'll have to ask about it. Sleeves are starting to pee me off lately. I often knock my knee against things (furniture, things on a construction site) and end up puncturing the sleeve. So sleeveless vacuums? Yes please!
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Post by stonecutter on May 8, 2013 14:57:50 GMT -7
Just on the subject of vacuum systems... Found this on Facebook this afternoon: www.ossur.com/?pageid=17800 Looks like it fits on my Reflex Shock with EVO foot. I'll have to ask about it. Sleeves are starting to pee me off lately. I often knock my knee against things (furniture, things on a construction site) and end up puncturing the sleeve. So sleeveless vacuums? Yes please!
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Post by cherylm on Jun 1, 2013 2:10:51 GMT -7
Hi, Gang...Time for an update! The custom liner was a smashing success, and we're moving ahead on the leg front. I've had NO more blisters or tearing skin...in fact, the leg is feeling awfully good. However, it appears that I'm still looking forward to one more (hopefully FINAL) round of casting, check socket, tweaking, test socket, more tweaking, trial period, and then A FINAL LEG!
This is more time than I've ever spent in getting a leg built (after my very first leg, that is...that one took five months). It's making some good-sized impositions on my lifestyle...but so far I think it's worth all the time and effort. I'm feeling so stable in this latest version of a test socket...and I can walk and actually enjoy the act of walking again. The "leg team" keeps saying that they can still improve on the socket, and so far they've kept that promise.
Only complaints now are 1) the time issue for constructions/revisions, 2) the time it takes to don the leg (getting better, but it's still about 15 minutes), and 3) my current pump, which behaves quite nicely but is also quite noisy. They may be able to improve on that, but I'm now one of those folks who has to worry about build height. Some of the other, quieter pumps they've tried are just large enough to not work with my flexible ankle...and NOTHING is going to make me want to give up my ankle!
So that's the latest........here's hoping for continued progress!
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Post by allenuk on Jun 1, 2013 5:11:31 GMT -7
Donning was one of many problems I had with suction, Cherylm, and one of the reasons we eventually dropped it as a project, so I really hope (given the fact that you LIKE the rest of it) that you get that 15 minutes down to something respectable, like 2 minutes!
I suppose if it's only once a day, then maybe 5 minutes wouldn't be a hardship - it's just that after 8 or so years of pinlock, anything that long sounds very long.
All good otherwise, and glad to hear it.
A.
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mitchee
Female Member
LBKA - 2006
Posts: 55
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Post by mitchee on Sept 4, 2013 14:28:26 GMT -7
I'm considering using the Ottobock Triton Harmony vacuum socket (with a Triton foot). After reading the comments, I'm not so sure about it. I'm very active... hiking, cycling, rollerblading, etc. and now I'm worried that this won't work for me. I thought it would be a good idea because it is supposed to help reduce the amount of sweat that always seems to be in my liner. I'm going to be going to Scott Sabolich in OKC in a few weeks to get a new leg made. I don't want to travel to OKC (15 hour drive from Wisconsin) if I'm going to end up with another pin system. I might have to rethink this...
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Post by cherylm on Sept 4, 2013 22:17:40 GMT -7
Mitchee, I've never been the most active person in the world, but I've been able to be a lot more active since getting my vacuum system. I think that hiking would be a possibility (I did use to hike quite a bit and am trying to work my nerve up to try it again), and I'm also considering another attempt to get back on a bike with this leg. (It works quite well on a stationary bike.) I haven't roller skated (roller blades didn't exist back then) since I was 20 or so, and I don't think I'd be anxious to try it again now...but that may be more due to my general clumsiness than my prosthesis!
I do have a friend who has used Scott Sabolich for several years and absolutely swears by the guys at the firm. He's very much of the "show me the latest and greatest in everything" school, and Sabolich has accommodated him. Perhaps a phone or e-mail consult before your visit could help you decide if the visit would be worthwhile??
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Post by bassett on Mar 19, 2017 13:38:44 GMT -7
I'm bumping this old thread because I found it while searching for reviews if Otto Bock EMS vacuum systems.
So, this thread being 3-4 years old, my question is; has the research and design of the newer vacuum systems solved the old problems of long donning time periods, hard to get on because it's so tight, "eating" away at the skin and creating blisters?
Thanks for any info guys. I'm 4 days out of BKA and really trying to figure out the best setup for my lifestyle. I'm a football and track coach and a science teacher. So I'm on my feet from 7am to 7pm 6 days a week usually.
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