|
|
Post by allenuk on Jun 14, 2010 7:51:20 GMT -7
Any ideas on this one?
I've been on pinlock, quite happily, for years. My prosthetist thought I was pistoning (socket going up and down independently of stump) and that I'd be better off in a full suction system instead.
So, fitted a couple of weeks ago, and since then I've had no end of problems holding suction.
The 'exit' valve is a little one-way thing dangling off the bottom rear of the socket, the idea being when you push your stump down, the air is expelled, so after about 8 or 10 paces, all the air is gone, and you are in full suction until you de-leg again.
Suction is kept in by a big exterior liner, like an Alpha liner but just a long tube, so the set up is this:
Stump
Inner alpha liner
socket
outer alpha liner, rolled down over the socket and secured by tape, and then at legging-up rolled UP over your thigh.
And that's about it.
But every time I walked, I either got the 'shhhhh' of air going OUT of the bottom valve, or sometimes the trumpeting of air coming UP past the liners, and the result was that my socket wasn't being secured, and the whole kaboosh was uncomfortable.
1) We tested the valve; okay, functioning.
2) We replaced the outer liner, as he thought that a) it was not tight enough, and b) it had been cut a bit short, thus not covering enough skin on the thigh.
Okay for a couple of days, then losing air again.
So, next tries:
3) Shaving thigh. Moderately hairy leg (although not particularly Simian), now as smooth as the proverbial.
Okay-ish round the flat, back to losing suction as soon as I walked outside.
So,
4) An OLD length of Alpha-liner, end cut off, rolled up OVER the proper outer liner, making a double thickness of liner.
So far so good.
Is there anything we're missing, and/or is this a common problem?
The new foot, the Echelon, is fine, but very heavy so any suction loss is made worse by the foot and gravity.
Ideas welcomed!
Allen, bka, suction, Echelon, London, fed up.
|
|
|
|
Post by stonecutter on Jun 14, 2010 9:48:59 GMT -7
Allen,
During the construction of my latest prosthesis, it was considered as an option to go this route + an actual vacuum pump that works it's way to keeping an active suction, but between the initial casting for the Alpha custom liner (which was a dismal failure for me...) and the time to actually cast for the new socket, this idea was abandoned. Apparently, my prostetist found in his experience that suction is hard to maintain with these pumps.
Currently I have the exact system you describe. I'm back to the normal 'off the shelf' alpha liner, I'm wearing two 3 ply socks, an iceross sleeve, and an alpha liner over it. And - Still no seal.
So - I feel your pain...
|
|
ann58
Female Member 
Posts: 278
|
Post by ann58 on Jun 14, 2010 10:16:52 GMT -7
OK guys....I also went to the vacuum system...am having no trouble what so ever. I also use the echelon foot.{which I love} very good for outside & uneven ground....Evolution liner and sleeve. I take air out w/ a small hand pump. Hardly ever have to take air out during the day...suction stays good. This is a Stan Patterson system.{ think that's his name}. Allen, you had to shave your leg  I thought we weren't supposed to shave our leg. |
|
|
|
Post by ann- on Jun 14, 2010 10:30:22 GMT -7
Allen, I wear a similar b/k suction leg ... but just with an alpha liner over the stump and a pelite socket nothing else. I have the valve thingy which goes between the outside of the hard socket and the foam, but don't get any noises with it and it works quite well. I don't seem to get any pistoning (even though the one I am presently wearing isn't fitting that well). Mine is held on with a sleeve (no shaving involved though).
Am presently wearing, I think a pretty basic single axis foot, but am going to tria the College Park Trustep on the new pair they are making me.
|
|
|
|
Post by allenuk on Jun 15, 2010 1:32:07 GMT -7
Well, ann(58 that is), me man didn't TELL me to shave it, just told me that the amount (not particularly hairy) of body hair I had on my thighs was an impediment to a good seal, and that it was enough to allow air to go up and down between the skin and the liner.
So, out came the razor.
Did it work?
Did it flip.
The very FINAL thing seems so far to be working a bit better, i.e. the old bit of alpha liner cut down and pulled up OVER the proper liner, thus trying to give a double-seal to the leg. Not quite as 'shhhhh'y as before, so we live in hope.
Stonecutter: doesn't that screw up your fit stump/socket? It does mine - I can feel them moving independently, and when they're not in the right place, they're sore!
Allen.
|
|
|
|
Post by ann- on Jun 15, 2010 7:12:16 GMT -7
Allen, During the construction of my latest prosthesis, it was considered as an option to go this route + an actual vacuum pump that works it's way to keeping an active suction, but between the initial casting for the Alpha custom liner (which was a dismal failure for me...) and the time to actually cast for the new socket, this idea was abandoned. Apparently, my prostetist found in his experience that suction is hard to maintain with these pumps. Currently I have the exact system you describe. I'm back to the normal 'off the shelf' alpha liner, I'm wearing two 3 ply socks, an iceross sleeve, and an alpha liner over it. And - Still no seal. So - I feel your pain... How high does your Alpha liner come above your knee Stonecutter, and do your socks come above your liner. If they do, turn them down a bit. So they come beneath the edge of the liner, but don't allow them to be too bulky. I have recently had my liner trimmed down so its only a couple of inches or so over the knee. Am not quite sure what sleeve I am currently wearing, but I have quite a good seal, and even though the actual socket is not fitting me properly, am not getting pistoning, so think the suction is working. |
|
|
|
Post by stonecutter on Jun 15, 2010 10:41:33 GMT -7
|
|
|
|
Post by stonecutter on Jun 15, 2010 10:51:18 GMT -7
Stonecutter: doesn't that screw up your fit stump/socket? It does mine - I can feel them moving independently, and when they're not in the right place, they're sore! It doesn't screw up my fit. what it does do is limit my flexibility and mobility of the overall leg. It bulks up material behind my knee... |
|
|
|
Post by ann- on Jun 15, 2010 13:09:39 GMT -7
is that two sleeves stonecutter?
not sure I'd like all that bunching up round my knee
|
|
|
|
Post by stonecutter on Jun 15, 2010 13:20:59 GMT -7
Yes. Two sleeves. And, like you, I really don't like it bunching up behind the knee, and every so often I need to go and pull the sleeves up, as they settle with time.
I found that unless the suction is absolutely perfect, the whole thing doesn't feel stable and in order to establish the feeling that everything is one unit. Otherwise it feels kind of like there's support at the top of the socket, but loose inside. (I don't know how else to describe it). THAT, and it feels heavy without the extra sleeve.
|
|
|
|
Post by ann- on Jun 16, 2010 0:19:36 GMT -7
Yes. Two sleeves. And, like you, I really don't like it bunching up behind the knee, and every so often I need to go and pull the sleeves up, as they settle with time. I found that unless the suction is absolutely perfect, the whole thing doesn't feel stable and in order to establish the feeling that everything is one unit. Otherwise it feels kind of like there's support at the top of the socket, but loose inside. (I don't know how else to describe it). THAT, and it feels heavy without the extra sleeve. If I get that heavy feeling with the prosthesis, for me personally, it usually indicates that it is not fitting properly. At the moment I have prob got the opposite to you with one of my current prosthesis, in that there is not much support round the top of the socket. Did they originally cast with the extra sleeve Stonecutter, or is it that you added it after for extra comfort? Interesting when you say that 'unless the suction is perfect, the whole thing feels unstable' .... I recently had a new leg made which I couldn't wear as felt so unstable, and am now in the process of having it redone ... though I didn't relate this to the suction ...more to the socket trimline being cut down quite short and a different foot. Maybe I shld have been thinking about the suction also. |
|
|
|
Post by allenuk on Jun 16, 2010 1:22:28 GMT -7
Stonecutter:
And there was me thinking this was a temporary setback!
How long have you had the suction set-up?
What does your prosthetist advise re. keeping the suction in?
What do you think the long-term solution is?
Me? I've got a spare leg, a pinlock, which was intended just for cycling (as you can bend the knee without all those layers of liner), but I suspect it will be back on my leg before the week is out. In the longer term, my man wants to redo a pinlock socket incorporating the distal cup that I've currently only got on my suction socket, which sounds like a good solution.
I can get the suction to work, standing in one place, but as soon as I lift my (okay heavy) Echelon for 5 seconds, and put my foot back on the ground, then 'Shhhhh' as the air has to get expelled again! Drives me mad.
Why aren't you on a pinlock, or similar?
Allen.
|
|
ann58
Female Member
Posts: 278
|
Post by ann58 on Jun 16, 2010 8:04:17 GMT -7
I got out of the pinlock leg due to the pulling of the skin on the bottom of my leg....it was causing a neroma{spelling}...they could never get the pinlock to fit.
As Ann said. be sure your sock is below your liner or it won't seal very good.
|
|
|
|
Post by ann- on Jun 16, 2010 23:52:45 GMT -7
I got out of the pinlock leg due to the pulling of the skin on the bottom of my leg....it was causing a neroma{spelling}...they could never get the pinlock to fit. As Ann said. be sure your sock is below your liner or it won't seal very good. I don't use pin-lock either ... similar reasons |
|
|
|
Post by cherylm on Jun 17, 2010 21:39:14 GMT -7
I'm still in a pin-lock system and think periodically about trying suction...but then I hear about the problems when the suction doesn't work and I chicken out. I must say that I've been pretty lucky with my pin suspension, but I also wear a suspension sleeve over the top of the whole get-up. My set-up goes:
lightweight silver-fiber "undersock" on my stump
pin-lock liner
three-ply stump sock
socket
suspension sleeve
It's a little more than I really like at the back of my knee, but I have strong legs and can bend my knee to slightly more than 90 degrees with the whole set-up on. And the suspension sleeve means that, as long as my socket is fitting reasonably well, I don't get pistoning or much in the way of rotation.
I've worn this type of rig for about three years, and it's worked well for me........
Allen and Stonecutter, I hope you can find something that's better-suited to you.
|
|
|
|
Post by allenuk on Jun 18, 2010 3:15:35 GMT -7
Thanks, Cherlym, that's interesting - so you have a normal pinlock set-up, PLUS that sleeve, which in fact makes it (in bulk terms) very similar to the suction that stonecutter and me both have.
I've in fact given up on the suction this week, and switched back to my 'spare' pinlock leg. Much more comfortable, but I'll switch back over the weekend and give it another go.
Allen.
|
|
|
|
Post by stonecutter on Jun 22, 2010 14:54:22 GMT -7
Sorry it's taken me so long to get back to this thread. It's been a crazy week here... Did they originally cast with the extra sleeve Stonecutter, or is it that you added it after for extra comfort? Nope. They casted with the liner on... But there was no socket to install the sleeves over... Not sure I appropriately understand the question. How long have you had the suction set-up? Since about 98 or 99 or so... It worked really well. I've been working on this lates t prosthesis for just about two years, and the leg I had before was pretty good. I got it in May of 2000 and it lasted until mid 2008. The only reason I asked for a new one was that I was up to 24 socks. Still felt good though. What does your prosthetist advise re. keeping the suction in? Keeping brand new sleeves on. But I can only get 2 at a time and have to trek across town to pick them up. It's hard to do when I'm in my busy season... Insert another few excuses here... This is why I save the perforated old sleeves and double them up. Usually I get a seal. Sometimes not. (like now... (Still)).. What do you think the long-term solution is? I'm baffled. Why aren't you on a pinlock, or similar? I have a quite fleshy stump, and I have this one spot that is very nerve-sensitive right in the bottom. Sometimes when I didn't have the angle of the liner on just perfectly, it would really drive me crazy. Sharp stabbing pain. The fleshy part would also be sucked by the pin-lock liner with every step to the point that when I took my leg off in the evening, the skin would be rock hard as fluid was suctioned into the skin. I'm told this is pretty unhealthy. |
|
|
|
Post by allenuk on Jun 24, 2010 12:59:15 GMT -7
Well, my guy took me off pin-lock and tried me on suction for very similar reasons to yours, stonecutter - a point on my stump (not fleshy in my case) where, whatever we tried, it hurt like hell!
He put me in a distal cup (a fat white silicone cuppy thing that goes from base of stump up to just below the knee), and then a standard (but big) liner, and THEN recast me over all that lot.
So although the suction sucks, the actual SOCKET part is a lot better - not, mind you, that I've walked very far in it, as it's so uncomfortable because of the sodding SUCTION!
Anyway, this isn't just a ramble, the point is this: I spoke to him today and what he proposes doing is this. He is going to use the distal cup still, plus a PIN-LOCK liner as before, and make a new socket from the current cast, but adding the necessary hole etc. at the base to make it a pin-lock socket.
Hopefully this will give us the best of both worlds, i.e. that added protection for the stump base, plus pin-lock cos it works better (oh, and the Echelon, which again hasn't had a proper trial with me because of the other problems).
I will keep you posted because if it DOES all work, it might be a route you could try.
Allen.
|
|
|
|
Post by allenuk on Jul 1, 2010 3:57:18 GMT -7
Just an aside for stonecutter and anyone else having suction problems: my man yesterday reckoned my problem was the soppy little VALVE intermittently leaking, and he said he'd had a few like that over the past months.
In fact the first replacement valve he tried ALSO leaked, so he ended up swapping the crude bit of plastic tube with a black one-way valve in the end for a posh-looking job, a circle made of ally or something, button in the centre for 'emergency' suction release.
Anyway, 24 hours on, suction holding together, so if you haven't already, check out your valves...
Allen.
|
|
Tom
New Member
Posts: 24
|
Post by Tom on Jul 4, 2010 11:30:22 GMT -7
Ann: I have recently had my liner trimmed down so its only a couple of inches or so over the knee.
Thanks for mentioning that, I've got the same setup (but with a vacuum pump) and I suspect I'll have less problems with a shorter liner.
|
|
I thought we weren't supposed to shave our leg.
