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Post by allenuk on Jul 13, 2011 12:42:10 GMT -7
Just some ramblings, which might help someone else in similar troubles...
Temporarily, we've abandoned the suction project; my prosthetist still reckons he could make me a leg which would fit, but the lifestyle difficulties (cycling, general pain-in-the-arse getting the very tight inner liner on, etc), tend to militate against suction and towards keeping on with pinlock.
Anyway, he gave me some silicone 'comfort socks' to try - you put one on next to your skin, then the ordinary Alpha liner, then less cotton socks than usual - and damn me it works. Not 100%, but enough to start doing larger jobs around the house (whereas before after 10 minutes I'd give up and sit down with a cup of tea as my stump was hurting!)
Then, his assistant spent half an hour with me adjusting and re-adjusting my alignment - not just half-a-turn this way or that way, and 'is that any better', but by tiny amounts, 1/4 turn, even 1/8 turn, and so on, until it really felt good.
The problem that seemed to manifest itself after all that was that my socket seemed to go out of alignment in a couple of days, and at present we're putting it down to my stump 'window' being so big. When it was first cut, it was a great relief (quite a big hole, about 2 x 2 inches or more), but what seems to be happening is that my inner socket, no longer constrained by the outer wall, has a tendency to drift forwards. Obviously the pin stays where it is, and the top of the socket stays where is it, but a mill or 2 of movement can quickly and adversely affect all that fine-tuning of the alignment.
My solution, again fairly short-term, is to use '2nd skin' gel circles. They're not designed for prosthetic use really, but for burns, but the effect is that you can place one between your stump point and the liner (or comfort sock), and it adds a layer of gel at that point. Tend to need replacing at least daily, as (well in my case) my stump point just wears through the gel and leaves a hole, but I found a cheapish place on the web where you can get them for £30 for a tub of 48 gels (Amazon are nearer £44). Anyway, point is that while they're whole and working, they do tend to stop that annoying front of stump pain.
Let me know if you want further details about any of this, and I'll post pictures.
Allen.
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ann58
Female Member 
Posts: 278
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Post by ann58 on Jul 16, 2011 18:12:20 GMT -7
Allen, glad to hear from you. What a time you're having.
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Post by ann- on Jul 17, 2011 1:02:09 GMT -7
Can you post further details of these Allen.
I am in a similar situation at the moment regards fittings .... am waiting to try a different kind of liner, but would be interested to know about the 'comfort liners and the gel pads'.
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Post by allenuk on Jul 17, 2011 8:28:52 GMT -7
Okay Ann, here's the pictures:
It was easier to do a movie...
So, the gel circles are '2nd Skin Gel Circles' which come in a tub of 48. Amazon do them for something like £45, but in the UK you can get them for about £32 from Foothealthcare.com. They are BURN dressings, nothing to do with prosthetics, but serve the purpose - I find that fixed rubber things just hurt more, but these move around and, crucially, degenerate over a day or two. You might make them last 3 days if you're very careful, but they will break up, believe me.
What I describe as the 'comfort sock' is in fact a 'Gel Sheath Skin Reliever' from ALPS. No idea of a price but I'd guess it would be at least £60, if not more - my limb-fitting centre gave me 3. Drawback of these things is that you are ADDING another layer of rubbery stuff to your stump - these are 3mm at the bottom end, so added to my fairly hefty Alpha Liner, I end up with quite a rubbery feel.
In terms of socket comfort, pain has gone from a nasty 1 or 2/10 up to a fairly pleasant 7 or even 8/10, which as I said above, means I can at least get on with things around the house.
But for walking, well, walking comfort has gone from a not-very-nice 3/10 to a not-much-better 4/10, mainly because of the 'rubbery' feel that I mentioned.
All in all, not a long-term solution, but it certainly helps.
Let me know if you want more info (or even pictures!)
Allen
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Post by barclay on Jul 17, 2011 21:52:08 GMT -7
Hi Allen,
Is that a standard system in the UK ? It's different from what I've seen here in Austria. I have no inner liner, but a second soft-shell which goes on over pin-liner. I put the pin liner on, then an old nylon stocking and then the soft-shell. The nylon goes out the hole and get pulled back up over the soft-shell. and then all goes into the socket. The nylon allows the inner shell to slip in easily. I hope that's understandable.
Thanks for posting that, It was really interesting to see. Your residual limb looks great; you seem to take good care of it!
Best, Cynthia
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Post by allenuk on Jul 17, 2011 23:51:55 GMT -7
Hello Cynthia.
No, never seen your version, and no, mine isn't a standard system in the UK. My prosthetist is trying it on me because of my boney bits. Yours sounds similar to what I'm doing, but with the second soft-shell reversed, i.e. over the liner rather than under. As I've got some spares, I might cut a hole in the bottom of a soft one and try it over the Alpha liner and report back.
My residual limb? Well, once upon a time it had a lot more tissue covering those boney bits, and life was simpler!
Allen.
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Post by tedatrowercpo on Jul 18, 2011 9:17:06 GMT -7
Given the placement of your skin irritation it's clear to me that your foot needs to be outset from its present position. Your prosthetist may resist this because according to the books it is not "correct" but it is what you need done.
Also as a separate issue, when you roll on the liner it is important that the seams be placed squarely on the side of your limb as they do not stretch and will pull on the skin each time you flex your knee if they are out of place.
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Post by allenuk on Jul 18, 2011 12:36:54 GMT -7
Hello Ted,
Long time no talk. Good to hear from you.
I'll look into the outset foot business and talk to my prosthetist about it - he's not one for doing things by the book, so should be open to suggestions.
On the liner - the reason I roll the Alpha up off-centre is so that the left-hand seam misses my fib. head, which after my stump point is always a source of irritation unless I'm careful. I have a fair-sized window cut into this socket to relieve the fib. head, which helps, but I find that if I put the liner on dead centre, the extra pressure from the seam can cause problems.
Allen.
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Post by ann- on Jul 19, 2011 0:52:56 GMT -7
Many thanks for posting the movie Allen, its always interesting to see how others manage things and learn new tips.
I am in a similar situation to you with bony bits, on one side my stump is fairly long and pointed as bones have grown and probs are in the same area as yours, to date I have only been wearing socks, but am in the process of now getting leg made that will accommodate an Alpha liner. Almost ready to take delivery of it so will up date you on how it goes.
On the other side my stump's been revised so much better end now, but have skin graft on the front, so not much padding and tissues shrunk down a bit so now old spur mid way on the front is causing problems. Am currently using Alpha liner on this side which works fairly well but am in the process of changing liner to one that apparently 'flows' and will accommodate the boney bits and dips more, thats the theory anyway.
Interested in your comfort liner and will be asking about that, as not seen them before, though did think your Alpha liner appeared quite thin, as mine seem a lot thicker. I have used second skin before, years back, used to buy them from Millets and were about the only kind of blister thing that worked on my legs, unfortunately they stopped selling them so good to see they are still on the market. Be good to learn where you can get them a bit cheaper.
Cynthia, I know the system you are talking about, with the nylon sock in the hole that gets pulled back over the soft shell .... it was shown to me on my last visit to centre, and I was amazed at the difference it made in comfort. Though it was not nylon, more cotton, kind of tubular sock cut off, I think from a roll. Also the soft liner you speak about, I think in the UK we refer to as a pelite liner, and I am also using these on both my legs to further protect them. So not sure if you have that Allen, but it does add extra protection, I don't think its normally used on people who use the liners as well, but I use it to protect the grafting, and have opted to have it on the other side as well, as it does make a difference also.
However, Cynthia mentioned standard systems in the UK, and I don't think there is any one standard system, often you start with the basic set up and from there things are generally tailored to what you might need. Allen mentions that "there was once more tissue covering the bony bits" and unfortunately I think this is what does happen, esp for b/k's, as the years go by walking on prosthetics. I am not sure if there is a lot we can do about it but seems most peoples stumps do shrink down, which does make comfort more difficult.
Ann
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Post by allenuk on Jul 19, 2011 1:56:00 GMT -7
Hello Ann. Reading of your experiences, mine really do pale into less significance. And one thing I've noticed since my PAIN score went from 1/10 to 8/10 is that my mood is so much better. When it hurts it's not a big pain, not like a 'proper' pain, but it's those low-level background pains that niggle away at you and make you snappy. Nice to be free of it, albeit temporarily. My Alpha is a 6mm, but I know they go much bigger (9mm, or even 12mm). The interweb link for 2nd Skin is: www.foothealthcare.com/shop/site_search.php?q=NV5369where they are currently £30 (plus p&p), so way cheaper than Amazon. No, don't think I've seen a pelite liner, but yes, I have come across gel liners that claim to 'flow', but haven't had much luck with them. I think they're a bit like Echelon feet - brilliant if you've got a really comfortable socket, but not a lot of use if you haven't! Allen |
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Post by ann- on Jul 19, 2011 23:51:51 GMT -7
I don't think your experiences are any less significant Allen, for any of us when the legs are not right they are a pain in more ways than one, and like you, I find when they are comfy my mood changes and am not so grumpy. LOL.
What I do find with mine though, and am not sure if all bilaterals find this, is that I only really notice the one side which is more uncomfortable, then if that side gets fixed, I immediately seem to have a problem with the other side .... which I am sure is frustrating for my prosthetist.
I am sure you have seen the pelite liners (not sure if am spelling it right, maybe two e's), they used to be the pink inner soft sockets, but now seem to get them in other colours too.
I am keeping my fingers crossed for the new liner so am hoping I have more luck with it than you say you have, but do agree that everything is down to the 'fit' of the socket.
Thanks for the link for the second skin, might try and get some for emergencies, am also trying to source Adaptskin which is being talked about on another forum, and am wondering where I can get it in the UK.
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Post by oneblueleg on Jul 21, 2011 9:37:42 GMT -7
Hello Ted, Long time no talk. Good to hear from you. I just thought the very same thing... |
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Post by allenuk on Jul 21, 2011 12:18:14 GMT -7
Hello Oneblue, good to hear from YOU too.
Ann: Pelite. I think I actually HAD a pelite liner late last year - my prosthetist described it as an 'old man's socket', i.e. one for particularly non-active old geezers. Old I might be, but as someone who cycles and tries to get on with housework and cooking, it was probably TOO old for me. Anyway, it wasn't very successful, unlike the current set-up. My ideal would be a fairly firm socket, which (crucially!) didn't hurt anywhere.
Oh, I tried the 'comfort sock' OVER my Alps liner rather than under it, and it doesn't make a huge difference - I think it's that extra 3mm of gel that helps wherever you put it.
Most of these sort of experiments need to be done at home, where you've got time to try a different set-up for hours rather than the ten minutes you get at the limb-fitting centre, I find.
Allen.
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Post by ann- on Jul 21, 2011 23:56:54 GMT -7
"old mans socket" Allen ... what a cheek <grin> I've always had the pelite sockets from when I was a teenager and used to walk miles, through to being a mum always on the go with three very active children to now ... still have one of my youngsters at home ...and certainly don't think of myself as old (though maybe the young would).
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Post by allenuk on Jul 22, 2011 5:36:03 GMT -7
Ann, I think the experience of a single 'simple' bka and a bilateral amp must be profoundly different, i.e. not just twice as much of a problem, but many many times more. And I think my prosthetist and his 'old man's socket' comment was probably specifically directed at the bka community, at least I assumed it was!
A
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Post by ann- on Jul 22, 2011 11:09:37 GMT -7
Ann, I think the experience of a single 'simple' bka and a bilateral amp must be profoundly different, i.e. not just twice as much of a problem, but many many times more. And I think my prosthetist and his 'old man's socket' comment was probably specifically directed at the bka community, at least I assumed it was! A I think in the past the pelite socket type PTB was more commonplace, when I started wearing them even they were 'new' in the UK, whereas nowadays liners are more common, think I am just bit 'different' <grin> in that I use both, LOL, but I still see people around the fitting rooms some still using just socks and the pelite sockets (as I have been doing up to now with my right leg) and most of them are pretty active. Still wouldn't call them an 'old mans socket though" I remember watching a TV prog on oscar the blade runner chap, and think he showed some old legs he first started running in and am sure they had the old pink pelite sockets. |
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Post by allenuk on Jul 22, 2011 13:13:00 GMT -7
I shall berate my prosthetist when I see him, which won't be soon as the sod has left Stanmore and gorn off to work in Preston...
A
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Post by tedatrowercpo on Jul 22, 2011 14:38:20 GMT -7
Pelite would not be considered an "old mans socket" so much as it would be considered an "old fashioned socket". Still gets used a good bit in the states but gel liners are more common..
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Post by barclay on Jul 22, 2011 23:25:58 GMT -7
www.youtube.com/watch?v=7cvHM0gjejMFollowing in Allen's footstep..... I am not sure if I have this pelite liner/socket or not, so here is a video of the system I have (was given). Here they call it KMB, but that may be the German version of pelite. What you see is a distal cap (which is too big- so I have to squeegee the air out) followed by the pin-liner and then the soft-shell with the nylon. It seems to me that this KBM soft-shell version gives better protection than the liner which is fixed to the socket as the soft-shell (the bit that goes on with the nylon) moves with the leg, but I know that I don't know much. As for the old-man comment, if this was the system he meant, well, I play tennis (reasonably well) in it..... On the other hand, my Dad played 'till he was 87 :-). Ann - I had to laugh about the other leg always being the problem - I can imagine that so well! It's all relative, isn't it ? Any comments/advice on the donning of the leg are appreciated too- including terminology corrections !! Best, Cynthia
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Post by allenuk on Jul 23, 2011 5:58:02 GMT -7
Well, if that's Pelite, Cynthia, then mine wasn't! The thing I had (albeit briefly) was a curious OUTER socket, which wasn't as rock-solid as normal. It was white, plastic, and you could bend it between your fingers (not very easily, but it was bendable).
So, I'll stick to my guy's description of it as an old man's socket, but apparently not a Pelite one after all.
(Cynthia, your fib head is about as boney as mine...)
And on the 'other leg' business - although I have only one plastic leg, the other (allegedly) good leg often gives problems, and the real foot hurts, and there certainly is a heirarchy of pain. If the good foot hurts, I don't notice the plastic one being uncomfortable, and vice versa. And when they both hurt? I sit down.
Allen.
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Post by ann- on Jul 23, 2011 22:54:58 GMT -7
Cynthia, the system you show on the UTube is virtually the same as I am using, though not using a pin liner, mine is soft ended and don't put anything under the liner, which I think you might of. I would say thats a pelite socket or very similar to a pelite socket, couldn't make out the material, thought it might have been slightly different but the method of donning is the same I have recently been given, and did make quite a difference.
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