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Post by bassett on May 2, 2017 10:11:49 GMT -7
Ok, so I was fit last night with my leg. It's a BKA socket with vacuum tech with a PII HD pump and a Rush 87 foot. It is difficult to walk, I wont act like it is easy, but my question is this; Will my limb adjust to the pressures it is feeling and "normalize". Each step I take I feel a huge amount of pressure behind the knee and I'm starting to feel the shin in the front. My prostetist warned me about this being something in the beginning, but I wonder how much I should be on it this first week or so. I'm been getting up every hour or so at work and moving around with my walker. It is exciting to think that I could eventually not notice or feel the uncomfortable feeling I have now. I guess only time will tell. And, I don't think its the fit. That seems to be fine. I think its just the leg not understanding or liking the feeling of supporting my weight. The knee is a bit wobbly too...
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Post by stonecutter on May 2, 2017 11:15:31 GMT -7
The work doesn't stop for a long time trying to get a fit for the first socket. Tell your guy/gal where you hurt and for the love of all things holy - don't think you're a super hero and overdo it. Until you're comfortable in your socket, you should only wear it for shorter periods between inspections of your stump.
Others may have a differing opinion.
Super stoked that you're upright again though - this is a milestone!
T.
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Post by cherylm on May 3, 2017 2:43:35 GMT -7
I agree with Trevor here, bassett...go very, very slowly and give your stump plenty of time to adjust to wearing a prosthesis. It IS going to feel somewhat weird, clumsy, and heavy at first...and it's most likely going to take a LOT of "tweaking" on the fit front. Bear in mind that you're still an "amateur" on the fit of a socket, so make sure you tell your leg guy EVERYTHING you're feeling, good, bad, or indifferent.
You're now using what's left of your leg to basically heave around a large and heavy dead weight that's been strapped onto you. It will take some time and effort to work up to that feeling "natural." Your suction system will help, building your strength up will help, and your prosthetist should be continuing to work with you and make adjustments to keep things as comfortable as possible. You WILL get there, eventually...just know that your improvement is likely to be "slow and steady" rather than a frantic sprint back to full mobility.
One thing that helped me during that whole adjustment window was to keep track of specific activities that were giving me trouble and then make a point of going back to the same place to try the same activity again every few weeks. If I got to feeling frustrated by how slowly I seemed to be improving, just realizing that I was now able to do something that had seemed very difficult previously was a big boost.
Also, remember that you're going to continue to shrink in that new socket...so make sure that both you and your prosthetist make sure you're being appropriately "padded" and recasted as necessary to keep a snug fit. "Snug" is going to come to feel good to you in time...just make sure that "snug" doesn't turn into "pain" and you'll be fine!
Good for you on taking your first steps...isn't it a grand feeling?
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Post by thebrianmo on May 3, 2017 7:01:02 GMT -7
You should get to the point that your socket fits like a custom made glove. It takes a lot of work and a lot more patience. After a couple years of poorly fitting sockets, I moved back to Pittsburgh, got a new prosthetist and we sat down with red sharpies and designed my socket the way I want it to fit. Yes, the prosthetist is the expert,but I also know what's comfortable, what feels right and what works for me. I've had my current socket about a year, which is the longest I've ever had any socket; I'll be getting a new one soon and will again sit down with my prosthetist with our sharpies and draw on a mock up of where I want everything to be and how I want it to fit. Remember, you always have the final say. All that being said, it did take a while to get used to the pressure on my residual limb and now, I don't even notice it at all. Best wishes to you.
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Post by bassett on May 3, 2017 7:30:49 GMT -7
Thanks for the replies guys. It is a good feeling to be upright again. My students (I'm teacher) keep commenting on how tall I am because I've been teaching from a wheelchair all year.
After day 1, I had a few small, dime sized blisters on the side of my leg, below the knee on the outside, and 1 in the front left of my shin, about an inch up the stump. Other than that all seems ok. I have not felt the bottom of the socket yet... I'm not sure if that is good or bad. It seems that all of my weight is dispersed around the under side of my knee; all the way around. My prostetist called this zone 3, and he said the weight bearing would move down to zone 2 (the mid section of my stump) by next week. I'm not in pain, just tight discomfort when I put all of my weight on the leg.
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Post by cherylm on May 4, 2017 1:36:17 GMT -7
Blisters--even small ones--can turn into trouble quickly, so keep a very close eye on those creatures. You definitely do NOT want to feel the bottom of your socket, at least not with any amount of pressure. When my own leg is fitting and feeling really, really good, I'm "kind of aware" of the bottom of my stump barely brushing over the bottom of my socket, but there's no feeling of bearing weight there...just that "awareness."
I've never had a prosthetist talk about numbered "zones"on my stump, but aiming for your weight bearing to be spread over the midsection is a good thing. It wouldn't surprise me if a good part of your discomfort is coming from the fact that the area around your knee is both bony and right at a a joint, so bending and moving your leg is going to be create a lot of pressure. You have more soft tissue as you move down your stump, and that will adapt better to the pressure of the socket.
Brian's description of a good socket fit makes perfect sense...a custom-made glove would be snug but still allow you to move your fingers and hands comfortably: ditto for your socket and your leg.
It's possible that you will ALWAYS be aware that you are wearing a prosthesis (although there's also a chance that you'll reach a point where you basically ignore that fact and feel like the "new" leg is your own), but no matter what your relationship with your socket, if it doesn't feel truly part of you, it should at least feel like a comfortable and supportive "companion." Hang in there...it will come!
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Post by bassett on May 4, 2017 9:20:35 GMT -7
Heading back this afternoon for a 2nd socket. My guy thinks this one is a tab too small, hence the blisters and whatnot.
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Post by bassett on May 5, 2017 6:24:37 GMT -7
So, I was not cleaning the leg and liner often enough, so I have developed some dermatitis. My lower knee is bruised in front and on the sides, basically where I am weight bearing, but it is getting easier each day. If the skin and bruises would clear it would not be as uncomfortable as it is now.
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Post by cherylm on May 6, 2017 0:03:10 GMT -7
Yeah, even if "housekeeping" is not your favorite thing in the world, clean your liner daily...it will spare you a world of hurt. A very quick-and-easy way to keep things clean between major washings is to just buy a batch of baby wipes--unscented and hypo-allergenic. When you take off your liner at night, just wipe down the liner with a baby wipe...then just let it dry overnight. You still need to do a periodic wash with an unscented soap and rinse in very hot water, but you can do that when it's actually convenient for you, instead of when you're just wanting to get into bed fast!
Good luck!
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Post by Ann on May 8, 2017 23:45:03 GMT -7
I would echo what everyone else has said on here regards taking time to break your leg in really gradually. A lot of pressure will be going through your leg, which it was not designed for or is used to, so taking it gently now, should prevent what could be, more problems in the future. Initially, I was told an hour at a time to start with and a gradual build up and this is something I still do even with new sockets.
Do keep a special watch on any areas that stay red for more than a minute or so after you have taken it off, ands keep an eye on those blister and dermatitis areas, what can seem a small problem to start with can quickly develop into something that might keep you off your leg for some weeks. Likewise, the 'housekeeping' side of things, if you can get into the practice of washing liners etc regularly now, it will soon become second nature and something that becomes routine for you.
Am really pleased your prosthetist is so on the ball with this and making you a second socket so quickly, it's not unusual to need sockets re-made, even years on but especially in the early days, it can also take a while for a prosthetist to know you and what works for you, you will probably find also that as you increase your walking your leg will shrink down so the socket becomes big and you need more refits.
Good luck with socket no.2, hope all goes well.
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Post by bassett on May 9, 2017 18:07:38 GMT -7
Thanks for the comments guys and gals. So I'm 1 week in at this point and I'm walking without the walker. The first 10-15 steps are uncomfortable, but it seems to ease up if I just walk through those first few steps. I'm on the second socket, my guy, Ryan Fann, made the second socket 3 ply larger, so it's a nice fit now. I went in today for the 3rd time on a week and we decided to go ahead and order a flexable inner liner. So, things are rolling along. I'll say this, of you need a good prostetist in the South East then you should look up Ryan. If you Google his name you'll get a good idea of who he is and what his practice is all about. He raises money to give away 20-30 running prosthetics each year through Amp Blade Runners each year and he's a former paralympian. Practices out of Savannah and I could not be happier with the work he is doing for me. So all seems to be falling into place. I've gone 2 days now with no walker and I feel great. Oh, and I've begun taking salt water bathes at night and it's really helping clear up the leg.
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Post by stonecutter on May 10, 2017 7:54:18 GMT -7
Oh yes... I remember the first few angry steps...
It gets better as you get stronger. Just takes a while - keep it up and keep us posted on your progress!
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Post by cherylm on May 11, 2017 2:49:04 GMT -7
Sounds like you're getting the hang of it now and really starting to make progress! Keep increasing your activity GRADUALLY and steadily. Also...part of your first "angry" steps might be related to your knee...if you're "locking" your knee as you walk, it puts more pressure on you. Make sure you're relaxed and walking with a "soft" knee...it can make a world of difference!
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Post by stonecutter on May 11, 2017 7:24:34 GMT -7
The angry steps I remember was an all-over protest-like reaction from the new anatomy of the stump not liking the pressure of the socket. Was normal first thing in the morning. Kind of felt like squeeze pressure for me.
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Post by bassett on May 13, 2017 11:14:59 GMT -7
So, I spent all day Thursday in the leg and in the sun. Too much heat and sweat and I had a good amount of dermatitis pop up again. Is there any way to calm down the pimples and sores other than cleaning the system and the leg every hour or so? I'm hoping the skin will adjust with time.
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Post by cherylm on May 14, 2017 8:15:47 GMT -7
You most likely WILL adjust within several months. There are also antiperspirants you can use to help with the sweating, but I've never used one of those, having rather sensitive skin myself. (Ask your prosthetist about that.) At any rate, I went through a miserable, sweaty first summer in my leg...but by the following summer, things had calmed down and I no longer even thought about the sweat issue. Until then, though, I did have to periodically take the leg off and mop up the sweaty puddles from the liner. (Sorry about that news.....)
It can be a long and complicated process breaking in a prosthesis...but hang in there and you'll be fine in the end!
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Post by stonecutter on May 15, 2017 10:34:29 GMT -7
Would echo what cherylm had to tell you. Until you get used to it - it's a sweaty mess. I do sometimes still get heat blisters through at the top of the liner where it transitions from liner to sleeve.
On very rare occasions when I am working outside or doing something very strenuous in hot weather, I will get a sweaty stump. Feels kind of slippery when I walk and I can feel sweat gushing around in there. I will have to take a break and clean up before proceeding. You don't want to keep that going all day - you'd be prone to skin break downs and possible infection.
What a charming topic! Ahhh... the life of an amputee!
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Post by bassett on May 22, 2017 6:14:59 GMT -7
Maybe not charming, but true! So, I've moved on to a new socket. We went with an "EMS" style flexible inner liner. So far, it feels great. I do feel more pressure, lower on the socket, but overall, it is a more comfortable walk. Before, I had all of my weight on a ring around my knee, now it seems to be much more dispersed. Don't get me wrong, there is still discomfort at times and soreness, but its improving so I am focusing on the positives.
Quick question. I have a small place low on the back of my stump, it could be an ingrown hair or pimple, but it feels like it has a direct link to a nerve. The slightest pressure sends nerve lightening blots up and down my stump and creates some phantom pain (outer toes). I'm hoping that it will resolve when the pimple or ingrown hair resolves... Is that common?
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Post by stonecutter on May 23, 2017 10:04:33 GMT -7
Glad to hear you're more comfortable in your new rig. With reference to that sensitive spot - is it anywhere near your incision?
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Post by bassett on May 24, 2017 5:54:52 GMT -7
Sure is Stonecutter. About 1 cm off of an incision that used to run uu the back of my calf. So, not from the amputation, but a scar from a previous surgery. I finally put 2 and 2 together on that after a day or so. The nerve pain is improving as the "pimple" reduces.
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