R AKA Newby. What should I expect from my prosthetist and PT

[lisa1967]

Hi,

My stepdad Gary began with a R BKA in Nov. 2016. He became an AKA Jan. 2017. Due to infections, etc. he just got his prosthetic leg this past July 14.

He began with home PT and the prosthetist came to the house also. Of course there's a learning curve with the whole thing, putting it on correctly, ensuring a good fit. And we expect adjustments might be needed.

We totally understand that this is a process that will take time.  His stump still has to shrink quite a bit.  It's just so new, not sure if we've got a good guy, or if he should be more attentive.  We have no clue... he's nice and sounds like he knows his stuff, but whatta we know.

In between home PT visits, Gary, my mom, and I practice for at least an hour and a half, twice a day. We felt more confident about us putting this on more correctly and he started to be able to feel if it was on securely.

But it continued to twist inward. we added sock plys. Seemed to help a bit.  

Anyway, the next time he saw both those people, Gary told them it feels like the prosthetic leg was taller than his real leg.  They both said it may be, but the issue was dropped... no measurements taken. They seemed to dismiss it.

As of last week Gary started outpatient rehab, and within his first few visits, the PT lady there said.... "Well, first off your prosthetic is about 1/2"  to 3/4"   longer than your real leg.  She strapped lifts to his real leg shoe... and he felt a lot better.

My question, I guess.. is... should the prosthetist have been more attentive and recognized that, resolved it ?  Or, is it normal in the beginning to have to wait for his stump to settle more ?

Also, I'm a little disappointed that he only has a half hour session twice a week for PT.  I just think that is so minimal. 

My parents live near a college campus... The 3 of us have been going there to practice on the ramps, stairs, walkways, grassy areas....every day, twice a day...

I want him to learn correct habits form PT, but it seems like he's getting more practice with us at home. 

Is that the standard PT time allotted ?

Thank you in advance for any replies, I'm back to work tomorrow, but will be logging on as often as I can.... This seems like such an awesome avenue to learn,

Thank you,

Lisa

[cherylm]

While the prosthetist may have had a reason for waiting on adjusting the length of the prosthesis, I'd press him hard on explaining that reason...a 1/2 to 3/4" height difference is pretty darned significant and would be likely to create problems. Has your stepdad had much in the way of shrinkage yet, Lisa? The only reason I can see for ignoring leg length would be that the prosthetist was counting on an awful lot of very rapid shrinkage...and I mean A LOT happening VERY rapidly.

When I got my first prosthesis, it was truly set at a good length from the beginning, but I shrank so rapidly that I was being cast for my next socket less than one week later. That's kind of unusual, but not totally unheard-of. Do keep in mind that it can sometimes take at least a year for a new amputee's stump to settle down and start behaving predictably. The "twisting" issue is likely caused by Gary's stump still being fleshy enough that it is more or less circular and the prosthesis has nothing in the way of a bone structure to grab on to. Wearing a good suspension sleeve over the prosthesis can give good relief from a twisting foot, so see about that possibility if it continues to be a problem.

As for the PT schedule, if he's at home at this point, that's a fairly common schedule to go in for a PT appointment. If he were in a rehab facility, he'd be meeting with the PT staff much more often (like five or six days a week). Your family is on the right track in continuing to work on the PT exercises in between...and if Gary's insurance will cover it, you could also ask for additional appointments. Also, make sure that the PT department has provided written instructions and illustrations of his exercises and that they provide clear feedback during his appointments.

You are right...no matter how much research you try to do, a new amputee and family members really do NOT know how it all should go. Ask TONS of questions of your stepdad's leg team, see if you can get hooked up with an in-person amputee support group, keep doing research...it can seem like an overwhelming learning curve, but the day will come when it WILL all seem "normal" again.

Best to ALL of you!

[lisa1967]

Thank you so much for your reply cherylm. We will certainly ask him for the reason. Gary's stump hasn't shrunk all that much yet. It still seems pretty fleshy, but I can see that it has begun to shrink and reshape a bit.

He's going to an outpatient facility for his PT. I just think a half hour twice a week is so minimal. He actually just found out he may be able to go more often. He's looking into that today at PT. Hopefully he'll be able to. We will also request his exercises and feedback.

I think a support group would also be helpful to learn about all this.

We will continue to work together at home, research different things, and ask questions. I don't get a lot of time to visit these sites, but they are so informative. So thankful this exists.
Thank you again,
Lisa

[stonecutter]

That PT regiment sounds very light. When I was in recovery prior to receiving my first prosthetic I was in PT twice a day for an hour 5 days per week. Bear in mind that I was 19, had a goal of starting school in a few weeks and the amputation was the result of an industrial incident.

Does Gary's PT give him a lot of 'homework' to do?

I wish Gary well with his recovery.

[lisa1967]

Thank you so much for your reply. We looked into his PT allowance and just learned he can go for more visits, so we plan to sign him up for as many as he can have.
He does have PT homework to do. He's doing very well with that, we just want him to have as much instruction as possible. Thankfully now, we think he will.