Frequently Asked Questions

Prosthetics

Q: What happens after the amputation? Are bionic limbs available that can make me just like I was before?

A: A prosthesis is an artificial replacement for a missing limb or part of a limb. Although a prosthesis is never as natural as your own limb, it can help you to do many things quite effectively if you are willing to combine your energy and willpower into learning how to use it. The most important aspect of success is working with your doctor, prosthetist and therapist to address all of your concerns, and then to work with them on the processes of design, fitting and training, which are required to be a successful user.

Q: What does a prosthesis look like? How will it stay on?

A: Depending on the level of your amputation, physical ability and functional needs, each prosthesis will be somewhat different. If you desire a "cosmetic look," prosthetic supplements are available. But, for most standard prostheses, they are comprised of conventional component parts attached to a socket that fits over your residual limb.

Q: How does a prosthesis work? Will I be able to do all the things I did before I lost my limb?

A: The majority of people who lose a limb can get back to a normal mode of functioning within a few to several months, depending on the location of the amputation as well as physical ability. How well they function depends primarily on their goals along with timely, comfortable prosthetic fitting, good follow-up care, and a "can do" attitude from themselves as well as their medical team.

Q: When will I get a prosthesis?

A: Generally, you should be ready for prosthetic measurements and fitting a few weeks after surgery, when the wound is healed and the tissue swelling is decreased. Then you will be ready for prosthetic measurements and fitting. This process can be easily attained with exercise and rehabilitation. During this stage, your medical team also will be concerned with maintaining proper shape of the residual limb, as well as increasing overall strength and function. Fitting is usually stress-free and involves several steps to create a unique prosthesis for you.

Q: What if the prosthesis doesn't fit right?

A: Follow-up is as important as the initial fitting. You will need to make several visits for adjustments with the prosthetist as well as training with a therapist. They can help you ease pressure areas, adjust alignment, work out any problems, and regain the skills you need to adapt to life after limb loss. Tell your prosthetist if the manufactured limb is uncomfortable, too loose or too tight. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you communicate with your prosthetist and therapist, the better you will be able to succeed with a prosthesis.

Q: How long will it last?

A: Depending on your age, activity level and growth, the prosthesis can last anywhere from several months to several years. In the early stages after limb loss, many changes occur in the residual limb that can lead to shrinking of the limb. This may require socket changes, the addition of liners, or even a different device. Later on, increased activity level and desire for additional function can necessitate a change in the prosthesis or its parts. Once you are comfortably adjusted and functioning at the desired level of activity, the prosthesis needs only minor repairs or maintenance and can last for an average of three years.

Q: Is it difficult learning to use a prosthesis?

A: Learning to use a prosthesis is a tough job. It takes time, great effort, strength, patience and perseverance. You will do best to work with a therapist while learning how to handle the new device. Much like learning how to operate a car, you will need guidance on how to:
- take care of the prosthesis
- put on (don) and take off (doff) the prosthesis
- walk on different types of surfaces, including stairs and uneven terrain
- handle emergencies safely, including falling down and getting up again
- perform daily activities at home, at work and even in a car
- investigate new things you may be uncertain of, including sports and recreational activities.

Q: What can I do to prepare myself for a prosthesis?

A: There is a lot you can and must do to be able to use a prosthesis and use it well. The top priorities are:
- working through the feelings about losing a limb and deciding how to rebuild your life after amputation
- exercising to build the muscles needed for balance and ambulation
- preparing and taking care of your residual limb to attain a proper, sound shape for the prosthesis
- learning proper body positioning and strengthening, to maintain tone and prevent contractures.

Q: Will I need to use a wheelchair or crutches?

A: Some people elect not to use a prosthesis, relying exclusively on mobility devices. However, with a prosthesis, the use of crutches or a wheelchair depends on several factors including level of amputation, whether you have a single or bilateral amputation, and your respective level of balance and strength. Most amputees have a pair of crutches for times when the limb is off, including nighttime trips to the bathroom, showering, participating in certain sports, and to help if problems arise that may require leaving the prosthesis off for any length of time.

If you are a person who has lost both legs, you will probably use a wheelchair at least some of the time. Unilateral amputees may find it helpful to use a cane or crutches for balance and support in the early stages of walking or just to have a break from the prosthesis. This is an individual decision based on factors such as age, balance, strength and sense of security.

Q: Once I have been fitted and feel comfortable in its function, what will happen next?

A: Plan on making follow-up visits to your prosthetist a normal part of your life. Proper fit of the socket and good alignment will insure that the prosthesis is useful to you. Prostheses, like cars, need regular maintenance and repair to continue efficient functioning. Small adjustments can make a big difference.

Q: Can the limb break down?

A: Yes, things can happen that will require repair or replacement, so it's a good idea to know about warranties and what to expect from your prosthetist. Get small problems with your prosthesis taken care of promptly. There is no benefit to waiting until something falls apart or causes you serious skin breakdown. If you wear a prosthesis too long when it needs repairs or replacement, you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back and shoulders, will affect posture in addition to performance of the device and energy needed to use it. Early prevention is more valuable than long-term treatment

Orthotics

Q: What is an orthosis?

A: An orthosis provides correction, support, or protection
to a part of the body. Orthoses are named for the parts of the body they control. For example, AFO stands for ankle foot orthosis and TLSO stands for thoracic lumbosacral orthosis. These kinds of braces are usually made of different types of thermoplastics.

Q: How do I get used to my new orthosis?

A: A new orthosis must be broken in slowly. When first wearing your new orthosis, start a little at a
time.
• Begin with 2 hours on and one (1) hour off.
• During the next 2 or 3 days, gradually increase the time the orthosis is used until it is being worn for
the amount of time that your orthotist or therapist prescribed.

Q: How do I wear my ankle foot orthosis?

A: Always follow instructions given by your practitioner. If you have questions regarding the fit of the orthosis feel free to contact the office for an appointmet to address your concerns. Here a few helpful reminders:
• Always wear a sock or stocking under the orthosis. It helps to reduce friction and decreases irritation
of your skin from sweat.
• The sock you wear should be taller than the orthosis. You may even choose to wear a knee-high sock
for more comfort.
• Cotton socks allow air to circulate better and absorb sweat. For more comfort, use talcum powder and
change your sock after sweating.
• Inspect your socks to ensure they are wrinkle free.
• Be sure that the straps on your orthosis are snug and your heel is completely back in the orthosis to
ensure a proper fit.
• Shoes worn with your orthosis should have good support and the correct heel height for which your
orthosis was designed. Ask your orthotist or therapist which shoes are best for your orthosis.
• Do not wear your orthosis barefooted or with slippers, sandals, loafers or any shoe without a back.

Q: How do I care for my orthosis?

A: Since your orthosis will be worn for long periods of time, it may become very dirty. The following tips will help you keep it clean:
• Clean your orthosis frequently inside and out with a damp cloth. Let it dry fully before you put it back
on.
• Use a towel or let your orthosis dry at room temperature. Do not place your orthosis in front of a
heater. Do not use a hair dryer for drying, or leave it in the sun or a hot car.
• A solution of one (1) tablespoon of unscented bleach in a gallon of water can be used to clean your
orthosis.
• Velcro can be kept clean with soap and water and can be kept free of lint and hair with a wire brush,
toothbrush, or fine-toothed comb.
• Metal joints should be lubricated occasionally with silicon spray or a light oil.

Q: How do I care for my skin?

A: • Any part of the body covered by the orthosis should be washed daily with warm water and mild soap.
• Be sure to clean the bottoms of your feet and between your toes to eliminate bacteria and dirt
collection.
• Your body should be completely dry before wearing your orthosis.
• Remember to keep socks clean, dry and wrinkle-free. Inspect skin daily.

Q: Why do I need to examine my skin?

A: • It should become a habit to inspect your skin daily. People with decreased sense of touch are not as
likely to notice that their skin is irritated. Irritation is especially common in bony areas such as the
shin or sides of the feet. Even minor irritations should be treated.
• An orthosis should provide steady pressure, not sharp pain. Inspect your skin daily for bruises,
calluses, or blisters.
• A new orthosis may cause redness, but this should disappear within 15 minutes once the orthotic is
removed.
• Swelling may occur after prolonged standing or during hot, humid weather. If this occurs, you should
remove the orthosis, sit or lie down, and elevate your leg above your heart until the swelling subsides.

Q: For your safety, it is important to quickly inspect the orthosis every day.

A: • Check rivets and screws for tightness.
• Check plastic and metal uprights for cracks.
• Check straps and buckles for proper fit.
• With daytime foot and leg orthoses, shoes should be worn at all times because the footplate is
slippery and can cause a trip on uneven surfaces.