Commonly Asked Questions
The rigid dressing is a sterile dressing combined with a plastic cast. Your doctor may prescribe a rigid dressing which is applied, usually by your prosthetist, to the residual limb immediately after surgery. A tube or pylon and an artificial foot or hand may be attached to the cast so you can begin using the residual limb soon after surgery. Dressing changes usually occur at two-week intervals.
Swelling is a natural reaction to the trauma of surgery and will continue throughout the healing process. There is also a tendency for fluids to build up as a result of less muscle activity in the amputated limb.
Wrapping with elastic bandages or using elastic "shrinkers" decreases the swelling and helps shape the residual limb. It is important that you keep your residual limb properly wrapped or within the shrinker at all times. The swelling will continue to decrease over the next several months as your residual limb shrinks significantly from both fluid loss and muscle inactivity.
After the first dressing is changed, an elastic bandage should be used to wrap the residual limb. This bandage should be removed and rewrapped several times each day so it will continue to provide adequate support as your limb shrinks.
Many people experience the sensation that the amputated limb is still present. You may have the sensation of tingling, itching, or movement, as well as fleeting episodes of sharp, squeezing, or burning pain. The causes of phantom sensation are not clearly understood, but the experience usually disappears within a few months after surgery. Inform your doctor and prosthetist of any discomfort that you may experience.
Many factors determine when you are ready for your first prosthesis. Your residual limb must be well-healed with no tenderness and minimal swelling. Generally, if there are no complications, the first fitting occurs approximately four to five weeks after amputation. If you have poor circulation, the fitting may be delayed an additional two to three weeks to allow for adequate healing.
Exercise is important in increasing your overall strength, flexibility and preparing your muscles for the prosthesis. A physical or occupational therapist assesses your overall physical condition and may prescribe an exercise program. Isometric exercise, which involves tightening and relaxing the muscles, helps you maintain good muscle tone and can be started while you are still in bed. Along with exercise, gradually desensitizing your residual limb is an important step in preparing for your prosthesis. Begin by massaging your limb, then work up to patting it, rubbing it with a towel, and even lightly slapping your residual limb. Preventing contractures (the tightening of the muscles and joints) also makes wearing your prosthesis easier.
Your prosthetist consults with your physician regarding the prescription for a prosthesis. There are many individual factors to consider in prescribing the right prosthesis for you. Some of these include the shape and condition, previous activity level and lifestyle, commitment, and financial situation. Discuss your interests, lifestyle, work and goals with your prosthetist, so he or she can design a prosthesis that provides the highest level of function and independence possible.
Your prosthesis is made up of many different components selected specifically for you and your lifestyle. Your prosthetist begins by taking a series of measurements and a cast of your residual limb. From the cast, a mold is made and used to design a custom socket. Your residual limb fits snugly in the socket which is attached to the other components that make up your prosthesis. There are also a variety of skin-like coverings that can be used to resemble your other limb as closely as possible.
During the initial fittings, your prosthetist guides you through the basic principles of using your prosthesis, fine-tuning the fit and alignment as needed. For lower limb amputees, more extensive training (walking on different terrains, climbing stairs, getting in and out of a car) is provided by a physical therapist. If you have an upper limb prosthesis, an occupational therapist helps you perform daily living activities such as grooming, eating and handling various objects.
Your prosthesis is custom-designed to meet your specific needs using advanced and expensive materials and components. Insurance coverage varies widely, but most private insurance plans and Medicare pays a large portion of the charges. Medi-Cal covers certain types of prosthetic devices. Many HMO and PPO plans do not cover prosthetic devices unless you have the higher option plans that include orthotic and prosthetic devices. You will probably have many questions before and after your amputation. We encourage you to talk to your physician, therapist, and prosthetist, and discuss your concerns and recieve answers to your questions.
Your first prosthesis is usually worn for about three to six months. During this time, your residual limb continues to shrink and becomes less sensitive. Your prosthetist also makes many adjustments, and prosthetic socks may be added to help the socket fit properly as your limb shrinks. You learn to walk and balance on your new prosthesis, which helps shrink the residual limb faster. If you've lost an arm, your first prosthesis allows you to pick up objects and regain daily living skills.
As soon as your residual limb is healed and the size and shape have stabilized, you are ready for a more complex "definitive" prosthesis. Your definitive prosthesis can last for many years especially if you take proper care of it and have it periodically "checked and serviced" by your prosthetist. Also, it is very important that you maintain your weight. Even a ten-pound weight gain or loss could affect the prosthetic fitting, which requires adjustments or a new prosthesis.
We carry many off the shelf items, but we also fabricate custom items. Your physician has recommended which style is best for you depending on several factors, including activity level and medical condition. If you are to be fit with an off the shelf item, we may still have to order it if we don't have your size. Custom devices are fabricated based on measurements and/or a model obtained from the affected limb and therefore providing a custom requires more than 1 visit.
You can find pictures of our products on the Products & Services page.
This is dependent on the particular device provided. Shoe inserts and Prosthetic limbs generally do not require a different shoe. Some orthotic devices are intended to wear inside a shoe and having the correct size and style is important to the success of your device. This means you may need to acquire a shoe that is slightly larger to accomodate the brace without crowding the foot and causing potential sores. We can assist you with shoe selection.
Most devices allow for normal range of motion. However, depending on your orthopedic need and the item your physician ordered, restriction of knee or ankle motion may be necessary to accomplish the goals of the prescription.
While some may find wearing the knee brace over pants works best for their lifestyle, we recommend that most style be worn on the skin. A knee brace is more likely to function properly and stay in the position if worn this way. A special knee sleeve is available to wear under the brace, to avoid direct skin contact, if you choose.
We do not recommend driving with a prosthesis or brace on the driving foot. These devices make it more difficult to "feel" the pedals and may restrict range of motion at the ankle. your orthotist or prosthetist will help you find a local vendor that can perform necessary automobile modifications so you can continue to drive safely.
Most devices can be cleaned with soap and water or rubbing alcohol. You will be provided with specific cleaning instructions, as well as the opportunity to discuss additional options with your practitioner, at your appointment.
Off the Shelf Orthotic Device: - In most cases, an off the shelf device can be fit in under an hour.
Custom Orthotic Device: - Custom orthotic devices require a casting or measurement process, which typically can be completed in under an hour. Custom knee braces should be ready to deliver in approximately 3 weeks. Completion of all other custom orthotic devices can range from a day to over a week, depending on the complexity of your need. The fitting process is usally done in under an hour. Your practitioner can provide you with a more accurate timeline for your device at your initial appointment.
Prosthetic Devices: - Because prosthetic devices are custom fabricated, and have many different components, the process to fit takes time. Once your limb has healed, you will be molded for a test socket, which is the initial device you will be learning to walk on. In about a week, given your availability, you will be able to come in for a fitting. You may have to come back several times, depending on complications, availability, and tolerance to the device. Once it's determined that the fit and alignment of the device are appropriate, the device will be "finished". This process takes about a week. The total process time for the fit of a final prosthesis varies by individual, but an average time frame to consider is about a month.
No, it's necessary for a device to be assessed by a certified practitioner, in order to evaluate the fit and make any changes necessary to achieve the proper function. An in-person fitting is also required in order for us to remain an accredited facility.
Discontinue use immediately if there is any skin breakdown. Call our office immediately and discuss the issue with your practitioner. A resolution may be achieved over the phone or you may need to schedule an appointment for an adjustment.
Generally, follow up is scheduled as needed; if you are experiencing discomfort or skin irritation. However, on a device being used for long term, an annual follow up is encouraged to assess the fit and to ensure the device is still providing optimal support and function.
A common misconception is that a prosthesis is heavy. Usually a Below the Knee prosthesis weights about 3.5-4.0lbs and an Above the Knee prosthesis weighs about 7-9.5lbs.
Please see these tips: http://www.tsa.gov/traveler-information/passengers-prosthetics
This is not a Prosthetic Laboratories Policy; it is a Medicare specific policy. Federal Statute requires a physician to follow a patient's diabetic management program in order for Medicare to consider coverage of diabetic footwear and inserts. They put this rule in place to make sure patients are being seen for their diabetes on a regular basis. Unfortunately, it must be an MD (Medical Doctor) or DO (Doctor of Osteopathy). If you chose to see someone other than an MD or DO, you may be held financially responsible for any diabetic items you wish to recieve.
An appointment is preferred so we can ensure that someone is available to help you in a timely fashion. Walk-ins are accepted; however you may encounter a wait or be asked to make an appointment if there is no one available to see you.
Absolutely. Please call as soon as you know you will be unable to make the appointment and we will be happy to reschedule.
Yes. An in-person examination and fitting is required to make sure the device is functioning properly. Our facilities have the tools necessary to fabricate and modify a device; therefore it's necessary for you to be seen on location.
This varies greatly depending on the service you require. More information can be provided to you upon scheduling an appointment.
Medicare and select other insurances require us to notify you ahead of time, in writing, when a device won't be covered. This is to protect you and keep you aware of any financial liability that you may incur.
Insurance companies require a prescription for all new devices and many replacement items that we supply. Additionally, we must follow certain standards in order to remain an accredited facility. One of these standards is to provide patient care according to a current prescription.
Because the existence of paperwork is directly related to a visit by you, it's easier for you to obtain the paperwork. We can certainly request information from your physician, but we can't force them to supply it to us.
No, your physician must let us know what it is that they would like us to do for you.
Insurance Coverage Questions
The amount billed for a device is calculated using several elements. It includes the evaluation time, casting or measurement process, fitting appointments, cost of materials, and any follow up appointments needed to ensure the proper fit of each device.
Insurance companies "cover" items by applying your benefits to an item or service. Your insurance then pays a percentage of the billed amount, after applying your deductible amount. This means even after your insurance "covers" an item, you could still owe a balance.
We do our best to check to make sure your items are coverable by insurance. There are some items that insurance never covers. You can call your insurance provider ahead of time to find out.
Medicare coverage is specific to your condition. For more information, please call Medicare Member Services at 1-800-Medicare or visit myMedicare.gov.
Injuries that occur during a work incident or an auto accident are subject to review by a third party liability payer. If a claim is approved, payment must be obtained from this carrier. Your individual health insurance is not responsible. You will need to provide us with your work comp or auto adjuster information so we may contact them for approval.
This is dependent on your insurance coverage and what your physician's requesting. Please contact your insurance carrier for benefit limitations.