Ask the Prosthetist: The Six Questions Patients Ask Over and Over

Ask the Prosthetist: The Six Questions Patients Ask Over and Over

by Jeff Lutz, CPO

In my 26 years of practice as a prosthetist, there have been six questions patients ask over and over. As an advocate for people with limb loss, I love questions! The most informed people are always those who ask the most questions, and we all know that those who arm themselves with information are almost exclusively more successful.

Q: Why does my leg have to be so heavy?

A: Prostheses range from very light to heavy duty. The components that are used in your prosthesis are designed for specific patient weights and activity levels. All lower-limb prostheses are subjected to very high degrees of stress. The forces generated by simply walking on a level surface are significantly higher than your body weight. Walking up and down ramps and stairs creates even greater stresses on the prosthesis, so it is very important that you and your prosthetist discuss your environment and activity level. Modern advancements have led to stronger yet lighter-weight components, made from materials such as carbon fiber and titanium. The goal for the design of your prosthesis is to provide you with the lightest-weight device possible, which will safely allow you to perform to your highest potential activity level. A loose-fitting socket or lack of adequate suspension can also lead to a feeling that the prosthesis is too heavy. If you find that your prosthesis feels heavy, see your prosthetist.

Q: How can I control perspiration in my prosthesis?

A: Different people have different levels of perspiration. New amputees often experience a period of high levels of residual limb perspiration when first wearing their prosthesis. This heavy perspiration period generally subsides as your limb adjusts to its environment inside the socket. If unusually heavy perspiration continues, your physician may prescribe specially formulated antiperspirants, such as Drysol®.

Q: How long is my prosthesis supposed to last?

A: The useful lifespan of your prosthesis depends on several factors. Changes in the residual limb volume (size) often necessitate modifying or replacing the socket to maintain a proper and comfortable fit. Changes in activity level, body weight, component fatigue and general wear and tear are all factors that determine the lifespan of the rest of the prosthesis. It is critical that your prosthesis fit properly and be in sound physical condition to withstand the forces placed on it daily. I recommend that prostheses be evaluated and safety-checked at least every 6 months by a certified prosthetist. Often, major problems can be prevented by early detection.

Q: Why can’t it look more like my other leg?

A: Advancements in prosthetic cover material and skins allow most prostheses to have a very pleasing cosmetic appearance. When desired by the patient, a cosmetic cover and skin can be made to be removable by the wearer. Some prosthetic users have times when they prefer to not use a cover and other times when they do. The cover and skin not only provides a pleasing cosmesis, but it also protects the prosthetic components from moisture and physical damage. A satisfactory cosmetic effect can be challenging in cases where the residual limb is actually larger than the sound limb. This is more often the case when dealing with a recent amputation. As the swelling in the residual limb subsides over time, closer cosmetic results will follow. It is important to share your preferences for cosmetic appearance with your prosthetist.

Q: How will I ever be able to pay for my prosthetic care?

A: Most private insurance, as well as Medicare and Medicaid, covers prosthetic care. The Amputee Coalition and other groups have worked very hard to introduce and pass parity legislation in many states to ensure that insurance companies do not place unrealistic limits on prosthetic care. Federal legislation is also pending. If you are not insured, talk to your prosthetist. Other sources of funding are out there, and he or she will help you find and secure it. Don’t give up – there is always a solution!

Q: Is there something new out there that would make a difference in my life?

A: It is difficult for people with limb loss to keep up with the advancements in prosthetics. Over the past 5 years, huge strides have been made in available options. New technology, including microprocessor knees and feet, advanced hands and sockets, has made significant improvements in the lifestyle of countless amputees. The Amputee Coalition’s publications and your prosthetist can keep you informed about what advancements could benefit you.