Last updated 05/2015
You have reached a point in your journey where your residual limb is healing after your amputation and you are considering your options for a prosthesis. Thinking about your first prosthesis can be both an exciting and scary process. This will be another step in your journey toward returning to your new normal after surgery. It is important to make an informed decision about whether a prosthesis, or what kind of prosthesis, will be the right choice for you. Here are some answers to questions that new amputees frequently ask:
WHY WOULD I USE A PROSTHESIS?
A prosthesis is simply a tool. It is an artificial replacement for a missing limb or part of a limb that can help you regain independence after your amputation. Choosing to use one, or not, depends on your personal goals. The best prosthesis is one that will help you reach your goals. Some important things to ask yourself are:
- What do you want to be able to do with the prosthesis?
- What activities do you plan to do?
- Do you want to walk or run?
- Do you care about the way it looks?
There is no one device that is best for everyone. The key to success is working with your doctor, prosthetist and therapists to address your needs and concerns. Your prosthetist will work with you on design and fit. Your physical and occupational therapists will work with you to teach you how to use your new prosthesis.
IN GENERAL, HOW DOES A PROSTHESIS WORK? WHAT DOES IT LOOK LIKE?
Each device will be different, depending on the level of your amputation, physical ability and needs. Your prosthetist will create a device that is custom-made to fit you. Your prosthetist will make suggestions based on the type of amputation and your activity level. A prosthesis is basically an extension of your body. A standard prosthesis is made of conventional component parts that create the leg and prosthetic foot. These parts are connected to a socket that fits over your residual limb.
The socket allows the prosthetic device to connect to your residual limb. An additional layer, called a liner, fits over your residual limb and provides a barrier between your skin and the socket. The liner provides cushion and comfort while providing a better fit for the socket. It is essential that the socket fits correctly. A poorly fitted socket can lead to pain, sores and blisters on your residual limb. The most common socket options are suction, vacuum and pin lock.
A prosthesis can look however you want it to. From the purely functional look of the mechanical parts to a cosmetic cover that looks like a natural limb, your options are endless. If you want to make a fashion statement, you can have your socket covered in your favorite team’s logo or accessorize it with your favorite color or pattern. The prosthesis is an extension of you and your style – wear it proudly!
Technology continues to change the prosthetic market. With advances in the microprocessor knee and foot, and advanced hands and sockets, prosthetics continue to offer new opportunities to improve the lifestyle of people with limb loss. You can find more information on your prosthetic options by visiting the Amputee Coalition’s National Limb Loss Resource Center.
WILL I NEED TO USE A WHEELCHAIR OR CRUTCHES?
Some amputees find a wheelchair or crutches to be helpful in reaching their goals. The type of assistive device you use is your choice. You should use the device that will help you live the life you want to live. This may mean using a wheelchair or crutches for some activities. Many amputees have a wheelchair or pair of crutches that they use at least part of the time. They may use them for nighttime trips to the bathroom, showering, traveling long distances, or if problems arise that require leaving the prosthesis off for a period of time. This is an individual decision, based on your needs and comfort level.
HOW MUCH WILL A PROSTHESIS COST, AND HOW CAN I PAY FOR IT?
A prosthesis can range widely in price, depending on your amputation level and the type of device you are looking for. Typically, your prosthetic device will be partially covered by your insurance plan. Some insurance plans may even cover the entire cost of the device. You will need to work closely with your insurance company to understand the types of devices and services that will be covered under your policy. Be prepared to make several phone calls, provide documentation and be your own advocate. Check that your policy includes prosthetic coverage. Know the limitations and exclusions in your policy. It is important to know that working with your prosthetist on fit and alignment of your prosthesis should be bundled with the total cost of your device. Your prosthetist should continue to work with you until you reach a comfortable fit and alignment.
The Amputee Coalition has created an Insurance Coverage and Reimbursement Guide to help you figure out common insurance questions. Contact the Amputee Coalition’s National Limb Loss Resource Center at 888/267-5669 to get a copy. If you find yourself in need of help in paying for a prosthesis, you can find out more about funding options by reading the Financial Assistance for Prosthetic Services, Durable Medical Equipment, and Other Assistive Devices fact sheet.
WHAT IS A K-LEVEL?
A K-level is a scale used by Medicare to rate your rehabilitation potential. Many private insurance companies follow Medicare’s example to establish coverage guidelines. The K-level is a rating from 0 to 4 to predict your potential success with your prosthesis. Basically, if you had a device and training to learn how to use it, would it work for you? Would you be able to use it well? The K-level is important because it is used by your insurance company to figure out what type of prosthetic they will cover for you. Insurance companies want to know that the prosthesis you receive will be realistic and functional. Your doctor will complete an assessment of your physical and cognitive abilities to determine your K-level. The Amputee Coalition’s National Resource Center can connect you with additional information and tools to help you understand what your K-level means and how it might impact your prosthetic options.
WHEN WILL I GET A PROSTHESIS?
The timing depends on how quickly your residual limb fully heals from the surgery. Some individuals receive a temporary prosthesis immediately following amputation or within two to three weeks after surgery. Usually, a prosthetic fitting begins two to six months after surgery. This will be when the surgical incision has healed, the swelling has gone down, and your physical condition improves.
ONCE I GET MY PROSTHESIS, HOW SOON CAN I GET BACK TO WHAT I USED TO DO BEFORE THE SURGERY?
You should be able to get back to a normal level of functioning within a few months. This new normal will depend on the location of your amputation as well as your overall health and well-being. Your prosthesis will be a tool to help you do the things you used to. How well you do depends on your goals, a comfortable prosthetic fitting, follow-up care, and determination. It is common to spend about six months to a year working with a rehabilitation team. The first year following an amputation is tough. There will be changes in the shape and size of your residual limb. A lot of work will be needed to recondition muscles. Your body will need to relearn activities, gait, balance and coordination.
You will continue to improve with time and effort. It is important to have a strong support network around you for this journey. The Amputee Coalition’s Peer Support Program is an excellent resource to assist you in building support. The Peer Support Program can connect you with a support group in your area or a certified peer visitor who can offer you both encouragement and information from their perspective. For more information on how to connect with others in the limb loss community, visit the Amputee Coalition Support Network.
WHAT IF THE PROSTHESIS DOES NOT FIT RIGHT?
The process of being fit for your prosthesis will involve several visits to create a device that fits you and your needs. Follow-up visits with your prosthetist are as important as the initial fitting. You will need to make several visits for adjustments with the prosthetist as your residual limb changes and continues to heal. Tell your prosthetist if the prosthesis is uncomfortable in any way. They can help you ease pressure areas, adjust alignment and work out any problems you may experience. Using your prosthesis should not be painful. The more comfortable the fit, the more likely you are to use it. Talk honestly with your prosthetist about your needs and goals. Discuss the things you want and need to do in your life after surgery.
HOW LONG WILL MY PROSTHESIS LAST?
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, liners, or even a different device. Increased activity level and a desire to do more activities can create a need for a change in the prosthesis or its parts. Once you are comfortable with the fit of your device, the prosthesis needs only minor repairs or maintenance and can last an average of three years. Your prosthesis should be regularly checked by your prosthetist to avoid any major problems.
IS IT DIFFICULT TO LEARN TO USE A PROSTHESIS?
Learning to use a prosthesis is a tough job. It takes time, effort, strength, patience and determination. Your prosthetist should give you some training on using your prosthesis. Many people find it helpful to work with a physical therapist who is familiar with amputees. Much like learning how to operate a car, there is a lot to learn at the beginning. It will become second nature with practice. Your prosthetist should teach you 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 surfaces.
A physical or occupational therapist can teach you to:
- Handle emergencies safely, including falling down and getting up again
- Perform daily activities at home, work and in a car
- Improve your gait to help you walk better
- Try out new things you may be unsure about, including sports and other recreational activities.
WHAT CAN I DO TO PREPARE MYSELF FOR A PROSTHESIS?
There is a lot you can and must do to be able to use a prosthesis, beginning with these top priorities.
- Work through the feelings and emotions you are experiencing and decide how to rebuild your life after amputation. Remember that everyone responds differently to the loss of a limb.
- Exercise to build the muscles needed for balance and moving around.
- Prepare and take care of your residual limb to attain a proper, sound shape.
- Learn body positioning and strengthening to maintain muscle tone and prevent contractures.
ONCE I HAVE BEEN FITTED FOR A PROSTHESIS AND IT FEELS COMFORTABLE, WHAT HAPPENS NEXT?
You should plan to make follow-up visits to your prosthetist a normal part of your life. Any changes in your residual limb, such as swelling or shrinkage, or a significant change in your body weight, may require a follow-up with your prosthetist to adjust the fit of your socket. Prostheses, just like cars, need regular maintenance and repair to keep working. Small adjustments can make a big difference. Proper fit of the socket and good alignment will make sure that the prosthesis works for you. It can also help prevent some secondary conditions amputees may experience.
CAN THE PROSTHESIS BREAK DOWN?
Yes, things can happen that will require repair or replacement. It’s a good idea to know about warranties and what to expect from your prosthetist. Get small problems taken care of right away. There is no benefit to waiting. Waiting may cause a more difficult repair or even a serious skin breakdown. You can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, like your back and shoulders, will affect your posture and the performance of the device, and will increase the amount of energy needed to use it.
WOULD IT BE HELPFUL TO SPEAK WITH OTHERS WHO USE A PROSTHETIC DEVICE?
Don’t underestimate the value of talking and meeting with others in the limb loss community. The Amputee Coalition can connect you in a variety of ways with others who have experienced limb loss and have chosen to use, or not to use, a prosthesis. Visit the Amputee Coalition Support Network to explore the many different ways you can connect with other amputees locally and across the country.
WEB ADDRESSES FOR LINKED MATERIALS
- Amputee Coalition National Limb Loss Resource Center
- Financial Assistance for Prosthetic Services, Durable Medical Equipment, and Other Assistive Devices Fact Sheet
- Patient and Prosthetist: Working Together for a Successful Outcome
- The Prosthetist Finder
- Amputee Coalition – Support Network
It is not the intention of the Amputee Coalition to provide specific medical or legal advice but rather to provide consumers with information to better understand their health and healthcare issues. The Amputee Coalition does not endorse any specific treatment, technology, company, service or device. Consumers are urged to consult with their healthcare providers for specific medical advice or before making any purchasing decisions involving their care.
National Limb Loss Resource Center, a program of the Amputee Coalition, located at 900 East Hill Ave., Suite 390, Knoxville, TN 37915 | 888/267-5669
© Amputee Coalition. Local reproduction for use by Amputee Coalition constituents is permitted as long as this copyright information is included. Organizations or individuals wishing to reprint this article in other publications, including other World Wide Web sites must contact the Amputee Coalition for permission to do so.