McKinney Prosthetics - Frequently Asked Questions

FAQs

Q: Describe what a prosthetist does.
A: It's best to first explain what a prosthesis is. A prosthesis is a device that replaces a missing body part with an artificial one. As prosthetists, we evaluate, design and fit prostheses to the needs of the individual person.

Q: How does amputation surgery emotionally affect the average person?
A: Amputation surgery affects people differently depending upon their age, activity level, vocation and the reason for the surgery. It's common for people to question what their lives will be like after the amputation. For instance, someone losing their leg will wonder whether they will ever be able to walk again. Or if skin breakdown and an open ulceration on a diabetic patient leads to gangrene, a person may question whether this wound will ever heal. These types of questions are normal. As odd as it may sound, a number of people eventually come to the conclusion that they would be better off without the affected limb. The trauma that some people go through treating an infection that won't heal properly can far exceed the permanent loss of a limb. After months, or even years in some cases, the decision to amputate a limb represents a return to a higher quality of life. Initially a person may feel inferior, but once they are fit with a prosthesis and are able to have a fulfilling lifestyle, these feelings usually diminish.

Q: What should those considering a prosthesis know that might help them make an informed decision?
A: Anyone thinking of getting a prosthesis should set realistic goals and be flexible to modify them as needed. For example, if they were golfing and bike riding prior to the amputation, it is a realistic goal to eventually return to these activities wearing a prosthesis. But it may take some time to adjust. Wearing a prosthesis can be very comfortable and give you great mobility, depending on the type of device you choose. But there may some activities, such as certain athletic events, that may need to be modified. But as long as a person sets realistic goals and is willing to adapt to new challenges that present, they usually do quite well.

Q: How soon after surgery can you fit a patient for a prosthesis?
A: We can evaluate the patient right after surgery and depending on how the wound is healing we can fit the patient with their prosthesis as soon as one week after the sutures are out.

Q: What is a shrinker and will I have to wear one?
A: A shrinker is used for compressing and shaping your residual limb. For trans-tibial amputees, a shrinker is shaped like a sock; for trans-femoral amputees, shrinkers often have a belt that help hold the shrinker onto the limb. Most new amputees will wear a shrinker for a few days after their stitches are removed. Also, long time prosthetic wearers may need a shrinker if their limb swells.

Q: Describe the adjustment period after obtaining a prosthesis. What can family members and caregivers do to help facilitate and support a healthy adjustment?
A: Patients tells us the main issue following the placement of a prothesis is one of balance with a new prosthetic leg. The prosthesis obviously has a different "feel" than the bodily part that was removed so it takes some time to adjust to this. If a person has a high level of mobility or activity prior to amputation surgery it may improve a person's sense of balance, stability and weight shifting when using the new prosthesis. Family members and caregivers can support their loved one by making every effort to attend the prosthetic appointments, listen carefully to instructions regarding the fit, and assisting with the donning (putting on) and doffing (taking off) of the prosthesis. And an optimistic attitude goes a long way toward helping your loved one realize that they will eventually adjust and be able to have a fulfilling life.

Q: What do you say to a person who feels inferior to others as a result of having lost a limb?
A: Once the prosthesis is fit and the person realizes that it is not only possible to walk but do so comfortably, feelings of inferiority, if they exist at all, will usually begin to diminish. This is usually followed by a return to work and engagement in family activities and leisure interests. Over time, the person with the prosthesis begins to feel normal and accepts the artificial limb. In fact, many are so grateful to be alive and have such a high quality of life that any hint of being inferior to others is gone.

Q: Explain the range of different prosthetic devices that are currently available and how each of them work.
A: Currently there is a wide range of prosthetic devices that are currently available. The conventional leg prosthetic is made of foam and plastic and held on with pins and straps. Layers of socks are worn to help the prosthetic device fit the constantly fluctuating volume of the residual limb. The volume of the limb changes because the positive pressure of the prosthetic device "squeezes" the residual limb so it will effectively bear weight. We prefer to use a new technology called the Harmony system. Instead of "squeezing" the limb, it uses a vacuum suction technology to stabilize pressure between the limb and the prosthesis so that the person's leg volume changes only 1%, not the 7% to 12% that is common with a conventional prosthetic device. The vacuum technology allows the prosthesis to fit so well, common problems like blisters, sores and sweating are greatly reduced.

Q: How often will I have to get a new prosthesis?
A: Some people are under the impression that once they receive a prosthesis they are to have it for the rest of their life. Most patients receive a number of prosthesis up to a year after amputation or a switch from conventional prosthesis to Harmony. The goal is to achieve a perfect socket fit. After amputation the residual limb usually is filled with excess fluid. Once properly fit with a prosthesis, the patients limb will gradually return to their optimal size and shape. In the mean time, whenever fillers such as socks or gel pads cannot compensate for the loss of volume we will recast and make a new prosthesis. We continue to make new sockets for a patient until they achieve a great fit.

Q: Does Medicare or private insurance typically pay for a prosthesis?
A: Medicare and most private insurance pay for a prosthesis. Letters and prior authorization can be obtained from private payors to help the patient understand his or her financial obligation in advance. When possible, patients should establish a "contact person" in the insurance company to help them fully understand their coverage. When considering reimbursement, it is also important for the patient to communicate to the prosthetist any vocational, leisure and athletic goals along with any pertinent medical history such as skin breakdown, weight loss or gain, or any changes in overall health. This information will help the prosthetist communicate with the insurance company about medical necessity for a new prosthesis.

Q: What types of insurance do you accept?
A: We accept most types of insurance. However we accept assignment on Medicare and Blue Cross Blue Shield. The patient is responsible for the remainder balance that their insurance does not cover. We gladly accept payment plans.