Next Steps for New Amputees
The first priority is for the amputation wound to heal and for your health to be stabilized. The newly amputated limb is often swollen as a reaction to this major surgery. An elasticised compression sock will be fitted for you to control the swelling. This sock should be comfortable enough to be worn all day and night, and can be removed for dressing changes and wound inspection.
You may also be fitted with a “Limb Protector”. This can be a removable cast made of light-weight breathable synthetic material, or it could be flexible, padded pre-fabricated splint. This is applied to your limb, but may also be removed for wound inspection and dressing changes. This Limb Protector will protect the wound site from any bumps or falls. (It is not uncommon for new and even experienced amputees to step onto the missing limb and fall). The other purpose of the Limb Protector is to help you keep your knee straight which prevents a knee flexion contracture.
Even without a prosthesis, rehabilitation can begin. You will meet a Physical Therapist, who will help you do some strengthening and stretching exercises. An Occupational Therapist will work with you to help you re-learn how to do regular daily tasks. Some patients remain in the hospital after surgery and are transferred to the rehabilitation floor as in-patients. Other patients are discharged home, and return to the hospital on a regular basis several times during the week to complete their rehabilitation as outpatients.
Usually after 14-30 days the wound has healed well enough to tolerate initial weight bearing. The prosthesis is made from a cast of your limb and takes about 3-5 days to fabricate. This initial prosthesis serves as a starting point to allow you to learn to walk and to learn to tolerate full weight-bearing through your amputated limb. Over time, your limb will change in size and shape, as the swelling subsides and then eventually as the muscles atrophy. This process of “shrinking” can be rapid or slow or it may slow and then speed up again. My job as your prosthetist is to adjust your socket throughout this process to maintain a comfortable, safe and solid connection between your body and the prosthesis.
Initially you will walk in parallel bars with weight supported through your arms. As you progress, you will use a walker and then eventually crutches or a cane. Our goal is that you will become more independent and regain confidence to safely walk almost anywhere you want to. Gradually, you will be able to use your prosthesis for more and more hours per day, eventually leading to a full day of prosthetic wear.
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