Each Month we answer through Email several questions related to Prosthetics-Orthotics. We will post several of the questions and answers here. If you have a specific question, fill out the feedback at the top of the page. An ABC Certified Practitioner will answer your Email ASAP. We refresh the list on a yearly basis.
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Question: I have transportation problems and live 40 miles from you. My daughter comes once a week to take me to the grocery store and otherwise will bring things when she comes. I need a new prosthesis my old one is causing sores on my leg. Who can help me with transportation?
ABC CPO: We offer home visits for prosthetic care only within a 50 mile radius of Heber Springs, AR. There are alternative sources for transportation, you would have to contact your local Medicaid office to find out more details.
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Question: I've been taking my daughter to the Children's Hospital which is over 70 miles away for her scoliosis brace. This usually takes 3-4 trips to get these fitted comfortably. I want to get this closer to home. Is that possible?
ABC CO: As long as you have insurance whether it's Medicaid or private insurance and a prescription, you have the right to go anywhere you want for treatment. I'm sure that you can find places closer to home. Make sure that wherever you go is able to fit these and has experience.
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Question: My father has had a below knee amputation and has been in the wheelchair for a while waiting for his leg to heal. He's now all healed. I want him to walk, but the VA Hospital physician says that he will not be a candidate for a prosthesis. I really am not prepared for my father to spend the rest of his life in a bed. What can we do?
ABC CPO: The VA is notorious for giving what I call, "the death penalty" to their patients. It's very cavalier for the resident physician to make that judgment. My suggestion is to get an appointment with a Prosthetist and have an evaluation performed. He may even schedule him for an Amputee clinic. That's attended by a Prosthetist, PT, OT, RN, and an MD. That way you can get an honest appraisal of his situation and they can develop a treatment plan.
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Question: My husband was injured in an electrical accident 2 months ago at work. The result left him with a bilateral below knee amputations. He was told by his physician that he would never walk again. He's 32 years old and in poor spirits NOW. How can I get him re-evaluated to see if he is a candidate for prosthetic care?
ABC CP: My advice is to contact your case manager with the insurance company and demand an outside opinion with a physician of YOUR choice. Usually an amputee clinic is a good place for at-risk patients to attend. That way you have a MD, PT and a Certified practitioner in attendance. It's hard to argue with a clinical finding.
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Question: My family has recently moved to a new area-75 miles away from our old town. I need a few adjustments on my prosthesis. I have Medicare as my insurance. What do I need to do?
ABC CP: Unfortunately, Medicare does not cover any adjustments nor does any private insurance. Adjustments should never be performed by a non-trained person. You really need to be seen by an ABC certified Prosthetist to have the work done.
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Question: My AK suction prosthesis now that it's hot seems to be slipping off easy. I weigh around 180 lbs. and have lost about 22lbs in the past 3 months. What's going on with my prosthesis? HELP!!!
ABC CPO: Hot weather is always an ill factor in a true AK suction suspension prosthesis. However anytime a person has a 10% weight change in either direction up or down- AK or BK, the prosthetic socket simply does not fit anymore. Depending on the age of your components, you either need just a socket replacement or an entire prosthesis replaced. If your components are aged, or the prosthetic foot is an energy storage type ( these are designed custom to your weight and activities), the whole prosthesis needs replacement. We need to set up an appointment for evaluation of your prosthesis ASAP. The process can take up to 6 weeks, depending on your insurance approval, before you receive your new product.
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Question: My daughter had a club foot and has had several surgeries performed. The Doctor has said that there is no more to be done. The problem is that her ankle appears to be leaning at an extreme angle. Is there anything that can be done to fix this problem.
ABC CPO: She needs to be evaluated by a Physical Therapist that specializes in juvenile development. Depending on the severity of the deformity, an Orthosis can be made. This can be a plastic style AFO or if extreme enough perhaps a metal Orthosis. It's hard to tell without looking at your child. Call us for an evaluation.....
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Question: My Doctor wrote a prescription for a new prosthesis but he wants to send me to another provider other than your company. I do want to use your company for my new Prosthesis, what should I do?
ABC CPO: Being a patient and having your own insurance, you can go wherever you want to go for your medical care. Your Physician may not like that, but in reality, you do not even have to use him / her for your medical care. Your insurance is somewhat portable.
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Question: When I received my new BK Prosthesis, everything felt great. Now a little over a week later, I have some pain on the bottom of my stump. What's happened to my fit?
ABC CP: 90% of all problems involving the fit of a new BK Prosthesis involves wearing the correct amount of stump socks. If you are feeling pain on the distal end of your residual limb (bottom of your stump), that is indeed a sign that there is a stump sock fit problem. Too many stump socks can cause you just as many problems. Reply back when you add/ remove stump socks to let me know your progress.
Thank you for your help. That was the problem. I was wearing a 3 ply when I first received this new Prosthesis. I added 2 ply to have a total of 5 ply and it feels like a new leg again. Thanks again.
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Question: I just bought some new arch supports around 9 months ago. My feet are really starting to bother me again. What can I do?
ABC CO: Inserts or arch supports are generally speaking only good for 6 months to a year. I generally recommend that a person that is on their feet a lot receive 2-3 pair per year- depending on their activities and weight. You need to order some replacement arch supports. If you have ordered from this site, we will have your original molds/ information on file and can usually ship the replacements within a week.
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Question: I've been reading about the C-Leg that's new on the market. How can I get this new prosthesis for myself?
ABC CPO: This is the largest advancement in above knee prosthetics since the creation of endoskeletal prosthetics. Being one of only 150 people in the entire world that's certified for the new C-Leg and having done over 35 of them, this is what I've found. The first thing that MUST happen is for you to receive a prescription from your physician for this prosthesis along with a certificate of medical necessity deeming this type of knee unit as medically needed. Then you will need approval from your insurance company in which they will give your prosthetic provider an authorization number. Most of the C-Leg's that I've done have been for workers compensation.
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Question: Whenever someone has a traumatic amputation such as the fireman that rode down the collapsing World Trade Center 82 stories, how fast can they be placed in a prosthesis?
ABC CP: Tragic circumstances indeed. The 1st consideration is to stabilize their condition/save their life. The 2nd consideration is to make sure that the wound has ample blood supply and can heal completely. The 3rd consideration is to make sure that the wound is free of debris and all of the skin grafts will take. After all of that, we can start to think about prosthetic care.
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Question: My Prosthetist has retired and I need some suction liners for my prosthesis, I don't know the size, can you help me?
ABC CPO: There is more to know than simply what size that you wear. There are also different brands of suction liners. We realize that it is difficult for you to do, but if you could send us the liner that's in the worst shape (so you aren't without your best one) and then we can research the brand and size. We will make this a priority in order to keep you going as soon as possible.
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