Because every patient of Palmetto P&O is important and unique, we developed LEAP, our very own Life-Enhancing Amputee Program.
Our LEAP program ensures continuing communication with referring doctors with regard to their patients’ condition and progress. We also offer support group meetings, where you can come and share and learn from other friendly folks just like you.
On our LEAP team, John L. Moyd, CPO, can answer questions about prosthetic comfort and clinical care, as well as componentry selection. We are also proud to have on our LEAP Team - Andy Krawiec, CPO and Chad Welch, Amputee Consultant. Your prosthetist considers many different variables when selecting
your componentry, such as your height and weight, your level of amputation and the length and shape of your residual limb. Your lifestyle and daily activities are also a factor, not to mention your attitude, aspirations and goals. Through LEAP, our clinicians are available to answer your questions before surgery or after surgery. We can help by example and consultation. Please call us toll free at 877-670-9222 with any questions.
Follow-Ups: After surgery, we can follow up with you and your needs once a week, or once a month, depending on the level of support you would like.
Componentry Selection: Considerable, careful, biomechanical thought goes into prosthetic componentry selection, including your expectations and lifestyle considerations. Once componentry is selected, our clinicians examine gait efficiency to ensure you feel maximum comfort with minimal exertion. The first step in prosthetic fitting is a shrinker, which is a compression garment that will control swelling and reduce edema. Once your lower limb size has stabilized, (and your doctor says your suture line has healed), you will come in to our office for a casting.
A casting is where we take a plaster or fiberglass cast of your leg and then remove the cast. With this negative impression of you in hand, our clinicians can make a positive mold to build from. They can make notations for alignment and pressure points or bony prominences. Unlike many other facilities, at Palmetto P&O, we have on-site fabrication, where we actually thermo-mold polypropylene (polyethylene?) plastic over the modified plaster cast with vacuum suction. With careful trimlines, what is called the test socket is now ready for a trial fitting.
When you come in, you will try on the clear test socket and stand in it. The clinician will be able to see through the clear plastic, and check for pressure points and comfort.
When you bear weight in the socket, he will be able to make alignment lines and componentry strategies with the latest, lightweight technologies available on the market, including pylons and feet.
Bring your walking shoes! Your next fitting will be the actual prosthesis. You will probably get to walk in the parallel bars under careful supervision.
Medicare and other insurance carriers have classified different levels of walkers:
K0 – non ambulatory
K1 – household ambulator?
K2 – limited community ambulator
K3 – different cadences, traverse barriers
K4 – athlete, active child
K0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance a beneficiary’s quality of life or mobility.
K1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. Typical of the limited and unlimited household ambulator.
K2 - has the ability or potential for ambulation with the ability to traverse low-level environmental barriers such as curbs, stairs or uneven surfaces. Typical of the limited community ambulator.
K3 - has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic or exercise activity that demands prosthetic utilization beyond simple locomotion.
K4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.
Your componentry will be selected based on your K-function category and assessment.
Suspension mechanisms are how your prosthesis suspends from your residual limb. One of the newest and most comfortable selections is a locking silicone liner, where the silicone sleeve rolls on your leg like a sock, and provides and interface between the skin and the socket. This is the basis of comfort and performance, while stabilizing soft tissue, and improving circulation. The bottom of the liner has a pin that clicks down into the prosthesis and locks in place. The suction releases with the push of a button on the side.
There are many different kinds of prosthetic feet, some have carbon graphite springs like a diving board, to put a spring in your step! Sometimes this may be too much energy for a limited ambulator, so other feet with more stability may be selected to control the toe-off bounce and energy return.
After you wear your first prosthesis for a few months, and your limb changes, you will probably become ready for a permanent prosthesis. This prosthesis is cosmetically finished to look like skin. Some even have hair! This is the prosthesis that most people can wear for many years with minor adjustments.