What is Phantom Pain?
Phantom pain sensations are described as perceptions that an individual experiences relating to a limb or an organ that is not physically part of the body. As many as 80% of amputees experience some kind of “phantom” sensation in their amputated limbs.
Is there treatment for phantom pain?
The most common approaches for treatment are medication, mirror treatment, stump stimulation and cognitive therapies.
What happens after the amputation? Are prosthetic limbs available that can make me just like I was before?
A prosthesis is not bionic. It is an artificial replacement for a missing limb or part of a limb. Although a prosthesis is never as natural as your own limb, it can help you do many things quite effectively if you are willing to combine your energy and willpower into learning how to use it. The most important aspect of success is working with your doctor, prosthetist and therapist to address all of your concerns, and then to work with them on the processes of designing, fitting and training, which are required to be a successful user.
What does a prosthesis look like? How will it stay on?
Depending on the level of your amputation, physical ability and functional needs, each prosthesis will be somewhat different. But, for most standard prostheses, they are comprised of conventional component parts attached to a socket that fits over your residual limb.
How does a prosthesis work? Will I be able to do all the things I did before I lost my limb?
The majority of people who lose a limb can get back to a normal mode of functioning within several months, depending on the location of the amputation as well as physical ability. How well they function depends primarily on their goals along with timely, comfortable prosthetic fitting, good follow-up care, and a “can do” attitude from themselves as well as their medical team.
When will I get a prosthesis?
Generally, you should be ready for prosthetic measurements and fitting 4-8 weeks after surgery, when the wound has healed and the tissue swelling is decreased. This process can be easily attained with guided exercise and rehabilitation. During this stage, your medical team also will be concerned with maintaining proper shape of the residual limb, as well as increasing overall strength and function.
What if the prosthesis doesn’t fit right?
Follow-up is as important as the initial fitting. You will need to make several visits for adjustments with your prosthetist as well as training with a therapist. They can help with pressure areas, and problem solve issues, leading you to regain the skills needed to adapt to life after limb loss. Tell your prosthetist if the prosthesis is uncomfortable, too loose or too tight. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you communicate with your prosthetist and therapist, the better you will be able to succeed with a prosthesis.
How long will it 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, the addition of liners or even a different device. Later on, increased activity level and desire for additional function can necessitate a change in the prosthesis or its parts. Once you are comfortably adjusted and functioning at the desired level of activity, the prosthesis may need only minor repairs or maintenance and can last for an average of three years.
Is it difficult learning to use a prosthesis?
Learning to use a prosthesis is a tough job. It takes time, great effort, strength, patience and perseverance. You will do best to work with a therapist while learning how to handle the new device. Much like learning how to operate a car, you will need guidance on 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 terrain
• handle emergencies safely, including falling down and getting up again
• perform daily activities at home, at work and even in a car
• investigate new things you may be uncertain of, including sports and 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 and use it well. The top priorities are:
• working through the feelings about losing a limb and deciding how to rebuild your life after amputation
• exercising to build the muscles needed for balance and ambulation
• preparing and taking care of your residual limb to attain a proper, sound shape for the prosthesis
• learning proper body positioning and strengthening, to maintain tone and prevent contractures
Will I need to use a wheelchair or crutches?
With a prosthesis, the use of crutches or a wheelchair depends on several factors including level of amputation, whether you have a single or bilateral amputation, and your respective level of balance and strength. Most amputees have a pair of crutches for times when the limb is off, including nighttime trips to the bathroom, showering, participating in certain sports, and to help if problems arise that may require leaving the prosthesis off for any length of time. If you are a person who has lost both legs, you will probably use a wheelchair occasionally. Unilateral amputees may find it helpful to use a cane or crutches for balance and support in the early stages of walking or just to have a break from the prosthesis. This is an individual decision based on factors such as age, balance, strength and sense of security.
Once I have been fit and feel comfortable in its function, what will happen next?
Plan on making follow-up visits to your prosthetist a normal part of your life. Proper fit of the socket and good alignment will ensure that the prosthesis is useful to you. Prostheses, like cars, need regular maintenance and repair to continue efficient functioning. Small adjustments can make a big difference.
Can the limb break down?
Yes, things can happen that will require repair or replacement, so it’s a good idea to know about warranties and what to expect from your prosthetist. Get small problems with your prosthesis taken care of promptly. There is no benefit to waiting until something falls apart or causes you serious skin breakdown. If you wear a prosthesis too long when it needs repairs or replacement, you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back and shoulders, will affect posture in addition to performance of the device and energy needed to use it. Early prevention is more valuable than long-term treatment.
Does Medicare or private insurance typically pay for a prosthesis?
Medicare, Medicaid and most private insurance carriers will provide coverage for a prosthesis. Letters and prior authorization can be obtained from private insurance carriers 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 the medical necessity for a new prosthesis.