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RozM

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About RozM

  • Rank
    Advanced Member
  • Birthday 01/11/1959

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  • Gender
    Female
  • Location
    Staffordshire, England
  • Interests
    Consciousness, IT, Music, Movies, Cars, Life, and People!

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  • Membership Type:
    Amputee
  • Amputation Type:
    Ertl RBK
  • Amputation Date:
    08-10-2006
  • Amputation Cause:
    Arthritis 27 years post trauma

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  1. RozM

    ertl procedure - uk nhs

    Hi Hannah; Yes - the Ertl IS available on the NHS. I had my ERTL done on the NHS by Mr. Nigel Rossiter in Basingstoke; I had to request an Extra Contractual Referral from my local Primary Care Trust, which they granted. I needed a scar revision 11 months later, which was brilliantly done by Mr. Henk Giele in Oxford, which my local PCT also funded. Our situations sound similar - I was offered a pan-talar fusion in my wrecked ankle, but I turned it down in preference to an amputation. I just knew I'd be more able with the amputation, and a certain well-respected medical professional pointed out to me that while you do see amputee athletes, you never see arthrodesed athletes... I'm more able now than I've been since my teens, and have never regretted having the amp, not even for a millisecond! I think I have derived significant benefit from having had the Ertl, as I have a fantastically strong stump, but it was indicated for other reasons in me too - I had very little muscle over where the distal end of my fibula would have ended up, so there wouldn't have been much cushioning over it, and I reasoned that I'd better have it just fixed in place by the Ertl. I wrote quite a lot about it all on this forum - just search for "Ertl" - but please do feel free to PM me if I can help further. Hang in there! All the best Roz.
  2. RozM

    nerve stuck to the scar

    Hi Gazza; After my BKA, I had one obvious nerve stuck in my scar, and the subsequent revision found a further two; once they were fixed, I couldn't believe the improvement in comfort! In my revision, I had a little more bone removed as well as having the nerves fixed and the scar tidied up, but it healed a lot quicker than the original amp; I think the time out-of-socket was about the same, but I was much more able and made much faster progress after the revision. Plastic surgeons are often more sensitive to how soft tissue should be dealt with than orthopods, and I've considered myself lucky to have ended up with a stump that's benefitted from both skill-sets. I hope it all works out well for you. Best wishes Roz.
  3. RozM

    Harmony vs LimbLogic

    Hi Stubby and ValkF6; Thanks for your comments - I'll certainly ask about the ProFlex sleeve. I'm on the NHS, so I don't want them to take away my old, comfortable 2nd leg (the one with the older Harmony socket and a vacuum valve instead of the pump), as it also has a cosmesis, and it's great for lower activity days too. They'd also be happy about the lower cost, I'm sure! However, I have been thinking of seeing Dorset Orthopaedics; are there any Dorset Harmony users out there? RozM.
  4. RozM

    Harmony vs LimbLogic

    Hi everyone, I've been absent for quite a while - hello again! I've had a manual Harmony HD for over a year, with an OttoBock Axtion foot, and it's an absolutely wonderful leg; the security of the vacuum makes me feel so stable and very able, and while it is heavy in comparison, I never notice it when wearing the leg. I've had trouble with getting well-fitting sockets, and the sleeve and liner pinch my skin behind my knee quite painfully. This latter problem is the limiting factor in how long I can wear my Harmony. I've had no trouble with liner durability, but an occasional tumble or even knocking my leg against a hard surface has punctured sleeves, which are frustratingly vulnerable in this regard. I also can't use my exercise bike with the Harmony system because of how much the sleeve and liner limit the degree to which I can comfortably bend my knee, so I'm getting a pin system leg just for exercise. I also have an old Harmony socket mounted on a basic pylon, with a one-way vacuum valve on the end of the vacuum tube, which I wear with a Harmony liner and sleeve, and even without the Harmony pump, this leg is good for lower activity days, as it still feels quite secure. I still get pinching behind my knee, though, so I'm looking forward to seeing how I get on with the pin system - I went straight from supracondylar to Harmony, and haven't had a pin system before. Best wishes, Roz.
  5. Hi Flip; You mentioned liners: my prosthetists have always demonstrated putting the Harmony liners on by turning them inside-out and sliding them upwards over themselves up my limb, but I found my hands weren't strong enough to use this method and get it right every time, I usually had quite a lot of air still trapped inside, and I was also afraid of puncturing the liners with my fingertips using this method. So I've ended up rolling my liner up from the top down, so that it becomes a donut shape, and unrolling it upwards over my limb. This makes getting the liner on much easier, and there's usually no air left inside. I've done this with 2 liners over 7 months with no ill-effects on them at all. Also, something that surprised me was that even though with a Harmony there are no daily worries about volume fluctuations, my stump has continued shrinking, hence my now needing a third socket after 7 months; however, I had revision surgery 15 months ago, so my stump is probably still settling down from that. I had read that you can't use regular socks to cope with size problems if you have a Harmony, but I've found that adding a cotton sock or two does fix the problem between sockets. I usually keep my limb on for at least 15 hours a day, and have even managed 22 hours before tiredness, not the leg, stopped me - it's an amazing system! Very best of luck with your new legs - I look forward to hearing how things go! Roz.
  6. Hi Flip; I've had the Otto Bock Harmony system for over seven months, and I think it's amazing! It's in a completely different league to my previous supracondylar sockets... Even though it's heavy, it doesn't feel it when it's on, because the vacuum really integrates it so well. In fact, I think that the extra mass compared to a lightweight prosthesis makes it about an equal weight to a normal lower leg, and my thigh muscles can control it naturally too. I've been an RBK for just over 2 years now, and I can honestly say that sometimes I genuinely forget that I'm an amp - it must be because of the vacuum that I always know exactly where my foot is in space, and that whatever activity I try, the socket won't twist and hurt me, so I can run, I run up and down stairs, and I hate having to take it off at night - it's been stunningly good for me. As regards liners and sleeves, the polyurethane liner is quite bulky and doesn't bend as well as silicone, but I cut about 2 inches off the top, making it lower behind my thigh and higher above the front of my knee, and this really helps. My prosthetist forbids me from doing this, but I do it anyway, and it works! The liners don't get appreciably thicker until much lower than 2 inches from the top, so it doesn't cause me any problems. A shorter liner means I can wear the sleeve lower on my thigh, which is less irritating and eases knee-bending too. I also found that bending my knee was more of a problem with my first socket, but I'm now on my second Harmony socket, and they made the rear trim-line lower, so the liner doesn't bunch up as much, and I can easily use my exercise bike. With the vacuum on, everything is held securely in place, even under loads from odd angles, like walking down slopes. The sleeve is thinner than a regular silicone one, and I generally don't have problems with it being visible through my trousers. They can be fragile, though - my sockets have sometimes had a ridge around the outside top edge, and if I've knocked the top of my socket on something like a wall, it has damaged the sleeve from the inside, but not actually punctured it. I've had one punctured sleeve, which was very frustrating, because the repair patches didn't work for more than a day, and being unable to achieve vacuum seriously degraded the fit and feel of my leg; care is needed regarding everyday activities around sleeves! I don't have a particularly long stump, but there is only just enough space to fit the Harmony pump in, so if it's possible to get a vacuum system with long-ish stumps, that can only be a good thing. Your choice of foot will be very important. Because I have so little space to spare, I use the low-profile Otto Bock Axtion foot; I hated it at first because it was so hard, but as I got used to the feel of the Harmony system I became more active, so I adapted into needing the more active characteristics of this foot, and now I love it; when I wear my spare leg which has a Seattle Lightfoot, I feel like I'm walking on sponges, and don't feel nearly as stable. Best of luck with your vacuum system; keep talking to your prosthetist about any issues and discomfort, because when you get them ironed out, I think you'll be delighted with how enabling a vacuum system can be. Best wishes Roz. :)
  7. RozM

    gabapentin

    Hi Harley! I'm just over 2 years RBK, and I still get a couple of stabbing phantom pains every day, and some days quite a few, but I don't take anything for them any more. In the days soon after my amp there were a lot more phantoms, stronger and more frequent, and I wanted to stay off Neurontin/Gabapentin, and thankfully I also found great relief from Amitriptyline, enabling me to get to sleep too. I had to have a plastic surgery scar revision 11 months after my amp, and at least 3 of the main nerves were re-cut, and despite those 3 having been freed from being entrapped in my amputation scar, they still trigger-off the same amount of phantoms, in the same places in my phantom foot. I know what you mean about cold - I find that a cold stump gives me an achy phantom foot, so when I'm not in my leg, I try to keep it warm. Over the last 2 years I've found a fascinating range of phantom sensations; I'm very active, and most of the time I feel like I still have a foot, but it's just a bit numb; when I flex what were my calf muscles, I get a tingling feeling in my phantom toes; and when I have my leg off and get a real zinging stabbing phantom, massaging my stump seems to calm them down. Best of luck with everything! RozM :)
  8. RozM

    Where has everyone gone?

    I'm still about, but it's after midnight and I STILL can't get away from work!!! That's what keeps me from posting as often as I'd like... I must say that it's great to see that whenever this question gets asked, so many old friends reappear! It confirms what I thought - we're all still here for each other, even if we can't always be at the party! I do check in whenever I can, and I'll never forget how this forum changed my frightening, degenerating, increasingly-painful and increasingly-immobile condition into understanding and knowledge about my options; I hope all the prior posts can continue to survive as an archive of knowledge, because it was a priceless resource for me, as well as experiencing all the support and often hilariously amusing interactions with new friends! Just to update y'all, I totally, utterly, completely LOVE my new Harmony system! I have the usual mild sleeve burn issues, and it's still not aligned quite right, but with the Otto Bock Axtion foot, it's an amazing combination. I haven't been this active since I had my accident, when I was 20, and it's an absolute joy being able to hurtle about like an adolescent again! It was a little worrying at first because the total contact socket was really quite uncomfortable for the first few weeks, but I've "walked through it", and my stump doesn't complain at all now; in fact, everything has come together synergistically - the Ertl, the excellent revision, and now the Harmony, and I can literally jump with all my (considerable!) weight onto my prosthesis, with no pain in my stump or other ill-effects at all - it's amazing... ...all of which means I'm now more aware of the problems with my hip on my amp side! I guess it's fate's way of telling me to slow down! They're going to do an arthroscopy and joint wash-out, and I'll just need to nurse it along for as long as I can - c'est la vie! Anyway, I must finish this darned artwork, and then I'm going for a drink or three! Take care everyone. Best wishes Roz. :)
  9. RozM

    I Know It Gets Better, But When?

    Hi Maryl; I'm so sorry to hear that the aches and pains have been catching up with you - they're so darned tiring, as well as being demoralising... I'm on the brink of getting a wonderful new prosthesis, but my "good" knee is getting really painful - worryingly-so; and my tennis-elbow is flaring-up like mad - for no reason whatsoever - why??? I can't even carry a shopping basket at the moment - not that I needed an excuse to avoid domestic chores! There are other anti-inflamatory drugs out there - I can't take Ibuprofen either, due to a sensitive digestive tract, but if things get bad, there's a drug in the UK called Arthrotec - it's like a buffered version of Voltarol (diclofenac sodium), which is an amazing anti-inflamatory. It's so good at settling down inflamed joints that it feels like you've taken a painkiller, and its effects can last quite a while. I'd ask my doctor for more advice if I were you, as there may be another biochemical reason for the flare-ups. I also wholeheartedly agree with the suggestion of using crutches with ergonomic hand grips - they've saved my hands and wrists a lot of pain which conventional crutches caused, as well as seeking out any other ergonomic solutions to painful activities. Hang in there! Things can indeed be better, but I've found that far from capitulating to the aches and pains, the right meds and a little rest can be wonderfully restorative! Good vibes and healing to you, my friend. Roz.
  10. RozM

    Roz's Revision

    Hi Lynne! The Harmony consultant did the casting. As I mentioned, the cast was done over the polyurethane liner, which was protected with clingfilm, and with a thin sock over the clingfilm with a roll of spare material at the end to create space at the end of the cast. For the cast, the consultant firstly put some folded wet plaster strip over my tibia and round the back of my fibula, and he held it in tight behind the back of my fibula while it set. Then he did the usual casting thing - wrapping wet plaster bandages around my stump, over the top of the first plaster section which covered my tib and fib. Then it was on with the big rubbery sock and the suction pump, and a negative pressure was maintained until the cast had set. I'd been told that even some non-supracondylar sockets can have high-ish sides to support the knee, but the consultant seemed happy that my knee was sufficiently stable to do without them; I was intrigued by the absence of the high sides, which made the socket seem really short, but at least half of my kneecap was covered by the socket. This led to the first check socket, and to check the fit, the consultant covered my liner with some kind of grease, which instantly revealed any gaps between the liner and the socket as I put my weight into the clear socket. Then, once the fit was seen to be OK, the position for mounting the Harmony pump was determined. I was intrigued by the way that a little space was left at the end of the cast by he roll of surplus sock, and also that the space was filled later by silicone injected into the check socket; I suppose the cast got the general shape of my stump, and the silicone got the exact contour of my soft tissue at the distal end, but - crucially - the soft tissue was accommodated by the silicone while I was putting my weight into the socket, so the silicone flowed to the exact shape required by my stump while weight-bearing. That clever procedure ensured a perfect total-contact fit and eliminated the last bit of discomfort I was getting; I was surprised that more contact and therefore more upward pressure from my soft tissue actually eliminated the last of the boney pain I was getting at the back of my tibial bone end. This first check socket with the silicone at the end will lead to the next check socket, which should be virtually perfect, but the fit will be checked again with the grease trick, to see how the liner bears against the inside of the clear check socket. If all goes well with the next check socket, I should leave the same day with a new Harmony leg... I just can't weight for the next appointment, but I still haven't heard from the limb centre when it might be, and the wait is agony! ...but after a few days care following my fall, my stump is fine again, so it's back to the luxury of wearing my old leg for 2 hours a day before it becomes unbearable..! Best wishes Roz.
  11. RozM

    Roz's Revision

    Hi everyone; Thanks very much for your informative feedback. I perhaps wasn't clear about the socket and Pelite liner problem - they had to cover the outside of the liner with leather to make it fit in the socket, as well as lining it with leather on the inside, and that was even though I was wearing a Derma Seal sock, which is quite thick anyway - this socket has been a bad fit right from the outset, when I was cast for it immediately after my revision surgery, which means it's a terrible fit now, six months later... Fiona - it's good to hear that the Elation is more responsive when worn with heels; I imagine I'll probably end up with one on one of my legs. I hope your work-avoidance helped you prepare for what lay ahead! I have to do that too - I think it helps! Well, the fitting of my new leg on the 17th was brilliant, and I'm going to be getting a Harmony socket! Before the appointment I wrote to my prosthetist and my consultant expressing my concerns about the lack of response from the Elation foot for everyday use, and also asking whether the proposed suction socket might lead to a Harmony system, and - lo and behold - when I arrived on 17th, I was introduced to an Otto Bock Harmony consultant! I was there for over 7 hours for just the initial fitting, and I'm extremely optimistic that the resultant system will be excellent. Firstly, I was told that the Harmony system involves the use of a total contact socket, which would include some contact with the distal end of my stump, and when the Harmony consultant pressed his palm against the end of my stump to see how it would react to this, there was no problem. I was then fitted with a Simplicity polyurethane liner, and, as my stump is not particularly bony, an off-the-shelf one was fine; we ended going down one size from the first trial. It was explained that in order to sustain the vacuum of the Harmony system I'd have to wear a sleeve, and I tried it to see how it felt; I haven't worn a sleeve since my first supracondylar socket, and I found that my original silicone sleeve was heavy and quite restrictive to my knee flexure, but this one (I think it was a VASS sleeve) was light and much less costricting. Then it was on to being cast. This was done over the liner, and, being my first non-supracondylar socket, I was interested to see how the plaster was kept so much lower around my knee. The cast was completely covered with a rubbery sock and a suction pump was attached, which really squeezed the cast to my stump, but some space at the distal end was maintained by a roll of material, I believe to allow for some accommodation of my soft tissue. I also had to partially tighten up the muscle in my stump to ensure that the resulting socket didn't press on any shape-change caused by muscle-tightening. I then had to wait for the check-socket to be made, so I caught up with some work and had lunch, and then it was on to working out where the Harmony pump attachment should be fitted on the check-socket. After another wait, I got to walk in a Harmony system for the first time. After tweaking the alignment a bit and making sure there was a proper seal between the socket and the sleeve, I had to ignore the stiffness of the basic foot, but I was intrigued by the feel of it; I didn't notice any problem with the weight of the Harmony unit, and after a few steps, it really did feel very much a part of me. The socket wasn't quite right, though - similarly to my previously-attempted pin-system socket, with each step I got a feeling of discomfort at the back of my tibial bone-end, a slight dull pain towards the back of the distal end of my stump. I wasn't aware of sinking into the socket, but the Harmony man said we should try adding more support under the end of my stump - making use of the adjustment space he had left during casting. He pumped some liquid silicone into the bottom of the check socket and I had to don the leg and stand in the socket for a few minutes while it set. Result! A big improvement - much less discomfort at the back of my stump. We even added more silicone, and it got even more comfortable - how about that?!? Adding support right at the distal end made the socket more comfortable, but then, because the silicone had flowed to exactly where it was needed, it was perfectly-fitted to my stump. There followed more tweaking of alignment and making sure that a vacuum was developing properly and quickly as I walked, and everything felt amazingly good - the Harmony man did what I suppose is the system's party-piece - I sat in a chair while he tried to pull the leg off, and it simply would not move - he ended up dragging me in the chair across the carpet, and the leg wasn't budging by even a millimetre! Most impressive! The next stage is another long session, during which I'll try out another check socket (made from a cast taken from the first check socket, including the corrections made with the liquid silicone), a definitive carbon fibre socket will be made, and then there'll be apparently extremely accurate alignment using lasers. All that should take place in about another two weeks... I'm not sure which foot he said I'll get (- Otto Bock Axtion, I think - any thoughts, anyone?), but having had the fit closely defined with the liquid silicone, the definitive socket will be shorter, so there's a little more height available; I'm hoping there might be enough space for an Endolite Brio adjustable ankle, but there simply might not be enough space, so I'll settle for a good foot. So, the saga of my trying to get a decent leg continues, but it's now looking very good indeed! Now, I'm the first to believe that every cloud has a silver lining, and the cloud of this wait for a decent leg looks like it really will have a silver lining in the shape of my Harmony system, but my brother has occasionally grimly asserted that every silver lining has a cloud! ...and, sure enough, the day after my brilliant Harmony session, I fell onto my stump! I was talking to my boss while walking (without leg) outside in the lovely English winter dampness, and I didn't realise that I'd planted my one-crutch onto a new eruption of moss, and suddenly it skidded away forwards, and I went down with my stump folded underneath me - ouch! I immediately developed a bruise on the front edge of my tibial bone end, and there's a bit of swelling at the end, but the skin wasn't broken. Oh, well - I needed an excuse for a lazy weekend - there's my silver lining! I'll be sure to be very careful in the days leading up to final fitting and receiving my Harmony leg, and I suppose I needed such a reminder..! However, I got a brilliant compliment from my boss - he said it wasn't until I fell that he was reminded that I am disabled, because even though I have to use my one-crutch almost all the time right now instead of my ill-fitting leg, no-one thinks of me as disabled at all... I think that's great (particularly since my boss used to be a professional athlete!), but they ain't seen nuthin' yet - when I've got a decent leg, they won't be able to keep up with me! Best wishes Roz. :)
  12. RozM

    Happy Birthday

    Thank you all very much! I think it's time for me to conveniently forget how many birthdays I've celebrated, but this was a nice birthday, surrounded by good friends, and with far too many alcoholic presents! On the other hand, I'll be able to drink to absolutely everyone's very good health! Cheers! (hiccup!) Best wishes Roz. :)
  13. RozM

    Roz's Revision

    Hello everyone; Happy New Year to you all! Many thanks for your informative and supportive replies. I've had three sockets in 2007 from my limb centre, and they've all been a bad fit - the Pelite liner of my first supracondylar socket of 2007 had to be covered with leather before it would even fit in the socket! Now, that can't possibly have been anything to do with my stump changing shape - they were actually made a different shape from each other! The sockets I had before my revision were a better fit, but I was compromised by my scar problems - a fine example of Sod's law at work, there! This confirms what my PT has said - that something's gone amiss with socket-making at my limb centre, and it's difficult to have confidence that they'll get it right if I give them another chance with a technology they've bungled before... Fiona, I can really relate to what you've said about being uncomfortable in meetings, and your argument is very compelling, and I might well mention to my consultant (without naming you) how you have no problems or discomfort from the pin system despite having a very sensitive stump. I'm just desperate to get a leg I can wear, and as my limb centre haven't been able to make me either a supracondylar or a pin leg which works, I'm inclined to try something different in the hope that it might yield better results. So, I've decided (for the moment) to proceed with the "specialist" who's coming to fit me for the TEC liner, followed by a new socket the same day (I believe); this approach might also take me one step closer to the mythical Harmony system, which I do like the sound of... When I was trying the pin system that didn't fit, I also got to try an Elation, albeit briefly - wow, it was odd! My first impression was that it was stiff and "dead" - nothing like as responsive as my Seattle Light Foot. For those who have an Elation as well as another everyday foot, do you get used to the difference? Thanks for the info on the Bioquest foot, fivestringcooper - that looks amazing! I liked the comparison on their Practitioner brochure, between their foot and my Seattle Light Foot; if the PerfectStride II is almost TWICE as energy-efficient, I've GOT to try it! I've put my request in! Has anyone else graduated from a regular (valved) suction socket to a Harmony system? And does the Harmony system restrict the height of foot you can use? Wish me luck for 17th! I can only wear my old socket for about 2 hours before it starts doing unpleasant things to my skin, so waiting 10 days under these conditions is driving me nuts..! Best wishes Roz. :)
  14. RozM

    Roz's Revision

    Hi gang! I hope you've all had deliciously over-indulgent Christmasses! Despite my best efforts not to, I'm afraid I have! Great to hear from you Londonguy! I'm so glad that you got the procedure you wanted, and that everything now feels good to you. Now that my revision has settled down, my stump feels amazingly strong - when I press sideways on the bottom of my fibula, it's absolutely solid, which is not only very reassuring, but I'm sure the strength really helps me to rush about at break-neck pace without feeling at all unstable. I look forward very much to hearing of your progress Londonguy, but I have some new information for you about our variation of the Ertl - weight-bearing on the end of the stump may be slightly problematic! More below... Cherylm and Lizzie2, thanks for your replies about the "hole" in my skin - it was indeed a pressure-sore, caused by my old supracondylar socket putting too much pressure on the back of my knee as it became an increasingly worse fit; keeping out of my leg for a week made it mostly heal up, but there's still a red mark there which flares up quickly when I wear my leg, so I've become restricted by my old socket... ...and I was supposed to have escaped from the darned thing! I was due to collect my new pin system leg (complete with Elation foot!!!) on 18th December, and I couldn't wait! A wonderful new leg for Christmas! In the days leading up to this crucial appointment I'd even begun singing, "All I want for Christmas is a decent leg..!" - but it was not to be - sob! I'd had a check socket fitting, and it was way too loose - just as the original supracondylar socket was; my prosthetist said she could make the definitive socket a tighter fit, but to my dismay, it was far too loose as well. Even with 3 additional thick socks over my liner, I went straight to the bottom of the new socket, and while I tried walking in it, I got a lot of unaccustomed discomfort from pressure on the end of my stump. How could they have got it so wrong, despite the check socket fitting only 2 weeks earlier? My prosthetist conceded that I would have to be re-cast, and I said that this time I'd want a socket with a pelite liner as well, so there would be some mechanism to accommodate the looseness that currently seems to be customary with new sockets at my limb centre... ...but then I saw my consultant. He said that pin systems always put more pressure on the end of the stump, but I'd never heard of this before; he pressed on the end of my stump, and I did feel discomfort at the back of the tibial bone-end, and his conclusion was that with the amount of sensitivity I seem to have, I almost certainly wouldn't be able to walk a mile using a pin system - as I could manage with my supracondylar before it began damaging me. Apparently, lots of BK amps have too much stump-end sensitivity to be able to tolerate a pin system, so they have to be given alternative suspension methods. Has anyone else been told about, or experienced, this stump-end-pressure problem with pin systems? What amazes me is that, if this is true, why wasn't I checked for stump-end sensitivity back in September, when the pin system was set in motion for me??? By the time I'll be cast for a new socket, it'll be four months since the (apparently inappropriate) decision to give me a pin system was made, so I'm really disappointed - on top of not getting my new heel-height-adjustable leg, this apparent complete waste of time has rather clouded my Christmas. So, on January 17th I'm going to be fitted with a Tec liner and a suction socket. As I've always assumed that a pin system would be the next logical step for me, I've found out all about liners and rods and clutches and ratchet systems, but I can't seem to find anything informative about either Tec liners or suction sockets - please help me, o wise ones!!! I believe that the original Tec system was bought by Otto Bock, and is sometimes associated with the Harmony system, but how does it work with a valved suction socket? Will I need to wear a suspension sleeve? Are there different types of BK suction sockets? Also, I suppose I'd be interested to know whether an Ossur seal-in liner would be a viable alternative to a pin system - is a seal-in liner less likely to put pressure on my bone-end? I understand that as I'm still less than 6 months from a revision, I may not be ready for a seal-in liner, but are volume changes likely to affect the fit and function of the proposed Tec liner and suction socket too? I would be most grateful for any thoughts anyone may have, and pointers to some information on Tec liners and suction sockets. I wish you all a very happy New Year, and better mobility and comfort (and quicker results!) for us all! Best wishes Roz. :)
  15. RozM

    Roz's Revision

    Hi everyone; It's time for a follow-up - I'm soon to get my first pin system leg! The (July 4th) revision has turned out extremely well - my stump is very "comfortable" - it can withstand pressure in all directions, including a lot directly on the end, and I think that the bevelling of the bone has been very helpful here. ...but my scar! Whereas previously I had a broad, soft, sensitive, blister-prone, hypertrophic scar, now it's a trouble-free fine line - and as the adhesions have gone, the scar is not pulled by the bone as it moves within my stump when I walk, so I no longer get any pain from that problem. It's also wonderful to be free from the agonizing sensitivity of having nerves entrapped within the scar! The only problem I've had since my revision has been more frequent phantom pain - I get several sharp shocks every day - a consequence of having 3 nerves re-cut, I suppose - but I can usually persuade it to go away by rhythmically tightening and relaxing the muscles in my stump. I've been increasing my activity levels, and I can now walk a mile on a treadmill at quite a fast pace (which I do several times a week), but my "starter" leg has become a major limitation - as it's a supracondylar design, I can't sit at work without it digging painfully into the sides of my knee, and walking a fast mile soon causes my Otto Bock Derma Seal sock to wrinkle up - the "starter" socket set-up is just not up to such activity levels, and, frustratingly, I haven't been able to get something better. That's down to my limb centre, which has been good and bad... The good news is that there's a new progressive consultant at my limb centre, and I was delighted when he said I should be fast-tracked to a pin system leg; however, a new computer appointments system has made getting anything done into a frustrating, dragged-out ordeal, and the quality of their work seems to have declined since I got my first legs. My first new socket after my revision was surprisingly badly-made - the PE socket liner was so loose in the socket that it had to be covered in leather to make it fit properly, before it was even given to me! And despite other fit problems and shrinkage of my stump, they wouldn't give me a new (re-cast) supracondylar socket because of a policy to only work on one leg at once, so my pin system must be sorted out first. That sounds fine in theory, but it took me 3 weeks to get the appointment during which the pin system was recommended, another 3 weeks to get an appointment to be given an Iceross liner to try, another 3 weeks to be cast over the Iceross liner, another 3 weeks to test a check socket - and I suppose it'll be another 3 weeks before I can get an appointment to collect the actual leg - a total of 15 weeks, or almost FOUR MONTHS for a leg!!! And, because of the one-leg-at-a-time policy, during all this time, I've been stuck with my badly-made and ill-fitting first socket - how's that for service?!? I suppose I'm doubly impatient because I'm so ready for a better leg, but my limb centre is driving me mad!!! It's really difficult to strike a balance between using my inadequate leg sensibly, and not using it; I have, unsurprisingly, overdone things, and had a few skin problems, which has made me slow down, but I really, really don't want to! I would be most grateful for any advice about my skin issues - I've had blisters (which I treat with blister plasters), but also red patches, and a "hole" about 2mm across at the back of my knee that's been reluctant to heal, even without wearing my leg. As regards the red patches, I've been a bit worried about them, as they seem like inflammation which might spread; I've been using aluminium chlorhexahydrate anti-perspirant, and have never had a problem with it, and therefore no problems with perspiration either. Could it be that my skin is not liking the Otto Bock Derma Seal silicone sock - particularly under the stresses of high activity levels? As regards the "hole" at the back of my knee, it's exactly where the top curve of my socket presses on my leg - which is quite hard when I put all my weight through it; is it possible to get a pressure sore from a socket? If so, how should they be treated, and, more importantly, prevented? ...or am I worrying needlessly, because this problem will not be an issue when I (eventually!) get my new socket? I must say that things are now looking very good - I'm amazed at how much more usable my stump is following the revision; I knew that the reconstructive plastic surgeon I chose was very good, and he's really delivered great results. Therefore, I would recommend considering a revision to fix the kind of scar problems I used to have, as long as a suitably talented surgeon can be found - and - in my experience - that's not necessarily an orthopaedic surgeon! Best wishes Roz. :)
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