Jump to content
Heather Mills - Amputee Forum
Karen

Test Socket Woes... Please Help!!! :-(

Recommended Posts

Hi, everyone WARNING...this is a very long and emotional post!!!!!!! I'm sitting here at the keyboard sobbing as I write.......

I am looking for some advice.... Yesterday I returned home with Test Socket #4. Because the design is different than any I have worn before, I understood going in that it may take some time to get the proper fit. The fact that I need to travel over 200 miles (RT) each visit, adds to my anxiety. This is what has been happening so far:

After doing some research on the web, I became very interested in trying the MAS socket design for AK's. My current prosthetist has not learned the technique and was not interested in learning it. So I did a search and found one in Florida who was experienced in it. I made a trip up there to consult with him and found him to be very personable, and up to date with latest technology.

Casting was done, and I returned a few days later to try test socket #1. It was too large in many areas so he made lots of marks on it and set up an appt. for the next week. Test socket #2 was also too large (lots of air escaping), so he made further marks. I did note that I liked the way it was low in front and back with just the one "finger" shaped piece over the iscial bone....I didn't feel any pressure there.

Ok, then there was the appt. for test socket #3. It was attached to my socket and I tried walking on it. It definitely did not feel right, and the foot was wiggling. It was not in proper alignment. But he asked me to take it home over the weekend to check the fit. I was so miserable that weekend....I could not walk straight and felt so unstable.

I arrived for the next appt. at 10am and was not seen until after Noon. I would not have minded if things had gone right from there! Instead, he worked with the alignment for a while and then determined knee was not attached at the right place on socket, so he reattached it. I tried it on, and he told me to walk "carefully" because the adhesive may not be totally set. I took one step (no bars) and fell because the leg came apart! Fortunately there was a chair behind me. I was still shaking when he returned with the repaired prosthesis, and tried again. The alignment was still way off, so he moved the connector to another spot on the socket. That seemed better, although still not right, but was hard to assess because the socket was not fitting well (he had made more marks on areas to change), but I was so anxious to get out of there (it was almost 7pm by that time) I said I'd wear it for a few days. I drove home that night hoping it would be better in the morning (I know better than that!!!!). Next day I was in tears because I was losing suction and so uncomfortable. The back side of the socket was sticking out too, and I found it hard to sit, so I called and asked if I could please come in and have my old socket put back on while they make a new one with the changes needed. My prosthestist was away at a conference for a few days, but his assistant (a recent grad of Pros. school) said she could do it, that it was a simple thing. She reconnected it no problem, but it was about 2 inches too long. She then said there was no way to shorten it without cutting the tube. Even I know that if you cut the tube on a C-leg you can destroy the unit! Then she was able to get ahold of the CPO at his conference and he came to the office and fixed it. At that time I told them I need a break....was too emotionally upset to deal with any more and wanted to make an appointment in two weeks after I had returned from a trip. I asked him to make the new test socket with all the changes needed and to please set aside 2 hours to work with me. He agreed and I left there feeling very proud of myself for being assertive. Two weeks later (yesterday), I arrived at the office at 9am full of hope.... until the receptionist called the CPO on his cell and he told her that there was still some "prep" to be done by one of the guys in back...who was not in yet. An hour and a half later, I tried the leg on. He didn't even apologize for the wait....and then mentioned something about putting a piece of foam on the back so I wouldn't be sitting on the hard socket. I did note that the socket looked very different from before, but put it on. I felt a definite difference in the rear end....like my bone was sitting on something.....not like before, but the inside socket itself was snug and felt good. He had me walk around the office for about 10 minutes to check how it felt. I mentioned that the back felt weird, and he checked it and said everything was in the right place. Because I was walking pretty decent and not hurting, I said I was OK with wearing it for a while. He said a week, and I agreed (again, why did I agree to wear it so long!?). Before I left he took it back and wrapped more casting material around the bottom of socket, making the part just above the knee about twice as large as my other leg. It wasn't until I got home and took it off again that I notice what was going on behind me! Just above the knee was a huge lump extending out about 2 inches.....that's why my leg felt uncomfortable and "elevated" on the drive home. I started to cry when I looked at the back trim line of the prosthesis. Gone was the long finger type extension, and in it's place was a rounder, shorter version of it with a little "shelf" looking thing just below. This does not look like the MAS socket design I saw in the photos. The round piece goes all the way to the middle of my bottom...way past the the ischial bone....then the trim line dips slightly before going back up again.....again, not looking like the MAS socket at all. I put it back on and saw that my "cheeks" were not even either. I think the prosthetist changed the shape of the socket to an ischial containment one!? Not sure since I have never had that design, but from what I've seen and read, that is what it looks like.

OK...... so this morning I woke up and called the prosthetists office. They were not in yet so I left a message saying I was not going to be able to deal with wearing this socket over the weekend since it is so uncomfortable to sit on (part that dips like a V in back is all curvy and sticks out ...that's where he placed the foam) and does not even fit into even my baggiest sweat pants because of all the casting material and huge lump in back. I asked to come in Friday instead. I have not heard from them yet....he probably has another "conference". At this point I am feeling hopeless that things will work out. I want to drive up there and grab my other socket (or have my husband do it!) and drive as fast as I can to another prosthetist!!! But then I am worried about financial obligations I might have for the test sockets, even though none of them fit. I am such a wreck! Has anyone else been in my position? Can you offer any advice on what I could/should do?????????

Karen :-(

Share this post


Link to post
Share on other sites

I can only offer sympathy I'm afraid. Hope you get it sorted out. People shouldn't be treated like this. :angry:

Share this post


Link to post
Share on other sites

OMG Karen:

I am sorry that, so far in my life, I cannot relate to what you are going through.

I have been blessed with a good prot guy. I have seen the work of some of the other idiots around this area and thank God that i selected Larry's name from the list I was given.

Reading a lot of stuff on this site, makes me wonder why people do not come to Canada to be serviced. I am sure that it would be cheaper in the long run.

Prot guys in this province are governed as to what they charge the government by fee schedules. My prot guy gets..........can you guys believe this........$375.00 per finished laminated socket!!! ...and he is GOOD!!!

I know of one American who told me that his casting fee was $10,000 USD!!!!!

I am sure that Canadian prot guys can do their business with non Canadians and charge directly.

Anybody want me to look into this?????

At any rate....getting back to what I started out with..............Karen...........your prot guy SUCKS.......and I would look into a law suit against anybody who knowingly put me into a check socket that was NOT set in curring!!!!!!!

ED

Share this post


Link to post
Share on other sites

Maybe you could file a complaint against him with the Board. That might make him sit up and take notice. He really shouldn't charge you for something you can't wear. That's just my opinion.

Share this post


Link to post
Share on other sites

Hi Karen

Yep, I have been where you are and can understand how you are feeling.

Not sure where you are, but know where ever you are funding is probably an issue. I would definitely talk to him and say how unhappy you are with it, altho saying that I took that approach and it didn't really work, I am in the UK with the NHS and I just flatly refused to go back, and thro. my GP managed to get to another centre for a short time.

From what I know the MAS socket is quite new, my problems started with a new type of socket also, but don't let it go on as long as I did.

Ann

Share this post


Link to post
Share on other sites

Karen,

I've been there, and really feel for you...

I had a similar experience with a socket that didn't fit about 8 years ago (I'm BK). I was with a new prosthetist since my guy had moved to a different facility. After 6 weeks of adjustments with no end in sight, I complained to NSW Health (the funding agency) and was allowed to move to a different provider - something they rarely did. If your prosthesis is covered by health insurance, you can complain to them - it is in their interest to have you walking in a prosthesis that fits (purely from a financial perspective, they want you to stay healthy and not require replacements too often). Complaining to the Board may also be a good idea. Make sure you document what's happened (sounds like you've already been doing that).

One problem I found with the US system is that it is not results-based - the insurance company doesn't have any way of ensuring the quality of the prosthesis (I think the VA Hospital system may be better). Here in NSW, Australia (other states may differ), your prosthesis must be prescribed by an amputee clinic, staffed with knowledgeable specialists, physios and prosthetists, and then the completed prosthesis signed off by the clinic before payment occurs (come to think of it, I didn't have to go back to the clinic this time, so perhaps they've changed the process). If the prosthesis doesn't fit, the prosthetist doesn't get paid. Of course you must have realistic expectations, and the prescribing clinic needs to set them - not everyone will be a paralympic sprinter.

Share this post


Link to post
Share on other sites

Hey Kam,

Down here it's pretty easy. I go see my doc who looks at the prosthesis. He writes a prescription with my prosthetist telling him what to write. I go for a cast right then, have a couple of fittings along the way and then take it home and try it out. About a month later I see my Doc again who reviews it and signs it off if it's all ok.

Cat

Share this post


Link to post
Share on other sites

It's the review and sign-off that was missing when I was in the US. The health insurance company paid no matter what (until they decided the whole thing was too expensive so they stopped covering prosthetics :( ).

-K

Share this post


Link to post
Share on other sites

i am an AKA and for four years i had badly fitting sockets, i dont think prosthesisists - hope i have put enough s in that stupid word, anyway i dont think they fully understand the concept of the equipment we need - i think the equipment and socket are two different specialised areas - you can have the best knee the best foot money can buy but if your socket dont fit forget it, the socket is everything, you can walk on a broom handle all day if your socket if comfy. You need to take control of the situation and demand starting again taking fresh castings - your prosthesisist has obviously cocked-up the first one and then attempted to get over it by adding bits - trust me that dont work it just does our head in atempting - demand a fresh start stating you will only exept a new socket and one that fits first time - he/she should have the skill to do this if they can't they should find another career. dont be down and depressed take control, when a good prosthesisist proud of their skill and profession makes a socket trust me it fits and the amputee can walk on it for hours - gaza x

Share this post


Link to post
Share on other sites

Agree with what you are saying Gaza, I am bilateral and have one very difficult stump, but when its done by someone experienced who knows what they're doing I don't get problems. When I started wearing limbs they were the basic metal models and you didn't choose the type of foot you wanted. I used to have very few problems and could do pretty much what I wanted, these days I seem to have horrendous problems.

For me a well-fitting socket is most important, drawings used to be taken as well as casts but this doesn't always seem the case now.

Sorry didn't mean to moan, I am not happy with my current limbs either, as you can probably tell. Anyway hope Karen gets things sorted out.

Ann

Share this post


Link to post
Share on other sites

Karen, this is awful. How frustrating for you. I hope the guy can sort this out. I've done a bit of reading on the MAS and from what I understand the guy that designed it has only just finished training up the new techinque.Can't remember what site I saw it on the other day.(maybe ACA) I wonder if it's worth emailing the designer direct and explain your case-maybe he can inturn discuss the situation with your pro.

Most important you need to feel safe & comfortable in the design stage even if you can't take it home. Gee I feel so bad for you.

I understand the foam seat thing-I have exactly that-but it's not what you ask for. to date I've been discouraged from the MAS my pro he's is a bit suspicious of them.

Don't think I've been much help-but good luck.

We're are not permitted to take test sockets home due to safety reasons.

Mel.

Share this post


Link to post
Share on other sites

hi Karen ,sorry to hear of your hassle. my prosthesis is also trying to make a mas type socket for me,although it is taking time ,as he is lowering the sides gradually,I think he is probably getting better results,maybe its because he is doing it because he wants to learn how to do it for our benifit.I'm lucky as I'm in the uk and it isn't costing me anything,but if it was I don't think I could handle what you have gone through.Are the prosthetists over there licenced or registered in anyway, if they are is there a governing body that keeps a lookout for 'bad workmanship ?

I hope you get things sorted soon,things are hard enough in life without this sort of hassle.

check out this email,it may give you some info,you may even be able to contact these people as it is from an online journal about prosthesists written by prosthetists (I think)

Ian

Share this post


Link to post
Share on other sites

Karen,

When I was reading your post I was almost in tears especially when I read that he gave you a socke that hadn't cured yet what in the hell was he thinking. Then have you walk on it without being in between bars so that you could hold onto just in case it even sounded like you were alone in the room and excuse me if I'm wrong on that. What the hell was this guy thinking????? You're making all these trips spending money on gas wear and tear on your car if you're driving that far, time away from your home. This has got to be a mental and physical strain on you and I feel for you. Please Please Please if he doesn't get it right soon fire him if he doesn't provide you with a leg that fits test socket or not he probably won't charge you or your insurance company. I had this happen to me 3 years ago, I was seeing this prosthestist and he made me the first check socket it was so big it was horrible I asked him are you going to make the finished leg smaller to match my sound leg and he said yes. I took that socket home for about a week when I returned it had masking tape all over it with the area to tight, this area too loose, this trim line needs to be lower you get my point. He took the leg we talked about all the notes that I had on it and he said ok it will take me two weeks to get you another check socket. After the two weeks I went back for the next fitting with the check socket guess what it was way to tight I couldn't even get my stump in the socket or the pelite liner. He cut the pelite liner in the back and then shaved it out in the area until it sorta fit, he heated the socket up until it sorta fit and had me take it home for a week. I took it home (even tho I knew it wasn't right) I couldn't wear it for more than five minutes before having to remove it. I kept it for about 2 weeks or so and asked lots of questions to my Phisical Therapist and some other people, I even called my insurance company to see if he had submitted a bill yet and they told me no. So after about 3 weeks total I finally called him and fired him and never went back he didn't bill me or my insurance company for the two check sockets. I worried about it for a while but then said hey this is my leg not his and have never regretted my decision. I now go to the best guy and IMHO everyone should have him or a clone of him.

He's in orlando if you want his info even if just to call him and ask him questions he's so helpful.

Share this post


Link to post
Share on other sites

Thanks, everyone for your wonderful support! I don't know where I 'd be right now if it wasn't for all of you..... in the looney bin, I imagine!

I am back in my old socket and feeling pretty normal again, and even though it is too big, at least it doesn hurt!

You know, after the incident where I fell when the socket came apart from the rest, I pretty much lost all confidence in achieving what I had come for... sigh. (Yes, Brenda, I was in a room with no handrails and he was across the room, telling me to walk "gently" because it may not be totally dry.....when I took my second step it cracked apart!) But I decided to hang in there because I REALLY want to try the MAS socket and he was the closest prosthetist I could find who has been trained in the technique. I'm hoping that after last week's fiasco he understands what needs to be done to make it work, and I will walk out of there with a great fitting socket. It's very obvious that he is "going to school on me", and I can only wonder how the rest of the eople he has tried to fit in the past 6 months are doing? If they are new amputees, they might not have a clue about how it should fit!? My plan is to have him transfer my old socket and foot to my current spare (which is really not in good shape) and take it with me along with the new prosthesis. That way, if it gets really bad I will switch to old socket, and run straight to BRENDA's guy!!!!! Brenda - after you wrote with me his name and your personal endorsement, I picked up an issue of O&P magazine in my prosthetist's office and read an article about how he "invented" a special socket for a guy who flew down from New York. Sitting there, I thought........oh, I should be in his office! The fact that it's only a 20 minute drive compared to 2 hours is a definite plus. But I'm still trying to be optimistic.... if he can just get that part in the back right, the rest of the socket fits well.

Oh look at me.........here I go writing another novel! LOL Just wanted to touch base again and thank everyone for your continued support. I'll keep you updated....wish me luck on Friday!!!! THANKS FOR BEING HERE!!!!!!

Karen

AKA - Orlando, FL

Share this post


Link to post
Share on other sites

Karen,

I read that article myself and the really funny thing about it is I was at his office one day and he happened to be working on the socket for this guy. One of the other guys that was making my adjustments was telling me how this guy was planning on running once he got a leg that worked. If you don't get a good leg this time at least you know you have another option and a 20 minute drive is way better than 2 hrs especially if you're not getting anywhere.

Share this post


Link to post
Share on other sites
On 4/19/2005 at 9:55 AM, eddie103 said:

OMG Karen:

I am sorry that, so far in my life, I cannot relate to what you are going through.

I have been blessed with a good prot guy. I have seen the work of some of the other idiots around this area and thank God that i selected Larry's name from the list I was given.

Reading a lot of stuff on this site, makes me wonder why people do not come to Canada to be serviced. I am sure that it would be cheaper in the long run.

Prot guys in this province are governed as to what they charge the government by fee schedules. My prot guy gets..........can you guys believe this........$375.00 per finished laminated socket!!! ...and he is GOOD!!!

I know of one American who told me that his casting fee was $10,000 USD!!!!!

I am sure that Canadian prot guys can do their business with non Canadians and charge directly.

Anybody want me to look into this?????

At any rate....getting back to what I started out with..............Karen...........your prot guy SUCKS.......and I would look into a law suit against anybody who knowingly put me into a check socket that was NOT set in curring!!!!!!!

ED

I know this is an old thread but would like to find out if I could have a vacuum socket re made out of pocket up there by someone. I'm in ny. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×