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Afet

TIPS FOR DAILY LIVING AS AN AMPUTEE

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OK, this is a 'spin off' from ED's thread in the Prosthetics and Related forum about Gait Training.

I had mentioned in a reply that, after physiotherapy that I received, I was able to get up from sitting USING JUST MY LEG STRENGTH, without needing to push with my arms.

It had come to my attention that others would like to know how to do this too.

Considering that we don't all get the same level of physiotherapy after our amputations - if any at all! - I thought that it would be very useful if we were to have a section here with our 'HOW TO' type of explanations on how we do things.

So, I'll start with an explanation of how to do the above, but please feel free to add your own. That's the reason this is here anyway.

If you are adding your own, I think it would be helpful if we added our level of amputation in our post, because, for example, my tips may not apply to an AK amputee, and so on.

HOW TO GET UP FROM SITTING, WITHOUT USING YOUR ARM STRENGTH

Type of amputee I am: Bilateral Below Knee

If you're a particularly new amputee or out of practise, I'd recommend having someone nearby to help you (or to act as padding!) should something go wrong. Anyway, here we go:

* First of all, you need to come to the edge of your seat.

* Ensure that your feet are at a comfortable distance apart - not too close together or too far apart.

* Make sure that they are not too far away (distance wise) from your whole body. I usually put my legs at a 90 degree angle.

* Get a feel for where your feet are.

* Try and feel that THE CENTRE OF YOUR FOOT/FEET are on the ground.

* Practise pushing down on your feet whilst you are still sitting.

* When ready, push down on your feet, whilst leaning forward at the same time.

* Lean as forward as you need to go (without toppling over), pushing down on your feet at the same time.

* Once up, breathe in and enjoy the view! YOU MADE IT!!

This took me a bit of practise, but I eventually got it!

You'd need to have done some form of leg exercises before hand, to strengthen the muscles in your legs and glutes (backside) - exercises which I may post myself if no-one else volunteers it.

Good luck! You can do it!! B)

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This is a great idea Afet! :) I'm adding to your method -

HOW TO GET UP FROM SITTING WITHOUT USING YOUR ARMS...for an above knee amputee:

* If you haven't done this before, try using a high seat to start with

* Your knees should no less than 90 degrees flexion (bend) & your feet should be flat on the floor

* Check (by looking) that your foot/feet are flat on the floor ;)

* Before you stand up, move towards the edge of the seat - the seat should just be supporting about half the length of your thigh

* Lean slightly forward

(* At first you may find it helps to put your hands on either thigh (at the front), towards the middle of the thigh)

* As you stand, tense your glutes (butt muscles) so that it feel as though you are pressing into the back of your socket

* You should also be using your quads (muscles at the front of your thigh) as these help to stabilize you too

* As you stand up you should also start to straighten your spine

I agree that it is a really good idea to strengthen your quads and your glutes. My physio thinks that the glutes are one of the most under-used muscles...she suggests that you should concentrate on using your glutes, everytime you walk - it's hard work, but a great way of losing weight! :)

Lizzie

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OK, to follow on from 'sitting to standing,' now we'll try from 'standing to sitting.'

HOW TO SIT DOWN FROM STANDING, WITHOUT USING YOUR ARMS

Again, I say this as a bilateral below knee amputee.

I'd recommend using fixed seating to start with. Something like a wheelchair with the brakes applied, so it won't move.

* For the first few attempts til you become confident, it's a good idea to stand so that you can feel the chair with the back of your knees (or thighs, depending on how tall you are!)

* Bend from the knees (they way they tell you to do when lifting something heavy), leaning forward slightly, but not too much.

* Try to remember that the chair has not miraculously moved all of a sudden! Yes, it's still there, and trust that fact!

* Still bending, slowly lower yourself into the chair.

That's it. You should be sitting now. Well done!

At first, I had a hard time trusting that the chair hadn't moved. Which is why I recommend using a fixed chair to start with. That way you know that it's all in the mind. You have to trust that, with the brakes applied on the wheelchair, it hasn't moved.

Lizzie's tip of placing your hands on your thighs is a good one. It works for sitting OR standing. I actually did that the first few times I learnt how to stand without using my arms, until my therapist told me to try it without doing that. <_< But, it did work!

What makes sense is to now practise sitting down with your new standing up techniques until you can do it perfectly. :)

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Well I think I will add my two cents worth about geting up and sitting down.

People like me are so rare that I now teach the physios here certain things 'cause they have no experience.

ED: bilateral above knee amp - zero leverage in the leg department.

Getting up from a chair to use a frame walker

- bring the walker as close as possible to the chair. Make sure that the height of the walker is ok for you.

-make your way, however, to the front edge of the chair.

- straight power lift with the arms

- watch your feet, once the legs are straight (the knees are then "locked"), lower your weight onto the arty legs

- get going!!!!!

ED

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ED: bilateral above knee amp - zero leverage in the leg department.

Sitting down to a chair while using a frame walker

Initially, one needs to have a chair that is stable. After a while, it won't matter 'cause you will be "adventurous"!!

- back your self up to the front edge of the chair or "landing". You should be 180 degrees to the place of landing at this point.

- check that the frame walker is set against any available solid object if possible and is square on to the chair.

- ready yourself.

- lower your self by arm strength only. You will need to lean a little back so that the leg's knees are then in an unlocked state.

After doing this a few times, you will realize that you can "fall" down to a seating position quite nicely however, it takes "skill" to do it a bit more like a human.

ED

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I agree totally Marcus.

One of the first things I do with clients presenting with lower back pain is check their shoes for unusual wear marks and the length of their legs. Small differences can create a hell of a lot of discomfort.

I hyper extend both knees......I wonder if this is normal for BK?

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We should get unlimited pairs for FREE. I totally hate spending $300 on the daggiest shoes I've ever seen in my whole entire life.

Mel.

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Ed – Bilateral Above Knee Amp

Getting “up” is probably the most difficult thing a person like myself has to deal with.

Walking is another but it isn’t worth a crap if you can’t get “up”.

Getting “up” with one or two canes:

•Move yourself to the front edge of the chair or whatever you are sitting on.

•Turn your body position a bit away from your favored “cane side”. By this I mean - -I am left handed. My strongest and most co-coordinated hand is my left. Therefore, I move to the edge, turn my body away from the left hand side and place the favored cane on the floor.

•“Wap” (such a technical term), in my case, the left (favored cane side) stump so that the leg is now extended thereby locking the knee.

•Once this is done place your other hand on whatever you are sitting on i.e. the chair seat……….

•While twisting the body towards the non cane side, lift with your cane side and push with the hand on the seat the same time and “ride” the leg that has been extended (now in the lock position).

•At the peak of the lift, whip the cane to a more supportive position, move the other leg into a position that is “locked” so that you are standing on two solid feet.

•Use the supportive cane to keep you up while you retrieve the other for use.

•Get going.

Man, this is hard to write this stuff down. For me this is now automatic and I do not think about anything when I do it. If unclear, please PM me.

ED

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Man, this is hard to write this stuff down. For me this is now automatic and I do not think about anything when I do it. If unclear, please PM me.

ED,

I know what you mean. When writing my tips, I found it difficult to put into writing something that I do without thinking.

I bet inbetween typing yours out, you ended up 'getting up' many times, trying to find the right way to put it! :) I know I did for the tips I wrote!! ;)

But I think that for an AKA, it will make perfect sense!

Please know that your efforts are appreciated by everybody here. :D :D B)

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Hi Ed

Your descriptions are great & whilst I'm reading them, I often think, 'Yes, I do do that like that, don't I?' I must just forget, as I've had my 'limbs' for such a long time. :)

Have you thought about drawing basic diagrams of how you do different things?

Lizzie

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Yes, I am bilateral and hyper extend both knees, altho. have done this right from the very start, even before I wore PTB's or any sort of limb it was picked up. I think Marcus may be right about it being genetic as someone told me I hyper extended my fingers as well.

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ED – Bilateral AKA

(A friend of mine who is ak / bk and is totally functioning “free”, once told me “ED, I never realized how lucky I am to have a knee, until I met you.”)

Sitting down using one or two canes:

•Face what you are going to try to sit on.

•Chuck one cane. Keep the stronger side one.

•Lean forward and place your free hand, palm down on the seat. It doesn’t matter where, just as long as you feel comfortable.

•Now – lower yourself with the cane arm while rotating the palm on the seat, while extending the cane side leg, while supporting your weight also with the free hand, while bending the free elbow, while spinning your torso 180 degrees, while “Wapping” (there’s that technical term again) the cane around into a new position to support you, while making sure the free hand isn’t slipping off the seat…………………Christ this is complicated!!!...................sit down!

The hard part of doing this, is to do it gracefully without taking the ass end of your pants.

ED

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ED – Bilateral AKA

You’ve “mastered” all the cane stuff about getting up and sitting down using a cane(s). So now you are over at your daughter’s place having a rum and all is going well.

Time passes and you then realize your grand daughter has decided to run off with your cane to play hockey…….

Getting up from a chair without an aide:

•Again move to the front edge of the chair.

•Again, extend your favorite leg so that the knee is locked.

•Place one hand on the seat of the chair.

•Now turn your body a bit towards that hand’s side, push on the seat while extending that arm, while rotating your body 180 degrees to the chair, while bringing the free hand to be also on the seat, while riding the extended leg, while moving the other leg in to position, while getting it in to the locked position also.

•Once completed, you have now “assumed the position”………that being, two feet flat on the floor and two hands flat on the chair seat (but officer, it wasn’t me!!)

•The trick now, and it is a hard thing to learn, is to “throw” yourself “up” by using your back muscles, hands, and anything else and try to get a grip on your balance. This is very possible, but you need to learn this step through a lot of practice.

Sitting down in a chair without an aide:

•Stand 90 degrees to the chair seat.

•In one motion, lean over to place a palm on the chair seat, start “falling” and rotate you body backwards so that hopefully your ass is pointed in the right direction, Wip (another technical term) your other arm around to grab anything possible and lower as gracefully as possible, your self onto the seat. More times than not, you just kind of crash down………….but hey, that’s your life!!!

ED

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Hi All:

The information on theis site is spread from here to Turkey and beyond. This thread has been pinned so that it remains at the top of the list. As such, I think valuable tips from all should be stated here........kind of like an "Encyclopedia of Amp Life"

Each of us can start a section under their name. Then when we remember something to add, we can then "edit" the post and resubmit the individual posting.

Sooooooooooo here is ED's..........................

:::"Encyclopedia of Amp Life":::

Tips and Tricks (in one place.......forever)

•To keep blisters from forming at the edge of a liner where it meets the skin area, use a bit of mineral oil on the skin to about one inch into the liner. Mineral oil is not readily absorbed by the skin and will act as a lubricant to reduce the skin shear.

•Keep the number of floor mats in the home down to a minimum or non existent. These are real easy to trip on or to slip on and they do not make a very good landing pad for a cane end.

•Plan you daily “personal” routine in sections. This almost should be a military operation. Make sure what you need is where you need it. There’s nothing more frustrating than an empty paper roll in the bathroom.

•Get to know your body, its limits, capabilities and its weaknesses. Only you can set your own “standard” to live by.

•Always wear clean socks (my mother used to tell me this). Used ones can get real “crusty” fast. Carry an extra set with you in lieu of a handkerchief. You can still use the sock as such anyway.

•If you use a cane…………..get it ready for winter. Check out the end tip for wear. Replace the end tip with a new one before the snows flies (or you do).

•Replace your favorite key chain with a hex key of the size needed for most parts of your prosthetic.

•In winter (if you have snow), wear shoes that have a lot of tread. I use Columbia hikers as my snow tires. The sole is deep in tread and is made of two types of rubber that do not freeze. Typical running shoes DO freeze and are way more dangerous that you may think until that first “yahooooooooooooooo” fall.

•In winter (if your’s is really cold), be aware of exposure to the cold of your stump. Most stumps have areas of less feeling and you may not “feel” what is happening to it.

•If you are an aka, and have stabilized in size, consider the following. In lieu of that one ply sock, try wearing a “trunk style” under garment that has a “close fitting leg” such as those from B.U.M. clothing. Slide the socket on OVER the under garment. This is much more comfortable and eliminates the “bunching effect” of a sock material.

•Learn how your arty part works to the degree that YOU can address some of the mechanical issues that can and will occur. If you have a pin suspension....learn how to take the shuttle lock apart, clean it and replace it properly!.

•Create a “tool kit” for maintaining your arty parts. This should consist of all the tools your prot guy gave you, a small can of WD40 spray, a couple of Q tips, a 4mm hex key and a small bottle of Locktite. You need to learn how to maintain yourself otherwise you are relying on somebody else to keep you going.

•If you live where the winter is brutal and you use a wheelchair at times, keep a can of lock de-icer or “Bic” lighter in your vehicle to thaw out your chair’s axels when they freeze!!

to be continued................

ED

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Excellent idea ED! :D

Here's Afet's...

:::How to handle being legless!:::

- Look after your stump/s, and it will look after you.

This means keeping it clean by washing it every day. This also means an occasional massage using creams and/or oils to soothe them after a long, hard, day. You could do this, or get someone else to do it, which usually makes it feel better. ;)

- If you use silicone/gel liners, wash them regularly too.

This prevents cross contamination of bacteria, which thrive in the conditions of a liner.

- Do something to challenge yourself each day.

This may be something that everybody else takes for granted and sees as insignificant, but to you, it's a great accomplishment! Things like:-

- walking a distance that you thought you never could

- getting on a bus

- disembarking off a bus

- making a cup of tea and taking it to the the other room, or

- just being able to stand up for more than a minute, etc., etc.

When you achieve these "little things," you'll start to feel like your old self and independent again, which is crucial in your recovery.

To be continued....

I'll add some more later. ;)

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I really appreciated everyone's insight on something that everyone who isn't an amputee takes for granted -- getting up and down from a chair. I have mastered the simple ones like getting off & on my wheelchair and the bedside toilet. Yeah! I never felt like saying "Look Mom, I'm a big girl now! I can use the big girl's toilet!"

Such a simple pleasure of using the bathroom toilet instead of the bedside one. ;)

The problem that I still having is standing up from a chair or seat that is real low to the floor. I have been trying to use my support dog for help. He's real eager to stand there and brace me as long as I need him. I, also, tried using my cane, but since I lost all my fingers except 1 1/2 thumbs, the cane has to one my left & it seems to slip when I try getting up. :unsure: Any suggestions?

Patti

St. Louis, MO

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Hi Patti_justthumbs:

The problem that I still having is standing up from a chair or seat that is real low to the floor. I have been trying to use my support dog for help. He's real eager to stand there and brace me as long as I need him. I, also, tried using my cane, but since I lost all my fingers except 1 1/2 thumbs, the cane has to one my left & it seems to slip when I try getting up. Any suggestions?

Well:

I am not an expert in getting up as person such as you. However, I have yet to find a chair that I can not get up from in my state.

If I am not mistaken, you still have your knees…right?..................I do not……..mine are mechanical. I have my full hands and use them to get up in a lot of circumstances. However………………………let me pretend I don’t.

Scenario:

I am sitting on a comfy couch……..you know ……the kind you sink way back in………..or maybe a low chair until………………..I need to get to the john.

I have a cane handy. Pretend I have one of those dogs you have (except I have no idea what he / she does!!!)

Pretend I have hands but no fingers……but I can hold a cane.

This is one way I know I can get up given these circumstances:

1.Scootch yourself to the front edge of the chair. I am left handed so I will need the cane to be available somewhere for me to use it with my left hand.

2.Scootch to the cane side of the chair so that you are sitting “half assed” (sorry about the terminology). You can use your dog to steady yourself. Place the other hand on the chair seat available.

3.Extend your legs (mechanical or real) so that the knees are in the locked position.

4.In one movement, press up with the hand on the chair seat so the elbow is extended, roll your body over to that hand side while bringing your cane / dog hand around to the seat………..understand???

5.If time was to stop, you would be in a position with both hands somewhere on the chair seat…………….and you would be looking at them (honest officer…it wasn’t me)!!!

6.Walk your legs towards the chair. You should be quite stable now.

7.Use the chair to steady yourself as you grab the cane / or get Fido to get it for you and use the cane to bring yourself upright.

How’s that for imagination?

I have contacted my friend Raquelle who is the same as you, that being, bilateral below knee, missing all fingers and both thumbs after being devastated by meningitis a few years ago. She will email me her methods. She is very, very, very, good at everything she does. I will post her comments for you here soon.

Take care

ED

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Thanks Ed for your great advice. You do have a great imagination! :D

I tried out your suggestions over this last weekend. It did help me get up alot better. But I'm sure it wasn't a pretty site for one to see. ;) I tried it both ways-with my support dog and with out. I'm not sure which way was better for me. I think I'm going to keep my support dog close by just in case. :blink:

Thanks again,

Patti

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Fantastic idea, this posting...be sure to leave it in the priority position so that we can find it easily. I often send people to this site when they see me in public and ask me questions, for themselves or a loved one. Now I can say 'there is an actual encyclopedia of info' waiting here for them....nice job, people!

Judy

LBK

Utah :D

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I just read Ed's "instructions". I would not have even known where to begin trying to figure something like that out.

That is what is so neat about this forum. It is a "text book" of experiences. We all offer our own insight here, and throw it out in the center for each person to pick up and use what works for them.

I am totally impressed with the offerings of the people on here - and of the people themselves.

Just something I felt like writing.

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:::How to handle being legless!:::

As a non amputee I don't want to make light of a serious subject but could not resist this piece of advise.

When legless from too many bevies and need to get to the bathroom in haste ALWAYS remember to put on your leg before running!

Cat knows what I mean!!!

If you don't the thud you make as you hit the floor is unique, and odds are your wife is not going to be impressed about scrubbing her maiden aunt's carpet at 3am!!!

Muchly

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:blink::blink: ........ooops

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How to get walking when you don't trust your leg

Here is what my prosthetist said to me when I had serious trust issues with a new socket and knee.

This is one of the only ways to get to know your leg, and get to 'work' it.

Get yourself off to a big soft rugby field, or a park with lovely lawn. Or get onto a stretch of beach with firm sand.

Choose a day where there aren't too many people.

Chin up - look forward and up, not at your feet.

Lose the sticks. That would be BOTH of them, yes?

Put your shoulders back.

AND STRIDE OUT. Just give it all you've got and walk. Don't be afraid of falling. Know that you if you fall, you will NOT hurt yourself.

Take even steps, not too big - SWING YOUR ARMS. Move forward with purpose. MOVE.

If you do this, you will get a rhythm going, you will start to 'feel' your leg. You will know how far you can push your leg, you will know how hard you can work it. You and your leg will start 'talking' to eachother. You will know when and if the leg is going to buckle on you (which it more than likely will NOT do). Trust. It will come from this.

Try it.....you and your leg will like it.

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Hi Ally,

I have this predicament, I am using 2 sticks but starting to use just 1.

My physio the other day showed me how to run (if you could call it that). You have to take 2 hops on your good leg and then 1 walk with the prosthetic leg. I am yet to try this, i will take your advice and go somewhere soft :unsure: .

What great advice you all have, Thanks

Yvonne

x

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