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Heather Mills - Amputee Forum

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Roz, as is the case with a lot of these specialized procedures, whether you can have the IPOP procedure done depends on whether the staff at the facility you're using for your surgery has been adequately trained for the procedure. This means the surgeon, prosthetist, and rehab therapists have all had the proper training for working with IPOP patients, and understand how to coordinate their services. I had physical therapy several times a day in the hospital and once a day for about six weeks after I was discharged. My understanding is that many places are not prepared to do this. Is this a problem? I did OK with the IPOP, but I couldn't tell you that I did better than someone with a conventional, uncomplicated amputation. My surgery was at the end of July and I was mobile in a permanent prosthesis by the middle of October; fully functional by February. One thing I did like about the IPOP was the big fiberglass cast: if you fell (and I did!) you had a lot of armor down there.

You need to talk with your surgeon, prosthetist, and physical therapists to see if they're ready to go the distance with this type of amputation. A Google search to detrmine the pros and cons would be a good idea, too. Good luck!

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I have a really hard time with pain assocaited with my floating tib/fib. Ertl seemed like a good idea. So far I haven't heard anything bad about ERTL which is what I am loking for in order to have an idea of what can be expected before going to my surgeon/prosthetist/consultant. There have been some very sobering comments made.

I know ERTL is not a super procedure that will have me doing back flips, but if it can offer me a slight edge in retaining some form of athleticism then I am all for it.

My conclusions so far are no better than what I felt at the beginning of this post. Is the quality of my physical well-being dependant on a trial and error effort?

Suddenly I get a queesy feeling in my stomach!!

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It's a tough problem, to be sure, and I don't blame you for feeling queasy about it. But one way to face these decisions is by being as analytical as you can; ask questions, and find out answers. For example, residual limb pain, as I think all of us here know, can be very difficult to diagnose and treat. You said your pain was associated with movement of the tibia and fibula. How was that decided? You may need some additional medical opinions to try to better define the problem before settling on a surgical procedure. You probably know that the Ertl procedure involves considerably more than just stabilizing the tibia and fibula, but also includes procedures for dealing with soft tissue, muscle, nerves, and blood vessels. There's nothing wrong with this, just no definitive proof it's a better way to amputate. It's sad that it should be true in 2006 but there is an element of chance in almost every amputation---what works really well for one person doesn't in another. Your best defense (sorry, American spelling!) is to be as well-informed as possible.

One additional aspect of this is that most studies objectively comparing surgical techniques conclude by saying that amputation outcomes are more heavily dependent on proper prosthetic care and rehabilitation than surgery. What have your prosthetists said about your problem? Have you had additional opinions from other specialists?

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What have your prosthetists said about your problem? Have you had additional opinions from other specialists?

The general concensus from my Consultant/Prosthetist/Dr is a revision bringing my stump to about 5-6 inches below my knee. My leg as it stands ( excuse the pun ), is about 15inches ( I am 6'4" ) and too long to accomodate active type legs.

An addtional problem is the area towards the outside edge of my Fib. When healing I fell and ever since then it has caused me so much pain. It is aggravated by the bones moving and flexing. Not the worst scenario but seeing as I am going through this, it seems as though I have a plethora of issues.

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I am an ERTL patient and I would answer any thing that you would like to ask.......Please do.....ERTL is awesome.....

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You know, londonguy, from what you've described so far I would be more concerned with actually getting a firm diagnosis of what's causing your chronic pain than worrying about revision surgical techniques. When you study sources of chronic amputation pain, tibia and fibula flexion in itself doesn't seem to be a real prominent cause. However, bone flexing exacerbating some other injury is another story. I don't want to second-guess your doctors but if it were me, I'd want to be darned sure that injury you suffered while healing was understood. I would have to wonder about things like a chronic osteomyleitis. The thing is, there are some forms of chronic pain you can "amputate away" but others you cannot. How sure are you and your doctors at this point that you really are suffering from chronic pain that would be solved by revision surgery? Have you seen a reputable pain specialist? Or is your need for a prosthesis that will give you a more athletic lifestyle really the overriding concern?

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Are there any ERTL amputee memebers in this forum? I am curious to get 1st hand post surgery experiences. ( Pros and Cons )

I am an Ertl amputee as of October 04. I would be glad to answer any questions if I can.

Debbie

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Have you seen a reputable pain specialist? Or is your need for a prosthesis that will give you a more athletic lifestyle really the overriding concern?

trwinship,

My problem is mainly too long of a tib/fib. It was a botched symes amputation that took off too much of the bell part of my tibula. In order to accomodate me with some form of comfort ( imagine the tendons stretched beyond belief around the front of my extra long Tib ). Also I have scar tissue that feels like it presses between my bones at the very tip of my stump which I have explained to my Consultant.

The active lifestyle I had before my accident is somewhat of a motivation for me leaning towards an ERTL procedure but ultimately there are a lack of ERTL amputees in my area, suggesting it isn't something my consultants here push for.

There is a member on this board that has praised ERTL so much and although everyone is different and results vary I really do like the extent of his ability to do that little bit extra and retain some of his active lifestyle he had b4.

To put your mind ( and mine ) at ease trwinship I will make a calculated decision along with a second opinion ( hard to do with the UK National Health System ).

I really do appreciate you keen interest. Nice to know people care. Feels like extended family!!

....and in true family fashion....where's my twenny you owe me!!?? :unsure:

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That twenny was a loan???!!!

Well. sounds like you've got everything under control. As I said, I don't think there's anything wrong with the Ertl procedure, but I am of the opinion that good surgery (whatever the procedure), an aggressive rehab program, combined with really competant prosthetic care are the keys to the kind of mobility you want to achieve. Anything you can do to ensure those things will benefit you in the end.

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