Jump to content
Heather Mills - Amputee Forum
stillstandin

reconstruction recovery

Recommended Posts

Hello my name is Nadine, lbk, traumatic...by a drunk driver 1986. Just had Ert procedure done march 11, 2011..by jan ertl. Am in the recovery stage and would love to chat with someone whom has gone through this. I am 7 weeks post-op and still not in a prosthetic leg....still have some end fib. pain..incision totally closed and healed. Just need some reassure this will get better. Thanks :-)

Share this post


Link to post
Share on other sites

Hi Nadine. My name is Kevin and I am an RBK recent. Surgery was Nov 30th, 2010. Mine was a result of a two year effort to save a badly mnagled ankle (violent pilon fracture motorcycle accident) My doctor here in Tucson did an Ertl on me. I first stepped in to a test socket on Jan 17th just a bit over six weeks post surgery.

I was dismayed at first how painful it seemed but in time it has gotten much better. On Jan 17th my residual limb still had lots of healing left to do and was much larger than it is now April 30th. I think they like to get us in a prosthetic as early as possible simply to begin the adaptation.

My limb now tapers very smoothly below the knee and the shrinkage and healing are self evident. The suture lines are nearly gone and I have a sense that the Ertl bone bridge is well on its way to full healing ossification.

I also have a lot less pain now then back in January. I hope and expect to experience in the next three months by the end of July another 50% to 60% reduction in pain directly at the residual end. I have virtually zero phantom pain or sensation.

I am curious ...did they put you in a shrinker sock within a day of surgery? I have heard that some Ertl practitioners do not like to compress the Ertl limb too much after surgery but according to my leg man that varies. I had a juzo shrinker on one day after surgery and consistently after that and it does not appear to have done any harm.

Share this post


Link to post
Share on other sites

Hi Nadine. My name is Kevin and I am an RBK recent. Surgery was Nov 30th, 2010. Mine was a result of a two year effort to save a badly mnagled ankle (violent pilon fracture motorcycle accident) My doctor here in Tucson did an Ertl on me. I first stepped in to a test socket on Jan 17th just a bit over six weeks post surgery.

I was dismayed at first how painful it seemed but in time it has gotten much better. On Jan 17th my residual limb still had lots of healing left to do and was much larger than it is now April 30th. I think they like to get us in a prosthetic as early as possible simply to begin the adaptation.

My limb now tapers very smoothly below the knee and the shrinkage and healing are self evident. The suture lines are nearly gone and I have a sense that the Ertl bone bridge is well on its way to full healing ossification.

I also have a lot less pain now then back in January. I hope and expect to experience in the next three months by the end of July another 50% to 60% reduction in pain directly at the residual end. I have virtually zero phantom pain or sensation.

I am curious ...did they put you in a shrinker sock within a day of surgery? I have heard that some Ertl practitioners do not like to compress the Ertl limb too much after surgery but according to my leg man that varies. I had a juzo shrinker on one day after surgery and consistently after that and it does not appear to have done any harm.

Hi Kevin,

Thank you so much for the reply...Dr. Jan Ertl does not like the shrinkers..not sure why. I was sent home with it wrapped in bandages and ace wraps. I was sooo swollen after the surgery that it did not feel like my leg, plus the shape was so radicaly and positively different. Now I wonder how I ever walked on it before.I spoke with Dr. Ertl yesterday and he gave the go-ahead to start the prosthetic process. I am still tender and ache, no phantom, electric, or nerve pain..just bone and muscle I think. I go next wed. for a casting..glad you shared your process with me..so afraid it will hurt. I know deep inside that this was what I had to do to get better.I am 7 weeks post-op tomorrow, will be 8 at casting and 9 I assume to try the test socket. Did you use crutches with your prosthesis? I assume I will. Dr. Ertl says it is critical to get me weight bearing as this is what stimulates the bone to build and solidify the bone bridge...it makes sense to me, but wish it would go more quickly.Thank you so much for responding..giving me home. I will keep you updated and may have more questions for. Thanks Nadine ~

Share this post


Link to post
Share on other sites

I used a walker to bear partial weight when walking with the first test sockets. I really believe it is simply an adaptation exercise early on as the limb is still present with significant edema and does not reveal itself for the purpose of deifinitive weight bearing until it settles down.

Initially the distal end of the tibia was a very hot spot for me and it was hard for the leg man to deal with it as it was hidden by fluid (edema) . The fourth test socket which I took delivery of eight days ago has been a near to perfect fit ...bears weight where it should with no tendency to bottom out and no feeling of viselike pressure on the end of the limb.

My residual limb seems to slide easily into the prosthetic and at the end of the day it pops out without feeling like its stuck. The previous sockets often felt that way.

Once that bone bridge matures and the myoplasty work (spelling) takes hold the end of the limb becomes a brute I believe. My leg man told me of one veteran Ertl recipient (25 plus years) and described the strenght of that individuals limb being adequate as a pile driver. That is of course an exaggeration but one can visualize the analogy. The ability to bear some weight on the bottom makes prosthetic possibilities greatly enhanced and the Ertl recipient once fully matured may be looser in a socket with less discomfort as the end of the limb will sustain some weight.

You will get where you want to go hang in there and you will get past the early discomfort.

Best of luck.

Share this post


Link to post
Share on other sites

I used a walker to bear partial weight when walking with the first test sockets. I really believe it is simply an adaptation exercise early on as the limb is still present with significant edema and does not reveal itself for the purpose of deifinitive weight bearing until it settles down.

Initially the distal end of the tibia was a very hot spot for me and it was hard for the leg man to deal with it as it was hidden by fluid (edema) . The fourth test socket which I took delivery of eight days ago has been a near to perfect fit ...bears weight where it should with no tendency to bottom out and no feeling of viselike pressure on the end of the limb.

My residual limb seems to slide easily into the prosthetic and at the end of the day it pops out without feeling like its stuck. The previous sockets often felt that way.

Once that bone bridge matures and the myoplasty work (spelling) takes hold the end of the limb becomes a brute I believe. My leg man told me of one veteran Ertl recipient (25 plus years) and described the strenght of that individuals limb being adequate as a pile driver. That is of course an exaggeration but one can visualize the analogy. The ability to bear some weight on the bottom makes prosthetic possibilities greatly enhanced and the Ertl recipient once fully matured may be looser in a socket with less discomfort as the end of the limb will sustain some weight.

You will get where you want to go hang in there and you will get past the early discomfort.

Best of luck.

Hi Kevin,

I hope this message finds you well. I am feeling dismayed as I went to get my temp. socket today.....ughhhh!!! Can not bear weight on end of limb, must use, and I mean use crutches. Surgery was March 11th, limb all healed visually..no complications, but man does the bone hurt when I put weight on the end. I have read and re-read your response and trying to see through to the light. Guess it just feels like its forever to get back to walking. If you dont mind can you describe what type of prosthesis you have. Silicone liner, pin system, sleeve? I guess I just need to see the light..Thanks..Nadine~

Share this post


Link to post
Share on other sites

I used a walker to bear partial weight when walking with the first test sockets. I really believe it is simply an adaptation exercise early on as the limb is still present with significant edema and does not reveal itself for the purpose of deifinitive weight bearing until it settles down.

Initially the distal end of the tibia was a very hot spot for me and it was hard for the leg man to deal with it as it was hidden by fluid (edema) . The fourth test socket which I took delivery of eight days ago has been a near to perfect fit ...bears weight where it should with no tendency to bottom out and no feeling of viselike pressure on the end of the limb.

My residual limb seems to slide easily into the prosthetic and at the end of the day it pops out without feeling like its stuck. The previous sockets often felt that way.

Once that bone bridge matures and the myoplasty work (spelling) takes hold the end of the limb becomes a brute I believe. My leg man told me of one veteran Ertl recipient (25 plus years) and described the strenght of that individuals limb being adequate as a pile driver. That is of course an exaggeration but one can visualize the analogy. The ability to bear some weight on the bottom makes prosthetic possibilities greatly enhanced and the Ertl recipient once fully matured may be looser in a socket with less discomfort as the end of the limb will sustain some weight.

You will get where you want to go hang in there and you will get past the early discomfort.

Best of luck.

Hi Kevin,

I hope this message finds you well. I am feeling dismayed as I went to get my temp. socket today.....ughhhh!!! Can not bear weight on end of limb, must use, and I mean use crutches. Surgery was March 11th, limb all healed visually..no complications, but man does the bone hurt when I put weight on the end. I have read and re-read your response and trying to see through to the light. Guess it just feels like its forever to get back to walking. If you dont mind can you describe what type of prosthesis you have. Silicone liner, pin system, sleeve? I guess I just need to see the light..Thanks..Nadine~

Nadine- keep looking for the light. I am bilateral below knee and was very sick and weak before the surgery, so it took me a while to build myself back up. Don't be discouraged because it took me a year of sockets and a bad leg guy before I found where I needed to go which is out of state and he figured out nerves, bones, everything and knew how to build a socket and system for me. I started with the pin system which is not the best for your limbs actually and I am now in a vacuum system and my legs look really good. Right now, that test socket you are in is probably not right, your nerves and yes even your bone gets sore. It takes time. I know how hard it is. I was so frustrated that when I took the measures to find who is considered one of the best prosthetists and it meant alot of flights back and forth to get it right..well, that was a huge step, both financially and putting alot of trust in them. What kind of system do they have you in? My liners are custom and also thin under the vacuum system in order to make it easier for bending since I'm bilateral.

Please hang in there. It will work out, it just seems hard sometimes. and just when you think you have it figured out, it can fool you once again. :blink:

Share this post


Link to post
Share on other sites

I used a walker to bear partial weight when walking with the first test sockets. I really believe it is simply an adaptation exercise early on as the limb is still present with significant edema and does not reveal itself for the purpose of deifinitive weight bearing until it settles down.

Initially the distal end of the tibia was a very hot spot for me and it was hard for the leg man to deal with it as it was hidden by fluid (edema) . The fourth test socket which I took delivery of eight days ago has been a near to perfect fit ...bears weight where it should with no tendency to bottom out and no feeling of viselike pressure on the end of the limb.

My residual limb seems to slide easily into the prosthetic and at the end of the day it pops out without feeling like its stuck. The previous sockets often felt that way.

Once that bone bridge matures and the myoplasty work (spelling) takes hold the end of the limb becomes a brute I believe. My leg man told me of one veteran Ertl recipient (25 plus years) and described the strenght of that individuals limb being adequate as a pile driver. That is of course an exaggeration but one can visualize the analogy. The ability to bear some weight on the bottom makes prosthetic possibilities greatly enhanced and the Ertl recipient once fully matured may be looser in a socket with less discomfort as the end of the limb will sustain some weight.

You will get where you want to go hang in there and you will get past the early discomfort.

Best of luck.

Hi Kevin,

I hope this message finds you well. I am feeling dismayed as I went to get my temp. socket today.....ughhhh!!! Can not bear weight on end of limb, must use, and I mean use crutches. Surgery was March 11th, limb all healed visually..no complications, but man does the bone hurt when I put weight on the end. I have read and re-read your response and trying to see through to the light. Guess it just feels like its forever to get back to walking. If you dont mind can you describe what type of prosthesis you have. Silicone liner, pin system, sleeve? I guess I just need to see the light..Thanks..Nadine~

Nadine- keep looking for the light. I am bilateral below knee and was very sick and weak before the surgery, so it took me a while to build myself back up. Don't be discouraged because it took me a year of sockets and a bad leg guy before I found where I needed to go which is out of state and he figured out nerves, bones, everything and knew how to build a socket and system for me. I started with the pin system which is not the best for your limbs actually and I am now in a vacuum system and my legs look really good. Right now, that test socket you are in is probably not right, your nerves and yes even your bone gets sore. It takes time. I know how hard it is. I was so frustrated that when I took the measures to find who is considered one of the best prosthetists and it meant alot of flights back and forth to get it right..well, that was a huge step, both financially and putting alot of trust in them. What kind of system do they have you in? My liners are custom and also thin under the vacuum system in order to make it easier for bending since I'm bilateral.

Please hang in there. It will work out, it just seems hard sometimes. and just when you think you have it figured out, it can fool you once again. :blink:

I am trying to..cant lie..am full of tears tight now..holding them back. I really thought it would be different. I dont know..is it that it is too soon to bear weight on the end? Is it that the bone bridge hasnt healed? I am sure the bridge is not fully formed...I suppose that it may be the socket..it seems too big, only got it 2 days ago..have reduced in size greatly.When did you get your 1st socket? Was it painful to bear weight? When did you notice a reduction in pain? Sorry for all of the questions. Thanks for your kind words..just feel lost right now..Nadine~

Share this post


Link to post
Share on other sites

I used a walker to bear partial weight when walking with the first test sockets. I really believe it is simply an adaptation exercise early on as the limb is still present with significant edema and does not reveal itself for the purpose of deifinitive weight bearing until it settles down.

Initially the distal end of the tibia was a very hot spot for me and it was hard for the leg man to deal with it as it was hidden by fluid (edema) . The fourth test socket which I took delivery of eight days ago has been a near to perfect fit ...bears weight where it should with no tendency to bottom out and no feeling of viselike pressure on the end of the limb.

My residual limb seems to slide easily into the prosthetic and at the end of the day it pops out without feeling like its stuck. The previous sockets often felt that way.

Once that bone bridge matures and the myoplasty work (spelling) takes hold the end of the limb becomes a brute I believe. My leg man told me of one veteran Ertl recipient (25 plus years) and described the strenght of that individuals limb being adequate as a pile driver. That is of course an exaggeration but one can visualize the analogy. The ability to bear some weight on the bottom makes prosthetic possibilities greatly enhanced and the Ertl recipient once fully matured may be looser in a socket with less discomfort as the end of the limb will sustain some weight.

You will get where you want to go hang in there and you will get past the early discomfort.

Best of luck.

Hi Kevin,

I hope this message finds you well. I am feeling dismayed as I went to get my temp. socket today.....ughhhh!!! Can not bear weight on end of limb, must use, and I mean use crutches. Surgery was March 11th, limb all healed visually..no complications, but man does the bone hurt when I put weight on the end. I have read and re-read your response and trying to see through to the light. Guess it just feels like its forever to get back to walking. If you dont mind can you describe what type of prosthesis you have. Silicone liner, pin system, sleeve? I guess I just need to see the light..Thanks..Nadine~

Nadine- keep looking for the light. I am bilateral below knee and was very sick and weak before the surgery, so it took me a while to build myself back up. Don't be discouraged because it took me a year of sockets and a bad leg guy before I found where I needed to go which is out of state and he figured out nerves, bones, everything and knew how to build a socket and system for me. I started with the pin system which is not the best for your limbs actually and I am now in a vacuum system and my legs look really good. Right now, that test socket you are in is probably not right, your nerves and yes even your bone gets sore. It takes time. I know how hard it is. I was so frustrated that when I took the measures to find who is considered one of the best prosthetists and it meant alot of flights back and forth to get it right..well, that was a huge step, both financially and putting alot of trust in them. What kind of system do they have you in? My liners are custom and also thin under the vacuum system in order to make it easier for bending since I'm bilateral.

Please hang in there. It will work out, it just seems hard sometimes. and just when you think you have it figured out, it can fool you once again. :blink:

I am trying to..cant lie..am full of tears tight now..holding them back. I really thought it would be different. I dont know..is it that it is too soon to bear weight on the end? Is it that the bone bridge hasnt healed? I am sure the bridge is not fully formed...I suppose that it may be the socket..it seems too big, only got it 2 days ago..have reduced in size greatly.When did you get your 1st socket? Was it painful to bear weight? When did you notice a reduction in pain? Sorry for all of the questions. Thanks for your kind words..just feel lost right now..Nadine~

I couldn't put weight on my legs right away and with both being involved, it was difficult. I may be too soon for you to bear weight. Each one of us is different regarding healing. Keep going back and going back until you get it right. Tell them your concerns. Talk to Dr. Ertl if you need to and explain what you are feeling. It may very well be the socket, your prosthetist needs to work with you and work with you until they get it right. It takes alot of trips to the prosthetist to get things right. I think all of us still have days when we have some pain. You are still getting over the surgery. I would check with Dr. Ertl and ask him if in your situation this is normal. He has seen your leg under surgery, he knows what it looks like. If you have any kind of vascular problem at all it takes longer to heal. Be patient...your legs change daily especially when you are a new amputee. I think alot of us think that once we make the decision or are forced to make the decision of having an amputation that all of the problems are over..when in actuality we still have alot to overcome. There is nothing in this world like what God gave us when it comes to feet and ankles and we still don't have anything that will take the place of them completely. Take a breath and ask questions and be patient :) You will be fine...hang in there and let us know how you are doing.....Flip

Share this post


Link to post
Share on other sites

I wanted to leave this discussion strictly to the Ertl folks...but now I think that I ought to at least mention that massive changes in a stump really CAN happen "overnight." I'm not an Ertl amp, but if I remember correctly, I received my first socket on a Thursday...and was back in to have adjustments made due to shrinkage on the following Monday. (It might have been "Friday" and "Tuesday" but you get the idea...got it near the end of the week and had managed to shrink out of it over the weekend.) And my first attempt at walking any "distance" was to go approximately 50 yards to my mailbox...at which point, I had to sit and rest for several minutes before walking the 50 yards to get back to my apartment.

There is a whole lot of adjusting in getting used to using a prosthesis, on both the part of the amputee and the prosthetist. While we all wish it was a "simple and easy" process, recovery comes in fits and starts and can take longer than you'd like.

Keep at it until you've fully healed...and you've found a socket that fits properly...and you've built your strength up to where it was before everything that led to the amputation happened. Yes, it takes LOTS of patience...but the odds are very, very good that it will work out fine!

Okay, Ertl amps...I'll duck out and let you get back to it now......... :smile:

Share this post


Link to post
Share on other sites

I wanted to leave this discussion strictly to the Ertl folks...but now I think that I ought to at least mention that massive changes in a stump really CAN happen "overnight." I'm not an Ertl amp, but if I remember correctly, I received my first socket on a Thursday...and was back in to have adjustments made due to shrinkage on the following Monday. (It might have been "Friday" and "Tuesday" but you get the idea...got it near the end of the week and had managed to shrink out of it over the weekend.) And my first attempt at walking any "distance" was to go approximately 50 yards to my mailbox...at which point, I had to sit and rest for several minutes before walking the 50 yards to get back to my apartment.

There is a whole lot of adjusting in getting used to using a prosthesis, on both the part of the amputee and the prosthetist. While we all wish it was a "simple and easy" process, recovery comes in fits and starts and can take longer than you'd like.

Keep at it until you've fully healed...and you've found a socket that fits properly...and you've built your strength up to where it was before everything that led to the amputation happened. Yes, it takes LOTS of patience...but the odds are very, very good that it will work out fine!

Okay, Ertl amps...I'll duck out and let you get back to it now......... :smile:

Cheryl, I'm ducking in to try to get across the fact that YES it does take alot of patience but everyone will make it fine!! :wink:

Share this post


Link to post
Share on other sites

I was going to keep out of this one too, as I have not had an Ertl and am a bilateral b/k of many years, but I had a revision and some reconstruction done a few years back, and just wanted to let you know Nadine, that I don't know much about the Ertl recovery expectations, but that by ordinary revision standards, you are still in very early days, and really I am not surprised it is still hurting.

Following my revision it did take about 2 -3 months to get fitted with a prosthesis, and I did find it pretty difficult for quite a few months and had to have a few investigations done, because I was getting quite a lot of nerve input around fib area, also. I did notice when I was having the rehab, there being a few of us who had had revision surgery, that once walking we were all complain of the nerve pain around the fib area, more than the primary amps., and did wonder if its because the stump isn't as padded, as it would be for a primary amp. I had some inflammation from the cut nerve and some old damage, but apart from that nothing really was wrong, though I ended up having another socket made to give me a bit more room in that area and things improved a bit from then on, I think though a lot was down to me stopping worrying about it. I was using crutches for probably about three or four months, then I went on to two metal sticks for a while and then one stick, I think it took a good nine months before I was walking comfortably.

So don't worry too much Nadine, 7 wks as it was back in April when you posted is still early, and although healed on the outside, everything on the inside takes longer, so be patient, keep happy and look after yourself, am sure you will get there.

Share this post


Link to post
Share on other sites

Hello- My name is Monte and I am a rbk ertl as of Sept. 2009. Just wanted to let you know that you are very early into this process. Please get your time frame more into a year process and you will be more reseptive to how new you are. Even with all my ankle surgeries I found anytime you mess with the bones you are looking at at least 6 months for pain to resolve. My thought on the ertl is that you are not trying to bear lots of weight on the end. The bridge just stabilizes the Tib/Fib to allow greater bearing throughout the limb. I only bear about 15-20 pounds out of 190, but have nice even load carry along my whole stump that makes for a nice ride. If you are bearing to a point of discomfort on the end time for a sock layer or a new socket. My first year I went through about 15 sockets as I shaped down. So try to find a leg guy that is willing to constantly work with you. Once your shaped down things will be great for you.

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

×