For New Amputees

These resources have been made available to assist new amputees. 

The Healing & Education Stage

This stage begins on the day of surgery and last for approximately 4-6 weeks.

Goals

  • Maintain range of motion and strength
  • Keep limb elevated
  • Keep joints extended as much as possible.
  • Research prosthetics (read publications, look online and seek out other amputees to learn from.)
  • Safely ambulate with a walker or crutches as much as possible to maximize endurance. (UNLESS ADVISED DIFFERENTLY BY A HEALTHCARE PROFESSIONAL!)
  • DO NOT FALL – If you happen to lose your balance your instinctive reaction will be to put the foot down that is no longer there. This can result in trauma to your limb.

Warning

  • Do not soak your limb
  • Do not shave your limb
  • Do not apply lotions to your limb unless instructed by a healthcare professional.
  • Do not sit or stand with your knee or hip flexed for extended period of time.
  • Much of what you read is advertisement designed for marketing purposes. If you find something interesting, show it to your Prosthetist and ask for more explanation. Also, realize that a prosthetic device is a device that is designed with your goals in mind. When you find something that works for you it does not always mean it will work for everyone.
  • DO NOT FALL!

The Fitting Stage

This stage begins on the day the sutures are removed and you are fit with a compression device.

POINTS TO REMEMBER

  • The compression device is applied to begin the process of swelling reduction, which will allow for a more consistent size limb.
  • During this period it is important that the patient safely improve strength and endurance. When the fitting day arrives it is important that strength and endurance are at an optimal level.
  • After approximately 10 days of compression device usage, a mold will be taken of the limb.
  • Within a week of the molding, a clear test socket (a diagnostic tool used to insure a proper fit) will be fit to the patient’s limb. Often, more than one test socket will be fit to achieve an optimum fit.
  • Once a properly fitting test socket is achieved, the mold is duplicated into a more structurally sound material which will be attached to the other components such as knee and/or foot. This is known as the dynamic fitting process. The device is applied to the patient and alignment changes are considered to optimize energy consumption and minimize unwanted stresses on the patient during ambulation.

It is a good idea on the day of your last test socket fitting to make plans for the time and place of your Gait Training. If you wait until your “dynamic fitting” appointment then it may be several days before the physical therapist can see you.

The Training Stage

The Prosthetic fits your prosthesis dynamically.

Things to Remember

  • On the day of your dynamic fitting it is very important that you bring the shoes for the prosthesis.
  • At this stage our focus is on fit and function. Cosmetics will be added one proper fit and function are achieved.
  • Once your prosthesis has been dynamically fit, we prefer you not to wear your prosthesis until a therapist sees you.
  • Your Physical Therapist will determine a wearing schedule and if any specific assistive devices are recommended.
  • It is a good idea to bring shorts to your appointment if you are a below the knee amputee. Females should consider bringing or wearing a one-piece bathing suit under clothes. Especially if you are an above the knee amputee or an upper extremity amputee.
  • This is the period of the most change and inconsistency. Your leg is not accustomed to bearing weight on soft tissue. It will react to this change by your limb changing in size and volume.

Health Insurance

Private Insurance

Private insurance come in many forms. In the New Patient information is a list of Insurance companies that ProCare is in network. If you do not see your Insurance listed let the front office know and we will call your insurance company to try and work out an arrangement.

Medicare-Federal Program

Prosthetic services are covered by Medicare under the Part B plan. If you do not already have Medicare coverage and you have been receiving disability benefits for at least 2 years, you are eligible for Medicare Part B coverage. Medicare pays 80% of the approved amount, leaving a 20% balance, which is to be paid by secondary insurance or the patient. This co-payment may not be dropped by ProCare. A provider who drops co-payments is violating federal law – please do not ask us to break the law. We are happy to discuss any special circumstances you may have concerning this balance.

Medicaid-State Program

Please contact your local Department of Human Services for more information.

Vocational Rehabilitation

If you are not covered by private insurance, you may be eligible for Vocational Rehabilitation. The Georgia Department of Labor/Vocational Rehabilitation Program (VR) provides services to assist Georgians with disabilities to prepare for, start and maintain meaningful employment. VR is co-funded by federal and state governments, and requires eligibility based on the level of individual consumer impairments(s), work goal(s) and other factors. Please call the Georgia Department of Labor-Rehabilitation Services at (404) 235-0140. You will be referred to a rehabilitation counselor in your area.

Veterans

Please Call Veterans Administration.

Worker’s Compensation

Requires your adjuster’s name and case number.

Credit Cards

A credit care company is better suited to offer a more long term, convenient payment plan rather than the prosthetic company. We do accept most major credit cards and would be happy to discuss this option with you in more detail.

Prescription

A prescription is required for the evaluation, fitting, repair and the billing of any prosthetic device. We are happy to send a detailed prescription to your physician for his/her signature. Please understand that we cannot start the fabrication process unless we have a prescription, and in many cases, an authorization.

Authorization

Many payers now required that one obtain prior authorization before services are rendered.In most cases the request for prior authorization must be accompanied by documentation to support the necessity for such a procedure.

Billing Procedure

As a service to our patients, ProCare will bill your insurance provider for services rendered. Deductibles and co-payments are to be paid at the time of your office visit. Patients are responsible for paying directly or through supplemental insurance. All billing procedures and coding will be explained to the patient in detail by the office staff.
Please remember our staff is here to assist you with all of your prosthetic and billing needs. Please feel free to discuss any questions or concerns you may have.

Finances

The billing side of your prosthetic rehabilitation can seem complicated and confusing. Although we would love to focus strictly on the clinical side, the law requires us to follow certain guidelines. These guidelines consist of the steps we must follow when dealing with payers. Once the payer is recognized the prescription and authorization process must begin. When a patient understands and gets involved in this process, the requirements are achieved much faster and more effectively, thereby, allowing the fitting process to begin as soon as possible. To expedite the process we have outlined specifications – including instructions, descriptions, as well as limitations – necessary for reimbursement. We hope that this facilitates the process, and please let us know if we can assist you in understanding your coverage.

Terms & Terminology

  • A.B.C. Certification– the oldest, most difficult and most respected national certification for the field of Prosthetics and Orthotics
  • Prosthetist – the healthcare professional who is trained to fit prosthetic devices
  • Residual Limb – the portion of the limb that is remaining after an amputation
  • BK – below the knee
  • AK – above the knee
  • AE – above the elbow
  • BE – below the elbow
  • Bilateral Amputee – amputation involving two limbs
  • Disarticulation – amputation through the joint
  • Gait – the manner in which one walks
  • Prosthesis – an artificial body part
  • Socket – the part of the prosthesis that contains the residual limb
  • Dynamic Fitting – the evaluation and adjustment of the fit and alignment of a prosthesis while it is worn by the patient
  • Test Socket – a diagnostic tool that consists most commonly of a clear socket. It is used to ensure that the socket is fitting properly.

Frequently Asked Questions

Can I wear my normal shoes?
Typically prosthetic feet are designed to fit either a 3/8” or ¾” heal height shoe. However, there are some specially designed feet that either accommodate higher heel shoes or are adjustable by the patient. We recommend you start your training with the 3/8” or ¾” heal height, preferably a lace-up shoe with a rubber sole.

Do I sleep with my prosthesis on?
We do not recommend sleeping with your prosthesis on, you may experience trauma to your other leg. Hygiene also becomes a concern.

How do I take a shower or bath?
There are devices made that are water proof. However, they are not comfortable for any extended periods of walking or standing.

How long will it take me to learn to walk?
Once you start your training with a physical therapist they will put you on a wearing schedule that will gradually increase. Each person progresses at a different rate depending on his or her individual condition.

How long will it take to make my prosthesis?
The fabrication process progresses in stages, we cannot proceed to the next stage until we are satisfied with the present stage.

How much will it weigh?
A typical below the knee prosthesis can weigh between 3 and 8 pounds depending on the componentry and structure. It is common for a new amputee to feel that any prosthesis is very heavy no matter how light it is.

Will it hurt to wear the prosthesis?
The residual limb of a new amputee is often hypersensitive. It is important to “desensitize” the limb through massage. The act of wearing a prosthesis should not be painful.

Other Helpful Information

American Academy of Orthotists and Prosthetists
The American Academy of Orthotists and Prosthetists is the professional organization representing practitioners credentialed by the American Board for Certification in Orthotics and Prosthetics.

American Board for Certification
The American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) is the national certifying and accrediting body for the orthotic and prosthetic professions.

American Orthotic & Prosthetic Association
The American Orthotic & Prosthetic Association (AOPA) is a national trade association committed to providing high quality, unprecedented business services and products to O&P professionals.

Amputee Coalition of America
The Amputee Coalition of America (ACA) is a national, non-profit amputee consumer educational organization representing people who have experienced amputation or are born with limb differences. The ACA includes individual amputees, amputee education and support groups for amputees, professionals, family members and friends of amputees, amputation or limb loss related agencies, and organizations.

National Commission on Orthotic & Prosthetic Education
The National Commission on Orthotic and Prosthetic Education (NCOPE) is the accreditation body for the orthotics and prosthetics (O&P) profession. As such, its primary mission and obligation is to ensure educational and residency programs meet the minimum standards of quality to prepare individuals to enter the O&P profession.

National Association for the Advancement of Orthotics and Prosthetics
The National Association for the Advancement of Orthotics and Prosthetics is a non-profit trade association dedicated to educating the public and promoting public policy that is in the interest of the O&P patient. Since 1987, NAAOP has shaped positive results in healthcare legislation and regulation through strong government relations advocacy and education of policymakers. NAAOP serves the profession by representing and partnering with only those providers of orthotic and prosthetic services who truly believe that the patient must come first.

Orthotic and Prosthetic Assistance Fund
Our primary mission: Enabling individuals served by the orthotic and prosthetic community to enjoy the rewards of personal achievement, physical fitness and social interaction.

The Prosthetic Outreach Foundation
POF creates opportunities for children and adults in developing countries who suffer from limb loss and limb deformities to lead more fulfilling lives. POF provides access to prosthetics, orthopedic surgery, physical rehabilitation, and non-medical assistance, such as micro-lending.

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