The arena of limb loss rehabilitation according to the world of insurance awards prosthetists by providing a completed product, and therapists by minutes spend with the patient. This creates a problem! Prosthetists are rushed to deliver a limb, while therapists borrow limited time from the prosthetists to adjust any complications they may see with the limb as the patient progresses through the rehabilitation process. Succeeding in this arena may prove difficult, but is certainly not impossible. Last week's blog encouraged the creation of interpersonal communication between the prosthetist and the therapist. After that bond is established, appreciate the hard to find time of the prosthetist. Rather than calling to say, "My patient is in pain and I need you to see them today," provide them with a basic prosthetic evaluation from your perspective. This will rule out situations that could be remedied in therapy sessions and guide the prosthetist to better prepare to assist the patient in their facility. Therapy sessions do not have to be cancelled because of pain in the prosthetic socket! First and foremost, if the patient is reporting pain in the prosthesis, ask if they are wearing the same shoes that they were wearing when they were first fit by the prosthetist. Changing the heel height, even slightly, especially for a new ambulater, will significantly change the entire alignment. This is true even when switching to new athletic shoes. Be sure that the patient is wearing the same or very similar shoes before stopping the therapy session to seek help from the prosthetist. Also, be sure to ask the patient about pain medications they are currently on and pain medications they were taking when first fit with the prosthesis. Typically, patients are taking increased dosages of pain medications when first fit by the prosthetist, altering the way they feel in the socket during gait training sessions. Ambulating in a prosthesis should never be painful, but it is important for the patient to understand that the process may be uncomfortable at times.
Check back next week for the four step prosthetic evaluation every therapist should know!