Author Topic: Getting a socket done RIGHT  (Read 1932 times)

Offline uScott

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Getting a socket done RIGHT
« on: March 19, 2010, 07:50:15 PM »
It must be socket-making season, I'm looking really hard at whether I should get a new one made.  The aching, stinging, throbbing, bruisy purple-red welt on my thigh says "yes"....

A brief history.  I started with one prosthetist who made my prep leg, but I had some trouble with my weight around then and ended up not spending a lot of time on it.  Fast forward six months, I had the leg remade by a different shop, and got a pretty comfortable socket for a couple of years until it failed in a non-warrantied and non-repairable way.  Next we tried recasting for a completely new socket, but for various reasons ended up duplicating the old one -- badly.  Since then I've had two or three sockets, all variations on a theme, all "comfortable" for a few hours but ultimately they all create sore spots that make them unusable.

For my part, I have utterly failed in my role as a persistent customer.  Each time a new sore spot appeared I'd go back to the shop for an adjustment, then two or three or four, and then I'd get frustrated with the lack of progress, throw the leg back into the closet and go back to crutches.  Repeat every few months.  I'm fed up...I actually don't mind crutches, but when I'm stuck with them because I CAN'T wear my leg, it's a different situation than using them just because I don't FEEL like wearing my leg.

I am fed up.  I want to blame my prosthetist for not knowing how to fix the problem.  I want to blame myself for not giving it more time and effort (er, I'm coming up on eight years now!).  I'm all but ready to sign on with yet another prosthetist and let him start over from square one, but I'm scared of that turning into another failure.  Money is an issue...I can afford the co-pays on a new socket, but I can't afford to try every shop in the area, and I can't afford another failure.  But I'm not willing to go on as I have been.

I want to go back to my current shop and discuss it with them, who knows, they may even agree and have an idea of which other shops I should talk to.  If I go elsewhere...well, I've been interviewing already.  They all talk a good game, don't they?  I just wish I knew more about my rights in case I end up with another lousy socket.  It doesn't seem right to let my insurance pay for something I can use, but most places seem to want a signed delivery receipt before you even take the leg out of the shop.  How can you tell if it's any good without spending at least a couple of weeks on it?

Argh...just can't decide...  ???

Offline herb

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Re: Getting a socket done RIGHT
« Reply #1 on: March 19, 2010, 09:54:38 PM »
Hi Scott - I do not know where you live, but if you are ever in New England, you might want to try my prosthetist. They have offices in New Hampshire, Ma, and RI. I know I have been happy with all my legs and sockets. They have people who are difficult to fit coming from all the world for legs. They get it right the first time and they are nice people. It may not be good in the long run to not use a prosthesis. Last year I was on crutches for 5 months due to infections and surgeries. I started developing contractures of the muscles in my residual leg. Good luck finding a prosthetist. Herb
NEXTSTEP Orthotics and Prosthetics here is a link to their website

http://www.nextstepoandp.com/
« Last Edit: March 20, 2010, 08:08:23 AM by herb »

Offline Genki_rockets

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Re: Getting a socket done RIGHT
« Reply #2 on: March 20, 2010, 08:42:52 AM »
Do you require special configuration?  I mean, is your stump shaped or scarred in a way the conventional socket cannot accommodate?

I live close to Walter Reed and my prosthetist is probably one of the best prosthetists in the country but even he can't get it perfect the first try.  Well, not every time.  (He does get it perfect on first try some times.)  But having socket issue after eight years?  That doesn't sound right at all.  

Any qualified prosthetist should be able to make that "perfect MAS socket" after few adjustments.  So that's why I am thinking your stump may require special attention/fitting?


Offline pegleg jack

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Re: Getting a socket done RIGHT
« Reply #3 on: March 20, 2010, 09:49:29 AM »
Uscott, my CPO, went through 4 sets of test sockets before he got them right and i could wear and walk with them and not have sore spots show up on me, am a bilateral BKA, and my left stump is 2 inche shorter than the right one. And on my last pair he used the lazer system to cast my stump, and i am going to let him use it a gian this time and we have allready maped my stumps and he is going to do it agian next tuesday when i go in and the a final mapping with no liner on, just my bare stumps so that we have a refferance set to go by. And before he made my last pair we sat down and talked about them for more than 2 hours and i think covered every inch of both stumps looking for possible trouble spots. And the way i know that i need new ones made is that i will develop a blister on the end of the shortest stump. He said that i had shrunk 3/4 of an inch since the last set was made, so in saying you have to have a good person to make them and be able to comminicate well with them, and then not be afraid to speak up if it dosent meet your standards, cause you are the one that has to wear it, i know i yelled at him a couple of times cause the test socket was pinching me real good, but a little heat and pressure fixed it right up. and i wore them for a week and they had more red ink on the out side showing just were the tight spots were at and then the person that made my carbon fiber sockets put all of the modifications in to it. and hence forth both of my sockets fit real good when we finally got them made.
you-all have a great day.

Offline Steve C

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Re: Getting a socket done RIGHT
« Reply #4 on: March 22, 2010, 02:25:27 PM »
uScott,

Sorry to hear things aren't going great in regards to your socket. I tend to have the same problem so I know what you may be feeling.
Right now I have a new pin leg I don't really wear as it isn't right and I am wearing the old suspension sleeve leg. I have been in contact with the limbfitter and he wants to get it right even if it means a new socket (which it may). I can only wear the new leg a few hours until it starts to press in places. I can't wear it at all if I am doing heavy labour as my leg swells a little and the leg becomes unbearable because of the very thin liner.
I called his shop and asked how much a new suspension sleeve would be as mine is well past the sell by date and is ripped and torn and has holes as well. I left a message with the receptionist and he calls back and gets my measurements over the phone. I ask how much it would cost and he said it was free. He felt bad my leg wasn't working for me and he thought the suspension sleeve could be the least he could do until my new leg is right.
I was shocked...happy but shocked.

I think Joe told me once that we are amputees but we are also consumers. We need to demand perfection. It is annoying having to go back and forth but you'll agree we obviously deserve a leg that fits well.
Where ever I go, I'll always have one foot in Ireland   /   I'm not a complete fool. Some parts are missing.

Offline chrysochloridae

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Re: Getting a socket done RIGHT
« Reply #5 on: March 22, 2010, 05:05:29 PM »
Hi all, sorry 4 my prolonged absence!

Uscott, it sounds really frustrating what you're going thorough. The best advice i could give you from a Prosthetists view is to stick with the same guy as long as you possibly can as with a little persistence (and perhaps a few attempts at a socket) your prosthetist will get to know what things work for you after they've made a few sockets for you. I don't always get the socket spot on at first, but thats because everyone's different and what work for some people won't necessarily work for another.

It sounds like the guy you saw second time around had it almost right for you, have you considered trying him again?

you said that you were having problems with you're weight initially, it's likely to be a combination of fluctuating weight and the amputation healing progress causing your stump volume/shape changes. This will make it quite difficult to get a socket that would fit you right for very long. Hopefully, most of the volume changing due to the amputation healing should be resolved by now, is you're weight staying roughly stable now?

What limb system are you on if you don't mind me asking? Sorry if i'm asking too many probing questions, i'm just trying to help as best as i can!

Offline Joe A.

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Re: Getting a socket done RIGHT
« Reply #6 on: March 23, 2010, 06:34:18 PM »
Uscott,
 Remember that all practitioners want the best for you (Except for J.G.McGuiness of Norristown, Pa.) who is just a crook.)  I suggest staying with your guy. There are many things that can help. There are 2 kinds of patients. Some you'll never see again while others are back every 2 weeks. Get more involved. Don't settle for a painful socket.

As for myself, I have been in the same quandary I was happy with my practitioner but he was a long was to go for adjustments. I am considering using Dick Stevens guy as they have a number of closer offices.

I was once asked by a CPO what my expectations were. I replied, "i'm hoping you can get me in the ballpark then I'll pack it with felt and PE-Lite until i make it work."
After these many years of cost and pain I have come to rely more on scooters and chairs. Harbor Freight offers an Aluminum slide in tray to carry a scooter or electric wheelchair. It is tax deductible.
Private discussions regardless of topic are welcome by writing to kapunui@windstream.com

Offline uScott

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Re: Getting a socket done RIGHT
« Reply #7 on: March 24, 2010, 01:18:19 PM »
Thanks all for the words of encouragement!

There are two things that stick in my mind about my current prosthetist.  First, I went to him based on the recommendation of a friend who used him.  Recently I realized that my friend was never happy with his prosthesis -- some basis for a recommendation, huh?  The second thing is that although we have tried several times, this pros has never made a socket from scratch that was anywhere near usable for me (as in couldn't even walk across the room).  Everything we've done has been a re-work of another prosthetist's socket, and each successive try ends up causing as many problems as it solves.  It doesn't sound like a formula for success, does it?

chrysochloridae, after ~8 years I do believe my stump volume is as stable as it's going to get.  I still have weight fluctuations of a few pounds, and it would do me a world of good to drop about 50lbs anyway, but you know the catch-22 involved with that.  My hardware is Ossur's TK2100 and Ceterus that I'm pretty happy with.  The socket is (I believe) a modified IC design in a hard frame/flex brim suction socket.  I wet don it, which is actually causing most of the problem; it creates tissue rolls over the brim, which then get rubbed raw and hurt like the dickens.  I have had zero success with pulling in, probably because the socket is so tight.  It actually feels very good control-wise, I have a good sense of being positively coupled to the leg and it doesn't wobble or move around at all.  But that doesn't matter when it's too painful to wear....

Joe, I'm glad you've got options and can make them work for you.  I get along fine on crutches when I can't wear my leg (and crutches give you awesome shoulder and ab muscles!).  Never considered a scooter.  But a Segway, now...that might do it for me.... :)

Offline pegleg jack

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Re: Getting a socket done RIGHT
« Reply #8 on: March 25, 2010, 10:21:42 AM »
Uscott, sorry to hear about all the probs you have been having getting a good fitting socket, am in the process of getting new ones my self and last tuesday i went in for the final measurements before he makes the first of many i believe test sockets, my last set he make four sets of test sockets before i said okay lets make the perminate one and then when i got it it fit like and old pair of good fiting shoes. We are going to try some thing a little differant this time dont know how it is going to come out, but do know one thing we sat and talked it over for about three hours and what and when we were going to do it and how each set would we hope will go.

I am what you might call a ginnie pig for him by trying out new ways and differant ways of making sockets, so far some have work great other we have trashed cause of the pain to  my stumps.

So it sound like you need to set down with him and make him explain each and every step to you and most of all ask questions. and have him explain it until you understand each and every step that is done.

I go in next tuesday for the first fitting and will post on here how it goes.
you-all have a great day.

Offline ann

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Re: Getting a socket done RIGHT
« Reply #9 on: March 25, 2010, 06:58:32 PM »
I had mine taken last Thursday....hopefully it will be ready this coming week to try on.   If not they are going to have to put some patches in so I don't drop to the bottom...am not happy about going to Dr. all the time for blisters.  Last time I got a terrible infection.

Here's hoping you get a good fit PLJ    :)

Offline Joe A.

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Re: Getting a socket done RIGHT
« Reply #10 on: March 26, 2010, 02:40:18 PM »
Segways are fun and in the price range of a good scooter but you have to stand on them. Preferably with two feet. Mobility stuff is making me lazy.
Private discussions regardless of topic are welcome by writing to kapunui@windstream.com