Amputee Treatment Center Forum

MY HISTORY => My History => Topic started by: GravyLeg Pirate on September 06, 2009, 01:13:09 PM

Title: Hey All From a Symes
Post by: GravyLeg Pirate on September 06, 2009, 01:13:09 PM
Hey there everyone, I've been lurking on this site for a little while now and decided to register finally. I was involved in a motorcycle accident in 1997 and have a Symes amputation. I'm a firefighter/paramedic and have had great success so far as long as I stay on top of my stump shrinking throughout the day. Normally a Symes means one can bear weight on the distal end of the stump, but I cannot. My medial malleolus has a notch on it that hurts like a bugger, and my heel pad has rotated posteriorly, so I add socks to keep suspended in my prosthesis.  But really outside of that I've been able to do the job I love, so really what more could one want?

Well, now that I have a 2 year old at home, I want to be able to run with her and am getting tired of the blisters and bumps that result from such a long residual limb, so I'm thinking about getting the Ertl procedure done. I see that several of you have had it, and I'm yet to read anything bad about it. So if anyone has any thoughts on it, I'm all ears!

Anyway, looking forward to posting and getting to know you all! Have a great holiday weekend!
Title: Re: Hey All From a Symes
Post by: Mitchee on September 06, 2009, 01:52:25 PM
Hello and welcome to the forum.  I'm an Ertl LBKA.  If you have any Ertl questions, please feel free to ask.  Hopefully, myself and others will be able to answer them.   :)

Title: Re: Hey All From a Symes
Post by: GravyLeg Pirate on September 06, 2009, 07:55:32 PM
Thanks! I'm suprised to run into a Ertl person already! I'm taking a trip to Oklahoma City this week to meet with Dr William Ertl and hopefully he'll have some more information. But in the mean time, they say that I'll have to be off the stump and unable to be fitted with a prosthesis until 6-8 weeks post surgery. Is that really true?  And also, I was able to hold a BK prosthesis last week and it seems awfully heavy, do you have good control over it? Are you really able to bear some weight on it?

I'll try and be easy with the questions! Thanks for posting!
Title: Re: Hey All From a Symes
Post by: Mitchee on September 07, 2009, 02:05:07 PM
Hello again.   

Recovery time is different for everyone but below the knee Ertl's generally have to wait 6-8 weeks because the bone bridge has to heal.  I didn't get my first prosthesis for 12 weeks because I didn't have enough bone growth in the bone bridge.  Looking back... Even though I was disappointed at my 8 week appointment, I'm glad that I had to wait another month because my residual limb felt a lot better at 12 weeks post op than it did at 8 weeks post op.  I think I was trying to rush it.  3 months after getting my first prosthesis (6 months post op) I was riding my bike and rollerblading.   

I can bear weight directly on the end of my residual limb.  I can push with full force with my residual limb into my doctor's hand without any pain.  The doctor can also squeeze my residual limb and I don't have any pain because of the bone bridge.  (There isn't any chopstick effect of the Tibia and Fibula.)  I can also place my residual limb on the floor and bear full weight on the end of it without any pain. 

I'm not exactly sure how much of my weightbearing is done thru my bone bridge but I know that I don't have a traditional style socket that off-loads the weight from the end of the residual limb.  I bear some weight directly thru the bone bridge.  To me, my socket looks like any other carbon fiber below the knee socket.  I use the pin/lock system and I don't have any problems with it.  The pin/lock system isn't for everyone, I know several Ertl's who use a vacuum system and love it.  I wear my prosthesis painfree for 12-18 hours a day.  I carry heavy materials (40-80 lbs) for my job and the additional weight is not painful for my residual limb. 

I was also surprised by the weight of my prosthesis.  It took a couple of weeks to get used to the weight.  I don't notice the weight of it anymore.  If you have a proper fitting prosthesis, you shouldn't notice the weight of it.  I really don't think about my prosthesis unless I notice that I need to add or remove a sock.  I don't think about walking unless I am on very uneven ground.  It sounds strange, but using a prosthesis seems normal to me now. 

I hope that I was able to answer some of your questions.  I hope your appt with Dr. Ertl goes well.

Title: Re: Hey All From a Symes
Post by: GravyLeg Pirate on September 07, 2009, 09:03:49 PM
Thats great information! I'm sorry to sound like a broken record, but its so nice to talk to someone who actually has it. I'm glad to see that you have to carry items on a regular basis and don't have any trouble with it. I have to wear my prosthesis for 12-18 hours occasionally now so that makes me feel better. My SCBA airpack runs about 45 pounds or so and my SCUBA equipment is about 60, so I need something pretty beefy.

Post-surgery what did you do to help shrink your stump? First time around all I had was a shrinker sock. Where are the most common places for blisters for you? Folliculitis (sp) really bugs me to the point I shave around my knee, does that go away with the silicon liner?

Just wondering. Thanks again!
Title: Re: Hey All From a Symes
Post by: herb on September 07, 2009, 09:32:15 PM
Hi Gravy leg I hope you research thoroughly and get several professional opinions before making a decision. Shortening your leg does not sound like a good idea to me. Can't they surgically modify the pad to solve your problem? Lots of people who have ertl procedures have problems. I have heard it can be great, but not always. Good luck. Herb
Title: Re: Hey All From a Symes
Post by: Mitchee on September 07, 2009, 09:50:14 PM
Title: Re: Hey All From a Symes
Post by: GravyLeg Pirate on September 14, 2009, 08:39:41 PM
Ok, so I took a road trip to OKC and had a great chat with Dr. Ertl. After waiting almost an hour we took new x-rays which was an adventure in itself. I had never seen an x-ray with my prosthesis on, and it was very interesting! I figured I hadn't had an x-ray of any kind in about 10-11 years. My stump had changed so much I thought I was looking at someone elses! The end of my stump is very pointed and wedged shaped, so that explained a lot of the pain I was having in certain places. So when Dr. Ertl came in he explained just about every option for me under the sun and he spent just about an hour in the room with us! I had never heard of any surgeon doing that, much less an orthopod. He was very informative, actually asked questions about me and my life outside, it was like he actually cared!

So, long story even longer, we're about 90% sure we're going to get the surgery for the Ertl procedure. I'm just checking with insurance, work, etc to make sure everything lines up. Its still a ways away, but I'll keep you posted. Thanks again for all the posts!
Title: Re: Hey All From a Symes
Post by: chrysochloridae on October 17, 2009, 07:31:09 PM
Hey gravy,

Sounds like you've done phenomenally well with a prosthetic limb. Although it sounds like Dr Ertl has explained the whole thing through, there is (as with ANY surgery) some risk. I'm certainly not trying to talk you out of it, but there are lots of prosthetic options that you might benefit from but might not have heard of e.g.
 - Silicone / Gel Liner system (i'm guessing you're using a foam liner at the minute)
 - Gel cups (iceross Distal Cup / Alps Skin Reliever / Alpha Gel Cups)
 - Gel socks (e.g. centri / silipos)

Remember that (with any re-trim or re-amp) the likelihood is that your stump would be swollen for a few weeks - which is likely to result in the prosthesis not fitting.

As i said Gravy, it's great that you've done so well and i'm not trying to talk you out of it or badmouth surgeons - but the worst that could happen with trying new prostheses is that you don't like it and go back to the old system - surgery is just that bit more permanent!

Best of luck with whatever you decide

Title: Re: Hey All From a Symes
Post by: GravyLeg Pirate on October 31, 2009, 03:57:38 PM
I did it! Thanks to all the folks who replied, but after a lot of soul searching and long discussions late into the night, I decided to pull the trigger. I had the Ertl procedure done in OKC at OU Med, and so far couldn't be happier.

It is swollen, but not bad. The biggest surprise though? My stump is actually warm for a change! My old stump, which was quite long, was always cold and at least two or three degrees cooler than the regular limb. The pain is not near what they told me it would be, and is very manageable. I opted out of the epidural, but did elect to have a hip block done, which bought me about 12 hours of general post-surgical relief.

So, now i'm just hanging out waiting for the stitches to come out and am doing some range of motion exercises. Thats all for now!  ;D
Title: Re: Hey All From a Symes
Post by: pegleg jack on November 01, 2009, 11:00:54 AM
Gravyleg, hat is outstanding news and i pray that you have a complete recovery.