Last Wednesday they took a new plaster cast of my stump. Bradley first measured my stump circumference, and said it is much smaller, and time for a new socket. We are not sure if this will be the final socket, or just another temporary socket on the path to a permanent one.
The constant wearing of a silicone liner, or a sleep shrinker sock gradually reduces the volume of the stump. Some people have a stump that looks like a skin covered bone. My stump varies in volume more than most. That makes it hard to fit snugly inside the socket.
Here is the nylon sleeper sock I wear at night. This is necessary to make the stump small enough to fit in the socket the next morning.
If I don't wear a liner for a few days, then my bare stump is so large, that it won't even fit in the socket. If I wear a liner and wrap the stump, then the next day my stump is so skinny, it goes right to the bottom of the socket with little touching of the sides. This variance in volume is why I use stump socks. Stump socks are toeless, fluffy, wool socks that are used to increase the volume of the stump.
Stump socks like these go between the stump liner, and the socket.
A tight, snug fitting socket makes feedback from the prosthetic leg much more sensitive. I can easily "feel" the leg when it hits the ground, and I can "feel" if it is locked before I put weight on the leg. Each layer of stump socks reduces the sensitivity, and makes the leg feel more "sloppy".
Also having layers of wool sock between the leg socket, and my stump makes the alignment of the leg to be less precise. The prosthetic leg is allowed to rotate on the stump more than a tight, snug socket would allow.
I normally wear 3 stump socks now to get a tight fit. I am looking forward to the new socket that should require no socks. Of course needing no socks, also means that a slight swelling of the stump may prevent the stump from being able to fit into the socket. A smaller socket means more control and feedback when everything is working as should, but also means less variance is allowed in the volume of the stump. Socks can add volume, but nothing can reduce the volume except constant wearing of some kind of stump shrinker.
While I was at Bradley's, his next patient arrived, a 5 year old boy. The way this boy was zooming and jumping and climbing left no doubt that this kid was used to his prosthesis. He lost his left leg below the knee about 2 years ago. while I was getting my leg on, he came over, and swung on the parallel bars. He looped his feet and lower leg through his hands, and hung by his knees. Cool to see.
Today I decided to give the Total Knee 2000 a good walk. I walked about 4 km in 1:20. The total knee swings forward much easier than my Mauch knee. It also feels more stable once it is down and locked. The ease and quickness of change from locked to floppy still worries me. But I never stumbled or fell.
This short video shows how easy the Total Knee 2000 locks and unlocks
https://youtu.be/m6Mjxi1Wm9U
One thing I did notice was while walking with my Mauch Knee, I sometimes hear the toe scrape the ground. Just a slight "swish" but enough to warn me that my attention is not all there. Today the Total Knee never did a swish. The fact that it shortens the leg on swing forward is a welcome, noticeable, characteristic.
Maybe tomorrow, I'll try a walk to the mall.
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