IT DOES NOT CAUSE PAIN!!!!
It is hard to explain the importance of that to me.
The end of my stump that is farthest from the body center, is called the "distal" end. Actually, distal is the farthest of anything from the center of the body. Proximal is the end closest to the center of the body.
This is Doctor talk, but does help is being precise about body directions.
The problems of my stump are mostly at the distal end. Pressure on the distal end is very painful. If the skin on the stump is pulled toward the hip (Proximaly), it puts pressure on the distal end. So when donning (that is medical talk for "putting on") a socket, the friction force on the skin, toward the proximal end of the stump, causes skin to pull and puts pressure on the distal end. Of course this is also a factor when my entire body weight is on the stump inside the socket.
This latest socket is kind of weird. My stump is about 35 cm long (14 in). This socket is build so that the most distal half of my stump is not in contact with the socket. The distal end just floats around like a clanger in a bell. This means that 100% of by body weight is supported on just 15 cm (6 in) of the proximal end of the stump. By putting all the weight up high on my thigh fat, it makes the pain on the distal end zero. Having all the weight concentrated is a small area is not comfortable. Like wearing shoes that are way to small.
The big problem with having the distal end floating, is proprioception.
Wiki says:
proprioception pro·pri·o·cep·tion (prō'prē-ō-sěp'shən)
n.
The unconscious perception of movement and spatial orientation arising from stimuli within the body itself.
Proprioception is deteriorated with drugs and alcohol. That is why traffic cops have you close your eyes and try to touch your nose with your fingers.
By having the stump distal end floating, I loose track of, and have no feedback of, where the prosthetic leg is. I must walk slow, and watch where the leg is to know if it is in front and ready to have weight put on it.
I spent 4 hours at the prosthetic place today. We were determined to improve proprioception, comfort, and control.
This socket needs me to wear a silicone liner against the stump skin. The socket is made of fiberglass and carbon fiber. Inside the socket is a thick plastic liner. It has the feeling of a small tire. It is flexible, but tough.
Here is me bending the inside liner of the socket with my thumb.
The inside liner is riveted to the fiberglass shell. The vacuum is formed between the flexible socket liner, and the silicone liner on my stump. That is what keeps the prosthetic leg from falling off when I take a step. So there is the stump, silicone liner, flexible liner, then fiberglass shell.
What we have been doing the last few days was putting pieces of thin foam between the flexible liner and the fiberglass shell. These foam pieces are used to push against the stump closer to the distal end, to increase proprioception. This works, BUT, the pieces of foam also increase the force needed to push the stump into the socket. The more foam, the more proprioception, but more pain. :-(
Today we cut big holes in the fiberglass shell, and put thick foam on the pieces cut out.
At first we had a ratchet assembly that pulled a stainless steel cable. This broke before we could get enough force.
Then we used my big hose clamps to pull the cut out pieces in tight once the stump is inside the socket. So the stump fits in the socket easy, THEN we add the force near the distal end to aid in proprioception and control. These movable pads put force on the femur, without putting force on the distal end.
When tight, there is a LOT of force on the stump sides. This steadies the femur and really gives me good control and it makes the whole prosthetic feel so much more like a part of my body.
The next thing we need to work on is the force required. When I release the clamps, I feel the blood rush into the stump.
But there is NO pain. I can go shopping and get in and out of the car easily.I wore the leg about 6 hours today.
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I passed the learners test part of getting a South African drivers licence. Next is to get the car registered into my name from Maddie's name. She mailed me all the required documents express, registered mail, about 10 days ago. The post office advised me today that I can go collect the documents at the post office. 10 days for express mail to go 1300 km (600 miles).
To get the car in my name needs a roadworthy inspection. The tires won't pass because they are non standard. New tires are R3000. The one brake is leaking, and that is R1000. This money is coming out of the money set aside for plane tickets to go to America. Between this and the driving lessons, I have used half the ticket money. I am now way short of money. But being short of money, is nominal now days.
I decided I'll take the drivers licence road test, in my car. It is much easier to get in and out of than the driving schools cars. I have also removed the rest place for the left foot, to give my prosthetic leg more room. But first I need the car in my name.
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Today at the pharmacy I chatted about an hour with a guy that works there. He is a right leg, above the knee amputee. It is so nice to hear someone complain exactly about the things, that I complain about. :-)
He has been using one of the very first bionic knees for about 10 years. An OttoBock C-Leg. He got a loaner unit for 2 weeks of an Ossur Rheo-3 knee with a bionic foot.
He said after a few days he was walking up and down stairs, and up and down steep slopes without a thought. He said for 20 years he has had to concentrate on walking, but with the Rheo bionic foot/knee combination he occasionally, actually forgot about the prosthetic leg.
He has had many falls in his 20 years of amputation. He has been hospitalized 3 times from falls. Usually when accidentally stepping backwards, and putting weight on the toe that breaks the leg loose, and it suddenly collapses. His wife has been with him all three times.
While wearing the loaner Rheo knee/foot combination they went to a party, and were standing talking to a guy, that was opening a beer. The beer squirted foam all over. He and his wife both jumped back. Then she screamed and reached for him, knowing he would fall. But the computer cut in and locked the knee, and he didn't even stumble. She looked at him and said "We are buying that leg."
That leg costs R850,000 ( $70,000). They are selling one of their rental houses to buy the leg. He is very excited.
He had to give the Rheo back after 2 weeks. He says his old bionic leg feels like an dangerous antique.
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