Day 108 - How to Cone a stump

16:00
I slept well after a 2 hour battle with the phantom pain keeping me from sleep.
Last weeks chemo seems almost wore off. My angiosarcoma will only have to wait a few more days before it gets another chemo whack.

We drove to the wound care lady and I got my stump wound looked at. She says it looks perfect. She played with the scabs from the stitches. She said the scabs are not ready to come off yet. Maybe next week, but most probably the following week. Only after the scabs fall off by themselves will she start the coning procedure. She guesses 2 to 4 weeks of coning before the stump is ready for its first socket. So we are looking at first of the new year before any prosthesis work can begin. I am ready now!

Coning is a pain, but necessary to get the stump shaped right for the socket.
Here is how to cone a stump.

 The biggest hassle with coning is the stump must be unwrapped, massaged, and re wrapped every 6 hours. The stump will quickly regain a swollen shape if left unwrapped for more than a few minutes.
It usually takes between 2 and 4 weeks to get the stump shaped properly and ready for a socket.
An above the leg amputation has special problems. There is no firm support between the body, and the prosthetic leg. Just a fluid filled stump. Right now my stump looks like walrus. All fat and jelly like. Coning tries to remove most of the moisture, so as to have a more firm place to attach the prosthesis.

One interesting thing I read today, is the recommended medications for phantom pain. They recommend Pregabalin (Lyrica), Tripaline, and Tramadol (Tramacet). I guess my doctor reads the internet, because I am on all three.
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18:30
I just crutched .5km. I was going to do a kilometer, but my shoulder started talking to me, and I did 1km yesterday, so maybe I need a bit of a break. I want to crutch to the blood test place tomorrow. It is about 1.1km from home. Maddie will meet me at the small shopping center for breakfast.

We didn't watch Green Lantern last night, so we will watch it tonight.

Day 102 - Phlebotomy lady, and chat with Prosthesis guy.

09:00
I laid in bed from 23:00 till 02:30. Just phantom pain. I could never relax enough for sleep. I think today will be a nap day for sure.
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16:00
We just spent half a day  running around. Trying to sort out my money problems. I had to sell one of my coins :-(

We then went to my Phlebotomy lady. We had a nice chat. We will pick up the results tomorrow morning before chemo.

I also discovered that my stump is the same size as my head.

Then we went to pick up the long, American type crutches at the prosthesis factory. The longer ones they had for me were real cheap Chinese junk. They offered them for free, and I refused. They only had the good aluminum ones that were too short. They said they would make a plan, and took them away. They came back, and had put bottoms on them that were longer off of something else, and then they were now long enough. But now they couldn't sell the other device, so they say I have to bring them back when the good strong, long crutches on order arrive in a few weeks.

We chatted lots to the prosthesis guy. I asked him if I could somehow wrap the stump, as it feels better when I squeeze it slightly. He showed us how to wrap it with a normal elastic bandage. He cautioned that the wrapping at this stage of healing is to prevent swelling, NOT to reduce swelling.
Early in the morning the stump is small, and the more I let it hang, like while standing or crutching, the more it swells up.
The stump still has the normal arteries to supply blood to the leg muscles, but the action of the muscles that works the little valves in the veins, to return the blood to the heart no longer functions, so the stump swells up, and will only drain slowly while I sleep. So we will wrap it loosely, early in the morning, and that will slow the swelling. As the leg swells during the day, the wrapping will get tighter. He said to never try to wrap it tight to squeeze out excess fluid.
He said that the Wound Care Lady is in charge, and she will say when coning will start. He says it should be next week as a guess.
Coning is the shaping of the stump so it will accept a socket. It takes about 4 weeks of coning before we can make the first socket. The first sockets are short lasting, because the stump changes shape quickly, and the socket no longer fits. The purpose of coning is to make the stump shape consistent.

If the prosthesis is taken off, then wrapping for coning preservation is done. 

Big rain storm. Power just went out. We are on batteries now. 

I better post this blog now before the cell towers batteries fail.

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