Jan 27 - chemo day and more PLP

16:45
I have had a bad few days with PLP ( Phantom Limb Pain). No sleep. Last night I took two tramacet pain killers, 2 Robaxin 750 muscle relaxers, one tripiline 25 tricyclic anti depression, a celebrex anti inflamatory, a lyrica 75 for nuropathic pain, and a domacot sleeping pill at 20:00. I was still wide awake in pain at 2:30. Couldn't read, play Sudoku, or surf.

Today the oncologist upped my lyrica to 150mg twice a day, and the tripiline to 50mg. and prescribed a B6/iron tablet for the low hemogoblin.

She also prescribed me Cymgen (Cymbalta 60mg). These make people gain weight fast, but Cymbalta seems to work for fibromyalgia, which is also a neuropathic pain.

Also she prescribed Tegretol. It is used for epilepsy
Tegretol (carbamazepine) is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.

If those don't work, then I will go see a psychiatrist.

Yesterday I went to see my physio lady and the prosthesis guy, Bradley.
She was impressed with my walking,and made me do weird walking exercises. They are hard to do and take lots of thinking.
She says I should always start walking with a step from the prosthetic leg first. That way I can be 100% sure it is in front and locked before walking. That is a good idea. Also in the kitchen where it is easy to reach for something with my good leg, which puts weight on the prosthetic toes and unlocks it. This means that when I reach for something and rock forward onto my good leg, I also unlock the prosthesis leg, so when I rock back, it is unlocked. Crash, boom, bang.
Always reach with the prosthesis leg leading.

Bradley says my stump is in that bad stage, when it won't fit in the socket in the morning, and hits the bottom by evening. A large variance in size as the day progresses.
He recommends that I wear the leg as long everyday as possible to shrink the stump to a steady size as soon as possible.

This morning I got up ready to put on the leg and wear it all day long util bedtime. But found my stump very tender, inside near the end. As if the end of the cut femur is poking into the muscle they wrapped around the end of it . I put on the liner, but it hurt pretty bad. I then realized that if I grip the stump anywhere, and pull the skin back toward my hip, I get pain. But it is like inside pain. There is nothing wrong with the skin anywhere.

So I took off the liner. and used only crutches to chemo and the shopping after. But by myself on crutches I have no free hands to shop with.
 I miss the leg.
So I crutched out of Woolies and away from all the health food, and crutched to the pizza place. They do free delivery within 20 kilometers. I had it delivered to my car outside in the parking lot.

I am now sleepy, but the PLP is bad. I had it in the pizza place, and at chemo. Even driving I could feel the foot.
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Jan 23-24-25 - More Phantom Pain

Jan 23 23:15
Last night was a drug night. Lots of phantom pain. But an excess of drugs seems to be the only thing that works. I need an "unconscious"pill. When the phantom pain comes, I don't want consciousness. If I can't stop the pain, I want to stop thought.

I don't seem to have phantom pain when I am walking or when I am busy. It comes when I am relaxed, or bored. Wearing the prosthetic leg for long periods seems to make it worse later on. Also when I walk lots, and get tired, it seems to be worse a few hours later. I remember before the prosthesis, when I would crutch lots, I would have phantom pain later that evening. Maybe I need to take tomorrow off, and let the stump just rest the whole day and see if the pain is less in the evening.

One thing I forgot to mention the other day about employment disability, is chronic pain. The use of narcotics and strong pain killers to stop pain is as bad for an employer as the physical inability of an employee to do a job related task. So even if the physical amputation does not result is being "officially" disabled, the use of drugs for phantom pain can make you "officially" disabled.

--
My friend and I went to the big mall today. They have expanded the mall with about 20 new stores in a new section. We ate and chatted at a restaurant that I used to enjoy. Now it is very big. I think I will spend lots of money there.
 My friend was explaining about a network security misconfiguration he has been dealing with.  I listened, and understood all that he said, but I could not put it all together to understand why it was bad. He explained it many times in different ways. My intelligence was just to low. I almost started crying. It was so sad.

 I figured that I would be able to do all the computer network related things I used to do. After all, cancer, and a leg amputation doesn't stop computer use. But the phantom pain does. With the drugs I take to be able to sleep, my mind is too fuzzy to be of any use when real thinking is required.

--
I have been reading lots about Doctors trying to use prosthetics to relieve phantom pain. One good article said:

Phantom Limb Pain (PLP) causes important disabilities to many of those living with it. It has been shown that PLP has a negative impact on people's social participation and health-related quality of life.
Moreover, some studies suggest that pain could be associated with difficulties with the prosthesis and could be a reason for prosthesis abandonment. However, the association between prosthesis use and PLP remains unclear because negative, positive, or no association has been found between these two variables in different studies. 

On guy said the following, which sounds very much like me:
"PLP does not change, except that when I wear my prosthesis and I work on machinery, on tractors, I think about what I'm doing and less about it [PLP]. When I sit, in the evening, it is more painful. When I'm not active, it is more painful. So it has to be drowned in something, in work." [Patient 9–43 years of experience]

The article also said:
One Professional reported that the prosthesis allows patients to engage in significant activities that often direct their attention away from their PLP. She also suggested that the prosthesis may have a normalizing effect by allowing patients to use their amputated limb which could contribute to decreasing PLP. However, three health professionals also said that the prosthesis can increase PLP when it is poorly adjusted, when it stimulates a trigger point, or when it is too heavy. Moreover, one of them reported, as did the patients, that after wearing the prosthesis for many hours, PLP seems to increase. 

One good thing this article taught me was to write PLP instead of writing out phantom pain. :-)
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Sunday 24 Jan 11:00
I just got out of bed. I had a good 12 hour drug induced sleep.

Cancer, then loosing a leg, then phantom pain, now loosing my intelligence.
There are many battles in this war of life. Sometimes I am not sure which battle I am currently fighting.

Today I am not using the prosthetic leg. Wearing it seems to make the phantom pain worse, which means more drugs, which means more stupid.
I have a choice:  Interact with the physical world, or interact with the mental world. Choose one. :-(
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Monday 25 Jan 00:20
 Lots of PLP. I spent the whole day laying in bed, or sitting in the wheel chair. No crutching, and no prosthetic leg. Tonight at 20:00 I only took a celebrex. No lyrica. I then took a 25 mg Tripiline. Hoping that I would be able to sleep without strong stupid making pills.
But by 23:00 I was in pain. I don't want to read, or play Sudoku, or play computer. It just hurts. My left toes are cramping bad. I took a muscle relaxer.
at 00:10 I took 2 Tramacet pain pills.
As usual when there is pain now, you want to take more drugs because the pain is worst, and you want relief NOW. I think the smart thing is to take lots of pills, but take them plenty early, so the PLP never gets a head start. But ...It hurts NOW!
I don't know why they don't make an "unconscious" pill. That would work great for chronic pain.

It is 01:40 and I guess I'll just publish this.
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Jan 22 -

15:00

I also just got back from the mall. The mall has many slopes and stairs. Not cripple friendly.
I hate slopes. Both slopes going up, and down. They are evil in their own way.

Stairs are safer for me than slopes. I have a physio appointment next Tuesday. I want her to help me with slopes.
By law, any "handicap friendly" slope can not be more than 4.8 degrees steep. One foot rise for 12 feet distance.

4.8 degrees feels very steep to me. Whether I am in a wheelchair, or using a prosthetic leg. Unfortunately the 1 in 12 is also the normal. That is the most economical for builders, so they tend to make all slopes 1 in 12.
To understand why slopes are bad for a prosthetic leg, you need to understand how a prosthetic leg works like a normal leg.
Here is a normal gait while walking.

My prosthetic knee is called a Mauch SnS. Mauch is pronounced "Mawk". The SnS stands for Stance and Swing. I can vary both the stance resistance and the swing resistance. 

When the weight is on the heel, (the beginning of the "Stance" phase), the knee is a tiny bit over center, and won't collapse. This is called "extension". At the beginning of a step, when the heel strikes the ground in front of me, my knee is theoretically locked at full extension.

As I move forward, I must use my buttocks muscles to keep back pressure on the knee to make sure it stays extended and locked as I put more weight on it. 

As I move forward, the weight gradually shifts to the toe. Weight on the toe pushes the knee farther back into hyper extension. The Mauch knee is designed with a tiny pendulum inside that detects when the leg is pushed into hyper extension. This pendulum unlocks the knee and allows it to flop about loose. The knee isn't 100% floppy. There is a resistance setting for the resistance of the bending of the knee, as I move forward. This is called "flexion" resistance. To little resistance and the knee will try to kick me in the ass. To much resistance and the knee won't bend far enough to use its weight to swing all the way forward when it is time for that. We are now at maximum flexion and enter the "Swing" phase.

Now the leg is free to swing forward. The resistance that I set for extension determines the resistance to the knee flopping forward. If this resistance is too little, the leg will snap forward with force. Like a kick. It makes me look like a Nazi goose stepper. 

To much resistance and the leg won't swing far enough, and it won't be locked in full extension when I put weight on it when the heel hits. This is a guaranteed fall. 

To me the swing forward is the most dangerous period of a gait. It the foot swinging forward touches the ground or is blocked, it will stop, and when I move my weight onto what I hope is a locked knee, there is no leg in front of me, and I will fall hard. This is called a "stumble".

If everything goes right, and I have the extension resistance set right, the leg swings forward into extension just as the heel hits the ground. End of swing phase.

Now lets see what happens on a down slope. 

The heel strikes and locks the knee. But because of the down slope, the toe never touches the ground as I move forward, and the knee never goes into hyper extension, and never unlocks into swing mode. This means that as I am trying to swing the knee forward, it is still locked in full extension. The leg stays stiff, and I must  swing it off to the side in an arc to get it around in front of me so I can put weight on it. 

So on a down slope the leg will never get into swing mode.

On an up slope, the toe hits early, and the knee unlocks into swing mode while I am still putting weight on it, thinking I am still in the stance mode. Halfway into a step, the knee unlocks and I will fall if I am not expecting it. 

This also will happen if there is an uneven floor. The toe may be on a rock or a raised tile. it will unlock early while I have weight on it, and am still thinking it is locked.

The opposite is also true. If the floor is uneven, and there is a depression where the toe should hit, then the knee will not go into hyper extension, and unlock. I will be trying to swing the leg forward, but it will still be locked straight.

One good feature of the Mauch Knee is that I can set it to stay in a mode. 

I can make it stay in extension mode, so it will never bend. This is very secure and safe mode. I use it when I am standing for a long period of time, like doing dishes.

I can also make it stay in swing mode. This is useful for cycling. 

There are many prosthetic knees on the market. They all are different, and do things in different ways. One I will get to test soon is the Total Knee 2000. It has a device that jams the knee whenever there is weight on the heel. Weight onto the toe releases the jam and allows the leg to swing. It is harder to use, but many athletes run with it. 

The one feature it has that sets it apart, is that the mechanical linkages make the leg shorter on swing forward. This drastically reduces the chance of a stumble.

--

18:00

I just got all padded up, and walked up and down the street in front of my house. .5km. I get very tired.

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Jan 21 - Nominal day after chemo.

09:45

Chemo was normal. Lots of people. At one time there were 9 people on drips. The lounge only sits 6. They had to bring in extra chairs. I arrived at 10:30 and left at 15:30. I used crutches and the prosthesis.

Last night I took all my mixture of pills that make me sleep best. Nothing. So I took the same mixture again. Still very bad, constant phantom pain. Sleep was impossible. This pain produced moaning. I was shocked to hear myself moaning. I didn't know where the sound came from at first.

I read a bit, and started a new book. The last book in the series. :-(

I watched a very good documentary of the Marikana Massacre. The suppression of the workers by government is now worse than during the apartheid era. Black on black violence is worse that the white on black violence ever was. It seems as if the whole Marikana events lead to the execution by the government forces of the strike leaders.

Was still awake at 03:00, but dozed off till 5:30, then slept for a few hours. I am very tired, exhausted, and sleepy. I will make a big breakfast then sleep more.
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12:30

Trying to figure out the disability laws is very hard using the internet. The laws are constantly changing with law suits and new legislation. A legal document may be a year old, but still comes up on a search. It could be invalid because of a change in the laws in the last year. How can I know if a law has been superseded in the last few months? 

California is weird. A single amputation below the knee is not a disability, but a mastectomy is. Apparently a tit is an "appendage", and total removal of an appendage is a disability.

California also considers a double amputation below the knee to be less of a disability than a single amputation above the knee.

US Social Security says:

You will generally qualify for Social Security Disability benefits if you meet one of the following conditions:

• Loss of both hands
• Have lost either lower limb above the ankle (tarsal region) AND have complications that medically prevent you from using a prosthetic device to help you walk and effectively ambulate.
• Loss of one hand and one lower limb above the ankle with inability to use a prosthetic device.
• Loss of an entire leg at the hip or pelvic region.

As the prosthesis technology improves, so does a disability not become a handicap. There have been many major improvements in prosthesis since the war in Iraq and Afghanistan has produced so many amputations. The problem is that since the government is paying, the price on the latest prosthesis is stupid expensive. If someone really cares about helping amputees, and not about the balance sheet, then a perfectly good hydraulic only knee could be built. It would be better, AND sell for about 1/4 of a new bionic knee.

The big selling point of course is "stumble recovery". Computerized knees can do that. Pure mechanical or hydraulic knees currently do not. 

A hydraulic knee could be built that pumped a tiny bit of fluid during the swing forward phase, and if the pumping stopped before full extension then the leg would lock allowing force to be put on the bent leg, preventing a fall. This is not rocket science. It is below the technological level that the fluidic computers in the Cobra helicopter used in the mid 1960's.

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15:00

I just walked to the back yard, and did 10 large figure 8s. Then I walked to the street and retrieved our garbage bin and took it to the back yard. All without a crutch.

I just thought of something that embarrasses me, that I never thought of before. I have a set of complete body armor from my motorcycle days. Gloves, elbow guards, knee guards, helmet, even a complete kevlar body armor suit if I feel like it :-)

I think realistically gloves, elbow guards, and knee guards will be enough to allow me unlimited walking on the street, and have adequate protection in a fall.

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16:30

I just walked .55 kms. Lots of body protection but no crutches, and no falls. Very tiring. I am exhausted and breathing hard. I'm all sweaty. 

I feel so much safer with the gloves and elbow/knee guards on. It still takes a lot of concentration. 

I almost had a stumble, but that was trying to get out of the way of a speeding car. 

I live on a dead end road that is open during rush hour to relieve the traffic on the main road. When the gate is open and the cars can come through, they are always going fast on the way to work, or on the way home from work. The rest of the time the gates are closed, and then all traffic has to go through security booms on another road.

But a few times a day somebody that is used to the gates being open is trying to take a short cut in the hours the gate is closed. They come zooming down the street at about 4 times the legal speed limit, then slam on brakes when they see the gates are closed, then they turn around and go back even faster. 

I only walk when the gates are closed. Many times kids learn to ride their bikes and skateboards in front of my house, because there is no through traffic with the closed gates.

I fear someday a rich, bitch, yuppy in a big Mercedes will take out some kids in front of my house.

--

Supper was fish and chips. I drove to the shops and bought supper and came home. No crutches.

Maybe I will figure this leg out.

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Jan 19 - Blood day and a visit to the prosthesis place.

18:00
I sit here feeling stupid.
The oncologist gave me new pills that help with the phantom pain. They also make me sleep lots, and I feel dumb all day. They also produce "Lackadaisicalness". I just couldn't be bothered with stuff like blogs,  TV, computers, and books.

I have been taking the pills for 4 nights now. I sleep for about 12 hours a day, and am dozy for another 6 hours.

Today was a busy day. I did blood tests, because tomorrow is chemo day. :-(

 Then I went to the prosthesis guy, Bradley. There were many things that needed to be done. And I like that place.

My stump is loosing mass very fast because of all the wrapping, and liner, and socket. My socket is now loose, and a week ago it was hard to get my leg even into the socket. Also my leg seems to want to be in the socket at a different angle than last week.
Bradley was ready to build a new socket, but decided that maybe a thin piece of leather in the inside of the socket would give enough added volume to allow another week with the socket.

The left leg is getting skinnier daily.

While I sat on a bed, and waited for my socket to be redone, a very fit looking guy came in to the same room as I, and asked if they could use this room for a consultation. I said sure. This guy works for Bradley and sells shoes in their running shoe store. They specialize in "Natural Running". It is a return to running for long periods without injury. The shoes are different, and very expensive. They have less padding, and most of the natural runners hit the ground first with the center of the foot, not the heel. This guy was having calf muscle problems. Because he works for the same company, the whole staff knew him. He brought with 8 pairs of shoes he wears. Each shoe has a special purpose, and helps with certain injuries. They have a large pad that records the pressures of the foot. He had to run back and forth many times with each pair of shoes.

We looked at all the computer analysis of each shoe, and how it affects his foot strike in different ways.

Running was never this high tech with me. I just bought shoes and ran them till the soles came off.

They finally decided to have him wear a certain pair, and do a certain exercise to strengthen a certain muscle in the calf, without strengthening other muscles in the calf.

Then they are back with my socket. The white leather looks good. it was cut and glued inside the socket.

 Now my stump fits tight. Bradley cut the silicone liner a bit as it was rolling up at my groin and pulling out my pubic hair. With the chemo I don't have enough pubic hairs spare to have some pulled out.

Bradley's assistant is a very nice Serbian lady that actually builds the sockets. She asked me what color I wanted the out side of my final socket when she builds it, as she can make it any color. I told her I wanted a Texas flag. She made some drawings. After I got home, I made a demo model from a Texas flag I have.

This is what I am thinking about.

Bradley then did his normal adjustments, as I walk back and forth.

Bradley said that next week would be with a physio lady, as I have reached his knowledge of how to walk best. He said I need to get rid of the crutches more, and walk natural more, BUT DON'T FALL. He also said that walking in large figure 8's would be good. 

I left Bradley's and headed for home. Then I started thinking about a small park near my house. I bet I could walk there, and if I fell it would be onto the grass. I drove to the park, and it was empty. I found an area with relatively short grass. I set my crutches down about 10 meters apart, and started walking figure eights around the crutches. I did this till I got bored, and I never fell. 

Then I decided to drive home. I need to do shopping, but need someone to go with me. I was feeling all competent with the leg, so decided to try shopping. I tried last week to hang on to the trolley and walk behind it, and I failed. I tried again. This time I concentrated on just walking, and only used the shopping trolley for balance. I put the crutches in the trolley. It actually went pretty well. The chance of someone bumping me while I am behind a trolley is minimal. So I walked along behind my guard/shield trolley and bought stuff. I told the cashier lady to put everything back into the trolley, and took it straight to the car, loaded the car, and paid a car guard to take the trolley back.

Selfie of me shopping.

When I got home, the real problem began because I don't have a shopping trolley to move stuff around the house with. So I made 4 trips from the car to the front door.

It was good to take off the leg after 10 hours. It always feels good to take off the leg, because if it doesn't bother you, you will leave it on. Only when it bothers you, do you take it off. Then it always feels good. :-)

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Jan 13 -

12:30

I am sitting in the prosthesis office while they adjust my socket. They are moving my socket to knee alignment about 5 mm. That will make it more steady while standing, but also more difficult to initiate the swing forward while walking. So we will increase the hole for the hydraulics during swing forward, and at the same time raise the front of the foot. This should make the toe less likely to catch during the swing forward phase.
--

 Whew! What a busy day.
I had very bad phantom pain last night, and was awake til 02:00. I took a lot of drugs last night, and they seemed to have not helped at all.
I was up at 7:30 and put on my leg. I had hoped for a nap during the day.
My friend came over about 08:00 and we chatted a bit.
I did my blood test, and will get the results tomorrow before going to chemo.
I then went to the prosthesis guys, for a 13:00 appointment with the physio.
When I arrived, Bradley came over and said he wanted to see some things first. He had me walk crutch-less, and turn around, and walk around a table. He then called the physio lady and told her not to come. He said I am about equivalent of week 6 or 7 of the training.
He said there is a week 2 patient that still doesn't know how to put on the prosthesis. He has a note book of the procedures to follow.
He said he had another week 3 patient that had not figured out how to force the knee to bend using the stump.
Bradley and I sat in an office, and he asked me if I had any questions or comments. He smiled when I whipped out my list. :-)
1.I told him I never REALLY know where the prosthesis foot is without looking.
2.I told him I had fallen about 10 times, but always caught myself with the crutches.
3.I complained that there is no "stumble recovery” in the Mauch Knee that he sold me.
4.I have small blisters all over the stump.
5. In the morning the stump is too big for the socket, and by evening it is too small.
6.The leg slowly collapses while standing if I don't keep back pressure on the socket.

He then said it was his turn:
1.With much practice you will learn to feel if the prosthetic is extended by the weight on the stump, and the snap of the leg going forward and stopping.
2.With any prosthesis, you will fall. With any set of ice skates, you will fall. Learning a skateboard, you will fall.
3.He agreed. There is no stumble recovery in the Mauch knee, and it is one of the main bad points of the knee. But thousands of people switch to the Mauch knee every year knowing this. There are some very good points about the Mauch knee.
4. Small blisters are not friction or burn blisters, but the squeezing of the stump is forcing liquid out of the stump. If the lymphatic system can't get the water out fast enough, it is forced out through the skin. Ignore them unless they start to hurt.
5. The varying stump size is what we will live with until we get a steady stump size, and can build a permanent socket. Until then we will have these temporary sockets, and varying stump sizes.
6.He will move the line of alignment to make it more steady in stance phase. He said that later when I will be stronger, I will want it moved back to where it is now.

He then took my prosthetic away, and I sat and waited. He then came by and asked if I wanted to watch the programming of a bionic knee. Duh, of course I do.

The guy was a double amputee, both above the knee with short stumps. He was trading in his Medi knees.

http://mediusa.com/portfolio-item/oh5sfkh5/

I got to play with these knees. The are cool, but fail a lot - not very good manufacture or service. They are like a combination of the Mauch knee and the Total knee. Very good idea, just poorly done :-(

He was getting The Rheo 3 knees.

http://www.ossur.co.za/rheoknee

The Rheo are bionic knees, not mechanical. They brag about the computers updating all solutions 200 times a second.
The torque clutches are very similar to autopilot servos. A magnetic gel that changes viscosity with applied electricity.

This guy got up and walked. He liked the fact that the Rheo had a bleed down for sitting. My Mauch knee does that also. It gives about a 75pound (35kg) force to lower you into a chair.
The Rheo knee has an AI (artificial intelligence program that learns each persons way of doing things, and it gets better and better.
He is getting 2 knees, at R930,000 each. My house is worth 1.2 million.

I don't think I'll be getting one of those soon.

Bradly brought back my leg, and he did many adjustments. I walked back and forth. He videoed my walking. He says I need to work on making my prosthesis leg take larger steps.
The moving of the alignment now means I don't need to use muscles to stand, and prevent the leg from collapsing. It feels much better when standing. He made the swing forward time quicker so the end of the swing is more pronounced, and noticable.
He trimmed some off the socket where it was rubbing.

He said he plans on swapping my knees to the total knee 2000, medi knee, and the 3R60. He has all of these in stock.

http://www.ottobock.com.tr/en/prosthetics/lower-limb/solution-overview/knee-joint-3r60-ebs/

He said it will take a few weeks before I will know enough to tell what I like best. He said they can make a plan if I like one of those other 3 knees. They are all more expensive than my Mauch knee.

Before I left I told him about my fear of falling.We discussed it a lot. We talked about wearing skateboarding protection. But the best solution was when he showed me how to kneel.
A "stumble" is when the leg coming forward is delayed or stopped, like hitting a curb or brick. Some prosthesis have stumble recovery. If the leg sees that it is in forward swing phase, and the leg stops before full forward extension, the knee locks up solid. Now, even though it is bent, it can support my full weight. The Mauch knee will stay in swing mode (no hydraulics at all) until the knee is at full extension. No support at all in a stumble.
We practiced a stumble a few times. If I am VERY quick, as soon as I detect a stumble, and totally collapse my good leg, then the prosthetic leg also collapses, but into a kneeling position, not a total collapse. This means that I will now fall from a kneeling position instead of a standing position. Much lower to the ground. Also any forward motion has been addressed. He says it may break the mounting to the socket, but that can be fixed a lot easier than a broken arm. I am not sure I could react quick enough. The times I have tripped, I didn't even know what happened till after the fact.

I have taken lots of pills, and a sleeping pill.
Later
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Jan 12 - Video of walking

12:00
I was up at 07:30 after a nice drug induced sleep.

My stump still has many small water blisters on it. Google says it is because the water is being squeezed out of the stump faster than the drainage system can handle, so it goes out the skin. All the internet experts :-) say to totally ignore small blisters. So I do.
 The stump was quite swollen this morning, and it took almost 3 hours before the stump was far enough into the socket to allow me to walk a bit.

I just went to the gate and back. Coming back was crutch-less, except for using them as a fall catcher.

I find that if I concentrate, I can walk crutch-less.

Or:

https://youtu.be/0KeVa2c1h-M

But this is still in the realm of a party trick. I shouldn't carry babies around for a while yet.

 A study  which surveyed a population of 396 lower limb amputees reported that 64% of trans-femoral amputee respondents experienced a fall in the previous month period.

--
13:30
The itching from the blisters is hard to ignore, so I took the leg off, and rolled down the liner so I could get to the blisters, and let the stump breath air.

Reading on the internet about actual people that have worn the Mauch Knee for awhile and they all seem to say the same thing. Like these...


-----I have been a Mauch user for 4yrs, prior to this I had demo on Ultra Knee, Ottobok 3R80 and Total 2000. The Mauch is a free swinging stance-phase unit so there is no weight-activated lock. Alignment is easy but crucial and I would guess only pros who know the unit well will be able to get the alignment right. The unit is good, a compitent amputee would be able to walk very well at variable speed and learn to jog, ride a bike etc - maybe, I say maybe because all that would require extensive training and much, much confidence. the biggest down sides to these 'none locking' hydraulic units is mainly two fold, firstly they require good strenght to be usable, and will 'deck' you often.
my advice...if you are strong, confident and wish to be a high-active amputee then the Mauch is a good bet - but you will fall regular untill you master it.
 
-----Hi, I had six month trial on a Mauch 18 months ago, I tried to make the knee work for me. I'm very active, work as a surveyor on and off building sites and such. The Mauch is very fast action but very very unpredictable. I fell in the road once in front of a car, which led me to call the Mauch a day. I since use a high spec total knee which is much safer. The Mauch is the faster leg on the market if you have the stump power to control it. Definitely not for the faint hearted, good luck with your choice :D
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I just went to the shops. Leg and crutches.
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21:30
Tomorrow is blood test and prosthesis lesson.
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