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The MAS Socket Diaries - AUGUST 2005

Thursday 3 August 2005

Well the big day finally dawned. After reading and hearing so much hype about this new MAS socket, I made my way to Marco's offices (he's my stunning prosthetist in Pretoria) to start the long process of fitting for one of my very own.

There was a lot of measuring, which needs to be 100% accurate, and Marlo Ortiz's instructions must be followed to a ‘T’. I am lucky to have a special and trusting relationship with Marco, so all the prodding and poking, looking for ‘this bone’ and ‘that bone’ and the ‘bone in-between’ wasn’t as invasive as one would imagine it to be. Finally, after more than 10 years of being an amputee, I know where my Ramus and my Ischium are located. Exactly located! I feel educated.

Marco says I am relatively easy to measure because he can feel the bones under my skin. I smile to myself, I know that’s just age – you know – when your skin kind of thins out…..

The plaster-of-paris mould was as revolting as it normally is, with bits of gunk slopping around and making strange slurping noises as it was applied. I am still amazed that it goes on so cold, and slowly heats up as it sets. Catches me by surprise every time it does.

Note to self : Do a special guideline booklet for new female amputees on what to expect at your first fitting. It can be a frightening experience if you don’t know the procedure.

The entire measuring and mould making procedure took about an hour. Not bad. I should be seeing Marco again on Monday or Tuesday next week for the first test socket. I am a bit nervous. We are going to use a different knee, the Endolite Mercury Junior. Perhaps the Total Knee has made me lazy (it’s so easy to use), but I am dreading all the energy I am going to have to expend with the new hydraulic knee. I used every excuse in the book to get out of it (including “it’s a high energy knee for nutter-amps who run all the time”), but he just smiled and shook his head, like a parent indulging a spoilt child.

Roll on next week!

Tuesday 9 August 2005

Happy women’s day. And my first test socket is ready. Forget nervous. I am terrified!

11am - Ok, well, I take one look at this new socket, and it is WAY scary. The inside ‘ear’ is so high and pointy, how can that ever be comfortable?

I don’t want to put it on, but I do. I don’t want to put any weight on the leg, but I do. And it’s as awful as I thought it would be. Not sore, but so odd. With that damn ‘ear’ pushing right up my butt. No man. Marco just laughs at me, but I am not amused.

I feel as if I am wearing a socket that only comes to my mid-thigh. There is no pressure or feeling of tightness at all around the very top of the leg. In fact, I have to check to see that I am in properly. If not for that bloody ‘ear’, then I would swear that the new socket is half-size. And I don’t feel safe. I feel bow-legged and very precarious, like I am perched on top of the leg.

Sitting is a problem. That damn ear again. And it hurts. So it’s off, tweak, and on. Off, tweak, and on. I stop counting how many times we do that. And eventually we get to a point where I can sit almost comfortably, but walking is a problem. I have developed trust issues with the MAS socket already!

And if anyone thinks that the personal poking and prodding for the initial measurements is invasive, lawdy lawd, don’t even go near the first visit for the MAS test socket. You feel like saying “you realise you’re gonna have to marry me now”. No kidding.

12.15am – Marco says I can come back next week for the second test socket. Maybe even take it home. He says he thinks today went well. I’m not so sure. I’m getting too old for this sh*t. My nerves are shattered. I put my Ischial socket on and it feels like an old friend.

Marco can see I’m unsure. He reminds me how scared I was changing from a Quad socket to an Ischial Containment socket. Mmmm, I remember. He has the patience of a saint.

I’m going to have nightmares of being chased by giant ears.

And I am still terrified.

Friday 12 August 2005

10.30 appointment with Marco. Mental block makes me too tired to wake up, and I am late.

And there it is…the new socket with the same dreaded ear, larger than life.

It goes on much easier this time. I still feel a ring of tightness midway on my leg, and no pressure at the top, but somehow I feel a bit safer standing in it. I take a few steps using one crutch. Then a few more. I really don’t like the Endolite Mercury Junior knee. It’s on it’s lowest setting but it’s still hard to swing through, so Marco puts my Total 2000 knee on the socket.

Ahh! Pretty soon I am walking up and down between the two full-length mirrors. There’s no way I am going to fall out of this baby today. And it’s ok. The stupid ear is still digging into my butt and it bothers me. Marco asks if it’s sore. Nope, not sore. Could I get used to it? Maybe. Big maybe. I make a face, like “can you see I’m not convinced?”

The socket is very low in the front. Probably about a thumb’s length down. It’s weird. And sitting is still a problem. I tell Marco that maybe I need to learn how to sit so that the ear doesn’t move upwards and hurt me. But no, he isn’t happy with that. He wants me to be able to plop down and have immediate comfort. Hell, I can live with that! The outside of the socket (the bit opposite the ear) is very high up my hip, but comfortable. I can’t even feel it there, and it fits properly, no gaping at all. The socket will have to be a bit longer, I am hitting the bottom when I relax into it. I look down and there is NO CONTACT between the socket and that sensitive place in the groin area that has always given me trouble. In fact, there is a definite gap. Like I said, it’s weird. And not unpleasant.

The ring of pressure is very noticeable to me, but I remember when I changed from a Quad Socket to an Ischial Containment Socket, the pressure was so severe that I thought I would never get used to it. But of course, I did. And relatively quickly too. So I am willing to work through this new feeling because I have ‘been-there-done-that’ before. Marco looks at my stump with his CP eyes through the clear test socket and he is happy with what he sees.

I’m not taking it home today. There are too many adjustments. Marco shares a secret with me. The last test socket was scrapped because when he checked the measurements, he discovered that he had made a MAS Socket with his Ischial Containment Socket brain. This makes perfect sense to him but doesn’t mean much to me. So he made a new test socket with his MAS brain, and I must admit, today is a lot better than Tuesday.

Marco sits me down and shows me exactly how the MAS socket holds on to you and supports you and moves with you. Yip, I can feel the penny dropping. It’s so simple, it’s just got to work.

I’m still wearing my “I hate the ear” face, so he measures it. And what do you know? It’s too long! HAH!!!!!! So my little friend is going to be cut down to size. Hehehehe…..

I am out of there in less than an hour today. As I leave I say to Marco “you know, I would have taken it home for the weekend if you had told me to”.

And that’s a very good sign!

Tuesday 16 August 2005

Yip, another great day in Africa (this is when you haven’t been robbed, mugged or hi-jacked at gunpoint for two consecutive months), and off to see Marco.

And I’m not late, or terrified. ‘Apprehensive’ would be the word today.

There it is. And the ear! Well, I couldn’t be happier. It’s much flatter at the top, and shorter. About half an inch shorter. I smile. I ask Marco if I should give the Endolite knee another try, but he says that I should deal with the socket first. Good plan.

I don it and man it feels so tight. Squeezing the damn life out of me. I realise now that my Ischial Containment socket is too big. I must have had quite a bit of residual limb shrinkage since I first had it fitted in September last year. This is going to take some getting used to. Again.

We get the ‘ear’ where it’s s’posed to be and I can see why there is no room for error when you put on this socket. There’s only one spot that little brat-ear can fit. Marco made me put it on skew, or so it seemed to me. But it fits ok. Don’t think I would have gotten it on correctly by myself on the first try.

Walking is ok, no crutch today. Marco does his sergeant major thing :’SWING YOUR ARMS!!”. Sigh, I have to do everything in this damn relationship. So I swing, and stride, and try to look up, and when I finally de-stress a bit, and start to walk in a more relaxed and trusting way, it’s feeling good.

The front of the socket, which is very low cut, is digging into my thigh, pushing against my muscle, and I don’t think it’s something I can get used to. Marco says he will flare the lip out a bit.

The length is cool now, I don’t bump the bottom of the socket. Bit of pressure at the end of my stump on the side bit of the bone, Marco will push it out. We fiddle a bit with the alignment because I still feel a bit bow-legged. I’m not sure we get it 100% right, but I am very distracted with the tightness, and also with the front lip, which hurts.

And the ear…..I have to laugh….I have made such an issue about it, but I swear people, it was a monster extension in my previous visits here. Today the ear is more subdued, and although I can definitely feel it pushing up into my derrière, I reckon I might get used to it. It’s certainly not sore.

I go and sit down. Ok, that was fine. So I plop down. Hey hey! And it’s feeling not so bad. Definitely not sore, still feel the ear, but it’s not pushing on the bone. So I lean right back (almost flattened, with bum on end of chair and head on the back) and wham! The ear catches me. Marco looks at me with one eye. He wants to know what’s wrong. I say “I can’t sit like this” – he says “and why do you want to slouch?” I have no answer to that one.

We find a wall, and I do cross legged standing, and wide legged standing, and it’s comfy all the way. Marco wants to try the sitting cross legged thing, so down I go, and I manage to cross my legs about 60% of the way. I really don’t know how the girl on the MAS site does it, because the more I try to push the prosthesis towards the floor, the more it feels as though it’s going to lose grip against my skin, and twist out of position. (I know this because the ear warns me!)

And so, another fitting that even I have to say has gone well. Marco says that when I walk with the MAS socket, I look as though I have more control than when I use ‘old faithful’.

And of course, I have to take a look at my rear-end with this new MAS socket. My oh my. I have twin buttocks. TWIN! Not one that has succumbed to gravity, and one sitting halfway up my hip. You know that lopsided look I’m talking about ladies. They are almost identical. Wow. And you know what that means?? No more ruining good pants from sitting on the hard end of a high fitting socket. (I'm guessing, but the odds are really bent in favour of my new little theory).

Can’t take it home today, Marco is going to tweak it a bit : make the front lip flare, give me more space at the bottom where the bone is catching, and bring the hip-hugger side a bit higher. I still am in awe at the fact that there is nothing catching me around my groin. And I am not sitting on the rim of this socket. The back is almost as low as the front. It’s an amazing thing to feel.

Just over an hour, and I am on my way home. Yip, another great day in Africa!

Monday 22 August 2005

I’m sitting at the PC now wondering how to document everything since last Thursday. It feels like eons ago.

Thursday (the 18th) saw me back at Marco’s rooms with a slightly tweaked MAS socket waiting for me. Hells bells. Such small changes made such a big difference. I just couldn’t get comfortable. Not for love or money. The socket was slightly bigger to ease some of the pressure, but then I think I slipped further into the socket, because the ear nailed me again. So we had another day of off-tweak-on, off-tweak-on; it seemed endless. Even Marco was disappointed. We had almost got it right on Tuesday. How could such small changes make such a huge difference to the feel of the socket.

At one stage, Marco started to mark the places (again) where he was going to fiddle with the socket, and I moved it ever so slightly on my leg and it made such an immediate difference. I did the off-on thing again, and the fit was 100% better. Marco said that I put it on only 1 or 2 degrees differently. We both couldn’t believe the huge change.

The socket still felt tight. I had been there for 5 hours, and at the end of the day, I didn’t know if I was coming or going when it came to comfort. I was sore and dog-tired, and I really couldn’t tell anymore how the socket fitted. So I decided to take it home and give it a test drive.

By the time I got home (an hour’s drive), the ear was really digging into me, and I couldn’t walk properly. Took it off, collapsed in a heap, and didn’t look at it again till Friday morning.

Friday at about 11am I gathered up the courage to put the leg on. ‘Gingerly’ doesn’t begin to describe it. Marco had brought the sidewall up and it fitted very close to my hip. Well, one step and that was me. Instant agony. My hip was so sore that I even forgot about the ear. You can imagine. I tried to push through for about an hour, but I could see that it would be impossible. Phoned Marco and back I went.

Only spent about an hour there – Marco ground down the wall around the hip and flared it out a bit. I still wasn’t too sure about the ear, but decided to take it home again and give it another go.

Saturday was going to be a long one for me. I had 3 functions to go to, which means a lot of leg work. I put the socket on and it felt really tight. More so than yesterday. In fact, I kind ‘bulged’ out the top, even though I put it on 3 times. I think I was a bit swollen, and I didn’t manage to get in as deep as the day before. I Thought that if I wore it for a while, I would shrink a bit, and then I could put it on again.

Well, that didn’t happen. The shrinking, I mean. I must have put it on about 5 times from 3pm until just before midnight, but my leg was aching from the pressure, and I could feel that my prosthetic leg was definitely longer than it usually was because I just wasn’t getting in properly.

I didn’t wear it at all on Sunday.

Today I put it on again, and I went in easier than before, and deeper. I’ve been sitting at my desk for most of the day, and this is definitely not a comfortable socket to sit in at the moment. The ear isn’t hitting against any bones, but it is digging into my flesh properly. Feels like I am sitting on a rock. This can’t be right. I’m just wondering if the ear needs to be flared out a bit, because it also catches me like that when I stand. Or maybe if it wasn’t so damn hard it wouldn’t hurt like this. I don’t know. Am going to try again tomorrow and see if maybe I can get a better fit. Could be that I am still a bit swollen, although that doesn’t make any sense. I am feeling like I should be further in. Maybe.

Marco offered to send a courier collection service to my house to fetch the socket today if I didn’t come right so he could make a new one by Wednesday. How nice is that?

The one thing I learned about this socket is that you’ve got to put it on correctly. A few millimeters in the wrong direction, and you’re stuffed.

So where am I now? Tired, a bit sore from the rock-ear, and totally confused about why I can’t seem to get it on right.

Courage does not always roar. Sometimes it is the quiet voice at the end of the day saying, “I will try again tomorrow”.

That never rang more true than it does tonight.

Wednesday 24 August 2005

Pretty soon I am going to be able to put my car into auto-pilot and it will get me to Marco’s on its own. 12pm and I’m going back. This week has been pretty dismal with the leg.

I’m still feeling as though I’m not in properly and the leg is bugging me. The ear in particular. I wouldn’t admit it to Marco, but I’m beginning to think that maybe it’s too short. Horror!

Marco decides to re-measure me compare it to the original measurements we took for the first socket. He takes one look at me, and declares me ‘definitely not in’.

I am convinced that my stump is at least twice its normal size. Marco measures, and then we compare the new notes to the original ones. Unbelievable. I am smaller. Ever so slightly, but smaller. And this is not making any sense to me.

Marco says that my residual limb is a bit fleshy, so he takes another set of measurements. This time, with a tape that is not elasticised at the end. And the sizes are a bit bigger.

Right, the new plan is to make another socket, use the third measurements (the bigger ones), decrease them by 5% (I think), and take it from there. Marco isn’t going to change anything to do with the ear, but I am slightly appeased with the fact that the new socket’s ear won’t be so thick.

I leave his rooms feeling tired, even though its only an hour’s visit.

Weary. And concerned that maybe I have expected too much from Marlo’s Marvelous Mas.

Thursday 25 August 2005

8am phone call from Marco (doesn’t this man sleep?), and the new test socket is ready. I get a couple of things done around the office and contemplate cancelling today’s appointment. But that would be silly. So off I go again.

The new test socket looks clean and shiny. And the ear doesn’t look so bad either. The shape of the MAS socket is still a thing of wonder. So very different to my IC Socket.

And on she goes. Nope, not right. On she goes again.

I think, “something’s not right”.

I say, “it’s too comfortable”.

It’s not tight enough. The ear isn’t digging into me. The front lip doesn’t hurt. I take a few steps. Where the hell is that ear?? I cop a quick feel just to check. Yip, it’s there alright. But where….

No man, how can this be? I ask Marco to check if I am sitting in deep enough. He says it’s fine. I feel like I am waiting for Chicken Licken to run in screaming that the sky is falling. Or something.

This is almost perfect. This is good. This is, like, WAY good. This could be it. This could very well be IT!

I sit down to do the cross legged thing and I manage to get right down to the floor. Both legs flat. But I feel that the socket has moved, and when I get up the socket fit is not right again.

Marco helps me to don the socket once more, and he pulls me into the socket this time. I can feel that I go in deeper than before, and when I walk now, I can feel the ear, or is it the shelf. I feel something, but it doesn’t hurt. And it doesn’t dig up into me either. It’s just there. Barely.

Because Marco has made the top of the socket wider, it no longer feels like the MAS is hanging on to me like a rabid animal. I have a very graphic imagination, and that was the exact image that flashed through my mind when I pictured the socket (between the ear and the hip) latching onto my bum.

And I am absolutely ready to take this socket home today.

I stop off at the mall and buy myself a bottle of KWV. I think I shall make a few toasts tonight, and one of them shall be to Marco, and Marlo’s Marvelous Mas!

Post Script : It is now 9pm and I have done a good deal of sitting at my desk today. The ear is behaving and has lost its rock-like qualities. I can sit, I can plop, and best of all, I can slouch!

Go to MAS Diary - September

 

 

 

 

 


FAVOURITE LINKS :

 

Chronic Pain Chronic pain management by Dr Mitchell

Disability sport in South Africa DISSA

THE ANGRY GIMP Awesome must read site!

Marco Du Plooy My Pretoria based prosthetist

Sleeve Art by Fred's Legs

Employment Guidelines from SA Dept of Labour for PWD's & employers

Amputee Resource - Al Pike CP

MAS Socket - information

Fly SA - Paragliding

Jam Ally Entertainment - where Ally works

Eric Morse - Para-sport photographer & friend (Canada)