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Mas Socket Diaries - JANUARY 2006

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Saturday 14 January 2006

Oh boy.

Well, I am officially the size of a house. I gave up smoking on January 11th, and I have not stopped eating since. I have tried to walk the dog as some form of exercise, but she weighs 45 kg's, I weigh (probably) about 150 kg's, and she has NEVER walked on a lead before. She only pulled me over twice, so I think we did really well quite frankly (we are both newbies to the 'walkies' concept.). My son and my mother think that I am taking my life in my hands when I go out with Magnolia Mae. Eish, they must lighten up!

This is Maggie in October 2004 - she's a wee bit bigger now :)

Ok, enough waffling. The leg. Well. Let me see. I am not entirely happy with it and instead of just a steady flow of whinging in flowery language, let me try to put it as succinctly as possible.

Sometimes at the end of a day, the liner is leaving great welts and blisters at the top of my leg, where the liner ends. Sometimes it gets itchy after I take the leg off, and if I inadvertently scratch, well, the blisters become very inflamed and watery.

I feel like the ear is catching my skin and that i am not going in deep enough - just around the ear bit. Sometimes if I rub a bit of gel around the ear spot, then it doesn't pull there so much. I feel that this wouldn't happen if I were to pull my leg in with the kite, and not wear a liner. I'm not sure what to do about this. Maybe I will just have to continue using a gel-like substance to keep the ear lubricated so it doesn't irritate the skin.

I am not feeling completely stable in the leg. I don't know why. I think that if we made the prosthetic leg a bit shorter, I would feel better. (I can just see Marco shaking his head as he reads this - saying "No Ally - it's NOT too long!"). It's almost as if the prosthesis forces me to take the weight back quicker onto my good leg. It pushes me to do that.

I think the alignment is slightly out. I have discovered that the ear doesn't hurt as much if I don the leg with the ear really set towards the middle of my crotch area. But then, when I walk, the leg does a little flip thing (only Marco will know what I'm talking about). So it doesn't, like, swing STRAIGHT through to the front. If you know what I mean....

And that's about where I am at the moment. I have worn the leg all day. I went shopping, I went on a site inspection, I am sitting very comfortably. I am starting to feel a bit irritated at the top of the leg which I think is the liner..a bit itchy, but it's bearable - I'm not ready to take the leg off now. If I had to, I would be able to go out with this leg this evening.

Oh, silly me - Happy new year everyone :)

Sunday 21 January 2006

Well, I trust that by now everyone has 'met' Inspirational Ed (bi-lateral AK amp from Canada). He has written two articles for this site. If you haven't read them, do yourself a favour and go check them out. The following is a forum message sent to me from Ed about the hassles I had been having with this new Iceross liner.

Ed writes :

Ahhhhhhhhhhhh, Ally, Ally, Ally……………..

I commented a bit some where else about these liner things when you were ranting about getting one! As well, I tried to pass on a few tips then but your “blondeness” must have interfered.

I am not familiar with your previous system and others. I have seen some people greasing themselves up so that they can slide into their leg. Others I have witnessed “pulling” themselves (the stump Muz!) into a socket with a cord or something. I read about people in the old days whose socket was lacquered leather and they wore nothing but a woolen stump sock while the leg was held on by belts and other thingies.

But I do know liners and as a user of them in pairs, I believe I have run the gamut of problems and conditions to date.

When I was fresh cut, I started off in Iceross liners with a pin suspension. My arty guy used his skills to assess the sizes I needed and then proceeded to whack them to length with his scissors. They were great………….and then “the problems” began…………welts, blisters, blood lines at the edge, itching, rashes, strange pimples no human was designed to suffer through….and more.

The solution…………….time with use…………skin becoming tougher and “used” to being suffocated…………body systems realigning themselves for sweat, and on and on.

It is a process that is to be lived through and one must learn the ins and outs IF anybody can tell you.

I am now in Ossur Seal-in liners (the best for me as an aka so far - no rotation issues). However the material is still the same as before.

I would offer the following “things” that helped me make it through my journey to date:

• Remove the liner whenever you feel you’re swimming in your own sweat and dry the stump and liner.

• For the first while, strip and let your skin go back to normal for a while before re-donning the leg.

• Get used to the idea that, for the next time anyway, your stump may, may not, or will change in volume during use and that this will require the addition or removal of a sock layer so that your fit is maintained. Methinks yours has been living freely for a decade and now you want to compress it and pump it and sweat it and more. I am sure that it will go into some kind of shock at this abuse you are now demanding it to go through.

• Realize that now your stump is more like a piston encased in a big old plunger that is sucking and blowing enormous pressure within its silicone. This will give you some truly remarkable colours you have never seen before and can be quite scary.

• Your main problem will be welts created by internal heat, sweat and some friction. You must learn your tolerance before these turn to mega blister mode.

• Another area that creates havoc on a lot of people is where the top of the liner ends and your visible skin begins. This is an area susceptible to “skin shear” so you may find a line of small water blister forming or maybe a blood line. These mini blisters are the worst ‘cause they itch like hell, take forever to heal, will open again with use if not allowed to heal thoroughly and just generally suck. I tried everything from magic Emu oil to whatever. The best and ONLY solution I found to reduce, eliminate or whatever these things from hell is simply applying MINERAL OIL to the top inch of skin within the liner. This allows the suspension of the liner to still function 100% while eliminating the skin shear scenario.

I hope my comments help settle you down. New system………..may as well be a new amp!!!


Sunday 29 January 2006

I have been doing alright on the leg so far. Apart from the blistering at the top of the liner (which doesn't happen too frequently), I have been able to wear it for quite long periods before the ear starts to become too intrusive.

I wore the leg for about 15 hours yesterday, and everything seemed to go alright. I didn't do too much walking, but I managed to keep the prosthesis on ok. My leg started to hurt a bit right at the tip of my stump, but that was because the small piece of nylon liner that I use to stop the friction got itself a bit buckled and twisted down there. So I was quite relieved when it came time to take off the arty leg. I really was expecting to see more damage at the tip of my stump - it hurt like hell. But there was just a bit of redness and creasing in the skin.

BUT - I thought I had experienced blistering before. Hehehe, not on your life! Those little blisters that I got at the top of my leg were nothing - babies - tiny annoyances - a thing to be ignored and just to live with. Now, I am going to share with you my horror. If you have a queasy tummy - skip past the next pic. I was so surprised because I didn't feel this happening at all.

I swear - have you ever seen anything like this? And it developed over the 15 hours that I wore my leg and I had absolutely no warning that anything was amiss. I phoned Marco in a panic - bless him - he phoned me straight back. I have to let all the liquid come out, try to keep the skin intact, and let it dry itself out.

Trouble is, I have done that 3 times already and it just keeps on filling up. Ew, am I being too gross? Sorry guys - but this is exactly what is happening to me and I am at a complete loss. I never realised that amputees could get gigantic blisters like this. It's awful. I am going to see Marco on Tuesday. We have a big day planned, like from 8 in the morning until about 5pm and I am just hoping that this stupid blister doesn't throw a spanner in the works.

Tuesday 31 January 2006

Well, I think we had a good day today. I left home at 6.30am, got to Marco around 7.30am. Jeez, can't believe all the traffic at that time of the morning. What's wrong with these people? Don't they sleep?

We started off the day by remeasuring everything. Since I received the silicone liner (October 2005), we have measured twice, today would be the third time. I have definitely picked up weight, but the measurements are almost identical to the first ones in October. Marco realised the tremendous sacrifice I had made, putting on this extra weight after the expected stump shrinkage, to keep my limb in line with the original sizes, and to make his life a bit easier. :)

Marco reworked the shelf from scratch. We took the flat ear, with no shelf at all, and with some kind of silicone Marco managed to form the correct shelf shape, inch by inch, or rather millimetre by millimetre.

Next, Marco drilled 4 holes into the socket. Two at the bottom, and two near the top. We covered my leg (in the liner) with glad wrap. Then he squirted alginate (the stuff dentists use to get an impression of your teeth) into the holes he had drilled in the socket. The alginate filled up all the spaces and gaps between my limb and the socket. I had an especially big gap on the inside bottom of the socket.

Marco took the socket, filled it with plaster of paris, and had an EXACT mould of what my leg looks like when I am standing in the socket.

And then Marco made me a new test socket. I've lost count of how many Marco has had to make. I think he has too.

While the new socket was baking or drying or setting, or whatever it is that new test sockets do, Marco and I went to a hospital in Pretoria to visit a South African soldier who was blown up in Iraq at the end of December last year. I truely believe that if this is the price of freedom, then it is too high. The price these young men are paying cannot be justified, not now.

Back at Marco's rooms, we tried the new socket. Felt good people, must say, it felt good. The ear was behaving, the shelf was doing alright too. I was gently touching the bottom of the socket, but Marco said that I am supposed to do that.

The alignment feels good after very little tweaking. The leg is short (the way I like it and I hope Marco doesn't notice). I am standing almost 100% straight into the socket, something that we have been battling with right from the beginning. For the first time, the ear feels like it has found it's place, it's proper place, like the place it was made for. I can feel that the ear and the shelf are supporting me and are curving around my bones in all the right places. I think.

It's quite late by now though, and it's been a long day for us. I am feeling a bit tender around the ear spot, so I really can't say to Marco "it doesn't hurt now". I am tender from working through this all day. Also, the blister is giving me a bit of uphill. It is starting to rub a bit inside the socket and it feels sore.

You know, I really like the way a brand new test socket looks. It's so bright and shiny, almost like glass. Wouldn't it be nice if it could stay looking like that. But Marco whips it away into his work room to strengthen it (in other words to muck up the good looks with black stuff) and make sure that the knee is bonded to the socket (or something like that).

Finally, after almost 12 hours, the new socket is ready to come home with me. Now I realise that this is very unusual, for a patient to receive a test socket on the very day that the measurements/mould was taken, but see, this is what I don't get.... Why do some prosthetists make their patients wait for up to 3 and 4 weeks to get a test leg? That's just not cricket folks. They are either taking too many patients, or they aren't working 'smart' enough. Amputees are so desperate to get their new legs. Maybe Marco has spoiled me....or maybe he's just one of the better leg guys on the planet...

We do a final bit of fiddling with the alignment and I am ready to leave. Marco is sneaky hey, I tell you. "Just let me make it 2 millimetres longer, only 2, I promise".

Sigh. I leave with the leg about 5 millimetres longer.

And Marco is right, as usual. It does feel better.

Go to MAS Diary February 2006




Chronic Pain Chronic pain management by Dr Mitchell

To be or not to be by Kimberley Barreda

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

Co LeDahu - Personal Website

Jam Ally Entertainment - where Ally works

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