The Prosthetic Fitting Process
Our staff members have the experience, expertise, and compassionate understanding to provide the quality care and service our patients deserve.
The first step in the journey is being fit with a shrinker. A shrinker is a compression sock that controls swelling and shapes your residual limb as it heals. Shrinkers come in many different sizes based on the amputation level. A member of our staff will measure and fit you with the appropriate size once your surgeon gives us clearance to do so.
When your surgeon feels your limb is healed and ready to bear weight through a prosthetic device, they will give us clearance to begin the prosthetic evaluation and fitting process. Please keep in mind that healing times vary depending on a wide range of factors: level of amputation, skin integrity and comorbidities (i.e. diabetes, circulation issues, etc.). It is important not to rush this step as bearing weight too soon through your residual limb can lead to complications that will only further delay the prosthetic process.
After being cleared by your surgeon, you will be scheduled for an initial evaluation appointment. During this appointment, a practitioner will sit down and discuss your health history, lifestyle and goals to get an overall “snapshot” of you and your functional needs. Your prosthetist will also perform a functional test that asks you to perform a variety of tasks. The tasks help your practitioner indicate your current and potential level of mobility.
Information from the initial evaluation will be used to make a prosthetic recommendation. We will contact your insurance company with this recommendation to confirm coverage of prosthetic services and to determine any financial responsibility you may have. Prior to delivering the prosthesis, your responsibility must be met. We will discuss your financial obligations prior to starting the process.
Physical Medicine and Rehabilitation Physician Visit
In order to get your prosthesis, you will need to visit a Physical Medicine and Rehabilitation (PM&R) doctor. A PM&R doctor specializes in assessing and addressing the specific criteria necessary to qualify you for a prosthesis. During this appointment, the doctor will do a similar evaluation and some additional functional testing. If the physician agrees with our recommendation, they will fax us a detailed prescription so that we may proceed.
Once we have the documentation back from the PM&R doctor, we will initiate authorization with your insurance company, if required. Please note, it takes 2 weeks on average (and in some cases more) for insurance companies to reply with either an approval or denial for your prosthesis. Our office will communicate with you once we receive a response.
After the initial evaluation, we will schedule you for a scanning/casting appointment. A practitioner will either scan or cast your residual limb to capture an accurate shape so we may fabricate a prosthesis that fits specifically to you. Measurements will be taken of your limb as well to ensure accuracy of the scan or cast.
Diagnostic Socket Fittings
About 1 week after the scanning/casting appointment, you will be fit with your first diagnostic socket. This will be a clear, “mock” version of your prosthesis that will allow the prosthetist to see any areas of pressure you may have in the socket and make adjustments. Your prosthetist will have you walk on your components (like your prosthetic knee and/or foot) to align the prosthesis. Be sure to bring a matching pair of shoes so your prosthetist can dial in the height of the prosthesis. It typically takes several appointments and diagnostic sockets to obtain an optimal fit. If you would like to personalize your socket in any way, be sure to bring in the fabric or a t-shirt to the last diagnostic appointment. If you have any questions about personalization options, we have a helpful book that will show you some designs other patients have done.
Once everything is comfortable in the diagnostic socket, we will proceed to definitive fabrication. This takes approximately 1 week for the lab to complete. At your delivery appointment, your prosthetist will fine tune the fit and ensure that everything is comfortable and walking appropriately. Your prosthetist will provide you with an informational packet with use and care tips about your prosthesis.
Physical and/or Occupational Therapy
We strongly encourage our patients to get involved in a formal therapy program to help them learn to use their prosthesis and achieve their functional goals. It is easy to learn bad habits, but participating in a physical and/or occupational therapy program can help dramatically improve how you walk and function with a prosthesis. Ask your prosthetist for a list of local therapy clinics if you are unsure who to contact.
We will see you at regular intervals after you receive your prosthesis. We will continue to monitor the fit of your prosthesis and make any adjustments as necessary. If you have questions or if you are experiencing discomfort, you do not need to wait until your next scheduled appointment. Feel free to call the office any time to schedule an appointment for an adjustment.