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Veteran amputees that have received care from MCOP in the past at Walter Reed Military Hospital or the Veteran Administration can access your preferred clinician through one of MCOP's clinics. Click here to learn how to access your benefits and plan your visit. Learn More

How to prepare for upper limb amputation

 If you or a loved one is receiving an upper limb amputation, our team of expert prosthetists are here for you. If you reach out to one of us, you can rest assured that we’ll be available to support you, answer your questions, and make sure you get the best care possible. Part of that commitment is making sure you’re prepared for the process, which starts with understanding what the whole experience will be like. Below are some of the different ways your MCOP team will help you move forward with the best arm or hand prosthetic for your life. 

1. Pre-Amputation Consultation

During the pre-amputation consultation we will meet with you to discuss your activities of daily living, your work, your goals, etc. We do this to determine the best prosthetic approach for you from an understanding of your current lifestyle and what your goals are. We’ll also discuss what it’s like living with an upper extremity prosthetic and the types of prosthetic devices that you may be interested in.

To determine the right device for you, we will meet with you to understand your vocation, recreational activities, and other items to determine what type of prosthesis will be most appropriate to your life. We’ll discuss available technologies, the benefits and weaknesses of different products, and what is the right match for your needs.

2. Post-Amputation Assessment

After the procedure, we will schedule an initial clinical assessment where we will review your residual limb, your prosthetic needs, and your insurance options to determine your individual best path forward.

3. Prosthetic Selection & Fitting

We can begin prosthetic services as quickly as 2 weeks from surgery, depending on the length of the recovery. In some cases, an immediate or early post-operative prosthetic may be most appropriate. Ideally, you should try to begin using the prosthesis within 30 days of surgery, which allows you to more quickly adapt to using the device.

4. Obtaining Insurance Coverage

Once we’ve agreed on a direction, we’ll help navigate the pathways to obtain insurance coverage for your device. If you have a work-related injury, we will work with your workmen’s compensation case manager to obtain the best device for your needs. We may determine that multiple devices are required to allow full function based on your goals. Whether you have private or government insurance, VA, Tricare, or Medicare/Medicaid, most insurance companies offer multiple options for upper extremity prosthetics.

Following this decision, our prosthetic insurance experts will work to obtain pre-authorization from your insurance regarding the products that are best suited for your lifestyle. We will also check your benefits to make sure that there are no exclusions in your insurance policy.

5. Initial Fitting of Your Prosthetic

Once the pre-authorization has been obtained, we’ll order components and have you in for an impression. For a partial hand restoration, we use silicone. For higher level amputations, we opt for a plaster impression. At MCOP, we prefer plaster and physical molds over digital/3D imaging because it allows us to feel and plan for the prosthetic need – sometimese there are differing densities, bony prominences, neuromas, and more, and we find that plaster allows us to create the most comfortable, best fitting socket to meet your needs.

We then create a test or “check” socket for you try to test comfort and range of motion. For myoelectric prostheses, we’ll also evaluate the EMG (electro myograph) sites at this stage to test the strength and intensity of the signal. We’ll also create a diagnostic setup of the final prosthesis to determine length, alignment, and more. This is important because once the socket is weighted with the device, you may notice a change of fit.

6. Final Fitting of Your Prosthetic

Once we have a diagnostic set-up that is just right, we’ll fabricate a definitive, laminated carbon fiber prosthesis. At this stage, we will program the upper limb prosthesis to tune the functionality to your needs. We will perform some initial prosthetic training and work with your occupational therapist who will support your long-term training and rehab.

7. Follow-Up and Support

After the first fitting, we’ll schedule a follow-up for 1-2 weeks after. Once you’ve worn the prosthetic for some time, there may be some muscle or limb volume changes, and this meeting is a chance to assess those and discuss your comfort and use of the prosthetic. Additionally, most arm prosthetics require some level of maintenance which we will conduct. After the initial follow-up, we will typically meet every 3-6 months for routine maintenance and follow-up.

 

It’s never too soon to start preparing for an upper limb amputation, even if that means just talking to one of our licensed prosthetists

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