Phase I – Pre-Operative/Surgery
Depending on the urgency of the situation, this is an opportunity to discuss various surgical levels, assess the overall physical condition of individual undergoing treatment, provide patient education (this website), discuss post-operative rehabilitation, and begin to formulate prosthetic plans.
Surgery considerations are residual limb length determination, muscle closure options, nerve handling and reconstruction, and surgical dressing type (soft, semi-rigid, or rigid).
What are my next steps?
- Meet with your surgeon
- Visit this section of our website/Meet your Green P&O practitioner
- Determine where you will be discharged to after surgery, either a skilled nursing facility (Green P&O has recommendations) or to your home
Phase II – Post-Operative
Activities include a focus on: wound healing, pain management, body motion analysis, residual limb shaping and shrinking, therapeutic exercising, increasing muscle strength, and regaining and restoring control sensations (Physical Therapy).
What will happen after surgery?
In 1-2 days:
- You will receive Shrinkers/Sheaths for your residual limb in the hospital from Green P&O
- You will be discharged from the Hospital to skilled nursing facility or home
Phase III – Goal Establishment, Post-Operative Assessment, Treatment Plan
Very early on in the process it is important to establish both short-term and long-term recovery goals that are reachable in a reasonable amount of time. With goals as the backdrop a comprehensive assessment of the patients needs is performed. This includes reviewing the prescription, patient history, demographic characteristics, diagnosis, allergies, and current medications. The examination will include such things as muscle testing, gait analysis, evaluation of sensory functions, range of motion and joint stability.
In 10-14 days:
- Green P&O will schedule your prosthetic consultation either at the skilled nursing facility or in
our offices to complete the above assessment
- You will have a follow up appointment with your surgeon for staple removal and to be cleared to
have your ‘new’ prosthesis started
- Green P&O will schedule a physician appointment for you to have necessary insurance
Phase IV – Build & Fit Initial Prosthesis
Perform the necessary procedures to fabricate and fit an initial prosthesis (called a Temp). Activities include: taking measurements, digitized scans, building a test socket, and and selecting appropriate materials and components. It is important to recognize that in many instances the device being assembled may not be the final device. Once the prosthesis has been fabricated the device is tested on the patient for alignment, comfort, and functionality. A series of adjustments and design modifications may occur during this phase.
When will my ‘new’ prosthesis be finished?
ASAP (after you are cleared by your surgeon):
- A Green P&O appointment will be scheduled for the ‘Casting’ of your temporary prosthesis
- In 2 weeks: A Green P&O appointment will be scheduled for the ‘Fitting’ of your prosthesis in our offices
- 1-2 weeks later: A Green P&O appointment will be scheduled for either a 2nd fitting or ‘Delivery’ of your temporary prosthesis
- After Delivery: Green P&O recheck and adjustment appointments will be scheduled, as needed, to ensure your best possible success
- After Delivery: You will schedule an ‘In-patient’ stay at a SNF for physical therapy (most successful option) or ‘Out-patient’ physical therapy (Green P&O recommendations)
Phase V – Finalize Prosthesis
Once optimum fit and functionality is achieved, the temporary prosthesis is either replaced or is converted to a permanent prosthesis. The patient or care provider is then educated on the overall device, provided maintenance instructions, wear schedules, and other necessary information to ensure a successful milestone is achieved.
In 3-6 months (once your residual limb stabilizes):
- Green P&O appointments will be scheduled similar to Phase IV steps 1-4 above.
PHASE VI – CONTINUOUS CARE-FOR-LIFE PROGRESS
Providing lifetime patient care and periodic evaluations to assure, maintain, and document optimal fit and function of the orthosis/prosthesis is essential. While much of the early focus is on wear schedules, comfort, proper usage, and functionality — this is also the time to ensure progress is being made on short and long term goals. During this time it is important to continue communications with the entire recovery team and where it’s appropriate adjust goals and expectations to be in a position to embrace life.