FAQ

Everyone reacts differently to the loss of a limb/s. Limb loss can leave you feeling anxious, vulnerable and uncertain about the future. Your body has experienced a significant change. It is important to remember that your ability to adapt to these changes will become easier over time.

It is completely normal to feel strong emotions. Some people grieve for their loss. You may be feeling scared, angry, frustrated and even sad. Working through your feelings may take time.

To assist you to evaluate the role TAS might play in your recovery we offer these responses to commonly asked questions about your condition and how TAS might assist with your recovery.

Can I get financial assistance for limbs?

Unfortunately, the Tasmanian Amputee Society is not able to provide funding for prosthetics, orthotics, componentry (liners, silicon spray etc) medical equipment, electric bills, rent, or other similar needs. 

However, your support needs may be funded under the NDIS, if you meet the eligibility criteria. Refer to:

 https://www.ndis.gov.au/about-us/operational-guidelines/access-ndis-table-contents/access-ndis-access-criteria

or phone NDIS on 1800 800 110.

 If you are aged over 65 go to

 (https://agedcare.health.gov.au/aged-care-funding).

If you are over 65 you are eligible for the Tasmanian Limb Replacement Scheme. If your amputation was due to trauma, such as a motor vehicle or workplace accident, and compensation is identified as a possibility, your insurance company will fund your prosthesis and medical care as part of your rehabilitation needs.

Veterans who either lost their limb as a result of injuries received while serving, or who have a Gold Card, will have their prosthesis paid for by the Department of Veterans Affairs or the Department of Defence.   Most Private Health Insurance companies do not allocate funding for a prosthetic; however, you should contact your Private Health Insurance provider for further details.

How can The Tasmanian Amputee Society help me?
  • We can offer Peer Support
  • Provide you with access to free and up to date information
  • Help you meet other amputees and share experiences
  • We can help you navigate the NDIS and other complex support systems
  • TAS will support you and your family as you move forward through the recovery stage of your journey

People that are facing, or have faced, an amputation can experience a variety of emotions. Common, are depression, anxiety, anger, grief and the general feeling that life is going to be very gloomy. We can help your recovery to a normal fulfilled life.

How do I prepare for the NDIS?

Navigating the NDIS can be a very complex and frustrating experience. You need to be prepared before you apply to transition into the scheme. You are eligible for the National Disability Insurance Scheme (NDIS) if you are:

  • under 65 years of age
  • Are an Australian citizen or resident or permanent visa holder
  • Meet the disability or early intervention requirements. People who have leg or arm amputees are mostly likely to meet the criteria of having a permanent and ongoing disability.

To check your eligibility:

  • contact the NDIS:

https.www.ndis.gov.au

or phone 1800 800 110

  • You will be asked if you want to apply for NDIS
  • You will be asked a series of questions
  • NDIS will send you out the relevant forms
  • You have 28 days to return the forms to NDIS
  • This can be done electronically or be dropped into the local NDIS office
  • NDIS will send a form called “Access Request Supporting Evidence” form
  • This needs to be filled out by your Prosthetist who will confirm your primary disability, the impact it has on your life and treatment provided if relevant
  • As you obtain this form, you should also ask for a letter that outlines the products you use and how the overall management of your prosthesis is maintained
  • This is called “Continuation of service” and is necessary, as without this process you may receive less than you need to maintain your lifestyle
  • Once your prosthetist has completed the forms send them back to NDIS
  • In about 21 days you should be advised that you are now an NDIS participant
  • If you have not already received an NDIS number, you will be allocated one
  • This number allows you to access the services you need
  • You will need to use it when working with providers and the NDIS
  • Keep it in a safe place
  • The next step is to be allocated a Local Area Coordinator (LAC) or NDIS planner
  • Your planner will build your plan and include the funding you need
  • The goals you choose are critical to your plan
  • Setting goals provides a clear pathway for you over the length of your plan
  • The NDIS prefer people to use the SMART principle when setting goals (Specific, Measurable, Achievable, Resourced or Realistic and Time-sensitive).
  • Specific: something that is directly related to what you need and makes clear what needs to be achieved.
  • Measurable: describes what you need to do to achieve this goal
  • Achievable: something that is realistic, relative to how much time there is and what resources are available to help you achieve your goal
  • Resourced and Realistic: the goal must be important to you and something that is of benefit to you, your family, and your health
  • Time-sensitive: set a date or target to achieve your goal
  • The NDIS normally asks for two short term and one medium term goal
  • Short-term goals; these goals include the things that you may achieve in a short space of time. For example, when you first get your prosthesis it’s having the ability to stand up for short periods of time, and/or managing to walk the length of the parallel bars a specified number of times.
  • Medium-term goals; these goals include the things that may take a little longer to achieve. For example, having the ability to walk the length of a corridor and back again with a walking aid, or getting used to walking around safe areas of your house (like the kitchen) without a walking aid

Having a goal stating a particular prosthetic item or componentry.

What is an artificial limb/prosthesis?

Prosthetic Legs

There are two types of leg amputation – above-knee and below-knee. A well-fitting and well-used below-knee leg can give you a normal gait and no-one but experts – may realise that you have an artificial leg. There is a wide range of feet, ankles available. You need to talk to your prosthetist to find which componentry best suits your situation. There are also a range of liners, including urethane and silicone liners with differing levels of cushioning and these can be used for above knee and below knee amputee

 Above knee

An above-knee artificial leg will take longer to learn to use, because you need more balance. It will also require more concentration to walk with and could be a little more tiring. The range of knees available is extensive, from a simple lock knee for walking which unlocks when you sit to a safety knee so that if you stumble the knee will lock with weight bearing. There are also a wide range of pneumatic and hydraulic knees. The prosthetist will discuss the options for your particular amputation and daily needs

Because a prosthesis is exactly that – an artificial limb – it will never be comfortable all the time. You may from time to time that you have minor irritations, blisters and chafing from your limb. You will also feel a different kind of balance. Your prosthetist, with your help, as they have made sure your limb is as well-fitting and comfortable as it can be, you will learn to cope with these minor difficulties and discomforts.

 

Hints for Leg Amputees

Climbing Stairs and Walking Down Hill

When you have to climb stairs and get into buses etc., always remember to use your good foot first.  When you go downstairs or get off the bus, lead with your artificial foot.  On escalators, step on and off with your good foot.  When you are cycling, put your artificial foot on the pedal first and get off the bike with your sound foot

Walking down a steep hill feels safer going step-by-step sideways, especially when you wear a basic Sach foot and your own foot is smaller than average. Below-knee amputees put the artificial leg down first and keep abnormal pressure off the tender distal end of the tibia by going sideways.

Before you decide to try step-over-step downstairs with feet facing forwards, be sure the grab rail is at your prosthetic side and your handbag or anything you are carrying is on your non-prosthetic side.

Reaching Goals

Set a small goal not only for a day but for a week so that you give yourself a chance to reach or over-reach your limits.  In early days, you might feel safe only walking around the house but checking the mailbox extends your limit before tackling the street or stepping down and up a kerb.

Picking Up

Picking things up off the floor demands a different balancing strategy.  It isn’t always possible to bend your knees keeping a straight back, so take a wide step sideways and bend from the waist.

 Clothing

You may find it easier to dress your artificial leg in underpants, trousers and shoe, before inserting your residual limb, then to dress your good leg. Some amputees have a zipper inserted in the inside seam of their trousers on their artificial leg – this makes dressing much easier. When you buy socks, buy two or three identical pairs. Put one sock on your artificial foot and leave it there all the time. If your artificial leg causes wear on your trousers, protect them with extra lining or a patch on the trouble spot

 Solutions to a feminine problem – Women often find that an artificial leg tends to shine through pantyhose or that the foam cover is too pale. In winter, you can wear thick textured or ribbed pantyhose. A ‘knee high’ stocking on the artificial leg, worn under pantyhose and giving a double thickness, is also good. The under hose supplied with your prosthesis by your service provider are long-wearing and quite a natural colour under pantyhose, the colour of which can be adjusted to reflect a tan

 Training

A fun way to practice ‘normal’ walking is to push or kick a ball with your own leg while standing on your artificial leg beside a supporting chair.  You roll a tennis ball under your good leg while standing on your prosthetic limb also holding onto support. As you build strength and improve your balance you may need a support to steady you.

When standing, you may feel it more comfortable to stand with your artificial foot slightly behind your sound foot.  This gives you a relaxed stability and, if you are an above-knee amputee, lets you take more than half of your body weight on the prosthesis.

Artificial Arms

Artificial arms are so far more complicated than artificial legs, they take more training, practice and perseverance to learn to use. But the results are worth it. The split hook type of artificial arm can perform two actions – gripping and steadying. It is operated by cables attached to a shoulder harness. A below-elbow amputee opens and closes the hook by moving the upper arm. An above-elbow amputee operates the hook by moving the opposite shoulder. This needs quite a bit of practice and concentration, but after a while, these arm and shoulder movements become second nature.

What is phantom pain?

After the operation, you will certainly feel that your amputated arm or leg is still there. This is called a phantom limb.  For some amputees, their phantom leg is so real that they try to stand on it. This usually happens once only! The sensation of a phantom limb is natural and nothing at all to worry about. In fact, it is considered a sign that the wound is doing well. After the limb has been amputated, you may experience inconsistent sensations such as tightness, burning, numbness, coldness or certainty that part or all of your limb is still there. For example, you may be sure you can wriggle your toes or fingers. Sometimes these sensations will disappear and for others they will come and go, usually without any warning. The experience differs from amputee to amputee.

Relief from Pain

For the first few days after the operation, your phantom limb will be painful. In time, phantom sensations and pain becomes less intense and less frequent. If you are tired, upset or run down, or the weather is bad, or your prosthesis is ill-fitting, the phantom limb may annoy you. So, it is a good idea to keep active and make sure that your limb is well-fitting.

Some amputees experience varying degrees of pain, for which you should seek medical advice. Some may find relief from painkillers.

The following suggestions may also help:

  • Wrap your residual limb in a warm, soft fabric, such as a towel. The warmth will sometimes increase circulation. Poor circulation is thought to be one cause of phantom pain.
  • Mentally exercise the limb that is not there in the area that is painful.
  • Mentally relax the missing limb and its residual portion.
  • Do some mild overall exercise to increase circulation.
  • Exercise the residual limb.
  • Tighten muscles in the residual limb, then release them slowly.
  • Put Gladwrap or a shrinker sock on. If you have your prosthesis, put it on and take a short walk.
  • If you have pain with the prosthesis on, take it and the prosthetic sock off and put them back on after a few minutes. Sometimes the residual limb is being pinched and changing the way it is on will relieve the pressure on that nerve.
  • Change positions. If you are sitting, move around in your char, or stand up to let the blood get down into your residual limb.
  • Soak in a warm bath or use a shower massage or spa pool on your residual limb. A hot tub is reported to do wonders.
  • Massage your residual limb with your hands or better yet, have someone else massage it while you try to relax your entire body.
  • Keep a diary of when pain is most severe. This can help you and your doctor identify recurring causes.
  • Wrap the residual limb in a heating pad.
  • Tap the end of your residual limb with your fingers.
  • Some people find help through self-hypnosis, biofeedback and chiropractic. If you have not found relief through any home remedies and the pain is not being controlled through normal medication, a pain centre should be considered
What do I do if I need to repair or make an adjustment to my prosthesis?

When your prosthetic limb is in need of repair, you should contact your prosthetist immediately. No small repair should be left until such time as a major repair becomes necessary. If you are an NDIS participant and do not have repairs funded in your plan you may need to contact the NDIS to request a review to add repairs to your plan. You may need to obtain a quote as evidence that your prosthesis needs repairs.  Adjustments to the socket of your limb will be required from time to time, particularly if your weight has a tendency to fluctuate. If it becomes uncomfortable, you should make an early appointment to see your prosthetist. If you away from home, you should be able to have repairs that need to be made at a service provider close to where you are.

How long before I can start using and walking on prosthetic limb?

After your operation, your residual limb will be swollen, and very sensitive. your wound needs time to heal. You will go through a therapeutic process before your Allied Health professionals indicate you are ready to have a new prosthetic limb fitted. This will vary from person to person. The timing depends on how quickly your residual limb fully heals from the surgery. Some individuals receive a temporary prosthesis immediately following amputation or within two to three weeks after surgery. Generally speaking, a prosthetic fitting begins two to six months after surgery.

Can you shower or bath with my prosthetic leg on?
If you do not have wet leg (recreational leg) that is designed to allow use at a pool or beach in wet situations, the answer is no. Many components in a prosthetic leg are sensitive to moisture. Therefore, most amputees take their legs off when showering. It is not good for them to get wet but also because it is extremely important to keep stumps clean.
Can you sleep with a prosthetic leg?
An amputee with an above knee or below amputation should never sleep with their prosthesis on.
Can you drive a car with a prosthetic leg?
Some individuals can drive normally with their leg or foot prosthetic device, and thus require no special vehicle modifications. A left foot pedal or hand control modification for acceleration may be required so the driver can have adequate control of the vehicle. You may need to have a specialist Occupational Therapist determine if you are able drive safely and what modification you need for your vehicle. In Tasmania there are specialists who can modify your vehicle to suit your needs. The ability to drive following an amputation, is assessed by an Occupational Therapist. You should make contact with your local State Vehicle Registration and licensing centre. In Tasmania this is the Department of State Growth Transport. In many cases, only vehicles with an automatic transmission may be operated by amputees.
Can I return to work with my prosthesis?
Depending on your occupation, you can return to work with your prosthesis. If your work involves extreme physical strain, you should let your prosthetist know before the prosthesis is fabricated since the type of stress affects the characteristics of the socket and the selection of components.
When will I need a new prosthesis?
There is no standard answer to this question. If the socket of your prosthesis fits well over the long term and no difficulties arise, you may not need a new prosthesis. Though most components of prosthetic limbs should be replaced within 3 years to ensure safety and for the integrity of the prosthetic limb. The life of a prosthesis varies depending on the activity of the individual and type of prosthetic limb.
How much does a prosthetic leg cost?
The price of a new prosthetic leg can cost anywhere from $5,000 to $80,000 [Or more] but even the most expensive prosthetic limbs are built to withstand only three to five years of wear and tear. All will ultimately need to be replaced over the course of a lifetime. They are not a one-time cost.
What are the steps to recovery after an amputation?

Step 1 – After Surgery – amputation does not stop people from living active and healthy lives. While the recovery and the prosthetic process is unique to each individual, there are many residual limb care routines that apply to most amputees. Your recovery team will establish the correct process for you

 Step 2. After surgery you need to take care of your wound as it heals. With assistance from your physiotherapist. Learn to stretch and strengthen your muscles. Learn to transfer safely from your bed to either wheelchair or walking aides. Build your capacity around managing your daily living skills

 Step 3. Preparing to use your prosthetic limb. This step will not go ahead until your wound has healed sufficiently to bear weight

 Step 4. When you have your new prosthetic limb your need to continue to take care of your wound. Continue to exercise using the program your physiotherapist has developed. Move safely to avoid falls until you gained greater confidence and stability with your new prosthetic limb. Use your shrinker sock until your limb is no longer swollen

Step 5. Your residual limb will continue to shrink. This occurs as you are no longer using muscles to the same degree. After about 6-8 months your residual limb should have reached a stable shape. Prior to this stage you will have been fitted with temporary prosthetic limb as a precursor to your definitive prosthesis. Your prosthetist will advise you when you are ready for this. When you are provided with your new prosthesis you will learn how to walk, care for your stump and clean your prosthesis. Over time you will be able to increase the length of time you can wear your prosthesis

Step 6. Rehabilitation.  New prosthetic users will undergo a rehabilitation process administered by a team of professionals. Your physician, prosthetist, physical, occupational therapist and others cooperate to help increase your mobility and independence. It will important to remain active to build your stamina. Your prosthetist will play a key role for as long as you wear your prosthesis. Physical therapy will help you to learn to use your prosthesis. Learning to walk on different surfaces will be an ongoing challenge

How do I care for my stump?

You should wash your stump daily with warm soapy water, rinse and dry well. Change stump sock and liner regularly. You should wash and dry your liners after use. Dry your skin before putting on your prosthesis. Always avoid putting on wet or damp socks or liners. If you notice any changes to the skin on your stump you should seek advice. You should check the end of your stump using a mirror. Don’t forget to look after your good foot. Check for any changes.

Can I do recreational activities such as boating, fishing and swimming?

Yes. Having a prosthesis is all about living an ordinary life. As the componentry that make up your prosthesis can deteriorate dramatically with moister or water you should ask your prosthetist about supplying you with a recreational prosthesis known as “Wet leg”. These prosthesis are designed to be used in water.

What does term ‘residual limb’ mean?

Residual limb is the correct term to use, as opposed to “stump”.  Most amputees use both interchangeably, but ‘residual limb’ may be less confronting. Although we do reference “stump socks”.

Can I get a cover for my prosthesis that looks and feels like real skin?

Yes, several firms make them. You need to speak to your provider.

Are there many chances to interact with other amputees?

Yes there is a bi yearly conference organised by “Limbs4Life”. Manufacturers like Ottobock and Ossur have mobility days and conduct study days as well. There are regular golf and sporting tournaments and a broader range of organised recreational activities are becoming more popular.By joining the TAS as a member you will receive constant updates as to the activities organised around the state for amputees.