Q: Why do I need a prescription for the items I receive from Caldwell Prosthetics and Orthotics?
A: Caldwell Prosthetics and Orthotics is licensed by the State of Texas and as a licensed facility we are required to have a physician’s prescription for any devices that we provide. In addition, all insurance companies require prescriptions and Letters of Medical Necessity to establish grounds for payment.
Q: How much will my orthosis/prosthesis cost?
A: We cannot give estimates on the cost of a device without a practitioner seeing you first because of the varying additions many custom products require. After your initial evaluation we will be happy to review the costs of the various components of your orthosis/prosthesis with you.
Q: Will my orthosis/prosthesis be covered by my insurance?
A: As all insurance policies differ we cannot give you a definitive answer to this question without verifying your individual insurance policy. After your initial evaluation, insurance verification will be performed and you will be notified by our Insurance Specialist of your coverage benefits.
Medicare generally pays 80% of the cost with the exception of certain excluded items. In the event that you have been prescribed an item excluded by Medicare you will be informed of this prior to the delivery of the device.
Q: What is an orthosis?
A: An orthosis is an orthopedic brace or appliance that is used to improve the function of a body part or to reduce pain during normal daily activities.
Q: What is involved in the fabrication process for custom orthoses?
A: The fabrication of custom orthoses typically requires two visits to our office. During the initial visit we will make any measurements and/or castings that will be required for the specific orthosis you have been prescribed. We will also take a brief medical history at this time. During the second visit you will be fit with the device we have fabricated and any necessary adjustments will be made. You will also be educated on the use of your orthosis during this visit.
Orthoses typically take approximately two weeks to fabricate from initial appointment to delivery.
Q: What happens after the amputation? Are bionic limbs available that can make me just like I was before?
A: A prosthesis is not bionic. It is an artificial replacement for a missing limb or part of a limb. Although a prosthesis is never as natural as your own limb, it can help you to do many things quite effectively if you are willing to combine your energy and willpower into learning how to use it. The most important aspect of success is working with your doctor, prosthetist and therapist to address all of your concerns, and then to work with them on the processes of design, fitting and training, which are required to be a successful user.
Q: What does a prosthesis look like? How will it stay on?
A: Depending on the level of your amputation, physical ability and functional needs, each prosthesis will be somewhat different. If you desire a "cosmetic look," prosthetic supplements are available. But, for most standard prostheses, they are comprised of conventional component parts attached to a socket that fits over your residual limb.
Q: How does a prosthesis work? Will I be able to do all the things I did before I lost my limb?
A: The majority of people who lose a limb can get back to a normal mode of functioning within a few to several months, depending on the location of the amputation as well as physical ability. How well they function depends primarily on their goals along with timely, comfortable prosthetic fitting, good follow-up care, and a "can do" attitude from themselves as well as their medical team.
Q: What is the difference between a preparatory and definitive prosthesis?
A: A preparatory prosthesis is the first prosthesis that a new amputee will receive. It is the prosthesis that is used for physical therapy, gait training and is used until the residual limb has reached its final shape and size, typically for 3-6 months. It does not normally have a cosmetic cover.
A definitive prosthesis is the second leg a new amputee will receive or a replacement prosthesis for a mature amputee. If you are a new amputee, your physician or surgeon will usually determine when you are ready for your definitive prosthesis. This prosthesis should last for several years and will have a cosmetic covering. It is possible to modify or change componentry of this prosthesis as the functional ability of the patient increases.
Q: When will I get a prosthesis?
A: Generally, you should be ready for prosthetic measurements and fitting a few weeks after surgery, when the wound is healed and the tissue swelling is decreased. Then you will be ready for prosthetic measurements and fitting. This process can be easily attained with exercise and rehabilitation. During this stage, your medical team also will be concerned with maintaining proper shape of the residual limb, as well as increasing overall strength and function. Fitting is usually stress-free and involves several steps to create a unique prosthesis for you.
Q: What is involved in the fabrication process for prostheses?
A: The process for prosthetic fabrication is similar for new and mature amputees. It typically requires 3-4 visits to our office. As with orthoses, casting and measurement is completed during the initial visit. A test socket is then fabricated and the patient returns to the office for a test fit of the device. The test socket is used to create the final socket for the prosthesis so it is important to have a proper fit. It is often necessary to fabricate more than one test socket to achieve the most intimate fit. The final appointment will include the delivery of the prosthesis and education on the proper wear and use of the prosthesis.
Prostheses typically take between 2-4 weeks to fabricate from initial appointment to delivery depending upon the complexity of the case.
Q: What if the prosthesis doesn't fit right?
A: Follow-up is as important as the initial fitting. You will need to make several visits for adjustments with the prosthetist as well as training with a therapist. They can help you ease pressure areas, adjust alignment, work out any problems, and regain the skills you need to adapt to life after limb loss. Tell your prosthetist if the manufactured limb is uncomfortable, too loose or too tight. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you communicate with your prosthetist and therapist, the better you will be able to succeed with a prosthesis.
Q: How long will it last?
A: Depending on your age, activity level and growth, the prosthesis can last anywhere from several months to several years. In the early stages after limb loss, many changes occur in the residual limb that can lead to shrinking of the limb. This may require socket changes, the addition of liners, or even a different device. Later on, increased activity level and desire for additional function can necessitate a change in the prosthesis or its parts. Once you are comfortably adjusted and functioning at the desired level of activity, the prosthesis needs only minor repairs or maintenance and can last for an average of three years.
Q: Is it difficult learning to use a prosthesis?
A: Learning to use a prosthesis is a tough job. It takes time, great effort, strength, patience and perseverance. You will do best to work with a therapist while learning how to handle the new device. Much like learning how to operate a car, you will need guidance on how to:
Q: What can I do to prepare myself for a prosthesis?
A: There is a lot you can and must do to be able to use a prosthesis and use it well. The top priorities are:
Q: What type of shoes do I need to wear with my orthosis/prosthesis?
A: We typically recommend a sturdy, supportive, lace-up type shoe that will properly accommodate the device. It is important to note that badly worn shoes can have an adverse effect on the performance of your orthosis or prosthesis. If you are unsure if your shoes are appropriate for your device, please consult your practitioner.
Q: Will I need to use a wheelchair or crutches?
A: Some people elect not to use a prosthesis, relying exclusively on mobility devices. However, with a prosthesis, the use of crutches or a wheelchair depends on several factors including level of amputation, whether you have a single or bilateral amputation, and your respective level of balance and strength. Most amputees have a pair of crutches for times when the limb is off, including nighttime trips to the bathroom, showering, participating in certain sports, and to help if problems arise that may require leaving the prosthesis off for any length of time.
If you are a person who has lost both legs, you will probably use a wheelchair at least some of the time. Unilateral amputees may find it helpful to use a cane or crutches for balance and support in the early stages of walking or just to have a break from the prosthesis. This is an individual decision based on factors such as age, balance, strength and sense of security.
Q: Once I have been fitted and feel comfortable in its function, what will happen next?
A: Plan on making follow-up visits to your prosthetist a normal part of your life. Proper fit of the socket and good alignment will insure that the prosthesis is useful to you. Prostheses, like cars, need regular maintenance and repair to continue efficient functioning. Small adjustments can make a big difference.
Q: Can the limb break down?
A: Yes, things can happen that will require repair or replacement, so it's a good idea to know about warranties and what to expect from your prosthetist. Get small problems with your prosthesis taken care of promptly. There is no benefit to waiting until something falls apart or causes you serious skin breakdown. If you wear a prosthesis too long when it needs repairs or replacement, you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back and shoulders, will affect posture in addition to performance of the device and energy needed to use it. Early prevention is more valuable than long-term treatment.
Q: I need to have a strap/rivet/buckle replaced. Do I need an appointment?
A: We can often make minor repairs without an appointment; however, if your device requires further adjustment or major repairs you will need to schedule an appointment with a practitioner to ensure that all of your needs are appropriately met.
Q: Can I participate in sport/athletic activities with my orthosis?
A: Your orthosis should not prevent you from participation. If you have received bracing for a specific injury you should make sure that you have been cleared to participate by your physician.
Q: Can I take a shower with my prosthesis on?
A: Not unless it was designed specifically for swimming or bathing. Any contact with water can cause rusting and malfunction of the components of your prosthesis.
Q: How often do I need to replace my orthosis/prosthesis?
A: You can expect your orthosis/prosthesis to last for several years. However, if you have a change in your condition, such as weight loss/gain, worsening of condition, etc. you may require a replacement sooner. We recommend a yearly evaluation with your practitioner to evaluate the effectiveness of your orthosis/prosthesis and encourage you to call immediately if you notice a decrease in effectiveness, comfort or a change in the performance of your device.