The EMC prosthetic limb service provides artificial limbs to residents of Devon andSomerset. We are able to provide artificial arms, legs and digits.
The reasons you may require a prosthesis vary from:
congenital or limb absence
an amputation through trauma or electively
because of vascular or other disease processes which require amputation of the affected limb
There are two different reasons for wearing an artificial limb:
functional – mobility
cosmetic – limbs that look like a limb but have no functional ability
We can also make silicone digits for partial hands or to replace the function of balance in missing toes.
The different coverings on the prosthesis vary from a foam and stocking finish to silicone spray and high definition silicone limbs that are very life like.
For your first appointment you will need to be referred to the EMC by your GP or hospital consultant.
This is an opportunity for you and your family to gather as much information as possible so that you can make an informed decision about your future.
The consultant will talk to you about the amputation process from surgery to rehabilitation, including the healing process and how soon and at what stages we can start making your prosthesis. We can show you what an artificial limb looks like and if you want to meet an established limb wearer we can introduce you to someone of similar level, age and circumstance.
Will you need more visits?
We will see you often as is requested during the decision making process and/or once the surgery date has been set. Counsellors are available if you need added support or counselling.
A home assessment visit with an occupational therapist will be arranged for you before upi are discharged to identify if you need any additional support in your home.
You will have an first appointment to gather information to decide whether an artificial leg is suitable for you and what will need to be done to enable you to get back to leading as normal a life as possible.
You will be assessed to find out when would be the best time for you to have an artificial leg fitted and you can start physiotherapy.
Whilst you are in hospital you will given exercises to do by the physiotherapist.
You will have a first appointment to meet the team and assess your prosthetic needs. You may decide that an artificial arm or hand is not for you.
There are three different prosthetic limbs for arms:
Functional – there are different attachments that can be attached to the prosthetic for different functions
Myo-electric – this is a battery-powered hand that opens and closes on impulses picked up by electrodes placed over certain muscle groups. If you have one of these you will be provided with training on how to operate your hand.
Cosmetic – looks like a hand but does not move except by manual manipulation
A healthy person might heal within three to four weeks of their surgery. Within that time it might be possible to fit you with a ‘stump shrinker’ that helps remove any post-operative swelling left in the limb so that when we come to make the prosthesis your leg will not change shape too quickly.
You may have wear a "shrinker" for ten days to two weeks before we start making the limb. This involves either taking measurements of the affected limb or taking a plaster of paris cast of the limb in order to make the socket in which the limb will be enclosed and enable us to fit the prosthesis. We will also need to take measurements of the other leg to ascertain length and match up the calf size.
Eight to ten days after the ‘fitting appointment’ you can try on the limb in its ‘bare bones stage’ (without any coverings) in order to establish if it is the correct fit, to align the limb and ensure the right length. Following this appointment, providing everything is okay, the prosthesis goes back to the workshop to have the parts tightened and to be covered if required.
At this point the prosthesis is sent to you local physiotherapist or given to the yourself in order that you may begin ‘walking training’. This process can take from three to six months.
Measurements for an arm prosthesis are taken in a similar way and training is required to take the limb on and off and use it.
Physiotherapy involves assessing patients who have recently had an amputation. This will include checking your joint range of movement and muscle strength, balance, and functional capabilities such as transferring from bed to chair.
We can teach you exercises to maintain or increase your joint range of movement and strengthen your muscles and practise functional activities with you such as transfers and standing up. When the wound has healed sufficiently you can start walking using the parallel bars with an early walking aid such as the PPAM aid (pneumatic post amputation mobility).
When you have yuor prosthesis we teach you how to put it on correctly and you can start walking in the parallels bars progressing on to walking aids such as a walking frame, elbow crutches or walking sticks. You can practise walking up and down steps and slopes, over rough ground and kerbs and also how to get up from the ground in the event of a fall. Some patients are keen to get back into sports and we can advise them on how to do this.
If you are an established amputee changing to a new prosthesis with a different type of knee unit you can have some sessions of physio to practise with the new knee. Likewise if you have had some health problems or have lost confidence in your walking you can always return for a few sessions of walking training to improve.
Occupational therapists will discuss any difficulties you may have managing everyday activities and will provide you training if required. You may find it useful for us to visit you in your home in order to do this. If required we can help by referring youto other agencies eg. Social Services or re-ablement for help or equipment.
You may also require us to assist with difficulties you have in the workplace or at school. We can also help by providing information on how to access services or equipment not provided by the NHS or social services. This can include information on returning to driving and benefits.
The Counselling Service is open to anyone affected by limb absence or limb loss, it doesn’t have to be the person who has had the amputation. Anyone can make a referral to see the counsellor. The counsellor can be involved at all stages of surgical amputation and will visit patients on wards on request.
The counsellor provides the following service:
Information and support regarding the stages pre and post-amputation
Counselling is offered on a one-to-one basis or couple; either at the bedside or privately in the counselling room at the EMC or over the phone if the person is unable to travel.
Counsellor Tel: 01392 403654 (please leave a message on the answer machine).
The Prosthetic User Group is a links between users, carers, parents of children who use the service and the providers of the Exeter Mobility Centre Prosthetic Service. Members include representatives from across Devon and Somerset who have varying amputation levels along with parents of children who use the service.
The group allows members to express their views and opinions with members of staff on all aspects of the prosthetic service.