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Higher Level Limb Loss

With higher levels of amputation, i.e. at or above the hip such as an arm amputation, there is major change to your body weight and balance and your posture needs ongoing attention to minimise back strain as the normal muscle and tendon attachments to the spine have been lost along one side. If part of your pelvis has been amputated (trans-pelvic or hemi-pelvectomy) along with your limb then both sitting and standing balance will be affected. In this case a pelvic leveller (small foam cushion) under the amputated side may make sitting more comfortable.

Following loss of limb, your rehabilitation process will be slow and gradual, working with both your Prosthetist and Physiotherapist. There are many new techniques to be incorporated into becoming mobile and strength and stamina must be built up gradually as up to 200% more energy is required to walk than for the average person.

You will face issues which do not affect lower level amputees and are quite personal, such as using the bathroom, underwear choice and pregnancy. There will often be a person in a similar situation with whom the department can put you in contact.

In brief, readymade cotton based garments are available from the prosthetic centre although some people will choose to continue with their own underwear. If the underwear extends above the socket edge, this helps protect the skin against chafing. For ease of using the bathroom, some people will prefer to remove their prosthesis first. If you are not wearing the prosthesis, crutches are a better option than hopping on your remaining leg as hopping causes additional stress on your remaining joints and foot.

In pregnancy, the socket can be modified a certain amount but it is not recommended to use a prosthesis to full term to avoid putting pressure on the baby.

The website http://www.hphdhelp.org/ was developed by a user – Christina Skoski MD and may be of further interest.

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