Wendy Jensen, PT
“The first time I meet a pre-prosthetic amputee, I tell them ‘You are not going to be very happy with me, but you will be happy when you come back for prosthetic training.’” said Wendy Jensen, PT, who has worked with people recovering from amputation for many years at Bacharach.
She tells them, “I will be very strict with you about doing your exercises and your stretches here. And then you will go home and do them. If you do them faithfully, you will be very happy. If you don’t do the exercises at home, when you come back in for prosthetic training, I will know.”
Ideal Amputee Rehabilitation Program Has Two Phases
Wendy says the ideal rehabilitation program for people after amputation, whether above or below the knee, is a 2-step inpatient process. The first inpatient stay sets the foundation for their health going forward.
“We work on range of motion and strengthening. We start with wheelchair mobility and transferring so that the patient can go home safely for 6 to 8 weeks while the incision heals.”
“While the patient is home, I expect them to maintain the exercises and maintain the range of motion.”
“When they return for the second inpatient stay, that phase is for prosthetic training. It is a whole new level of intensity once the wound has healed and the prosthetic training can begin.”
“During this stay, they learn to don and doff (put on and remove) the prosthetic limb and to manage the sock. It is a process of fine-tuning. You have to slowly increase the wearing time – wearing the prosthesis for one hour, then taking it off and looking at the skin for redness or breakdown. Then, you wear it for 2 hours, with an hour off, and build up to a full day in about 1- to 14 days.”
Wendy works with the patient on being able to manage the sock and silicone sleeve. “I tell my patients it’s like wearing a corset. We are shaping the limb and if there is extra space, we add a sock to get the proper fit. The patient has to learn to manage this, because when they go home, it might be a little loose one day, or they could swell in the heat and need to remove a sock.”
Progression to Outpatient Therapy
Generally, when patients leave after the second inpatient stay, they leave using a rolling walker. Then they would transition to outpatient therapy for more gait training and to walk more independently utilizing a cane, and then potentially to progress to ambulation without an assistive device.
“I tell my patients life is a journey. You have a right to mourn the loss of the limb. Now we have to move forward. It’s a new you, but your life didn’t stop. Maybe it is a better adventure or a new bond with a spouse or a child. No matter what, it is always my privilege to be a part of their story.”