Re: Hip Disartic socket and Pregnancy
Christina Skoski M.D.
Description
Collection
Title:
Re: Hip Disartic socket and Pregnancy
Creator:
Christina Skoski M.D.
Date:
9/1/2005
Text:
>Does anyone have any experience of female hip disarticulation patients
>wearing their prosthesis through pregnancy? Any suggestions for modified
>socket designs would be much appreciated.
To Kevin et al.,
I apologize for responding directly to the oandp, but I wanted to make a
point. How many times must we re-invent the wheel? In the past, the only
information regarding rare topics such as 'high level female amputees and
pregnancy' were available only if they found their way into some obscure
journal which was rarely accessible to the next woman, physician or
prosthetist facing this unusual challenge. The last article published
about this topic that I've been able to find is : Modification for
Pregnancy of a Hip-Disarticulation Prosthesis by J.M. McFarlen,
C.P. which was published in the Orthopedic & Prosthetic Appliance
Journal, June 1963. Maybe you have a copy in your office...... if not, I
have a few yellowing copies in my possession, and would be happy to copy or
xerox and snail mail to anyone who might benefit, just contact me.....however
Shouldn't we be taking more advantage of the technology of the
Internet? Sites such as this and John Michael's corner, the Amputee
Coalition of America and my non profit site specifically dedicated to the
high level amputee www.hphdhelp.org exist to freely share information
which probably is too unusual or of little interest to get published in
most orthodox journals. I've researched this topic for a number of young
women, and the results can be found at
<URL Redacted> (helpful hints,
personal). Obviously, there is more information to be shared, so if you
develop something that works, PLEASE, take a picture or 2 of the socket,
and e mail your comments to me. I'll make sure it gets on my site at
least. Many more women HD/HP have delivered healthy babies than ever makes
it into the literature, I have a list of contacts, and perhaps your client
would be interested in speaking to others.
A few comments in general:
Just because it can be done, should it be done? Each 'Mother to be' is an
individual, as is her ability to walk and personal situation. Is she safer
in or out of the prosthetic? What is in her best interest? How much will
constant modifications cost in terms of time and money? What will really
suit her life style?
FYI, the top of the pregnant uterus is approximately at the level of the
umbilicus at the 5th month....2 finger breaths below the xiphoid at
term....how many changes are you and she willing to make?
The energy expenditure of walking with an HD prosthetic + cardiovascular
demands of a normal pregnancy may be the limiting factor. Many high level
amputees are a result of sarcoma, and have been treated with chemotherapy
in the past....some of these agents are known to cause cardiac myopathies
and renal impairment. Congestive heart failure is a serious potential
complication and something to be considered......is the patient being
followed up by a knowledgeable OB and/or oncologist? Even if chemo was not
a factor, it takes a lot of energy to walk in this situation, not to
mention comfort.
Renal and bladder considerations.....how many times do you want to take
your leg off each day to pee as the pregnant uterus places pressure on your
bladder?
The pelvis will probably not return to pre-pregnancy size and shape after
delivery (at least for first baby)....body shape will change. Does your
client recognize this and can she afford a new socket? Suspension over
the pelvis is critical for a HD amp. This has nothing to do with weight,
yet another issue. If she chooses to breast feed, she probably will need
to maintain a higher caloric intake and weight during this time....it may
be months before she is able to get back into her old leg.
Modifications to a HD socket during pregnancy are certainly doable, this a
mechanical problem and I have great faith in the prosthetic profession to
come up with many suggestions and solutions. I know it's been done,
however, what is learned should not stop here. As a female hemipelvectomy
amputee, and a practicing physician, I simply want to share what I've
experienced personally and learned from other amputees. It would have made
a difference in my life if only this information was more readily
accessible for me, my GYN and CP many years ago.
Sincerely yours,
Christina Skoski MD
www.hphdhelp.org
<Email Address Redacted>
>wearing their prosthesis through pregnancy? Any suggestions for modified
>socket designs would be much appreciated.
To Kevin et al.,
I apologize for responding directly to the oandp, but I wanted to make a
point. How many times must we re-invent the wheel? In the past, the only
information regarding rare topics such as 'high level female amputees and
pregnancy' were available only if they found their way into some obscure
journal which was rarely accessible to the next woman, physician or
prosthetist facing this unusual challenge. The last article published
about this topic that I've been able to find is : Modification for
Pregnancy of a Hip-Disarticulation Prosthesis by J.M. McFarlen,
C.P. which was published in the Orthopedic & Prosthetic Appliance
Journal, June 1963. Maybe you have a copy in your office...... if not, I
have a few yellowing copies in my possession, and would be happy to copy or
xerox and snail mail to anyone who might benefit, just contact me.....however
Shouldn't we be taking more advantage of the technology of the
Internet? Sites such as this and John Michael's corner, the Amputee
Coalition of America and my non profit site specifically dedicated to the
high level amputee www.hphdhelp.org exist to freely share information
which probably is too unusual or of little interest to get published in
most orthodox journals. I've researched this topic for a number of young
women, and the results can be found at
<URL Redacted> (helpful hints,
personal). Obviously, there is more information to be shared, so if you
develop something that works, PLEASE, take a picture or 2 of the socket,
and e mail your comments to me. I'll make sure it gets on my site at
least. Many more women HD/HP have delivered healthy babies than ever makes
it into the literature, I have a list of contacts, and perhaps your client
would be interested in speaking to others.
A few comments in general:
Just because it can be done, should it be done? Each 'Mother to be' is an
individual, as is her ability to walk and personal situation. Is she safer
in or out of the prosthetic? What is in her best interest? How much will
constant modifications cost in terms of time and money? What will really
suit her life style?
FYI, the top of the pregnant uterus is approximately at the level of the
umbilicus at the 5th month....2 finger breaths below the xiphoid at
term....how many changes are you and she willing to make?
The energy expenditure of walking with an HD prosthetic + cardiovascular
demands of a normal pregnancy may be the limiting factor. Many high level
amputees are a result of sarcoma, and have been treated with chemotherapy
in the past....some of these agents are known to cause cardiac myopathies
and renal impairment. Congestive heart failure is a serious potential
complication and something to be considered......is the patient being
followed up by a knowledgeable OB and/or oncologist? Even if chemo was not
a factor, it takes a lot of energy to walk in this situation, not to
mention comfort.
Renal and bladder considerations.....how many times do you want to take
your leg off each day to pee as the pregnant uterus places pressure on your
bladder?
The pelvis will probably not return to pre-pregnancy size and shape after
delivery (at least for first baby)....body shape will change. Does your
client recognize this and can she afford a new socket? Suspension over
the pelvis is critical for a HD amp. This has nothing to do with weight,
yet another issue. If she chooses to breast feed, she probably will need
to maintain a higher caloric intake and weight during this time....it may
be months before she is able to get back into her old leg.
Modifications to a HD socket during pregnancy are certainly doable, this a
mechanical problem and I have great faith in the prosthetic profession to
come up with many suggestions and solutions. I know it's been done,
however, what is learned should not stop here. As a female hemipelvectomy
amputee, and a practicing physician, I simply want to share what I've
experienced personally and learned from other amputees. It would have made
a difference in my life if only this information was more readily
accessible for me, my GYN and CP many years ago.
Sincerely yours,
Christina Skoski MD
www.hphdhelp.org
<Email Address Redacted>
Citation
Christina Skoski M.D., “Re: Hip Disartic socket and Pregnancy,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225410.
