What to Expect
Whether you are a new amputee, an established patient, or a current prosthetic user seeking a new provider, we look forward to helping you achieve your goals. We believe the best way to do this is by working closely with you, your physician, and anyone else who is a part of your health care team. Read below to gain an understanding of our process for creating a new prosthetic, as well as some Frequently Asked Questions (FAQ's).
Post-Operative Follow-up Appointment
In some cases, we will first meet patients at the hospital. In other cases, our first meeting with a new patient will occur at their follow up visit at the surgeon’s office. When possible, a practitioner and patient advocate will meet you at the surgeon’s office for your post-op appointment. If the physician decides that the suture line has healed completely, then your staples will be removed. After staples are removed a prosthetic shrinker will be fit for below the knee amputees and measurements for a gel liner will be taken for above the knee amputees. You will receive two shrinkers, which should be cleaned and switched out daily. At this appointment, you will be given the appropriate new patient paperwork and your insurance cards will be copied for verification of insurance benefits.
When the physician releases you to start the prosthetic fitting process, you will have an initial evaluation at our office.
Initial Evaluation at Choice Orthotics and Prosthetics
Once the patient advocate has received your referral and verified all your information, she will call you to make your first appointment. At this appointment, you will complete the appropriate new patient paperwork for verification of insurance benefits.
You will bring in a prescription from your referring physician for shrinkers and/or a prosthetic fitting. The prosthetist will complete an initial evaluation to review your needs. Unless this step has already been completed, prosthetic shrinkers will be fit for below the knee amputees and measurements for a gel liner will be taken for above the knee amputees. You will receive two shrinkers, which should be cleaned and switched out daily.
- New patient paperwork must be received, filled out completed and signed.
- We must have a prescription from the physician
- We need copies of insurance cards and driver’s license or photo id.
Once all the above is received, your insurance benefits will be verified to determine the following:
- The coverage by your plan for a prosthetic
- Whether an authorization is required
- What patient financial responsibility amount will be due
Measurements and Casting
After your insurance benefits have been verified, you will receive a phone call from our Business Manager, Jennifer Monroe, to make payment arrangements. We call you to discuss your Financial Responsibility before we proceed with the test socket because we do not want patients to experience any surprises in the billing process. Once the financial agreement is made, a Letter of Medical Necessity and request for medical records will be sent to your physician who prescribed your prosthetic. We cannot move forward with making your test socket until this has been received back in our office, due to insurance requirements. Next, if a Pre-Authorization is required by your insurance, the paperwork will be submitted to request this. The insurance company may take 2-20 days to approve the pre-authorization.
Once we have a financial agreement, all documents signed by your PCP, and an authorization from insurance (if required), You will receive a phone call to schedule you to come into our office for measurements and to take an impression (cast) of your residual limb for the prosthesis.
Fitting of Diagnostic or Test Socket
Approximately two weeks after the measurement and impression appointment, you will be contacted to schedule an appointment for fitting of the test socket. The test socket will be attached to the prosthetic foot or knee. If everything fits properly, you will walk in the parallel bars for initial gait training and dynamic alignment of the prosthesis. A follow-up appointment will be scheduled for two weeks out at the end of the visit. This is not your final socket and should not be worn for more than two weeks.
You will have follow-up visits as needed for any necessary adjustments of the socket fit or prosthetic alignment. There is never a charge for any adjustment appointments. If the test socket fit is comfortable and fits well after several weeks of wear, we will proceed with fabrication of the definitive or final socket. You should contact us immediately if you experience any problems such as sore spots, rubbing or if there is pain when wearing your prosthetic.
Fitting of Definitive/Final Socket
You will be called to schedule an appointment for fitting of the final socket about two weeks after your prior follow-up appointment. All appropriate adjustments will be made to the prosthesis to be sure you are walking well and the fit is comfortable. After fitting of the final socket, a six-month follow-up appointment will be scheduled. You should contact us immediately if you experience any problems such as sore spots, rubbing or if there is pain when wearing your prosthetic. These issues can lead to serious conditions and coming in to see your prosthetist immediately will reduce the risk.
FAQ’s for Prosthetic Patients
Losing a limb and wearing a prosthesis is a unique experience and one which can often leave you scrambling to find answers to some of the most basic questions. Below are some common questions and the answers we hope you’ll find helpful as you or your loved ones dive into this new chapter of life.
Have a question you don’t see here? Ask your prosthetist! Send us a message and one of our licensed and certified prosthetists will get back to you with an answer. You might even see your question added to the FAQ above!
Jennifer BrewerJennifer Brewer was born without a fibula in her left leg. When she was 7 months old her parents had to make a tough decision, and her leg was amputated below the knee. This was just the beginning of Jennifer’s journey as an amputee.
As a toddler, she learned to crawl and walk with the aid of a prosthetic leg. For the many years that followed, Jennifer remembers receiving two to three new prosthetics a year due to growth and being an active child. She has her mother and father to thank for the many trips back and forth to the doctor for fitting and adjustments of her prosthetics. Jennifer’s parents were a strong force continually encouraging her to do more and push her limits with her prosthetic leg.
When Jennifer was three, her family made the decision to move from Indiana to Tennessee where she would continue to grow up as an amputee. Grade school and high school were tough times for Jennifer as children can be very cruel to those who are different from them. She was called names, treated as an outcast, and told she could not do the same things as other kids due to her having a prosthetic leg. She never let this taunting stop her. Growing up with an older sister and younger brother gave her opportunities to be treated just like any other kid by doing all the things they did. She rode her bike, climbed trees with her brother, and every summer her family and friends would go tubing together down the river rapids. Jennifer never let anything stop her. If someone told her she could not do something because of her prosthetic she would push herself to do more. She would make a point to show them she was as capable as anyone else, despite her prosthetic leg.
At age twelve, Jennifer and her prosthetist experimented with different models of prosthetics. Jennifer was finally able to wear flip flops or high heels just like everyone else her age. Not being restricted to flat, closed-toe shoes was very important to Jennifer, and removing this restriction allowed her to tap into more confidence with her prosthetic leg. This encouraged her to try to motivate others.
It was not until Jennifer was in her teenage years that she began to realize her courage and perseverance were making an impression on others. One instance stands out in her mind when she made an impression on someone who was not an amputee but was dealing with their own battles of confidence and insecurity. Jennifer told them that if she can do something with one leg, then they can do it with two! At that moment, Jennifer realized many people, both young and old, are not as informed about prosthetics as she would like for them to be. Many people have never even been around someone with a prosthetic limb. This realization allowed her to have a better understanding of why children were cruel to her growing up and why adults would make comments that seemed to magnify her limitations.
As a teenager, Jennifer had the privilege of attending a week-long amputee camp for kids at Camp Wesley Woods. There she met other kids her age who all had stories of their own and a variety of prosthetic limbs. Attending this camp allowed Jennifer to really explore her nurturing side by giving her the opportunity to encourage new amputees and help with any questions they had.
In July of 2016, Jennifer attended Paddy Rossbach Youth Camp as a counselor. This is a sponsored summer camp where each counselor and camper has some form of limb loss. The camp allowed Jennifer to help inspire others as well as be inspired herself by campers and counselors adapting to participate in all activities. She never heard any camper or counselor say, “I can’t.”
Jennifer has made it her purpose in life to educate and encourage others about prosthetics and to understand that life does not have to be different just because someone has an amputation. Oftentimes you will hear Jennifer say she prefers having a prosthetic leg because it makes her different. She makes the best of her difference and helps make others feel more comfortable around prosthetics.
Jennifer has been fortunate to find a career with Choice O&P that lets her live out her purpose. In 2014, with the support of Choice O&P, she helped develop the Patient Advocate Program. This allows Jennifer to combine professional skills developed over a lifetime with a heart for helping others. In her role as Patient Advocate Jennifer meets amputees in the hospital, often within a day of their amputation, to help guide them through the steps ahead. She also meets with patients throughout the process to answer questions and provide further guidance. Jennifer wants to continue to help others see that even though they have an amputation they can do anything they want to do.
By sharing encouragement along with her personal experiences being an amputee, Jennifer hopes to help patients look forward to walking and returning to other activities that give life meaning. Jennifer also hopes to inspire and motivate other amputees to become advocates and share their own stories with those around them.
John GassOn November 28, 2015 I became an amputee (Right leg- above the knee). The amputation was due to a staph infection in a knee replacement. I was afraid I wouldn’t be able to do anything and I would become an invalid. Instead, I’m doing a lot of things I planned for in my retirement that I want to do. Thanks to a lot of help and from Abby Chandler and Jennifer Brewer, and a lot of hard work, I am now able to enjoy fishing on my bass boat.
Just remember, it takes a lot of hard work and concentration on all things you do. You have to work hard and strive towards whatever you look forward to in the future.
Best Wishes, John Gass
From: The Mountain Press
Kiefer rebounds from crash
Future pre-med student says injuries haven't slowed her
May 19, 2013 @ 09:53 PM
GATLINBURG - On a rainy morning toward the end of December 2011, as Aimee Kiefer was driving to her job as a tour guide at TOMB in Pigeon Forge, another driver's vehicle ran Kiefer's 1995 Land Rover off of Robeson Road in Wears Valley, causing the vehicle to smash head-on into a tree.
Kiefer, a graduating Pigeon Forge High School senior, suffered multiple injuries, including crushed legs, a cracked pelvis, a broken arm and a collapsed lung. It took EMTs, many of whom knew Kiefer personally, two hours to extract her from the car. She was conscious throughout most of the experience. "
For the first hour and a half, I was in shock and didn't realize it was this serious," Kiefer said in a conference room down the hall from the school's front office. Sitting in a mid-backed, rolling office chair, she was wearing a black and white polka dot dress. Her prosthetic leg displays an intricate, rose-themed flower design.
Kiefer's responses are confident and thorough, yet direct. She seemed willing to talk about anything in detail, and smiled constantly. "
I just kept asking why I couldn't get out and why they were doing all of that. I felt fine and not hurt. Then, afterwards, the shock wore off and I realized, 'Wow, this really hurts.'"
Kiefer felt sure she was't going to make it. "
I've seen so much on TV about (EMTs) asking questions to keep you awake, like, 'Oh, tell me about your brother. Tell me about what you want to do after high school.' Things you could tell were irrelevant - the 'stay with me' questions," Kiefer said. "I knew it wasn't good. I was cold, I couldn't feel anything in my lower body, and I was really tired."
After thinking it was the end, Kiefer's first shock was actually waking up in the hospital. Her second shock was realizing that her right leg had been amputated. "
I didn't know it was gone because I still felt it there," she said. "They had me completely wrapped up and I couldn't really see anything, so I kept asking my brother to scratch my ankle for me."
Kiefer said the initial shock at realizing her leg was gone quickly turned into appreciation that she still had her life.
With incredible support from friends, family and the entire community. "I decided early on that screaming and crying about it wasn't going to bring it back, so I might as well keep going forward," she said.
Kiefer ended up setting a record for fastest recovery from a dramatic amputation. She was supposed to remain in the hospital for months, but she left after just 17 days.
She had to remain at home, doing a lot of physical therapy, during the second semester of her junior year, but Kiefer was so determined not to let this experience change too much that she attended school in a wheelchair when she felt well enough.
Her parents, George and Elaine, even renovated the outside of their home with a wheelchair ramp. "
I'm blessed, lucky, whatever word is in your vernacular to describe how blessed I am to have the family I do," said Kiefer, the youngest of six siblings. "They are the absolute best support system."
In school, Kiefer has been involved in choir and Show Choir, a class that students must audition to be in. She said her injuries haven't slowed her down. "
I think I always wanted to be in the medical field," she said, "but it wasn't until I had reconstructive plastic surgery done on me that I knew that's what I really want to do."
Outside of school, Kiefer spends most of her time working and studying. She also said music is her hobby. She enjoys going to concerts and festivals, and she collects vinyl records - something she started doing after the accident.
As it happened, Kiefer's friends and family actively reached out to Kiefer's favorite band, Taking Back Sunday, the band on the only bumper sticker visible from photos of Kiefer's totaled Land Rover.
The group, in turn, reached out to Kiefer, sending care packages that included T-shirts, a letter and copies of unreleased vinyl records. She even got to meet them in person. "
I talk a million miles a minute, and I think that was the only time I was speechless," Kiefer said.
Martin Armendariz, Below Knee Prosthesis Patient
On September 20, 2008 while out for an evening ride on his motorcycle, Martin had no idea that the oncoming vehicle approaching his side of the lane would change his life forever. Martin, an experienced bike rider, maneuvered off the road to avoid the fast-approaching truck. He lost control of the bike and ended up with sever and multiple fractures to his left lower leg.
As the eternal optimist Martin faced several difficult surgeries with an intense positive outlook as the months wore on. He was anxious to get back on his feet and return to work. Martin has a passion for his career. His devotion to professionalism, and dedication to the craft of being one of the leading trim specialists in the construction market, puts his services in high demand. Though optimistic, one surgery led to another, then another, until the weeks became months. Due to a surgical infection that surfaced after the 4th surgery, doctors recommended the unthinkable; they had to remove the leg from the knee down. Although the eternal optimist, Martin realized it would be extremely difficult (if not all together impossible) for him to continue his line of work with only one leg. In an industry of ladders, scaffolding, rooftops, and use of heavy equipment, having to rely on crutches was simply out of the question.
Within six weeks of the amputation, Martin came to the services of Choice Orthotics & Prosthetics. Under the consultation and care of our team, Martin was fit with a prosthetic leg and foot. Several enhancements were performed on the leg, which in turn greatly aided Martin to perform in his job. In no time, Martin was climbing ladders, atop high scaffolding, and literally “back on his feet” for good. Martin has a deep appreciation for the stellar team at Choice Orthotics & Prosthetics.
From: The Connection
He's 'an inspiration'
Villager stays active after amputation
July 2, 2014
BY KATHERINE FERNANDEZ
Having his right leg amputated in 2010 because of the methicillin-resistant staphylococcus aureus infection didn’t stop Lynn Brinkley from staying active and physically fit.
He may not be a Tellico Village tennis star any longer, but he’s taken up golf and may even venture into pickleball, he said.
“I’m still trying to decide whether I’m going to pick the sport (pickleball) up or not,” Brinkley said. “It’s difficult for me to move with a prosthesis.”
Brinkley became an athlete as a young man. He said he was involved in many different sports but began focusing on tennis as a freshman in high school. He practiced the sport while at Illinois College until he graduated with a chemistry degree and became a junior high school teacher in Illinois.
During his 13-year tenure at the junior high school, Brinkley taught general science to seventh-graders and ninth-grade physical science. He also coached seventh-grade basketball and eighth-grade football.
After moving to the high school level, Brinkley taught regular chemistry, honors chemistry and second-year honors chemistry. He carried over his coaching skills to high school, but in tennis.
“I moved to the high school and coached boys tennis for 20 years and girls tennis for 15,” Brinkley said. “I had a good time.”
Eventually, his wife started became ill and the two decided to plan their retirement. The Brinkleys met a man at a hotel in Illinois who told them about Tellico Village, and the couple decided to sign up for visitation package. “We had gone into a Southern Living kind of exposition, I guess you would call it,” Brinkley said.
After seeing several different retirement areas, the couple decided on the Village because it had everything they wanted and needed. His wife passed away, but later in life he met B.J. Hanson through mutual friends and fell in love again. The two are now married and share two sets of children. Lynn has two, and B.J. has three of her own.
Lynn continued to stay active, playing plenty of tennis and beginning to take up golf. He also became a member of the Tellico Village Property Owners Association Recreation Advisory Committee. That’s where he met John Cherry, POA public relations manager.
Cherry said Brinkley is “an inspiration” to everyone who struggles in life.
“I think he made a decision to adjust his recreation routine to where he can still do things to stay in shape and stay active instead of letting his amputation put him at home,” Cherry said.
Brinkley went in to the doctor in 2010 for a knee replacement and found he had two infections. The second infection was MRSA, which is caused by a strain of staph bacteria.
“The problem with MRSA is there’s only about one antibiotic that kills it,” Brinkley said. “By the time we discovered that I had MRSA, it had gone into the bone of the leg, and there was no other option but to amputate.”
The prosthetic leg is above the knee for Brinkley, making quick movements more difficult than for people who have below-the-knee prosthetics. With not being able to move easily, Brinkley was forced to stop playing tennis. He said if the ball was hit right to him, he could hit the ball back, but otherwise the sport became too difficult to handle.
That’s when he began playing golf more often. He said he never had the opportunity to become truly involved in the sport until he could no longer practice tennis.
Brinkley said it takes him about 70 percent more energy to walk along flat surfaces than for the average person.
“People with above the knees, less than one-tenth of 1 percent ever learn how to run unless the amputation has taken place early in life, usually before the mid-20s,” Brinkley said.
But he won’t let his handicap stop him. He continues to work to find ways to stay active and keep himself involved in sports. He said sports kept him out of trouble all of his life.
“I’ve always been just a sports-oriented person,” Brinkley said.
While he struggles with quick movements and balance, he said that “it’s better than the alternative.”
“Anyone who has a setback like Lynn has had, they have choices to make as to whether they’re going to let it bring them down or if they’re going to keep going forward,” Cherry said. “He’s decided to keep going forward. I think it’s inspirational. I think it’s a good example for anybody who has a setback.”
Ronald Pratt, Below Knee Prosthesis Patient
At age 45, Ronald Pratt was diagnosed with Diabetes and spent the next five years being treated for poor leg circulation. Prior to his diagnosis, Ronald had been an employee of Asarco Zinc Mines for 24 years.
In the summer of 2013 after Ronald had been working in his garden he noticed that he had a small blister on the ball of his right foot. Ronald did not pay much attention to the small blister until it began to get bigger which then prompted him to visit his Podiatrist. Ronald's podiatrist recommended surgery for the blister; however, after two surgeries the wound still was not healing.
Ronald was then sent to the wound care center at UT Hospital where they also tried to get circulation going to his foot with no success. He was then seen by a vascular surgeon who gave Ronald the news that he did not want to hear - he needed to have his right leg amputated below the knee. After his surgery, Ronald was worried about being able to get around. He had seen other people walking on prosthetic legs, but he never thought that he would be in the position to need to learn how to live with a prosthetic limb. The prosthetist from Choice O&P visited with Ronald in the hospital, talked to him about a prosthetic leg, and helped Ronald to see that life really did go on without a limb.
Five weeks after Ronald got home from the hospital he came to Choice Orthotics & Prosthetics to meet with a prosthetist. We provided Ronald with a stump shrinker which he wore for several weeks. Ronald then returned to Choice Orthotics & Prosthetics in January of 2014 and was fit with his brand new prosthetic leg. Learning to walk was a challenge and he did have some therapy to help him learn.
Today Ronald can do just about anything he was doing before losing his leg. He drives and he keeps his yard mowed, two things that are very important to him.
Ronald and his wife are deeply appreciative of everything that all the team at Choice Orthotics & Prosthetics has done for him. Ronald says, "Choice O&P really made my life worth living again."
“Back on my mower”
In August 2013, I went to UT Medical Center and had both legs amputated below the knee. I was eighty years old and not sure if I could survive this part of my life. I spent eight weeks at UT Medical Center, then five weeks at Patricia Neal for rehabilitation. Before my surgery, I was an active volunteer fireman and provided lawn care services. I had goals I wanted to meet even though I had doubts. While I was at UT, along came Matt from Choice O&P. While at UT I told the doctor and rehab therapist that my goal was to get back on my mower and to return to the fire department. Matt was very encouraging and I made the choice to see Matt for my prosthetics when it was time to begin that process. I was fitted with my new legs in early 2014, then was referred to Mike Rhea at LeConte Therapy and he has been great. I am sure both he and Matt thought, “This ole’ man is not going to do this”. In August 2014, I started walking with a Rollator walker and as you can see, I am “back on my mower”. It has been a long road. I am now eighty-one years old. I am thanking God for his healing power, my family for support and Matt and Mike for your encouragement and help.
“It takes a lot of hard work and dedication, and you have to tell yourself, ‘I have got to do this!’”
On July 6th, 2017, I became an amputee on my right leg, below the knee. The amputation was due to a staph infection in my right foot. I was afraid that I would not be able to do anything, and that I would be stuck in a wheelchair forever. Now, thanks to Abby Chandler and Jennifer Brewer at Choice, I can do all the things I did before my amputation. I first met Jennifer when she came to visit me at NHC in Knoxville. I knew then that I had to make a choice where to go for help. I chose Choice. With all the hard work and dedicated employees, I am now back doing what I love to do. I can once again drive my trucks, mow the lawn, go fishing off my bass boat, and go camping. It takes a lot of hard work and dedication, and you have to tell yourself, “I have got to do this!” I tell all my family and friends that Choice is the only place to go for orthotics and prosthetics. Abby Chandler and Jennifer Brewer will help you. They helped me walk again. Thank you, Abby and Jennifer, for all the help! Best Wishes, Billy Johnson