What to expect

Send the operation date and level of amputation, the cause, the state of the wound, photographs of the residual limb, other medical conditions — particularly diabetes, heart and lung disease — and whether you already have a prosthesis. A physician replies within 48 hours.

The reply will say what a block at this point in your healing can realistically achieve. If the honest answer is "come two months later and get more from it", it will say that.

Assessment: wound and limb shape, contractures, strength, balance, cardiovascular capacity, the other limb, and where relevant the fit of an existing prosthesis. Goals are set from that.

Compression and stretching start immediately. Conditioning starts at whatever level the person is at, which after a long hospital stay is often low.

Strength, balance, conditioning and limb care daily. Where a prosthesis is in use, gait training builds from parallel bars to independent walking, then to stairs, slopes and outdoor surfaces.

Where a prosthesis is being prepared, this is when the assessment for components is completed and the residual limb is brought to a shape that can be cast.

Independence in limb care and donning the prosthesis, skin checks for both limbs, and the home programme. You leave with written instructions for what to do if the socket becomes uncomfortable or the skin breaks down — the two things that most often go wrong after discharge.

A follow-up point is agreed, because sockets stop fitting as the limb continues to remodel for six to eighteen months after amputation 4.