Overview of Amputation
Regardless of the reason, losing a limb is never easy. Both mentally and physically, amputation can negatively affect a person and inevitably change their life and the lives of their loved ones. While it may not be a cakewalk, life after amputation is simply a matter of finding a new routine. For new amputees, the entire process can seem intimidating, but it is always important to remember that no one goes through an amputation alone. There are lots of resources and organizations available to help with everything from pre-surgery consultations to programs for lifelong peer support.
A good way to calm fears is to learn as much as you can about the thing that scares you, so we have created this guide to help new amputees understand how to deal with amputation by explaining what happens through the different stages of this life-changing surgery.
The Healing Procedure
What is the recovery after amputation like? Well, the short answer is that it’s long and can last years. The long answer is that amputation is not just the physical loss of a limb- it is also the readjustment of a person’s very way of living and requires relearning how to do many things that were once second nature.
The healing process begins with three main components:
- Physical therapy and rehabilitation
- Managing the risk of complications
- Gaining mobility and independence
If you plan on getting a prosthesis, it may be months before you are fitted for your artificial limb, which makes physical therapy one of the most important parts of your recovery.
Physical Therapy And Rehabilitation
A part of rehabilitation is strengthening the muscles in your remaining limbs, and another part is helping you work towards independence. In the beginning, physical therapy will be difficult and frustrating, but just remember that it is the first step to getting back on your feet — figuratively and maybe even literally.
Your therapist will not expect you to strain yourself on the first day. Instead, you will start with gentle movements that will gradually become more active and strenuous. You will learn how to exercise the muscles in the other parts of your body, which will be used more than they were before the surgery.
When you have been discharged from the hospital, an occupational therapist may visit your home to see if it needs any adjustments to accommodate your change in mobility. For example, you may need to have a ramp installed.
You will continue to see more of the hospital in the weeks after since you will need to return to change your bandages and let the doctor see how your wound is healing and how you are adjusting to your new life at home. You may end up returning to have sutures removed, after which you will start wearing a compression sock on your residual limb to help it shrink even more. The shrinkage is necessary because it molds the stump, which helps it fit the prosthesis easily and more comfortably.
The stump will be a healing wound and, like any other healing wound, it needs to have adequate care to speed up healing and prevent infections. It is best to avoid submerging the stump in water, such as if you take a bath.
Managing the Risk of Complications
Like with any major surgery, there are risks of complications involved with amputations. These can include:
- Heart problems, including heart attacks
- Deep vein thrombosis, which is a fancy way of saying a blood clot that forms in the veins of your legs
- A slowdown of healing, potentially due to infection
- Pneumonia
- Phantom limb syndrome, which is common for amputees
The need for further surgery is also a potential, especially if there is pain, such as from nerves that have thickened, or if more tissue needs to be removed.
Gaining Mobility and Independence
Once you are discharged from the hospital, you will need to learn how to do everyday activities with your revised body. Our rehabilitation team will be able to provide you with the appropriate mobility device as well as living aids to help you ease back into your everyday life.
These devices will be crucial as you get used to embarking on your usual household tasks and activities with your residual limb, and they are designed to help amputees become more independent.
Long-Term Care and the Road to Recovery
When it comes to the long term, there are two parts of the recovery process:
- Physical recovery
- Emotional recovery
Both physical and emotional recovery is something you will be doing from the time of your surgery on, but while physical recovery likely has an end date, emotional recovery can be ongoing.
Physical Recovery
Physical recovery includes physiotherapy, which you will likely have to do three to five times a week. As we mentioned before, physical therapy may seem like a chore, but it is one of the most critical parts of recovery since it helps the body adapt to its new normal. Physiotherapy exercises are designed to help you learn how to redistribute your weight and balance with missing lower limbs or exercise your other limbs, which will be used more often, without injuring them.
These exercises are designed to help a person return to their regular routine by relearning how to do everyday activities. The exercises help you strengthen muscles to be able to better control limbs. Similarly, rehabilitation will also help you learn to live without the limb that has been amputated, which will decrease the chances of developing phantom limb syndrome.
Learning to care for the existing limbs — especially if the amputation was a result of a disease, like diabetes — and actively taking better care of the existing limbs to keep them from coming to harm are also necessary lessons during physical recovery.
Once you are fit for a prosthetic limb, you will learn how to move with an artificial limb and get used to living life with it. You will also learn how to care for your prosthesis.
Emotional Recovery
There are no wrong feelings when it comes to amputation, which is why emotional recovery is as important as physical recovery. The psychological impact of an amputation can run the gamut of emotions, with grief and bereavement being some of the most common emotions. The grief is sometimes strong enough to be likened to the death of a loved one.
Three key reasons an amputation can have such a strong effect on a person’s life are:
- Getting used to the lack of feeling and sensation in the amputated limb.
- Getting used to the lack of function of the amputated limb.
- Adapting to a new sense of body image.
How other people view your body may also have changed, and coping with that is another significant factor. Negative thoughts are extremely common and very much normal during this time, and they can be as mild as temporary frustration or sadness to suicidal ideations. Your rehabilitation team should be on top of these thoughts and, once you are discharged from the hospital, you may be directed to counselling or therapy to help you deal with these feelings constructively.
Feelings of negativity are more likely to be present if the amputation was done suddenly — such as after an accident or similar trauma. Without the opportunity to get used to the reality of what amputation means, it can be incredibly difficult to cope with it in the aftermath. Sometimes, there is an inability or unwillingness to accept the amputation as reality. Some people may refuse to accept that they will need to alter their lifestyles because of the amputation and may refuse help.
How We Care for Our Amputated Patient
Below is how we care for amputated patients here at Livingtower Integral Medical Care.
Psychological & Physiotherapy Care
- Our psychologists counsel patients and improve their psychological wellbeing
- Our medical team helps clients to adapt to a new sense of body image
- Our physiotherapy team encourages our client on daily rehabilitation exercise
- Our physiotherapy team helps clients to improve mobility and function ability
- Our occupational therapist helps the client to re-adapt to the new realities and look into possibilities of overcoming the everyday challenges in trying to get a source of income and conquering everyday challenges
Limb Care
- Our medical team advises our new amputees to take a bath or shower at night rather than in the morning, as their limbs will swell in hot water or when dangling as they sit or stand to shower, making it difficult to put on their prosthesis. In the beginning, we advise they should use a shrinker at night, and put on a prosthesis when they get up from the bed – in other words, they should avoid hanging their leg down to prevent the leg from swelling
- Our medical advises our client who has just undergone transtibial (below-knee) amputation, never to sit or sleep with a pillow under your knee, as this will lead to a contracture (inability to straighten the knee)
- Our medical team advises our client that has just undergone transfemoral (above-knee) amputation, to avoid sleeping with their limb resting on a pillow, as this promotes a hip flexion contracture (inability to completely straighten their hip
- Our physiotherapy team advises our client not to rest their limb over the handle piece of their crutches.
- Our physiotherapy team advise our client/patient to do stretching exercises daily to make sure that they can straighten their knee and hip because this makes walking, and even lying in bed, more comfortable.
Prosthetic Care
- Our caregiver helps our client to wash anything that makes skin contact (liners, socks, the inside of the socket, etc.) every day with mild soap and water and allows plenty of time to dry. And also follow manufacturers’ instructions for the care of liners. Unless specifically instructed, do not use anything containing alcohol or unknown chemicals.
- Our caregivers make sure our client’s shoe height is correct for their prosthesis to avoid the wrong alignment, and also put a strain on the client’s residual limb and surrounding joints.
- Our caregivers provide a “leg” handy bag with items our client might need in an emergency (stump socks, pull socks or bandages, antibiotic ointment, antihistamine ointment, etc.).
- Our medical team informs our prosthetist once a client is having trouble with his or her prosthesis or liner, for adjustment
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