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Life After Amputation

If you or a family member has recently undergone an amputation, you are aware of the life altering impact and changes that followed the surgery.

In the United States today there are about 2 million amputees living. Some lost limbs due to trauma. Some lost limbs due to disease. Some were born with limbs missing or so deformed that later required amputation. Roughly 185,000 people in the US will undergo an amputation this year. There are another 28 million people who are at risk of amputation. Most of those at risk are due to peripheral vascular disease and the complications of smoking.

I have always had a strong bond with the patients I have amputated. Amputee care is a two-way commitment. They are trusting me and I am helping them with the common goal of recovering independent living and self-confidence. Most amputees are grateful in the long run. In the short term it is a huge post-operative adjustment they and their family will have to overcome.

Common questions amputees have include the following:

Emotional health and wellbeing

Your emotional health and mental well-being is as equally as important as your physical health. If you are having trouble coping with your emotions there are a number of areas of support that you can tap into:

Peer support is an important part of the recovery and rehabilitation process. Early on in your journey to recovery you may experience uncertainty, have doubts and questions. Peer volunteers can help to ease the burden and provide support along the way. Receiving a visit from a Peer can be a rewarding experience and a wonderful way to gain insight to your new situation. Peer Support Volunteers are amputees like you; they are people who have experienced and lived with limb loss for a number of years. They have successfully adapted to their amputation, re- engaged with their community, and live independently.

Building a network of peers will enable you to share your own very personal experiences with people who understand. Peer networks can provide practical and emotional support in a group setting which will enable you to be listened to and heard. It may help you to develop confidence and feel more secure about your situation. Peer networks can be wonderful sources of information; they can give you tips, share hard earned knowledge and help to guide you to services and activities in your own community.

A Peer may be able to answer some of the many questions you may have about day to day activities; this may include using a prosthesis, using a wheelchair, driving a modified car, sport/s and community activities, along with addressing concerns of a personal and private nature.

Who is involved in Amputee care?

The amputee rehabilitation and recovery process is different for everyone, and can vary between facilities, states and territories. There may be a number of different healthcare team members involved in your care. Your healthcare team will work with you to help you to regain your independence and increase your confidence and help you to develop and achieve your goals. It is important to have recovery goals.

You should discuss your goals with your healthcare team and work with your team to develop a plan for
your recovery.

The healthcare team who may be involved in your care can include:

Orthopedic Surgeon– A physician with specialized training in musculoskeletal health care who routinely preforms amputation. Usually the Orthopedic Surgeon is captain of the ship until the wounds are healed, then care is handed off to a physical medicine specialist.

Physical Medicine and Rehabilitation Specialist (doctor) – oversees to ensure that your health and medical needs are being met. Your doctor together with your team will assess if you are fit and able to use a mechanical/assistive device, such as a prosthesis.

Occupational Therapist – helps you to adjust to day to day activities, like personal care, domestic tasks such as: meal preparation, accessing your place of residence, education or work readiness. If you are an upper limb amputee the Occupational Therapist will assist you with the functional training of your prosthesis.

Physical Therapist – will design an exercise program tailored to your needs. They will assist you to regain your balance, flexibility, strength and stamina. They will help you to use mobility aids such as: wheelchairs, walking frames, crutches and other assistive devices suitable for you. If you are a lower limb amputee, they will assist you to use a prosthesis.

Prosthetist – will look after the design, manufacture, supply and fit of the prosthesis. Together, you will discuss and decide on the prosthetic components to suit your needs and lifestyle. They will also teach you how to ‘donn and doff’ (put on and take off) your prosthesis and start your prosthetic training.

Social Worker – will provide confidential counselling assistance for you and your family. They can assist you with emotional support. Social workers will provide assistance with financial matters, transport, and your accommodation requirements.

Nursing team – assist you with medications, personal hygiene like bathing and dressing and any wound care and diabetic management that is required. They will liaise with your healthcare team about your specific needs or any referrals you may require.

YOU – The most important member of your recovery team is YOU. From the onset, you will be encouraged to play an active role in your recovery and care.

Depending on the reason for your amputation, other healthcare staff involved in your care may include:

Diabetic educator
Dietician
Exercise physiologist
Pastoral care worker/Spiritual Support from Clergy
Podiatrist
Psychologist (clinical or neuropsychologist) Sexual health counsellor

Caring for your residual Limb

Use a mirror to inspect the back side of your residual limb at least once a week or if you are having pain.
Check for stump/residual limb skin issues as you remove the socket style prosthesis
Check for skin breaks, ulcers or callus formation, if present the pressure points need to be adjusted.
A prosthetic limb should not be painful to wear or use.
If you find a red or irritated area when taking off the socket, take a picture and shoe your prosthetist.

There are a number of things that you should think about:

Prosthetics come in many shapes and sizes. You, your prosthetist, physiotherapist and your doctor will work with you to choose the best and safest prosthesis for you. This will depend on such things as:

A prosthesis for an elderly person who is only going to walk indoors will be very different to a prosthesis for someone who works all day in a manual job.

Prosthetic components have weight limits and recommendations based on mobility. Underestimating weight or activity levels could result in a prosthesis that is not strong enough to let you be active safely and this can be dangerous. However, overestimating weight or activity could result in you wearing a prosthesis that is heavier than it needs to be. To achieve the best outcome, you need to be honest in discussions with your doctor and prosthetist.

The help of a family member or career can sometimes be critical in deciding on the type of prosthesis that will best suit you. For example, as people age and/or other problems occur, some types of prostheses may be hard to put on properly. If you put on (donn) your prosthesis in the wrong way it can cause problems and be unsafe and uncomfortable, your doctor or prosthetist may suggest a simpler prosthetic system in order to keep you mobile and functioning. There are many other examples of how these factors can influence what is best for you. It is not always easy. Sometimes a certain type of prosthesis looks like a great choice, but problems may occur.

If you are a lower limb amputee sometimes prostheses, or the components of a prosthesis, are referred to by their ‘K’ classification. This is simply a measure of activity, for example:

Preparing your home after lower limb amputation

Tips for upper limb amputees

Driving

I offer the following links for amputee resources.

4100 North MLK Blvd.
Suite 100
North Las Vegas, NV 89032
Email: sncil2@aol.com
Phone Numbers:
Local: (702) 649-3822
Toll-free: (855) 649-3800
Fax: (702) 649-5022
Accessible: (702) 649-3822
Accessible Phone Type: TTY

The Department of Employment, Training & Rehabilitation (DETR) is the state’s lead workforce
development agency. It consists of divisions that offer workforce related services, job placement
and training, services for people with disabilities, investigation of claims of discrimination,
unemployment insurance benefits, labor market data and more. Many of these services are
provided through Nevada JobConnect career centers.

Ronald Hillock MD
Fellow American Academy of Orthopedic Surgeons
Diplomat American Board of Orthopedic Surgery
Adult Reconstruction and Orthopedic Oncology

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