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Adjusting to Your Amputation

 

This factsheet will advise you on how to best cope after having amputation. It is a difficult time for most patients. Here is some information to help you understand what you may be feeling and how best to cope.

 

GRIEF is the most common feeling after the loss of a limb. Grief for the loss of a limb is like grief for the loss of someone close to you. There are stages of grief. Knowing the stages can help you better understand your feelings, cope with the loss, and face the new challenges in your life.

 

Grief can show itself in many ways.  Generally, there are five stages in the process of grief:

  • Denial

  • Anger

  • Wishful thinking

  • Depression

  • Acceptance

 

One stage does not abruptly end and another begins. People in grief often move back and forth between stages. Some days will be easier than others.

 

Denial: At first you may be shocked and confused. This reaction is common, especially if the limb loss is unexpected. You may also feel helpless. During this time, the support of family and friends is very important.

 

Anger: You will probably feel angry and frustrated. Learning to use prosthesis is tiring. You may find that you can’t do things as fast as you used to. Anger is often.

 

Wishful thinking: When people are told an amputation is necessary, they try to bargain with themselves and others. They may say, “I’ll do whatever it takes to avoid the surgery.” After surgery, a person may think, “If I work hard and am very good, I will get back to doing everything I did before the surgery”.

 

Depression: This stage often begins when you and your family start to realize the full impact of your disability. You might feel sad and discouraged. Low mood is common and abnormal part of the grief process. It usually comes and goes as you move through healing and rehabilitation. For some people, the low mood can get worse. Sometimes, depressed feelings make it difficult to do normal daily activities. You may blame yourself for anything that goes wrong. You may also feel hopeless, tired, and helpless. Sometimes these emotions can prevent you from taking part in activities that might help you feel better and improve your abilities (such as attending therapy).

 

Acceptance:  This is the final stage of the grieving process. It is a time when you have come to understand and accept that your limb is gone and not coming back. This is a time when you and your family have learned to live with the disability.

 

Your Team Members

We are here to help you learn how to live with your amputation. Everyone heals at a different speed. The healing process depends on your physical, mental, and emotional abilities, as well as the amount of support you have from family and friends. The most important member of the team is you! Your recovery depends on you. If you need help or do not understand something, please ask.

 

Doctors: You already know your doctor and your surgeon. If you have other illnesses like diabetes and high blood pressure it’s important to still visit your primary doctor.

 

Physiotherapist: Your physiotherapist focuses on identifying the best rehabilitation program for you, helps you with walking and ways to move about safely. Your physiotherapist also teaches you how to care for your limbs, manage your pain, and do your exercises.

 

Prosthetist : Some people who have an amputation need an artificial leg (a prosthesis). If you need prosthesis, the prosthetist will makes the prosthesis and help you care for and use it.

 

Managing Pain

 

Stump pain: Following the surgery, you may have swelling. This can cause pain at the site of the wound and throughout the stump. This should get better over time.

 

Phantom pain: This is pain in the missing leg. It is quite common and it may be worse at night.

 

Phantom sensation: This is the feeling that the amputated leg is still there. It is not painful. These include itchiness, a pressure sensation, tingling, or pins and needles. If you feel phantom sensations, it can be easy to forget that you have an amputation, especially at night. You can put the bed rails up or walker beside your bed. This is meant to stop you from getting up and trying to walk to the bathroom.

 

How to manage phantom pain and sensations

 

  • Wrap your stump in a warm, soft fabric like a towel. Poor circulation can be a cause of phantom pain. Warmth can sometimes increase circulation.

  • Imagine your phantom limb is still there and try moving the painful area (for example, try moving your phantom toes).

  • Focus on trying to relax the missing limb.

  • Exercise the remaining part of your limb by tightening the muscles and relaxing them slowly. This will increase circulation.

  • Change positions. If you are sitting, move around in your chair or standup to let the blood flow down into your leg.

  • Massage your leg with your hands or ask someone to massage it while you focus on relaxing your whole body.

  • Keep a diary of when the pain is most severe. This can help you and your doctor find out the cause of the pain.

  • Try to distract yourself from the pain. Some people find it helpful to do puzzles, reading, or other activities to take their mind off the pain.

  • If your surgeon and your physiotherapist agree, you can put a tensor bandage or a shrinker sock on your stump.

 

Positioning

Some positions can cause tightness in your joints. If a limb is placed in a poor position for a long time, the muscles shorten and cause something called a contracture.

 

A contracture does not allow the limb to move normally. It can become permanent if the leg is kept in a bent position for long periods of time. To prevent contractures, there are certain positions you must avoid.

 

For below knee amputees (BKAs), you want to prevent contractures from forming at the back of the knee and front of the hip.

 

It is easier to prevent contractures from forming than to stretch them out after they have formed. Once a contracture forms, it decreases your chance of being eligible for an artificial leg.

 

Caring for The Remaining Leg In People with diabetes

 

  • Inspect your foot every day for blisters, cuts, and scratches.

  • Use a mirror to help see the bottom of your foot.

  • Always check between your toes for sores, blisters, cracks, or dry skin

  • Ask for help if your vision is impaired. Have a family member inspect your foot daily, trim your nails, and buff down calluses.

  • Wash your feet daily and dry them carefully, especially between the toes.

  • Wear a sock at night if your foot is cold.

  • Inspect the inside of shoes daily for foreign objects, nail points, torn linings, and rough areas.

  • Take special precautions to keep your foot warm. If you develop a blister or sore on your foot, arrange to see your doctor right away.

 

 

 

 

Source: http://vch.eduhealth.ca