Guest Author - Monica J. Foster
I have been having consistent wound care issues with my left leg since college in the mid-1990's. A wound on my left heel has consistently opened, closed, opened deeper and then variously not completely healed over. For the last two years I've been dealing with infections and weekly wound care clinic appointment that takes hours each visit. I've sought other professional opinions, support in my faith and among family and friends to figure out my next steps over the longer term. I cannot continue leaving myself vulnerable to an open wound prone to infection that's life-threatening.
It appears that amputation to preserve my overall quality of life and health is imminent. We'll see. Anything can happen, but that certainly looks like the road I am on and I'm seeking resources now to better accept this possibility. For others of us looking toward amputation, although grudgingly, I decided we all need steps to help us get into a better frame of mind about the possibility of limb amputation.
Ask your primary care physician, wound care clinic and/or surgeon details about the pros and cons of amputation. What will you gain? What will you lose, besides the obvious? The more information you get before the procedure, the better. In my case, my bone deep wound will not heal because of diminished blood flow. It remains open to infection. I was born with paraplegia and my legs and blood vessels in them are atrophied and less healthy, so healing ability and healing time are much slower if not nonexistent.
Find out the risks of amputation surgery. How long does the surgery take? I've found out whether I'm even healthy enough to handle the surgery at all, and I am indeed, so that's a load off of my mind. What should you and your family expect in recovery? How long before you can use a prosthetic limb? Is a prosthetic limb an option for you? In my case, I'm not sure I would use a prosthetic since I do not walk. The weight distribution between no limb and a prosthetic will be different than my natural left leg as I transfer in and out of the wheelchair, the car and bed. We'll have to cross that bridge when we get to it. Right now, optimal health and independence is my focus.
Consult with a physical therapist who'll help after the amputation surgery. I spoke with a physical therapist that worked with me on bed rest when I had a bad foot and leg infection about amputation. She was there to help maintain my upper body while I was healing from the infection so I could remain independent. She was a good resource to talk to when amputation happens. She talked to me about some of the exercises I'd perform and gave me an idea of exercises to work on before the surgery to strengthen my upper body for a faster recovery time. The important thing she said to do was to do what I was doing--do my research, keep an open mind and prepare for the days ahead as the possibility of amputation became more imminent.
If you are certain that a prosthetic is in your future, choose a prosthesist who is certified and has experience with the latest artificial limb technology. I've seen some amazing breakthroughs in prosthetics that bring to mind thoughts of The Bionic Man and Bionic Woman, keeping you running and gripping small objects, even remaining an active parent of small children. Meet with the prosthesist and ask what to expect at appointments. Once you've talked with them and chosen the right equipment for you, schedule follow-up appointments to ensure your artificial limb fits correctly. A friend of mine was a double leg amputee from diabetes. He had to ensure everything fit well and the amputation site was taking the weight of his body well enough to ward off pressure sores at the end of his knee joint. This is extremely important for amputation site maintenance and overall health success.
Speak with a counselor before and after surgery about the emotions you are feeling. I already seek periodic counseling to manage depression, so I am already speaking to my counselor about the possibility of amputation and how best to handle it. It's normal to be sad and angry. I've woven in and out of sobbing and making morbid pirate jokes about my impending leg amputation. Sounds terrible to joke, but you will handle the situation in the best way that suits you. Your emotions are yours and no one can tell you how best to react. Set aside time for yourself to deal with the amputation in a safe way so you can move past the negative and adapt to the changes in your life.
Seek out other amputees through your hospital or community support groups. As a life beyond limits coach working with others with disabilities and as the daughter of a disabled veteran, I am lucky enough to have community resources at my fingertips and I'm already reaching out to them before I have to. These people share a common experience and have already offered me needed support and the answers from typical to extreme. No question is dumb. Reach out and you will find the support you need.
I intend to be as active as possible after my amputation surgery for my overal health and for my own peace of mind. I have work to do, too, with other people with disabilties as a life and career coach, so I have to resume life as before. To maintain an active life, your physical and mental outlook improves.
Follow directions from your medical and rehabilitation team. Their instructions are tailored to your individual needs and should ease the healing process. I already understand that the odds of amputation are very likely. I also understand that a high protein diet rich in fruits and vegetables as well as supplementing with vitamins and exercise will help me with the healing process and afterward.
You might be wondering how much amputation I'm looking toward. My atrophy from paraplegia stops at the knee and the blood flow is much better there and above. Even though my left heel wound is what's impacted and prone to infection, an at the knee amputation seems the most healthy way to go to provide bulk and enough blood vessels for the amputation to heal well. That's quite a dramatic amount, but I'd rather do that than just take the foot and then have another issue with another low-healing wound and more infections. I'm on the road to preparing for the most dramatic result. I encourage you to do the same if you are facing amputation.