After limb loss, your body has become changed to you, both physically and through your emotional responses. You may feel overwhelmed by the effect upon your daily lifestyle initially, but progressing through activities as you recover will help you regain confidence to live as you are now and progress towards new goals.
It can take several months to recover from injury, surgery, chemotherapy or radiotherapy. It is important to build up a healthy lifestyle – to eat nutritiously to control your weight and to build up your strength and stamina as well as getting enough rest and sleep. The absence of a limb can cause physical strain on the rest of your body as well as the emotional strain of adapting to limb loss – both adding to feelings of tiredness. Being active, within your limits together with maintaining a healthy weight helps prevent cardiovascular disease and also helps lessen emotions like sadness and depression.
If you have had a lower limb amputation due to diabetes or vascular problems, you need to care for your remaining foot regularly – daily if possible. Wash and dry your foot thoroughly and if your eyesight and dexterity is not good, see a chiropodist or podiatrist for trimming your nails. You will not necessarily feel any injury to your foot if the sensation in your foot is reduced so protect your foot by wearing socks and footwear and protect your foot from extremes of hot and cold. Test the heat of water before washing and avoid heating pads.
You will first have met the physiotherapist in the hospital who, depending on your general health and well being, will refer you on to a specialist rehabilitation (prosthetic) centre. It will not be appropriate for everyone to be given an artificial limb but this will be discussed with you fully. We will discuss with you and your family members if you wish, to determine the most appropriate way forward for you to become as independent as you can.
The physiotherapist will have worked with you on a series of exercises to strengthen and improve your balance and control, to position yourself in bed, transfer to and from your bed and chair and possibly some standing balance work.
These exercises will be built upon with your specialist amputee physiotherapist over time to condition and strengthen the residual limb and tone your core body (posture) muscles. These exercises are very important for your future success in limb wearing.
Even before you receive your prosthesis (artificial limb), the physiotherapist will utilise a general walking aid to commence some standing and moving activities to prepare you for the future.
The occupational therapist will also have seen you with regard to returning home and specific daily activities such as dressing, using the bathroom, getting in and out of a car and the degree of assistance and any modifications to your home area you may require to further your independence.
Biokinetics is defined as the science of movement and the application of exercise in rehabilitative treatment or performance.
A Biokineticist is a clinical exercise specialist that uses exercise as a therapeutic modality in final phase rehabilitation, maintenance of physical abilities, and achieving maximum functional capacity. It is extremely important to start an exercise programme prior to receiving your prosthesis so that your residual limb is strong and fit to make the transition into your new limb. Our role in your rehabilitation team is to provide you with the tools to:
- Strengthen your residual limb in preparation for returning to maximum functional capacity (e.g walking)
- Improve your muscular endurance which is vital to successful use of your prosthesis
- Improve core stability that is needed for balance and sufficient power for ambulation
- Maintain your cardiovascular fitness
- Assist in achieving correct gait patterns once the prosthesis is fitted.
Continuing exercises for the residual limb are equally as important after you have received your prosthesis to achieve maximum use and benefit as well as to maintain muscular strength and fitness.
Psychology and Mental Wellbeing
Losing a limb is akin to loss of a loved one. You will experience similar stages of grief: shock/ numbness; denial/ unreality; anger; bargaining; depression and eventual acceptance/ readjustment. When a health condition has led to the amputation, you may feel as if your body has let you down or, alternatively, as if you have let your body down. Accident-induced amputations on the other hand, are often extremely sudden, with very little or no time to prepare oneself.
Loss of a limb whether because of vascular problems, diabetes, an accident or cancer, requires readjustment in almost all areas of your life.
The clinical psychologist helps patients and their families with psychological and emotional preparation before amputation. Following amputation, they will follow-up in the hospital ward and later, post-discharge, in their consulting rooms. Depending on the individual needs of a patient, aspects such as body image reintegration, interpersonal relationships, reclaiming quality of life, dealing with phantom limb sensations and phantom limb pain, release of body or cellular memory of trauma are dealt with.
You will already be familiar with the nursing staff in the hospital and the cleaning and dressing procedures in place. When you are discharged from the hospital, it is important you follow their instructions as to the care of your residual limb. It is very important to care for and monitor your residual limb and have good hygiene procedures both before and after you receive a prosthesis. The nurse will advise you on washing and moisturising your residual limb.