It all happened so fast. Eighty-five-year- old Ruth Casto’s shoe got tangled in an area rug, and she crashed to the floor with a sickening thud, shattering her left hip. The prognosis was grim: doctors agreed that Casto’s leg would have to be amputated and that she would be confined to a wheelchair for the rest of her life.
But Casto wasn’t going to accept this life sentence without a fight. “After all the flowers, visitors, cards, and endless comments about how brave I was, I found myself on a lonely island fighting to retain dignity and independence,” Casto recalls. “I made up my mind then and there that I would walk with a cane within a year.”
In 1995, after the amputation and surgery on her fractured hip, Casto was transported to Wake Rehabilitation Center in Raleigh, North Carolina, where she underwent extensive rehabilitation therapy. After 10 days a plaster cast of her stump was made, and she was given a temporary prosthesis. Despite her discomfort, Casto stood up between parallel bars and felt 10 feet tall. After 26 days at the rehab center, she was going home to begin a new life.
Casto’s family played an invaluable role in her recovery, offering their unlimited support, especially in day-to-day tasks that many people take for granted. Casto admits that there were times when she felt sorry for herself and needed her daughter Dianne’s guidance. “Dianne explained to me that I was entitled to feel sorry for myself once in a while, to shed tears and express anger that smoldered beneath my bravado,” Casto says. “She assured me that she was grateful that the amputation had restored my health and that I was still with her. With such wisdom from a daughter, how could I not adapt?”
In addition to her family support, however, Casto desperately wanted to talk with other amputees. Six months after her ordeal she attended her first meeting at the Rex Triangle Support Group in Raleigh. Sharing her fears, concerns and victories with those who had gone through the same experience helped Casto face and accept her limb loss.
“I met all types of amputees,” Casto remembers. “Most of them were considerably younger than I was but still there was a feeling of kinship among us. I felt that here was a group of people who would call a spade a spade, and who were totally without pretense.”
Casto told the group members that she didn’t mourn for her leg so much – it was the loss of her mobility and her independence that was so devastating, and she was eager to get her new prosthesis.
While Casto’s story is one of ultimate success, it is also an honest record of a full range of human emotions. En route to triumph, Casto’s emotions vacillated between hope and despair, successes and setbacks. “At 85, I was impatient,” she confesses. “There were the long intervals between appointments. One moment I was filled with hope that my new prosthesis would fit and release me from pain; the next moment I was overwhelmed by fear that I would never be able to walk again.”
Discomfort replaced pain as Casto’s prosthetist tried everything to accommodate her needs. Seven months after the amputation, Casto received a gel sock and a clip to suspend her prosthesis which gave her a renewed sense of security.
She quickly learned how to roll the gel sock on and off, experimenting with various layers of socks until she found comfort with very little pistoning. “One afternoon I was actually able to stand in the walker safely for up to five minutes! For the first time since the accident I helped my daughter prepare the evening meal,” Casto says. “Things were looking up.”
Casto worked hard to become completely self-sufficient. Though her wheelchair glided smoothly over hard surfaces, propelling it over her daughter’s thick carpeting made her hands, shoulders and hips sore from pushing the wheels. And she quickly learned that transferring from one sitting place to another was best accomplished without a shoe. “A bare foot facilitates spinning on the ball of the foot,” Casto says. “This takes away the strain on the ankle and knee.”
Her wheelchair had stiff brake handle levers, which her son-in-law lengthened by adding a six-inch section of hard plastic tubing to give Casto better leverage and make the brakes easier to apply. “I was stiff all over, and I had to stretch my muscles before standing up,” Casto recalls. “Age was trying to take over, and I was fighting back.” Listed below are a few assistive devices that Ruth Casto found made her life easier.
- a grabstick, attached to the front of her walker, added three feet to her reach and reduced her frustrations.
- a device called the “hose-on,” helped her put her stockings on without having to bend down.
- an easy-rolling walker – triangular with wheels and hand brakes.
- an egg-crate mattress over her existing mattress decreased pressure on boney areas for added comfort.
- a carryall pouch with shortened straps attached to her walker to hold her television remote control and water bottles, as well as her portable phone, programmed with important numbers.
“Each new piece of equipment speeded my recovery and enhanced my mental outlook,” Casto says.
At her eight-month checkup, Casto’s surgeon agreed that she was ready for a definitive prosthesis, despite the fact that she was still uncomfortable at times. “The many months of ups and downs were disheartening, and I wondered if I would have to go through it all again with the final prosthesis.”
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Casto recorded each step of her rehabilitation in a daily journal, which served as a reality check on how she was doing. By referring back to her journal, she could review her progress and see how far she had come. “The journal served as a guide, a record of my blind groping for answers, my frustrations while learning to cope and the swinging emotions that ranged from anger and despair to learning to accept that which I could not change,” Casto says.
“At times I questioned my progress,” she continues, “but then I would remember my first days home and realize the skills that I had developed, and my spirits would rise. I was filled with appreciation for those who had stood by and taken care of me, and I was fortunate to have a prosthetist who was patient and explained things to me.”
At last the call came that her definitive prosthesis was ready. To Casto’s surprise, it was not the one solid piece that she had expected. Instead, it could be broken down to its components, allowing adjustments. A flesh-colored sock hid all of the joints, giving it the look of natural skin, and it was lighter than the temporary prosthesis.
After a bit of fine tuning, Casto’s discomfort was over. “For the very first time I knew what security was. There was no pistoning! I walked between parallel bars barely holding on. After two trips, I let go for three steps! I knew I was on the threshold of walking with a cane, and as soon as I got home, I proved it. It was April, exactly one year. I had accomplished my mission!”
For a long time Casto was consumed with envy of people who could walk, an emotion that completely wiped out all the reasons to be thankful. “I was bitter,” she admits. “I even looked at athletes with a measure of contempt for putting their bodies in harm’s way.”
As time went by, however, her attitudes began to change. “I was no longer preoccupied with decor and superfluous things. Function became my number one priority,” she says. As her strength returned she started to look forward to outings at malls, parks and restaurants once again. That was when she took notice of how caring people were. They didn’t look away. They smiled and spoke. Some stopped and expressed interest in her three-wheeled walker, asking where they could find one like it for a relative.
“Perhaps seeing a senior reduced to a wheelchair or conquering a pipe prosthesis with the aid of a walker gave them a preview of their own vulnerability,” Casto observes. “I started to see the good in people. They not only opened doors and cleared paths for me physically, but psychologically as well. Just knowing that my fellow humans cared dissolved my bitterness and made me whole again.”
It’s been a long, hard road to recovery for Ruth Casto, now 89 years old. Her feisty spirit and persistent nature got her though some tough times, and today she is grateful for the blessings of good health and family. Casto’s message to her fellow amputees is to remember one thing: “If an 85-year-old, 108-pound, great, great grandmother can conquer the seemingly unconquerable…so can you!”