Living With a Limb Difference

Web Development inMotion

Volume 15 · Issue 5 · September/October 2005 | Download PDF

by Anne F. Street, MSPT, Prosthetist, CPI, STS

8 Keys to Success

I have worked as a physical therapist in an inpatient rehabilitation hospital for 14 years, and I specialize in the treatment of patients with limb differences. During this period, I have had the opportunity to talk to numerous amputees and to ask them what they learned after surgery that had a positive impact on their life. The following tips summarize what I have learned from these individuals and what I now teach my patients. They are important keys to living successfully as an amputee.

1. Talk to the members of your healthcare team

Keep your physician, nurse practitioner, physician’s assistant, etc. informed of any changes in your activities, diet, pain, residual limb or emotions. What may seem insignificant to you may be important to them, especially during the period shortly after your surgery. If the members of your healthcare team catch a problem early, they may be able to solve it with minimal pain and expense.

2. Establish attainable goals

Limb Difference 01

Don’t expect to be “leaping small buildings in a single bound” the first week after your surgery. With the help of your rehabilitation team, set smaller, achievable goals on a day-to-day basis that will help you eventually achieve larger, more complex goals on a week-to-week basis. Early on, for example, you might work on safely performing sit-to-stand transfers as a component of preparing to walk to and from the bathroom independently. Then, as your strength and abilities improve, you can change your goals accordingly. Discuss these goals with the members of your healthcare team; they should be able to tell you what is reasonable.

3. Develop new habits

Try to establish new routines for the care of your residual limb and prosthesis. It takes two to three weeks for an activity to become ingrained as a habit. Performing the same activities in the same way at the same time of day should help you develop patterns of activity that you will continue to perform regularly with minimal thought and effort. At the same time, these habits could have a profound impact on your life. For example, performing skin checks before donning and after doffing your shrinker and/or prosthesis can help prevent skin breakdown problems. This can help you minimize skin injuries that could cause you severe pain, prevent you from using your prosthesis, limit your mobility, and even lead to life-threatening infections. If you have diabetes, preventing such injury is especially important.

Limb Difference 024. Do your exercises!

The benefits of an established exercise program are endless and include improved circulation, endurance, strength, weight control, flexibility, balance, emotional outlook, independence, and overall quality of life. Take the time to learn and perform your exercise program. Then, talk to your therapists to find a way to maintain your program after you are discharged from formal therapy. (Caution: Always check with your physician before beginning a new fitness regimen.)

5. Be careful about your position

If you maintain the same position, such as sitting in a chair, for an extended period of time, your body will start to conform to that position. Your muscles and tendons will shorten, and pretty soon you won’t be able to straighten them. This situation is called a contracture.

To prevent or limit contracture formation, it is important to periodically stretch in the opposite direction of a maintained position. Lying on your stomach for 15 to 20 minutes a day, for example, can help you minimize hip flexion contractures caused by excessive sitting.

6. Practice energy conservation


People With Disabilities May Get Health Insurance for Life
by Gerald B. Kagan, JD

You may be able to guarantee lifetime health insurance benefits if you leave your job because of a disability. COBRA, a federal law, allows you to keep your health insurance under most group plans for 18 months, but permits an extension to 29 months if you qualify for Social Security Disability Insurance. This extra period will ensure continuous health coverage until you qualify for Medicare (29 months after your disability began), regardless of your age.

Copyright 2005 Gerald B. Kagan

This insurance tip was supplied by Gerald B. Kagan, JD, a patient advocate who assists those who are having significant problems with the medical system. You may contact him by e-mail atgbkagan@aol. com or by telephone at 310/230- 8333.

Taking a break in the middle of the day can allow you to be more productive later in the afternoon. If you separate a larger project into two or three smaller activities with rest periods in between, you will still get the job done but will not be exhausted when you finish it. If you have long distances to traverse, you might use a manual or power wheelchair to help cover the distance so that you will have the energy to enjoy dinner when you get there.

Look at your daily activities, and see if they can be modified to make them easier and you more efficient. Even though you use leg prostheses, for example, you might do some things around the house in a wheelchair so that you will have the energy to wear your prostheses when you go outside. If you have bilateral lower-limb amputations, you might make your bed while sitting on it without your prostheses so that you don’t have to walk around it with your prostheses on. This can help you conserve your energy for later in the day.

7. Realize that you are not alone

Become involved in a local peer support group. Don’t reinvent the wheel; instead, learn how other amputees have solved problems and are dealing with issues. Support groups can provide information on community resources for transportation, funding, prostheses, equipment, home renovations, etc. Many groups are open to spouses, friends and significant others. Talk to your family and friends about your concerns and goals. They won’t know what’s going on unless you tell them and involve them.

8. If you smoke, quit!

The vaso-constrictive effects of a single cigarette can last for up to two hours after you have finished smoking it. This reduces blood flow and the delivery of oxygen to your extremities and healing tissues. This effect is magnified if you also have diabetes or vascular disease. Talk with your physician about safe, effective methods to help you kick the habit.

About the Author

Limb Difference 0Anne F. Street, MSPT, Prosthetist, CPI, STS, received her Bachelor’s Degree in Sociology and Education and her Master’s Degree in Physical Therapy. She is also a certified Pilates instructor, has a certification as a strength training specialist, and recently completed the California State University at Dominguez Hills’ Prosthetics Program. She is practicing in Melbourne, Florida.