When it is decided that you no longer need the care provided in a surgical ward, it is often the case that you will be transferred to another ward or hospital for a period of rehabilitation. You may receive treatment such as physiotherapy, including balance techniques if you have lost a leg, or desensitisation to help you become familiar with touching your wound.
This time will also allow you, your family, and your care professionals to assess your on-going care requirements, and carry out any modifications that need to be made to your home or transport to allow you to live as independently as possible, particularly if you live alone. In some cases of course, your home will not be suitable for alteration and a move to more appropriate accommodation will be necessary.
Aids and equipment will be assessed and made available before you are discharged from hospital. Although you may wish to be provided with a prosthetic limb, it can take some time for this to be assessed and made available and you may need a wheelchair in the meantime, which may require further alterations to your home, even if temporary, including access to the property inside and out.
Your own general state of health will also be a factor in how long your rehabilitation may take and, during that time, you will probably meet with a dietician who will provide advice on making sure you eat a healthy diet. This should include nutrition to provide the necessary additional energy that is required if you are planning to use a prosthetic limb, particularly a lower limb, and ensures the continued health of the other limb to take the excess strain to compensate for your amputated limb.
During your pre-operative assessment, you should be introduced to a prosthetist (a specialist in prosthetic limbs) who will be able to tell you more about the type of prosthetic limbs (or other devices) that are available and how well a particular prosthetic limb will function.
Some amputees will find that they are not suitable for a prosthetic limb, which takes a considerable amount of additional energy (up to 80% more) to use it to the best effect. If for example, you suffer from a heart condition, the decision may be made that it would be more appropriate for you to use a cosmetic limb.
If you are found to be a suitable candidate for a prosthetic limb, you will be assessed to decide on the most appropriate type for you. Factors that will influence the type of prosthetic limb recommended for you include:
Although in some situations, it is possible for a prosthetic limb to provide you with both your physical desires and the functionality you need, it is possible that your needs may be so diverse that you will need to decide between the physical and functional.
Following your discharge by the hospital, you may have to attend follow-up appointments to discuss your situation at home, how well you are coping with the arrangements, and whether you have identified further help, support or equipment that you now realise are needed. Often it is only when you are faced with doing things for yourself, that you can fully appreciate the help that you may need, and even tying your shoelaces can become difficult. Do not hesitate to ask for all the help you need and to which you are entitled.
It is also vital that you avoid injury or damage to the remaining leg. If you are diabetic and your amputation is a result of the effects of this condition, those conditions may also be present in the remaining leg and you should take all steps necessary to ensure you do not ultimately require another amputation.
Poorly fitting footwear can lead to poor blood circulation and conditions requiring amputation, and care of your feet, including your nails, is critical to avoid future problems.
Once you have dealt with the practical side of living your life after amputaion, the whole area of relationships, and your emotional well-being may cause problems. One of the main issues for amputees in returning to normal relationships is that of body image. From when we are small, and throughout our lives, it is natural to have thoughts and feelings about body image, including shape, size and other physical attributes such as hair, teeth and skin, in fact, all our visual assets.
Although everyone’s body image changes naturally as we age, an amputation creates an immediate and significant change. As an amputee, you not only have to deal with changes in how our body works and feels but also how it looks.
It is important to remember that you are still the same person inside that you were before the amputation, a whole person who just happens to have a missing body part. Try to focus on new ways to do things that you enjoyed before, even if you need to be extra creative to find solutions, and focus on what the future holds rather than what you have lost. Your own body image is likely to become more positive once you are comfortable with your prosthesis and you will know this is starting to happen when you feel naked without it!
Relationships, no matter what kind, almost always have a positive influence on our physical and emotional lives. Whilst some relationships are merely friendships, other relationships involve close emotional bonds and without either type of relationship, we can feel lonely or depressed, with no one to talk to or distract us from our problems and pain.
Amputees often avoid relationships because of their negative thoughts on their body image, believing other people will see only the amputation and reject them. However, studies prove that this is not the case. Stay involved with people you already know and share feelings for, but it may also help to join an amputee support group to learn from others who have shared your experience but now live full and happy lives.
There is no reason why returning to work should not be a real option for many amputees. It will depend upon both the nature of your amputation, and the type of work you previously did. If you wish to return to your previous type of work, the Occupational Therapist, either one you have been involved with through the hospital or at your place of work, will be able to help you understand whether a return will be possible, or whether you should consider an alternative type of work.
Where possible your employer should make changes to your work environment to allow you to continue in your previous employment. These may include relocating you to a ground floor position, making a lift available, or providing you with aids such as a desktop PC rather than a laptop. It may also involve a change in hours, perhaps reduced hours or more sociable hours if you previously worked shifts which are no longer an option. For example, if you used public transport which is no longer accessible to you. The options may be many and varied and it may take some time to assess your full needs.
However, these adjustments may not be possible either for practical reasons related to your abilities, or because your employer is unable to accommodate your requirements due to cost, size or nature of his organisation. If this is the case, your Occupational Therapist will help you identify other types of work for which you could be suitable.
Whatever the possibilities are for future employment, they may result in lower earnings and this is another area that needs to be fully assessed before the final calculation is made in your claim for compensation.
During your rehabilitation, you should be provided with details of your nearest support group, who normally meet every month. These groups generally consist of both health professionals and others who are living with an amputation, all of whom will be able to provide you with information, advice and support to help you not only cope with your amputation but to look forward to living a full and happy life.
British Limbless Ex-Servicemen's Association
British Red Cross (National Branch)
Citizen's Advice Bureau (National Number)
Disabled Living Foundation (DLF)
Department for Work and Pensions Benefit Enquiry Line
DVLA (Driver and Vehicle Licensing Agency)
Mobility Centre - Queen Elizabeth's Foundation
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