Amputee reintegration and motivation specialist EMILY GRAY shares her insights into the physical and emotional stages amputees face after an amputation
When faced with the ordeal of having a limb amputated, people move through several stages, emotionally and physically. Many adaptations will take place and, if managed correctly, one can use their disadvantages to propel them towards a future much brighter than was ever previously thought possible.
The common barriers to rehabilitation are depression, anxiety, hopelessness and suicidal ideation. It was found that 21 to 35 percent of patients experienced clinical depression and post-traumatic stress disorder (PTSD) after a traumatic injury occurred. This emotional trauma will depend on the person’s age, type of limb loss, and the cause of amputation.
This emotional recovery is a personal process, which will vary for everyone in flow and duration. However, there are common stages through which patients go.
Shock
This may last several weeks after the amputation. When patients wake up for the first time as an amputee they will look down at the area where their limb used to be and feel an intense disconnection between their mind and body. You are the same person, yet, you don’t look and feel the same and will most probably never move in the same way.
Denial and isolation
This stage should be limited if not totally avoided as denial and isolation are cause by feeling ashamed and embarrassed due to negative thoughts and poor self-image. This mindset can lead to isolation from family, friends and, ultimately, society.
Anger
The question “Why me?” will crop up time and time again. Understanding that this situation isn’t a result of who you are as an individual is important. Turn inwards for self-refection as opposed to comparing yourself to others. Be proactive in finding ways to work through your frustrations and explore new ways to get physically active again.
Acceptance and identification
Be fully understanding and accepting that you cannot take back time. Owning this new “identity” will become the last stage of coping. Turning it into a positive self-image will result in a positive outlook and outcome in life. As children go through the stages it is important to remember the normal developmental stages they would typically pass through in life.
For example, the natural inquisitiveness seen in many three and four-year-olds may also be exhibited around the child’s limb loss, resulting in a period of “how and why” questions to parents about the amputation.
As children mature and develop the cognitive abilities necessary to project into the future and appreciate the permanence of their limb loss, adjustment difficulties may crop up in a child who previously seemed to be taking things in their stride.
The long-term effects of scar tissue can vary depending on the actual location and the level of severity. Scar tissue is primarily made up of dense fibres of collagen, which could restrict lymphatic and blood circulation. When nerves are cut from amputation the risk in developing stump neuromas is expected and are natural occurrences after nerve injury.
When damaged, the proximal (end section that remains) nerve segment attempts to regenerate, leading to a bulb-shaped thickening or stump. These neuromas can then cause referred pain due to the regenerating nerve fibres attempting to branch out into surrounding scar tissue.
This will cause surrounding structures and tissues to be put under stress resulting in:
- Pinched nerves;
- Numbing sensations and pain;
- Range of motion and flexibility restrictions;
- Atrophy in certain muscles.
In order to manage scar tissue, it is recommended to massage the area daily for at least two minutes. Working along and against the grain of the muscle fibres should loosen and break up scar tissue and will cause the adhesions to loosen up. This should relax constriction and promote increased flexibility and ability for movement.
A successful transition back into society can take many years. However, an unsuccessful transition will last a lifetime. The key is to be proactive instead of reactive in your situation.
