Initial rehabilitation that is sub-standard can do a lot of damage to patients physically and psychologically
Starting this very controversial article, the disclaimer is important. The following is all personal (informed) opinion. I built my first prosthesis at the age of 19, so it’s been 35 years, and have treated thousands of amputees locally and from around the globe in one of the biggest rehab hospitals in the world.
For us, optimal treatment includes a multi- disciplinary team of at least the referring or rehab doctor, a physio or occupational therapist, or both, and a psychologist. The social worker and nursing staff often also play a part.
Then of course, the prosthetic fitting procedure. It should be done with the utmost care and professionalism. The process takes at least three to six months, sometimes longer, to ensure that the patient walks away with a product that they can use to the best of their ability.
Quick fixes are not sustainable. Creating a prosthesis that adds value to a patient’s life without causing pain, skin breakdown or injury is of the utmost importance. And it is not always easy. Sometimes, it’s like forging with fire.
A prosthesis is expensive. But if you cannot use the product afterwards it becomes unbelievably expensive. You have just wasted precious funds!
We often treat patients who weren’t properly rehabilitated the first-time round. The psychological and physical damages caused by initial sub-standard rehabilitation protocols are far reaching:
- Patients become despondent and sometimes lose hope.
- Patients lose trust in their treating practitioner and in their own ability to bounce back.
- Patients stagnate.
- Falls and injuries occur.
- Secondary complications set in like skin breakdown, muscle weakness, flexion contractures and wound infections to name but a few.
- Post traumatic stress disorder rears its head.
- Patients think of a prosthesis as a hit or miss rather than a journey solving the possible complications along the way.
- The lack of patient education means patients are unable to help themselves and sort out the little complications and adjustments at home.
The list of complications is much longer. Fixing the problems can be very challenging. As a rule of thumb, the longer the period of sub-standard treatment continues from the date of amputation, the more complex it becomes to pull the patient back on track. And I can say without a doubt the psychological damage is the biggest hurdle to jump.
We have covered sub-standard initial rehabilitation in very broad strokes painting a doom and gloom picture.
But rest assured, when you find the practitioner who sees you as a whole, and recognises where it’s gone wrong; the practitioner who can identify your insecurities and fears will take your hand and lead you on a different path. A path of solutions, a path with a bright future, and most important of all, a path of hope!
