More Than Half of Amputees Don't Receive Post-Amputation Care

More than half of amputees don't receive post-amputation care. A study recently published in the Journal of Vascular Surgery (JVS) found that less than half of recent lower limb amputees got any referrals to a prosthetist. The ability of these professionals to get people into adequate prostheses and back on their feet is denied with." no justification. "More than half of amputees don't receive post-amputation care. The tragedy is that they don't know what they are missing as they are condemned to life-limited to their wheelchair.

According to the National Limb Loss and Preservation Registry director, Dr. Kenton Kaufman, "two-thirds of amputees never receive a prosthetic limb." To rectify this situation, Senators Tammy Duckworth and Marsha Blackburn introduced the Access to Assistive Technology and Devices for Americans Study Act in July 2020. This bill will guarantee access to a prosthesis evaluation. The lawmakers behind the bill found that of the 2.1 million Americans experiencing limb loss and limb difference, only 30% to 35% receive a prosthetic device through the Veterans Health Administration. Even worse, more than half of those VA amputees don't receive post-amputation care. 

New Study to Assess the Extent of Denial

In a new study in the National Library of Medicine, the authors found that it wasn't the cost of a new prosthesis or lack of insurance that prevented amputees from getting access to a prosthetist. Instead, the researchers found that it was the vascular surgeon's refusal to make a referral for an initial consultation with a prosthetist, who can often be availed for free. Furthermore, the study looked into patients that were referred to a prosthetic clinic that serves the underinsured and uninsured. More than half of amputees don't receive post-amputation care.

Static Attributes Precipitate Blanket Denial

If you have any of these attributes, you will never be referred to a prosthetist: (1) suffer from diabetes, (2) are not male, (3) currently smoke, (4) are in your seventies, and (5) have been evaluated by your last anesthesiologist as being an ASA four. (A patient with a severe systemic disease that is a constant threat to their lives) or an ASA five ( A moribund patient who is not expected to survive without an imminent operation.) They justify not making a referral because of the risks associated with stamina, balance, and other physical issues. More than half of amputees don't receive post-amputation care. 

The American Society of Anesthesiologists developed the ASA fitness scale to assess patients' fitness for surgery. It became a criterion for referral to a prosthetist for even an initial evaluation is unclear but sounds excessively exclusionary. Patients who score either 4 or 5 have significant life-threatening health issues besides their limb loss. They stop seeing the patient during the amputation. The authors noted in the study." Guidelines for Screening of Prosthetic Candidates, "that patients with a four or five ASA fitness score may be at too much physical risk if they are referred to be fitted for a prosthesis.

No Adequate Scientific Bases

Risk factors for post-amputation care referral have not been adequately investigated or standardized. The good news is that initiatives like the Triple-A Study Act and the Limb Loss Registry may lead healthcare providers to see more amputees that don't receive post-amputation care. Some may indeed be unsuitable for a prosthetic limb fitting. Unfortunately, other patients might be denied prosthetic care based on their gender, age, lifestyle, or flaws in the healthcare model. Since standardized criteria for prosthetist referral don't exist, it's impossible to determine whether these patients are genuinely unsuitable. Denying them post-amputee care is cruel. More than half of amputees don't receive post-amputation care. 

Who Says You Can't Change?

To deny anyone the chance to walk again just because they are seventy makes no sense other than ageism. We have two major health problems facing America today, which are diabetes and obesity. Denying someone the possibility of walking again opens older amputees to developing both of these. Health care workers would stop blaming the victim by saying," I only wish they could lose weight and control their blood sugar." It takes encouragement to address these deadly issues. It takes a strong optimism that any person will get healthy if they are given the opportunity.

Wrong Sex Is Not an Excuse Its Sexism

Being denied a referral to a prosthetist simply because you are of the wrong sex is unconscionable sexism. Worse than that, it is scientifically untrue. A recent study addressed this issue by," evaluating the possible differences between genders in amputation incidence, revascularization activity before and survival after amputation." The female population was older, as predicted by the difference in life expectancy. The study's conclusion was that although" The amputation incidence was found to be higher in men compared to women . "There was no significant difference between the genders in survival after amputation."

You Can Learn to Prevent a Fall

Fear of falling should not be a death sentence. People who regularly attend fall prevention classes have a statistically better chance of not getting hurt falling. It is a preventable risk factor and not a reason to deny someone a full recovery. Microprocessor prosthetics have been shown to provide a 79% relative risk reduction in falls causing injury. They've also been shown to increase the wearer's stability on variable terrain and require less effort for the wearer to move. Since many amputees are older, a reduced fall risk can be a life-saving feature. 

The last reason for denying the elderly amputee a chance to walk again is like all the rest. It assumes that the person can't change. Amputation shows that people are mortal and changes amputees' realization of their control over their longevity. If the possibility of a prosthesis is presented as contingent on their quitting smoking would be a better alternative to condemning them to a wheelchair. In one study, 30% of the smokers with peripheral artery disease quit smoking to reduce their risk of amputation. Amputees would stop smoking if it meant a chance to be able to walk again.

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