Pre-amputation Assessment

rubber feet with a flowering plantI found this article on assessment after my amputation. I was struggling with the raw feelings of never having my foot again. I felt like I was waking up from a dream where everything is in chaos, and regrets are not resolved. I wake up to people trying to be logical and not let their emotions get out of control. It took me a long time to join their world and fully wake up. What I found was a blueprint of what should be done before you have an amputation. It is a sound medical and psychological assessment that yields a wealth of knowledge and suggestions for getting over this transition. These days it is entirely up to you to get these things done before you go under the knife.

Pre Amputation Assessment should include:

  • a thorough medical examination – assessing your physical condition, nutritional status, bowel and bladder function, your cardiovascular system (heart, blood and blood vessels) and your respiratory system (lungs and airways)
  • an assessment of the condition and function of your healthy limb – removing one leg can place extra strain on the remaining one, so much more attention needs to be placed on the remaining limb
  • a psychological assessment – to determine how well you'll cope with the psychological and emotional impact of amputation, and whether you'll need additional support
  • an evaluation of your home, work, and social environments – to determine whether any additional provisions will need to be made to help you cope

After your amputation, these are the steps to follow. Interview potential Physical Therapists. You must feel comfortable with the person you choose, so you are encouraged and not forced to exercise. They will be the person to be there as you go through the often painful initial rebuilding your body to have the strength to get you back on your feet. I recommend insisting on the most inpatient rehabilitation you can and follow up with as much at home visits as possible. Your GP is the one to order it. You must insist that you get an Occupational Therapist as well. If you don’t, you won't have someone there who will teach you to shower, dress yourself, and take care of your personal hygiene while getting used to missing a limb. These specialists will answer your questions about adapting to your new body as it heals. Most importantly, they will teach you how not to fall.

While you are waiting for the stump to heal, this is an excellent time to research prosthesis. All you can think about is not falling and finally being completely healed. Recent advances in limb components are incredible and if you contact the manufactures, you can try their products out for a few weeks for free. They will contact the prosthesis maker you choose. There is a section on prosthetic innovations on my website. Eventually, when your stump finally heals you will need to find a Prosthetist. You must insist on seeing the different type of prosthetic limbs and ask him which ones he favors. Although he may have many to choose from, he may only prefer one particular type. What they don't tell you is that your first limb may not be replaced by another for several years if there is not significant shrinkage of your stump.

It is typical that through this whole process that no one will ask about your psychological rehabilitation. Having experienced this entire process, I was shocked to find out that physical therapists are not allowed to bring up this subject because "it is outside the scope of their practice." You can ask for a peer visitor from the Amputee Coalition, but they come out once. All the psychotherapists I tried to contact had no idea what dealing with an amputation entails. There are a few therapists who have gone through the process. They are usually listed as life coaches on the internet. If you neglect the psychological recovery that must take place, you have a greater risk of getting stuck. Some people stop in a wheelchair and never get used to a prosthesis. Some don't want to get out of bed. This is just another aspect of your all over recovery.

No one is potentially in a better position to understand about living life with amputation than an experienced therapist who has been there. They can use their therapeutic skills to offer encouragement from a place and at a pace, that an individual in this circumstance can better absorb.

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