The loss of a body part is one of the most massive bodily interventions a person can experience. Whether it concerns a leg or an arm, an amputation is never easy. With help and tips, the amputation can at least be made a little easier.
"When I woke up from the coma three days later, I saw that my arm was missing. Then I wanted to fall asleep again. I told myself it would be all right, I was just dreaming," says Katharina, recounting her first conscious thoughts after her accident.
Fall asleep, wake up and everything is as it was before. This is what many freshly amputated people wish for. But unfortunately an amputation is irrevocable physical event. Every amputation of an extremity, no matter how minor, means the loss of a differentiated part of the body for those affected, and with it the loss of physical integrity. "The loss of a limb is equivalent to the loss of a close relative," says Dagmar Gail, president and founder of the Amputee Initiative e.V. in Germany. Even the most sophisticated technique is not able to replace this loss more or less completely with a prosthesis.
Causes of amputation
There are different causes that can lead to an amputation. It is essential to know whether the affected person was able to come to terms with the impending loss before the amputation as a result of a long-standing illness, or whether the loss of a limb is due to a traumatic event.
The most frequent reason For an amputation of the lower extremity are vascular diseases. Other causes are for example diabetes mellitus, accidents, tumor and malignoma diseases. Upper limb amputations are about 17 times less common. The most common causes are Trauma.
The number of amputations can only be estimated. There is no amputation register. The number of leg amputations in Germany is about 60.000 in year. Amputations are increasing significantly worldwide due to the increasing incidence of diabetes mellitus and arterial occlusive disease. "This is related to increasing life expectancy and our eating habits," explains Thomas Boni, chief physician at Balgrist University Hospital.
Good preparation helps
Those who have the chance to prepare for an amputation should use this time until the operation as well as possible, so that the healing and rehabilitation also proceed optimally. It is important to take into account both the physical and the psychological aspects that arise during the medical intervention. It is important to get information about the complete procedure and the consequences of the operation from the treating doctors at an early stage. This should clarify all questions about the surgical procedure, aftercare and, if necessary, prostheses, and eliminate uncertainties about work and everyday life.
In addition, relatives should be involved in the entire amputation process. You are very important and can support the affected person morally and practically. Amputee support groups and EnableMe ambassadors can also be consulted as an additional source of information and support. Through the personal experiences of people with amputations, fears, worries and uncertainty can be reduced.
Finding the right attitude towards amputation
An important point is personal attitude of the affected person to the amputation. This should be seen as a positive step towards improving or stabilizing health status. Recovery and rehabilitation can only be successful if affected persons actively participate in the whole process. It must remain clear that the course of treatment individual and direct comparisons to other affected persons are not possible.
If no preparation phase is possible, Doctor Thomas Boni advises that affected persons immediately after the event and as early as possible, enter into conversation with self-affected persons who can convey a positive perspective on life. Equally important are psychological or Psychiatric support and a good treatment team that instills security and confidence without raising unrealistic hopes.
Top athletic performances are possible even after an amputation (Photo: pixabay)
The before and after
"Patients are often afraid of amputation and are sometimes very depressed. However, as soon as trust is established with the doctor and the treatment team, the mood brightens," says Thomas Boni. After the operation, the pain and immediate questions about the "new" life are in the foreground for the affected person. "The very first thing I struggled with was the pain. It was only later that I thought: What can I still do, what can I no longer do," says Manfred M. from his amputation after a car accident.
"For many patients, the idea is worse than the reality, and they soon find themselves coping surprisingly well with the new situation. Others need a little more time and may not be able to look at the residual limb at the beginning during dressing changes, for example. With patience and affection, patients can usually soon accept their condition. It is important that we and the relatives can credibly accept him as a full-fledged human being, this transfers to the patient and his self-esteem", says the amputation doctor Thomas Boni.
The time between surgery and prosthesis fitting
For most patients, the process between the operation and the fitting of the prosthesis is particularly exhausting and lengthy. After an amputation, those affected are confronted with a A multitude of changes confronted. In addition to physical functional limitations, developments in the psychosocial sphere also play a significant role. Often, changes in the professional and family environment must also be dealt with.
In this phase, many specialists work together to ensure the greatest possible mobility and mobility for the affected person. Besides these physical measures also play psychological rehabilitation and the social situation Essential rollers.
A large proportion of amputees experience residual limb or phantom limb pain during this phase.
Stump pain manifests itself through processes localized in the stump itself. Phantom limb pain can occur following the separation or denervation of a body part. They take on different pain characteristics and are triggered by a wide variety of factors. Phantom sensation is sensation in the area of the body part that is no longer present.
"To the extent that it is possible, patients must be made aware of the risk of phantom limb pain even before amputation. We reckon with about 10% of therapy-refractory phantom pains, which are a big problem. Good preoperative and postoperative pain management is important. Today, powerful medications are available to combat phantom limb pain, but early activity with the residual limb is also important," explains senior physician Thomas Boni.
There is no amputation management patent remedy
Every single person affected copes with their amputation differently. Personality factors, the social environment and previous life events are of great importance in the processing of an amputation.
Read both full interviews here: Manfred M. and Katharina S.