by Melissa Bean Sterzick
In a perfect world, amputees’ unaffected lower limbs would be exempt from all injury and inconvenience. There would be no bruises, sprains, strains, breaks, or blisters to intact legs. Those limbs already work overtime, are often ignored, and are as indispensable as any socket, joint or appendage on a prosthesis.
For all amputees, injuries to an unaffected lower limb come with a list of complications that might be hard for a general practitioner or even an orthopedist to understand. Mobility and transfers will be different. Rehab exercises will need adjustment. Upper-limb amputees who break a leg or sprain a knee might have difficulty using crutches, canes, walkers and wheelchairs. Lower-limb amputees may be completely non-ambulatory until their intact leg heals.
I’m a 51-year-old left-below-elbow congenital amputee, and I’ve dealt with many leg injuries throughout my life. Most recently, I had tendinitis in my ankle—its exact cause is still under investigation by a podiatrist and orthopedic surgeon.
It’s difficult for me to manage two crutches with one hand. Using one crutch on the right is fine for a very short distance, but isn’t going to get me across a parking lot. A walker won’t work without a special attachment—I would have to lean down to my right in order to use my nub on the left handgrip, and that would create imbalance and instability. A self-propelled wheelchair is impossible. I looked up knee crutches online, but don’t think I have the upper body strength to stay upright on what seems like a short stilt. I’m still healing and not ready to try a cane.
The solution I settled on is a knee scooter with a telescoping handle that brings the handgrips up to waist level. It keeps me mobile, but it’s bulky for use around the house and cumbersome for trips away from home. So far, I can’t run errands, or get to work or doctor’s appointments by myself—I need help with driving and moving the knee scooter in and out of the car.
In addition to wearing a heavy boot on my right ankle, I’ve braced my left knee and left ankle trying to protect those joints from strain. They are doing all the heavy lifting. My right wrist, already sensitive from years of overuse, needs a brace for protection, too, as it bears my weight moving from bed to scooter, toilet to crutches, scooter to car, and so on. I feel a little like Darth Vader covered in my black protective gear.
My family has placed barstools near the bathroom sink and kitchen counter, so I can sit while I brush my teeth or butter my toast. And, like a queen in her castle, I move around my home with a bag of essentials such as lotion, phone chargers, heating pads and a bottle of water. (Also, a book and reading glasses, a bottle of ibuprofen, and some snacks.) This saves me trips and makes life easier for my family members, who, try as they might, can’t possibly remember everything I need.
A lesson I learned after having two children by C-section is to keep medication and water in places where you sit down often—keeping them safe from small children and pets, obviously. If you’re taking more than one medication for pain, or forget your doses and schedule; keep a notebook with your medicine and write down when you’ve taken it. It might also be a good idea, if you’re having trouble getting around, to write down how much water you’ve had and how often you’ve eliminated. You can’t afford to restrict drinking and urinating, even though getting to the bathroom is a journey you can’t manage alone.
I am discouraged by how difficult it is to accomplish any task and how small my world will be until I’m mobile again. However, I’m able to bear weight on my injured ankle now, and that is a huge relief.
Educating Your Team
Tim Sullivan, a Los Angeles-based physical therapist, says being prepared for an injury to the unaffected lower limb requires maintaining the health of all unaffected limbs. “It’s important to stabilize your load,” he says. “We like to say ‘motion is lotion,’ so you should move, but not overdo things. You want to avoid overstressing the uninvolved side before it becomes the involved side.”
That includes ensuring the fit of the prosthesis, caring for the skin, and keeping up with occupational therapy or gait training. All amputees need to strengthen their core and back. Your prosthetist and physical therapist can help you address your residual limb’s safety while using boots, crutches, and other mobility devices to support the injured limb. There’s no one-size-fits-all solution; it depends on the location of your amputation, what type of leg injury you have, your overall fitness, and your comfort preferences. Upper-limb amputees need to adapt their activities and gather tools to prevent overuse of wrists, elbows, and shoulders. An injury to the unaffected side can expose and exacerbate weaknesses in overall stamina and strength.
When you’re receiving treatment to an injury on your unaffected lower limb, be ready to advocate for your specific needs. “We would love to think that practitioners are fully aware of what you’re going through, but you’re going to need to talk to your provider about what your amputation entails for you every day,” Sullivan says. “Educate your caregivers, and educate your team.”
Setting Up Your System
For injuries and treatments to the unaffected lower limb, amputees need specific tactics and tools to get through their hardest days. Life is too short to move around in bubble wrap, but if you get hurt, you want to be prepared. If you don’t already have all the following equipment at home, think about setting up your kit, just in case.
- Braces for knee, ankle, hip, wrist and shoulder
- Crutches
- Walker, wheelchair
- Knee scooter
- Toilet riser
- Shower chair
- Bolster pillows
- Reacher tool
- Bathroom rails
- Recliner with lift
- Hospital bed
Most of us have found being an amputee isn’t a free pass for having other health issues. There will still be stomachaches, stuffy noses, and opportunities to trip, twist an ankle, or wear out a knee joint. These injuries have nothing to do with being an amputee. Recovery, however, depends on accommodating our amputation along with the injury.
Melissa Bean Sterzick is a freelance writer and writing tutor with a congenital limb difference. She lives in Los Angeles with her husband and two daughters.