What to expect before and after your amputation surgery

Intro

Facing amputation through elective surgery or a traumatic event can feel overwhelming. Knowing what to expect during each step of the process can ease some concerns and being prepared has been proven to speed recovery and expedite the rehabilitation process.

Before you do anything, we strongly recommend that you connect with an Amputee Coalition Certified Peer Visitor. Contact your nearest Evergreen clinic to request a visit – many of our locations have Certified Peer Visitors on staff. A peer visitor or support group can support you mentally, as your care team supports you physically.

We would also like to give you one of our New Amputee Resource Backpacks. Reach out to your nearest clinic to request one.

How should I prepare for an elective amputation surgery?

You will be seeing your care team a lot in the coming months! Building strong relationships is key to your successful rehabilitation. If you can, carefully choose a prosthetist, physical therapist, primary care doctor and a specialized surgeon that has experience working with amputees. Getting your surgical and rehabilitation team in place before surgery will help you feel more comfortable and be better prepared. Your team can provide you with a complete care plan, as they work together to help you reach your goals.

Research the type of amputation you are having. Consult with your care team on behaviors that may help speed your recovery process, such as quitting smoking, managing your blood sugars and reducing your weight before surgery.

If you can, meet with your prosthetist before surgery so they can answer any questions you might have. Discuss what activities are important to you, determine your post-surgery goals and make sure your team is on the same page. Your prosthetist and surgeon may wish to meet before your surgery to discuss your specific surgical needs.

What should I have for my hospital stay?

Below are a few items to ease your hospital stay that have been recommended by individuals with amputations. Pack a bag to bring for your surgery or send this list to a family member or friend who can gather items for you.

• Clothing for your recovery – you’ll need loose, comfortable clothing that will allow easy access to the site of your amputation
• Clean undergarments – a clean set (or 2) of undergarments can keep you feeling clean and ready to tackle rehab
• Entertainment – have a book, magazine or electronic device to keep you entertained and help you relax
• Personal pillow or blanket – some comforts of home can help you sleep in an unfamiliar environment
• Notepad and pen – you’ll be receiving a lot of new information, so be ready to take notes
• Contact list – have contact information for your friends, family and your care team in case you need to reach any of them

What will my limb be like after surgery?

Even though you won’t be cast for your prosthetic for a few weeks, you will start the process of rehabilitation and preparing your residual limb for your prosthetic immediately after your surgery. In these early weeks, your limb will be very bulbous and swollen and may have small “dog ears” where the skin comes together at the incision. The incision will be closed with stitches and staples, which will gradually be removed as you heal. You will likely wear a protective covering for your limb to protect it if you fall, prevent infection and keep your leg fully extended to prevent muscle contractures.

The early weeks of recovery are a crucial phase with three main goals: caring for your residual limb, reducing your swelling and keeping your residual limb (or stump) clean.

How can I prepare my residual limb for my prosthesis?

Research has shown that the first several months of rehab are crucial to your long-term success as an amputee. Your physical therapist and prosthetist are the best resources to help you maintain the range of motion and strength in your body and extremities, as well as prepare you for learning to use or walk with a prosthesis. A comprehensive inpatient and outpatient therapy schedule is critical to reaching your goals and becoming a successful prosthetic user.

Begin massaging and exercising your residual limb as soon as you are able. This will help you become more comfortable with the changes in your body, reduce swelling and desensitize the tender skin. A proper massage and exercise routine will also strengthen the muscles and support tissues in the limb while increasing blood flow and circulation.

How will I know when I’m ready for my prosthesis?

About two to three weeks into your recovery you will begin seeing your prosthetist on a regular basis to evaluate your recovery. Based on the factors below, many amputees are ready to be cast for their initial prosthesis about five to seven weeks after surgery.

• Volume – The size of your limb will continue to decrease for the first year of your recovery. Your prosthetist will be looking for stabilization of the shape at the base of your limb and for fluctuations in volume to plateau.
• Pain – Casting and wearing a prosthesis requires manipulation of the limb and weight-bearing around the residual limb. You should have minimal pain and tenderness at this point.
• Healing – Your practitioner will wait until your wound is clean, dry and closed (CDC) and all of your sutures are removed before casting to prevent prolonging the healing process.

How can I get around before I have my prosthesis?

Lower body amputee patients are often concerned about how they will get around before their first appointment. Although you may first think of a wheelchair, we highly recommend using crutches during this time. Using crutches will help you stay in shape by moving and exercising.

Even after you are fitted for your prosthesis it is a good idea for you to keep a pair of crutches or a rollator for times when you are not wearing your prosthesis.

How can I alleviate my phantom pain?

Pain and phantom sensations can vary and may appear like cramping, aching, burning, or even a brief sharp pulse feeling. Stress, anxiety, fear, and lack of sleep or proper nutrition will usually increase your discomfort. There are several options to reduce pain or discomfort, including acupuncture, chiropractic care, or circulation therapy. Do not hesitate to discuss any pain or phantom sensation with your prosthetist, physician, or therapist.

• Wrap the residual limb in a warm, soft towel or a heating pad
• Wrap the residual limb in a cold pack or apply cooling cream or gel
• Tighten and slowly release the muscles in the residual limb
• Wear your shrinker sock or wrap the limb in an elastic or Ace bandage
• Change your position - get up, move around, sit down, etc.
• Massage the residual limb (with both hands, if a lower body amputation)

How often should I see my prosthetist?

Once indicating factors (volume, pain, healing) have stabilized, you’ve been cast and your initial prosthesis has been created and delivered, you will see your prosthetist about once a week for the first few months. If you are unable to get comfortable regardless of adjustments or have any areas of bright redness that do not go away after 30 minutes of removing your prosthesis, please stop wearing your prosthesis until you can be seen by a prosthetist. A non-healing blister or sore can prevent you from wearing your prosthesis and delay rehabilitation.

Contact your prosthetist immediately if something is wrong. Clicking, squeaking and strange noises may indicate that components are wearing out and need replacement. Even experienced amputees should see their prosthetist a few times a year to keep their prosthesis in good working condition.

What happens next?

Every individual has their own unique goals and activities that are important to them. Whether it’s ambulating around your home or community, being active with friends and family or participating in high-level athletics, communication and hard work with your rehab team is critical. Never let anyone tell you “there’s nothing more to be done.” There is always a solution to help you overcome obstacles. Don’t be afraid to ask questions, connect with support groups and be bold. There is life after amputation, it’s up to you what that life is going to be.