…one of my great scribbling pals is Lockie Young… not only does he pen extremely well, but he also has a lesson for me, and I suspect for more than a few of the rest of we Lads and Lassies of Blog Land… an indomitable spirit, and a deadpan sense of humour to match… read on…
As I look at the blinking cursor on the screen of my monitor, I adjust my new to me office chair so it is just so. My right leg, with the prosthetic on it, is stretched out in front of me under the desk because I still can’t sit with it at right angles to the seat. My thigh is too fat to allow this once normal and seldom thought of position, due to the extra fifty pounds of weight I put on while I was flat on my back in the hospital. My hospital stay was almost four months longer than the estimated five to seven days my doctor first predicted, because the routine operation, that had a ninety-five percent success rate, was in fact a fail of epic proportions and not as a result of a slip in the O. R. like you might expect. A rare allergic reaction to a commonly used drug turned my blood volume to jelly and both legs died due to lack of blood flow.
The miracle happened when the doctors restored the flow for the stream of life giving fluid and both limbs were saved, well that is to say the right leg had a short time to remain a part of me while my body fought for life. In the end, I would have another course of operations and procedures in an attempt to save the leg, but the final result would be an amputation.
I suspect some of you reading this might be thinking how awful, or feel in some way sympathetic to my plight, but the fact is I am grateful to be alive, and at the same time in awe of my body’s amazing ability to adapt to the assault, and at the same time initiate the process of rerouting blood vessels and nerves and detoxifying and rescuing vital organs. Of course the doctors helped too. I would be a fool if I thought I did it all on my own, but that’s not why I’m writing this piece.
Now that I have brought you all up to speed, I wanted to give you an intimate guided tour of the life of an amputee. Losing a limb, or part of a limb is not new. In fact, people have been losing body parts since time began. Of course, in the early days, most folks died. End of story. Oh, compound fracture…dead. Oh, splinter in your foot got infected…dead. It was just a fact of life in a pre medicinal world. Once we learned we could safely remove diseased parts and organs, life expectancy started getting a lot longer. So fast forward through all the icky parts, past the long days of healing and recovering, to the day I am being prepared for and fitted for a device.
You there in the back row! Get your mind out of the gutter. I’m talking about a prosthetic device. Firstly it must be looked on as an assistive tool and nothing more. Prosthetic devices are as varied as the injury itself. From artificial hands or feet, to complete legs and arms, these devices have grown in sophistication through the years. Remember reading about Black Beard the Pirate, or watching a movie about pirates? There was sure to be a wooden legged, hook handed pirate in there someplace. That was old school prosthetics. Now, these devices are made of titanium for its strength, and aluminium for its light weight properties, and electronics in some cases, that actually have computer brains at their core to make them operate as close as possible to the real limb or hand or foot.
In my case, before I was forced into this life detour, I would have questions if I saw someone with an artificial hand, or if I met someone with an artificial leg. I would wonder how they put that thing on, what in the world held it on, and how did they manage in their day to day lives. But I would never ask. I was much too embarrassed to ask to have a look at something so personal. The truth is, and this might be just my opinion although I suspect not; I would have no problem now or at any time showing someone how this leg stays on. In fact my family is likely bored to tears by now with me explaining the how’s and why’s to anyone who will listen. That’s why I am writing this personal essay, to let you into my personal space, just for a little while.
It’s been ten months since The Operation. That’s what I will always call it. That day I became the one legged man. My stump, that portion of my leg just below my knee that was beautifully sculpted by the surgeon into a nice round end, has healed enough that I can start to introduce some weight to it again. The thoughts of getting up and out of this wheelchair dance in my head. At this stage of my rehabilitation I have mastered the two wheeled walker. Slide hop, slide hop. It’s awkward with one leg, but it is mobility, and it gets me out of the chair. The first step to getting an artificial leg is to make a mold of my stump. I’ve been wearing the special liner I was given for a couple of weeks now, to get used to the feel. I would eventually have to wear this liner from the time I wake up in the morning, until bedtime. It is like a protective sock that is Teflon coated inside and fabric outside. The Teflon adheres to the skin without slipping, and protects the limb from being accidentally damaged while in the socket of the device that will soon be made. The process is the same for any device and each prosthetic is as unique as fingerprints to each patient. The technician covers my leg and stump with light cellophane right over the liner I have on, and then applies layers of plaster soaked strips, just like getting a cast, over the leg end and stops just above the knee joint. When that hardens the mold is the exact size and shape on the inside, of my leg and stump. The Prosthetist then makes another plastic mold called a relief, and fashions the socket from this second mold. The hard plastic socket is made to accommodate a special titanium fitting that is permanently molded into the end. The leg and foot will be attached to the fitting. This process takes about a week to two weeks, depending on how complicated the prosthetic device is. The cost can be anywhere from a few thousand dollars to many thousands of dollars.
Now it’s time to learn how to walk again. The learning starts with, as you might expect, use and care. Because the Teflon liner is worn directly next to the skin, special instructions are given for this very essential accessory to my new leg. It is crucial that this be washed and cleaned every night. Without this sanitation of the liner, an abrasion, a cut or even an ingrown hair on my leg could become infected because of the very nature of the dampness that the liner creates next to my skin. Imagine wrapping up your leg in plastic cling wrap for a day, with no place for perspiration to go. The special care is a necessary evil that a person gets used to very quickly with this unique thousand dollar liner; that and getting used to the leg farts. Leg farts happen when you roll the liner onto your leg. Air becomes trapped in little pockets between the Teflon and the skin. Apply pressure, like a tight plastic socket, and that air bubble slowly makes its way up your leg and out the top of the liner. These leg farts are silent, but the sensation is not unlike breaking wind in a tub of water. We’ve all done that, and felt that air bubble roll over our butt and up into the tub. Why not just ditch the liner and not wear it, you might ask? The liner must be worn. It is like a safety layer of protection between you and the socket. Remember those tight brand new shoes you bought. While ‘breaking them in’ your foot rode up and down inside your sock, up against the back of the shoe and you got that blister that turned into a nasty mess. Did that stop you from wearing those shoes again? Of course not, you just put a band aid over it and kept on walking, and that rub eventually turned into a callous, and the new shoes were ultimately worn enough to be comfy. However with the hard plastic socket there is no breaking in period. It doesn’t mold to your body, but rather your body molds to fit it. The liner, unlike a pair of socks, does not slip or slide on your skin. It stays put, and protects your leg from possible abrasions which could occur while walking. The other unique oddity that happens is the now shrunken and not so swollen stump continues to shrink while you are wearing the socket. At night when the leg is taken off, or at any time that the stump is not in the prosthetic device, the end of the limb will swell, as the blood flow is less restricted.
What most people think is that the stump of the leg fits into the socket and bottoms out into the rounded cup at the end. What actually happens is the leg is ‘sandwiched’ between the ridged sides of the socket, and is supported at the knee joint, so the stump and end of the leg float in the socket, and the only point of contact is at the very strong knee joint. While putting weight on the leg, the pressure is transferred to the knee, and when the step is finished, weight is then transferred to the good leg, and the patient is walking. While wearing the artificial leg, the stump is subjected to a continuous pressure on all sides from the hard plastic, and in reaction to this constant pressure, the stump continues to shrink. To counteract the shrinkage, a series of socks are worn over the protective liner, to take up the space between it and the socket. These special socks are of different thicknesses or plies. I was supplied with several one ply, three ply and five ply socks, to be worn over each other depending on the fit inside the socket. As the time spent in the socket increases, the diameter of the stump decreases and the socket becomes loose and uncomfortable, like a poorly fitting shoe or boot. Once the wearer gets up to about ten ply of socks, it’s time to replace the socket. In my case, because of the amount of weight gain, I was told to expect to go through several sockets until my weight loss was controlled, or I started to maintain weight. I was also told that generally speaking, the socket would need to be replaced with a smaller or bigger size, with every ten pounds, depending on weight gain or loss. I was shocked. I wanted to lose at least fifty pounds. That would be five sockets at about three thousand dollars each.
All of these oddities are part of the very steep learning curve I am experiencing on this new road I now travel, oddities that are both a blessing and a curse. Oddities like slamming your shin into that steel shopping cart rail are not a problem anymore. A cold or wet foot is also not a problem, at least for one side of my body. However, I do miss some of the more subtle things that I never thought twice about before. Not having the flexibility of an ankle may seem like an insignificant thing until you start to climb a steep incline. Ramps are fine for wheelchairs, but not so good for walking with an artificial leg. The oddity of not being able to feel anything south of your knee can also be a hindrance at times. I can’t count the number of times my artificial foot has gotten stuck under the kick space of the counter or wedged under the dash of a car because I couldn’t feel it getting stuck or wedged in. The strangest of all the oddities I was now getting used to was unexpected. This new to me prosthetic device had a life span of just three years. But it’s titanium you say. It’s made of the hardest and most durable materials known to man you exclaim. I know, but the fact is, we are so hard on these parts that they do indeed wear out in just three or four years. Makes you think twice about how rugged this amazing and durable body of ours is, doesn’t it?
So now you are just a bit more knowledgeable about the not so talked about subject of amputation. Now you are a bit more educated about the fantastic advances in the prosthetic industry, the struggle to adapt and get used to a different way of life, and hopefully, you now know a bit more about leg farts and other oddities.
…thanks for these insights, Lockie… and for the rest of yeez, catch up with my pal here :
Lockard Young /Author
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