Monday, January 30, 2017

How do I remain active with an amputation?

I cannot speak for others. I can only speak for myself. I have chosen to remain active, rather than wallow in a pit of self-despair. Being an amputee can be challenging in so many different ways. There are days that simply wearing my prosthesis causes pain. Other days I have severe phantom sensations, ranging from the twisted ankle syndrome to leg melting into a pit of lava. One thing that I noticed early on was that these sensations got worse when I became less active.

My degree is in physical therapy, even though I abandoned that career path 30 years ago, and haven't kept up with my studies with anything more than a mild interest. Two years ago when amputation was looming ahead, I focused my interests in areas specifically attuned to advances in rehabilitation of below-knee amputations. In almost every case, the recommendation called for  the patient [me] to keep a pain log, along with an activity log. I noticed that in many of the case studies, the writer was focusing on the level of phantom pain decreasing with increased activity. This seemed counter-intuitive at first.

After my amputation, I hit the therapy hard. Attempting to do every exercise that I could as quickly as I could. I didn't have any "phantom" sensations at all. That lasted about a month or so. Then it started, my toes were back... they were getting pinched. My ankle was back and it felt like it was twisted. It always seemed to hit me during times that I was resting, especially at bed time. I dutifully wrote it all down in my log. Funny thing about the phantom pain, medication never seemed to help, in fact it seemed to make it worse. It took me a bit to figure out why. When I took the medication, my activity level decreased, the pain level seemed to get worse.

Once I realized that they were interlinked, I made a decision to push through any minor pain I might have and increase my activity level. Keep walking, hiking, biking and what ever else i could think of. Active massage of the residual limb, making sure that I had a clean liner and clean socks, ensuring that I didn't have any wrinkles or bubbles that might irritate my skin. I had to think about it all the time, and I invested my time in activity, to prove to myself that activity decreased the pain. From my point of view, that is what happened. As a case study, it makes sense. It might be something that someone could prove is normal for others as well. I have a field study of one [me].

So how do I remain active? The first thing I do is make sure that I have a good fit in my socket. Stump pain from a bad fit, or careless dressing is a very hard thing to overcome. My liner has to be dry and completely lint free. I wash it using a generic Hibeclense I get from Walgreens. I use a very standard 5 mil sock (I don't have much deviation in stump size any more) I carry both a 1 and a 3 mil sock everywhere I go, just in case anything changes. I can go up or down using one of each sock. I also take my kit with me (small lotion, 2 socks, a 4mm Allen wrench, a metal 14" shoe horn, water and a granola bar) Second, I get up off my butt and go do something. from yard work, to walking to the store or the ball field, maybe riding my bike, or working on some project.

The key ingredient is to find something you can do and do it. Start small and just get after it. Challenge yourself to do a little more every day. You will soon find that you are able to tolerate more and more.

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