VIDEO: I Decided To Amputate My Foot: Gary Yerman's Story * 2023
VIDEO: I Decided To Amputate My Foot: Gary Yerman's Story * 2023

Amputation

Amputation is surgery to remove all or part of a limb or extremity (outer limbs). Leg or foot amputation is the removal of a leg, foot, or toes from the body. These body parts are called extremities. Amputations are done either by surgery or they occur by accident or trauma to the body.

Amputation is surgery to remove all or part of a limb or extremity.You may need an amputation if you’ve undergone a severe injury or infection, or have a health condition like peripheral arterial disease (PAD). Many people live a healthy, active lifestyle after an amputation, but it may take time to get used to life without a limb.

Types of lower extremity amputation

  • Partial foot amputation: removing part of the foot (there are many types of partial foot amputation).
  • Ankle disarticulation: removing the foot after separating it from the lower leg at the ankle.
  • Below-the-knee amputation: removing the foot and part of the lower leg by cutting across the bones of the lower leg (tibia and fibula).
  • Knee disarticulation: removal of the lower leg by separating it from the upper leg at the knee.
  • Above-the-knee amputation: removal of the lower leg, the knee and part of the upper leg by cutting across the upper leg bone (femur).
  • Hip disarticulation: removal of the entire leg by separating it from the pelvis at the hip joint.
  • Pelvic amputation, or hemipelvectomy: removal of the entire leg and part of the pelvis.
  • Double amputation is removal of both hands, feet, arms or legs.
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The main sites of amputation

Amputation is always a last resort and will only be recommended if your surgeon has decided it is not possible to improve the circulation in any other way.

Just below the knee
Through the knee
Through the thigh

The site of amputation will depend on how poor the blood supply to your leg is. If possible, below knee amputations are performed, as it is easier to walk with an artificial limb after the operation. However, many people do well after a thigh amputation.

The following information will help to explain the procedure of leg amputation:

Before your operation:

You will usually be admitted for one or two days before your operation. You will be admitted to your bed by one of the nurses. Who will also note down your personal details in your nursing records.

There are a number of tests that need to be done to make sure that you are fit for the operation. These will include:

X-ray of the arteries (arteriogram) to confirm where the blockages are located.
Chest X-ray.
Blood tests.
ECG (a heart tracing).
Breathing test.

You will be visited by the Surgeon who will be performing your operation and also the doctor who will give you the anaesthetic. They will decide where on the leg the amputation will happen. If you have any questions regarding the operation, please ask the doctors.

The operation:

In the anaesthetic room, you will be given a general anaesthetic to put you to sleep. Alternatively, you can have a tube inserted into your back, through which painkillers can be given to numb the lower half of your body whilst you remain awake (spinal or epidural). The anaesthetist may also use an epidural as well as a general anaesthetic to provide pain relief after your surgery.

Whilst you are asleep, tubes will be inserted into your bladder to drain your urine, and into a vein in your arm or neck (or both) for blood pressure measurements and to give you fluids following surgery.

The amputation stump will often be closed with a stitch under the skin that dissolves by itself, and occasionally a small tube to drain any fluid that builds up afterwards. A clear plastic dressing may be used to allow the stump to be inspected, but bandages or a plaster cast are sometimes used.

After the operation:

You will usually return to the ward once you have recovered from the anaesthetic. Sometimes the anaesthetist may decide to send you to the Post-Operative Surgical Unit (POSU) or High Dependency Unit (HDU) in order to be able to monitor your progress more closely.

You will be given fluids by a drip in one of your veins until you are well enough to sit up and take fluids and food by mouth. The nurses and doctors will try and keep you free of pain by giving painkillers by injection, via a tube in your back, or by a machine that you are able to control yourself by pressing a button.

It is quite common to experience pain that feels as though it is in part of the leg that has been removed (phantom limb pain) and this can be helped with medication and rapidly disappears. You may also require a small blood transfusion.

As you recover, the various tubes will be removed, and you will become gradually more mobile until you are fit enough to go home.

You will be visited by the physiotherapist before and after your operation, who will help you with your breathing (to prevent you developing a chest infection) and with your mobility. Initially you will be shown exercises in bed, and then you will be encouraged to transfer from your bed to a chair.

As your wound heals, the physiotherapist will start you walking with help, on a temporary artificial limb, if it is felt safe for you to wear one. If not, you will be taught how to use a wheelchair.

You will also be visited by an occupational therapist who will help with your rehabilitation. Even if you are planning to walk, you may still need a wheelchair temporarily or for long trips.

Before the procedure

When your amputation is planned, you will be asked to do certain things to prepare for it. Tell your health care provider:

  • What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.
  • How much alcohol you have been drinking.
  • During the days before your surgery, you may be asked to stop taking aspirin, ibuprofen (such as Advil or Motrin), warfarin (Coumadin), and any other medicines that make it hard for your blood to clot.
  • Ask your provider which medicines you should still take on the day of your surgery. If you smoke or use tobacco, stop, ideally at least 4 weeks before your surgery.
  • If you have diabetes, follow your diet and take your medicines as usual until the day of surgery.
  • On the day of the surgery, you will likely be asked not to drink or eat anything for 8 to 12 hours before your surgery.

Prepare your home before surgery:

  • Plan for what help you will need when you come home from the hospital.
  • Arrange for a family member, friend, or neighbour to help you. Or, ask your provider for help to plan for a home health aide to come into your home.
  • Ensure that your bathroom and the rest of your house are safe for you to move around in. For example, remove tripping hazards such as throw rugs.
  • Ensure that you will be able to get in and out of your home safely.

After the procedure

The end of your leg (residual limb) will have a dressing and bandage that will remain on for 3 or more days. You may have pain for the first few days. You will be able to take pain medicine as you need them. You may have a tube that drains fluid from the wound. This will be taken out after a few days.

Before leaving the hospital, you will begin learning how to:

  • Use a wheelchair or a walker.
  • Stretch your muscles to make them stronger.
  • Strengthen your arms and legs.
  • Begin walking with a walking aid and parallel bars.
  • Start moving around the bed and into the chair in your hospital room.
  • Keep your joints mobile.
  • Sit or lie in different positions to keep your joints from becoming stiff.
  • Control swelling in the area around your amputation.
  • Properly put weight on your residual limb. You will be told how much weight to put on your residual limb. You may not be allowed to put weight on your residual limb until it is fully healed.
  • Fitting for a prosthesis, a manmade part to replace your limb, may occur when your wound is mostly healed and the surrounding area is no longer tender to the touch.

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