Could a person be healthier with no legs?
July 30, 2009 2:15 AM Subscribe
Might there be health advantages to, say, not having any legs?
I've been having an ongoing discussion with a friend inspired by some of Aimee Mullins' TED talks and how downright awesome she makes it sound to have no legs.
One question that neither of us can figure out is what might be the health benefits of not having legs. Would your heart have less stress because it doesn't need to pump blood out of your feet? Could you oxygenate your blood more efficiently? (Since you have less blood but the same lungs.) Would your immune system be more efficient, having to cover less ground?
Yes, these are the things that keep me up at night.
I've been having an ongoing discussion with a friend inspired by some of Aimee Mullins' TED talks and how downright awesome she makes it sound to have no legs.
One question that neither of us can figure out is what might be the health benefits of not having legs. Would your heart have less stress because it doesn't need to pump blood out of your feet? Could you oxygenate your blood more efficiently? (Since you have less blood but the same lungs.) Would your immune system be more efficient, having to cover less ground?
Yes, these are the things that keep me up at night.
I don't know about advantages, but there are definite detriments, like pressure sores and skin breakdown from the prostheses rubbing against parts of the body that weren't designed to bear weight (ie, weight borne by the bottom surface of an arched foot with a thick sole is very different from weight borne on a cone-shaped residual limb with delicate normal skin wrapped around a pointy bone end- it'd be like walking on your elbows all day).
It's also easier for amputees to overheat because their bodies' surface-to-volume ratio changes.
Plus lots of amputees develop scoliosis if their amputations aren't symmetrical, even from really small amputations. I know a guy who's only missing his fingers on one hand, but over a period of years, using that arm less to carry things, etc, and favouring his other hand for most tasks, his whole upper-body musculature is noticeably atrophied on that side, and crooked. I'm pretty sure the disadvantages outweigh the advantages, and most of the advantages (ie, the body has less live tissue to maintain) could probably be matched with just a little weight loss.
posted by pseudostrabismus at 2:45 AM on July 30, 2009 [1 favorite]
It's also easier for amputees to overheat because their bodies' surface-to-volume ratio changes.
Plus lots of amputees develop scoliosis if their amputations aren't symmetrical, even from really small amputations. I know a guy who's only missing his fingers on one hand, but over a period of years, using that arm less to carry things, etc, and favouring his other hand for most tasks, his whole upper-body musculature is noticeably atrophied on that side, and crooked. I'm pretty sure the disadvantages outweigh the advantages, and most of the advantages (ie, the body has less live tissue to maintain) could probably be matched with just a little weight loss.
posted by pseudostrabismus at 2:45 AM on July 30, 2009 [1 favorite]
Could be? Sure, I guess it's possible that there might be some benefits, but some studies suggest that traumatic leg amputees have a higher morbidity and mortality from cardiovascular disease and non-traumatic amputees have a 50% mortality at 4 years if you're non-diabetic, and 3 years if you're diabetic.
posted by gramcracker at 2:57 AM on July 30, 2009 [1 favorite]
posted by gramcracker at 2:57 AM on July 30, 2009 [1 favorite]
Amputees make better astronauts
The case for an amputee astronaut
They're not really health advantages though.
posted by edd at 3:46 AM on July 30, 2009
The case for an amputee astronaut
They're not really health advantages though.
posted by edd at 3:46 AM on July 30, 2009
Best answer: Your heart pumps blood into the arteries. The blood eventually makes its way into capillaries. From the capillaries, the blood begins its return through the venous system towards back to the heart. That blood return is almost completely dependent on your muscles (including the little valves in the veins).
No legs means a large deficit of muscles for this task. Weak venous return causes backward congestion throughout the circulatory system and leads to a multitude of consequences (ie skin ulcers, congestive heart failure, poor oxygenation, etc).
I see no advantage to be gained. I see a condition that can be compensated for, to a certain degree, but no gain.
posted by reflecked at 4:18 AM on July 30, 2009 [3 favorites]
No legs means a large deficit of muscles for this task. Weak venous return causes backward congestion throughout the circulatory system and leads to a multitude of consequences (ie skin ulcers, congestive heart failure, poor oxygenation, etc).
I see no advantage to be gained. I see a condition that can be compensated for, to a certain degree, but no gain.
posted by reflecked at 4:18 AM on July 30, 2009 [3 favorites]
2nding pseudostrabismus: I am deaf in one ear and the muscles on one side of my face and neck are stronger on one side than the other. The body tends to overcompensate for asymmetry to the detriment of the affected limb/muscle/side.
posted by wingless_angel at 5:00 AM on July 30, 2009
posted by wingless_angel at 5:00 AM on July 30, 2009
wingless_angel: "2nding pseudostrabismus: I am deaf in one ear and the muscles on one side of my face and neck are stronger on one side than the other. The body tends to overcompensate for asymmetry to the detriment of the affected limb/muscle/side."
Holy crap...I'm deaf in one ear, and never thought about this...but yeah, I 'lead' with my good ear, so I favor that eye...on the other hand (heh) I often reach with my left (hearing-ear) side hand, instead of my naturally dominant hand, and am thus nearly ambidextrous. When my right hand was run over by a Jeep and I couldn't use it for a month, I was still able to do construction with my left hand, which...I guess I could attribute to my left-earedness.
posted by notsnot at 5:23 AM on July 30, 2009
Holy crap...I'm deaf in one ear, and never thought about this...but yeah, I 'lead' with my good ear, so I favor that eye...on the other hand (heh) I often reach with my left (hearing-ear) side hand, instead of my naturally dominant hand, and am thus nearly ambidextrous. When my right hand was run over by a Jeep and I couldn't use it for a month, I was still able to do construction with my left hand, which...I guess I could attribute to my left-earedness.
posted by notsnot at 5:23 AM on July 30, 2009
I believe it's also true that the impact from walking/running is one of the major factors in keeping your bone density up.
posted by paanta at 5:54 AM on July 30, 2009
posted by paanta at 5:54 AM on July 30, 2009
Well, I bet I could finally do pull-ups.
posted by applemeat at 6:00 AM on July 30, 2009 [2 favorites]
posted by applemeat at 6:00 AM on July 30, 2009 [2 favorites]
I'm currently administering a program which pays for home and vehicle modifications for people with disabilities. We're one of the good places the ARRA money is going...
Anyway, just a quick note, most of my consumers are in wheelchairs. Most of them start out in a wheelchair for something simple enough---diabetic amputation, degenerative MS, bad knees, arterial issues, whatever.
And then they have to spend their lives sitting down. The ones who have legs often wind up losing them, due to a lack of money to pay for the therapy keeping them full of blood, the muscles stretched and with some muscle mass. The rest often, at some point, wind up with COPD or other respiratory distress, fun things like hernias, blood pressure problems, and back and spine problems based on how they're sitting, not to mention pressure sores and abrasions from the bind-points in their chairs.
They don't usually die of whatever put them in the chair, they usually die of complications that arise afterwards.
We also service a large number of folks who use prostheses, but obviously those aren't for everyone and bring their own complications. You could be like Oscar Pistorius, I'm sure, but most people aren't.
I'm sure you could say "HAHA no legs means I'd never need shoes again!" or "Big boobied ladies will always be putting them in my face!", but more realistically it's a loss of privacy, understanding, and an entirely new way you have to see yourself.
That doesn't mean you can't be perfectly happy, and it certainly doesn't mean that there aren't thousands of people who feel like they're better people because of their disability, however...
I can't think of much of a serious reason why you'd even ask this question.
posted by TomMelee at 6:56 AM on July 30, 2009 [3 favorites]
Anyway, just a quick note, most of my consumers are in wheelchairs. Most of them start out in a wheelchair for something simple enough---diabetic amputation, degenerative MS, bad knees, arterial issues, whatever.
And then they have to spend their lives sitting down. The ones who have legs often wind up losing them, due to a lack of money to pay for the therapy keeping them full of blood, the muscles stretched and with some muscle mass. The rest often, at some point, wind up with COPD or other respiratory distress, fun things like hernias, blood pressure problems, and back and spine problems based on how they're sitting, not to mention pressure sores and abrasions from the bind-points in their chairs.
They don't usually die of whatever put them in the chair, they usually die of complications that arise afterwards.
We also service a large number of folks who use prostheses, but obviously those aren't for everyone and bring their own complications. You could be like Oscar Pistorius, I'm sure, but most people aren't.
I'm sure you could say "HAHA no legs means I'd never need shoes again!" or "Big boobied ladies will always be putting them in my face!", but more realistically it's a loss of privacy, understanding, and an entirely new way you have to see yourself.
That doesn't mean you can't be perfectly happy, and it certainly doesn't mean that there aren't thousands of people who feel like they're better people because of their disability, however...
I can't think of much of a serious reason why you'd even ask this question.
posted by TomMelee at 6:56 AM on July 30, 2009 [3 favorites]
That blood return is almost completely dependent on your muscles (including the little valves in the veins). No legs means a large deficit of muscles for this task.
Given that there aren't any veins traveling through the legs (because the legs aren't there), would you really miss the leg muscles? My impression was always that each muscle helps blood return to the heart by squeezing the veins that pass through that specific muscle. Valves prevent backflow, so the blood gets pushed a bit further up the vein, but I had the impression that it was only a local effect. So, muscles in the abdomen would be responsible for propelling the blood back to the heart through the legless person's remaining veins. I could be wrong, though. I suppose the torso blood in front of the leg blood would have to move somewhere to make way for what the leg muscles were pushing.
On a marginally related note, I would imagine that people without legs die less often of pulmonary emboli, which often occur when huge blood clots form in the deep veins of the legs and then break off and travel to the lungs where they block blood flow.
posted by vytae at 7:04 AM on July 30, 2009
Given that there aren't any veins traveling through the legs (because the legs aren't there), would you really miss the leg muscles? My impression was always that each muscle helps blood return to the heart by squeezing the veins that pass through that specific muscle. Valves prevent backflow, so the blood gets pushed a bit further up the vein, but I had the impression that it was only a local effect. So, muscles in the abdomen would be responsible for propelling the blood back to the heart through the legless person's remaining veins. I could be wrong, though. I suppose the torso blood in front of the leg blood would have to move somewhere to make way for what the leg muscles were pushing.
On a marginally related note, I would imagine that people without legs die less often of pulmonary emboli, which often occur when huge blood clots form in the deep veins of the legs and then break off and travel to the lungs where they block blood flow.
posted by vytae at 7:04 AM on July 30, 2009
I don't know what else Aimee Mullins could say. If I had no legs, I'd certainly hope to have a good attitude, but there's no objective reason why deviation from the baseline is good.
posted by Lesser Shrew at 7:20 AM on July 30, 2009
posted by Lesser Shrew at 7:20 AM on July 30, 2009
Given that there aren't any veins traveling through the legs (because the legs aren't there), would you really miss the leg muscles?
While it's true that the volume of blood to be moved is proportionally reduced, legs are big strong pumping conduits.
The large veins in the abdomen are also very strong, but without legs, what's missing is the constant (relatively strong) contraction/relaxation that continues complete the cycle of blood circulation at rest that our lower limbs provide. All muscles provide some. Legs got "legs" (as in: provide more force and velocity to the blood being circulated than other muscles relative to their size (with a nod to the abdominal circulation's fat pipes).
:) I got no cites for you, this is just "work-seen" from all that CCU/SCU time. LE Amputees trend to having more difficulty preventing or healing pressure sores; this is over and above any failures in routine prevention measures. Younger amputees adjust better than older, but they have a higher proportion of left sided failure than usual, and as the population ages, right sided failure is more usual than in a comparable group (again, observation) who have their lower limbs. This is also true of people who are paraplegic.
posted by reflecked at 11:07 AM on July 30, 2009
While it's true that the volume of blood to be moved is proportionally reduced, legs are big strong pumping conduits.
The large veins in the abdomen are also very strong, but without legs, what's missing is the constant (relatively strong) contraction/relaxation that continues complete the cycle of blood circulation at rest that our lower limbs provide. All muscles provide some. Legs got "legs" (as in: provide more force and velocity to the blood being circulated than other muscles relative to their size (with a nod to the abdominal circulation's fat pipes).
:) I got no cites for you, this is just "work-seen" from all that CCU/SCU time. LE Amputees trend to having more difficulty preventing or healing pressure sores; this is over and above any failures in routine prevention measures. Younger amputees adjust better than older, but they have a higher proportion of left sided failure than usual, and as the population ages, right sided failure is more usual than in a comparable group (again, observation) who have their lower limbs. This is also true of people who are paraplegic.
posted by reflecked at 11:07 AM on July 30, 2009
Response by poster: -I can't think of much of a serious reason why you'd even ask this question.
I can't think of much of a reason that you'd take time to answer it if that's how you feel about the question. I don't need a lot of help understanding a life in a wheelchair, two of my closest friends are spending the rest of their life in them.
I'm not saying that there aren't a myriad of health problems, that much is obvious and there's tons of literature on it. What I'm exploring with this question are the measurable/potential health benefits.
I know little about biology, which is why I asked. Thanks to reflecked for a better understanding of the cardiovascular system. That taught me something new and helped answer the question. I'll happily hand out more more Best Answers to anyone who can do more of that.
posted by Ookseer at 6:30 PM on July 30, 2009
I can't think of much of a reason that you'd take time to answer it if that's how you feel about the question. I don't need a lot of help understanding a life in a wheelchair, two of my closest friends are spending the rest of their life in them.
I'm not saying that there aren't a myriad of health problems, that much is obvious and there's tons of literature on it. What I'm exploring with this question are the measurable/potential health benefits.
I know little about biology, which is why I asked. Thanks to reflecked for a better understanding of the cardiovascular system. That taught me something new and helped answer the question. I'll happily hand out more more Best Answers to anyone who can do more of that.
posted by Ookseer at 6:30 PM on July 30, 2009
Fine and fair enough.
Remember, we're not your huckleberry, existing only to tell you what you want to hear. I answered you because your question, while innocent enough, shows (to me) a complete lack of whatever understanding you propose to possess, as well as a dangerous short-sightedness regarding the actual breadth and depth of the issue at hand.
Given that I'm sure you're really actually trying to expand your scope on these sorts of things, I apologize for my tone---however, I find it difficult to believe that you're surprised by an answer that isn't entirely sensitive of your position.
posted by TomMelee at 4:53 AM on July 31, 2009
Remember, we're not your huckleberry, existing only to tell you what you want to hear. I answered you because your question, while innocent enough, shows (to me) a complete lack of whatever understanding you propose to possess, as well as a dangerous short-sightedness regarding the actual breadth and depth of the issue at hand.
Given that I'm sure you're really actually trying to expand your scope on these sorts of things, I apologize for my tone---however, I find it difficult to believe that you're surprised by an answer that isn't entirely sensitive of your position.
posted by TomMelee at 4:53 AM on July 31, 2009
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posted by le morte de bea arthur at 2:43 AM on July 30, 2009