More info on amputation please?

October 29, 2012 9:31 AM

Practical advice on lower leg amputation? IKYANMD

My 17 year old nephew had a compound fracture of both his tibia and fibula last week, he was hit on the outside of his right legs and the bone was pushed through the inside. This occurred during a high school football game, they were able to repair the inner muscle and bones, but the outer muscle was badly damaged. The kid has had 5 surgeries thus far and with every surgery they have to remove more and more dead tissue and infection, they have decided that they are now unable to save the leg and will be amputating below the knee first thing tomorrow.

OK, enough back history, during their discussion with the doctors there were a lot of tears and some of the questions they have were forgotten. I was just wondering if any of you could give me VALID website information for some of the bigger questions like:
How long does it take the amputation site to heal?
How long before a prothetic is fitted?
How long does it take to get back to your life after an amputation?
I know all of the answers would be ballpark due to everyone being and healing different, I'd just like to know where to start.

Also if you know of any books on either dealing with an amputation or helping someone recover after amputation I'd appreciate the info. I have already done a MeFy search and found lots of inspirational stories that I will print out and take to him, but additional books or movie ideas would be welcomed as well.

Thanks in advance,
Jayed

posted by Jayed to health & fitness (14 answers total)

I hope your nephew is at a first-rate children's hospital. My first course of action would be to get second, third, and fourth opinions. If they've done this, then the next step would be to get a hospital social worker involved to be the go-to person for all of their questions.

I'm so sorry your family is going through this.
posted by cooker girl at 9:41 AM on October 29, 2012 [13 favorites]

W/r/t getting life back post-amputation:

I am sure for something this serious, they will have a physical therapist. But I've known a lot of people who had serious leg injuries (no loss, though) and no one ever told them how to use a cane properly, which is on the side opposite the injured leg.
posted by MonsieurBon at 9:49 AM on October 29, 2012

A guy I knew broke his leg playing rugby in winter 1994. He was 19 or 20 at the time. He had surgeries, including the removal of his calf muscle, until eventually the doctors amputated below the knee. It sounds similar to what your nephew has had.

He got well enough to go compete in the Paralympics in Atlanta in 1996 18 months later, where he came fourth in the single amputee classification in the 200m. You can hear him talk about it briefly it here.

His day job is now, basically, a rocket scientist. I don't know the ins and outs of how long it took him to get his life back on track but it did not derail his professional life and my wife's sister dated him for a while and apparently it didn't stop him trying to bring a tray with full breakfast in bed to her before he had put on his prosthetic leg for the day.
posted by MuffinMan at 10:47 AM on October 29, 2012 [5 favorites]

Have you seen this? 10 Best Amputee Support Groups and Resource Sites. My local big orthopedic provider also has their own resource lists (some of the links are Ohio-specific.)

My general understanding is that it takes six months to a year to basically be back up to fighting form, as it were (the whole "activities of daily living" thing.) The wound/oh crap there's pus and stuff period is supposed to be way shorter - measured in weeks rather than months, but the weeks are in the upper rather than lower single digits for full healing. But most of the stories I've read have been on two extremes: athletes and diabetics; the only people I know personally have all been diabetics who were in poor shape and had a lot of complications; some were still sore years later. It seems like they mostly got their prosthetics fast - faster than I'd be comfortable with personally, like while stuff is still healing (WebMD says "practice" starts as soon as 10-14 days after surgery.) And PT started even before that, through lots of pain (theoretically it's gentle; I don't know a single person who said it was anything on the "fun" side of the spectrum.) Talk to your hospital social worker, surgeons, etc. for realistic timeframes, particularly given his age (he may not be done growing in height, and he shouldn't be done growing in terms of muscle mass.)

For the emotional stuff, you probably need to go beyond amputee and into disability themes more generally. "Hope Unseen" and "Life Without Limits" might be worth checking out (it depends a lot on current emotional state for figuring out whether someone is going to be helped by any one thing, which is why I think you need to reach out to bigger support groups full of people who've been in all the various stages of recovery/acceptance/anger/grieving/etc.)

If your nephew is also in Montana, it looks like you want to reach out to these folks:

NW Montana Amputee Outreach
Dan Richardson
580 Conrad Drive
Kalispell, MT 59901
406-257-5286

ACE'S, Inc.
P.O. Box 277
Seeley Lake, MT 59868
[phone]
[e-mail]

Don't forget about BoysTown and the resources they provide explicitly for teenagers, and PTSD resources just in case. I believe very strongly that he should have access to several different crisis-line options, as in "has them on a piece of paper or a magnet in a place it won't be lost;" YMMV.

(Trauma lasts much longer than physical wounds do, and it's sometimes invisible to outsiders, particularly if a person is prone to being "manly" or "not bothering other people" or somesuch thing. There is no good reason to assume he isn't dealing with severe emotional issues over this, and there are good reasons to believe that if there is neglect in terms of his care, this will be where it's happening, rather than wound treatment/physical therapy stuff.)

Lastly, this young(er than me) gentleman is a Montana-born below-the-knee amputee who had a compound fracture of both the tibia and fibula and his surgery when he was about 23. He just finished competing in the Paralympics in London, where he got a Bronze medal in team cycling. He might be specifically inspiring/helpful; the website of US Paralympics has a lot of stuff for a variety of sports-specific amputee/disability inspiration, and they have a directory of local clubs.
posted by SMPA at 10:51 AM on October 29, 2012 [5 favorites]

Also, this book has a lot of bigger emotional (frankly potentially scary) stuff, but it was written by an amputee; I've heard good things but never read it, and it was never once suggested in the context of disability/amputation, so I have no idea if it's appropriate. I would not give a recently-traumatized 17-year-old this book without reading it first, particularly due to the fact it deals with a suicide attempt.
posted by SMPA at 10:55 AM on October 29, 2012

This looks like an excellent resource for right now, Sharecare. Common sense, general information about the amputation procedure and what to expect after.

Hanger is the largest prosthetics supplier and their website can inform your nephew regarding questions on his prosthetic fitting.

howstuffworks has some nuts and bolts practicality as well.

Your nephew may feel like he has a cramp in the shin he no longer has, or like he needs to wiggle his toes. Perfectly normal, and I think we have all heard of it, but phantom pain will still mess with your mind when it's happening to you, so it might be helpful to have more info on that.

Your nephew may find some community in Empowerment Amputees, a free resource for people going through/having gone through what is dealing with.

I am so sorry for what your family, especially your nephew, are going through right now. The physical and mental impact on your nephew, I know, is uppermost in your thoughts right now.

Please do not neglect the emotional impact of this on ALL of you as you go through this process. You are suffering right along with him and will need support as well. I hope, wherever he is getting treatment, the team is sensitive to the emotional and as well as physical shock that will have your nephew reeiing after surgery, especially as he is an athlete.

I say IS an athlete because of course he can still continue to be active and healthy after the surgery--but he won't be feeling like that is a possibility right now. Hugs to all of you, and hang in there.
posted by misha at 10:58 AM on October 29, 2012

Oh, and generally after an amputation, patients get a temporary prosthetic and are encouraged to start walking with it as soon as possible, which sounds crazy fast, but the reason is it helps the stump to shrink (I'm not sure of the medical processes behind that).
posted by misha at 11:01 AM on October 29, 2012

Thanks so much! All of your suggestions are much appreciated and will be heartily delved into further!

Second opinion was given, here in Billings that's really all that can be expected, but the second opinion highly recommended the doctor from the competing hospital that was the first opinion, so the family is content with this course of action.

SMPA, you have given me LOTS to go on, and I am going to start wading through it!
I believe the paralympian from Bozeman is already making arrangements to come and visit the hospital, that should help. I will check into the support groups you posted ASAP
I've ordered the books on Amazon, our local book store had nothing useful in stock.

As far as the emotional trauma goes, we are more worried about that than the physical. I assure you, if any kid can conquer this hurtle it's my nephew. To be honest, we are sure he will be up and playing football again ASAP! The prosthetic will make it far more possible than the permanent leg braces we thought he would have after surgery #3.
posted by Jayed at 11:39 AM on October 29, 2012 [3 favorites]

Your nephew's story reminds me of this recent story about a high school athlete who lost part of his leg to a football injury. You might want to read through it before passing along to your nephew, but I remember it being positive and optimistic.
posted by i_am_a_fiesta at 12:28 PM on October 29, 2012 [1 favorite]

You need to make sure he's allowed to grieve and complain and do all of the NON-inspirational stuff. Not everybody who suffers a disabling injury goes on to become a world-class athlete and motivational speaker.

I'm reminded of Young Adult, when Patton Oswalt's character (disabled from a beating) spies Charlize Theron's cousin, who uses a wheelchair, and goes, "Oh, great -- here comes the happiest cripple in Minnesota." The cousin says, "We can do anything a normal can do. Probably more, because we've had to reboot for extra positivity. You know what I'm saying? You should try it, Matt." ("Yeah, you should try it, Matt!" says Charlize.)

It's true that your nephew can pretty much do whatever he could have done before. Maybe even some things that he couldn't before. Absolutely, he needs positivity and stories of hope. Just make sure that he gets the chance to be normal -- in the sense that "normal" means sitting around on your ass and just being a kid, without expectations. He's losing some of the expectations he might have had, but the new expectations won't just sprout up to fill that space -- nor should they.
posted by Madamina at 1:24 PM on October 29, 2012 [1 favorite]

Jayed's hubby here. I just wanted to add a brief update. The amputation surgery went well, and Nephew is in pretty good spirits and looking forward to getting out of the hospital soon.

Here's the coverage from our local TV news. As noted in the story, he refers to this incident as a "bump in the road."

Thanks for all of your answers; they have been extremely helpful. (After the first few answers came in, Jayed told me, "I love Metafilter so much!")
posted by The Deej at 6:28 AM on November 1, 2012 [1 favorite]

And here is yet another Local News Reel, this time with a personal interview. Thanks again to the hive mind! =D
posted by Jayed at 3:19 PM on November 2, 2012 [1 favorite]

What a great kid! I'm glad you found some info here that you think will be helpful. Keep us updated, please.
posted by misha at 7:34 PM on November 2, 2012

Another update with an awesome photo of Koni working out.
posted by The Deej at 3:59 PM on November 4, 2012 [1 favorite]