Loss of a leg

February 22, 2008 5:51 PM

I would like to help my father to deal with a loss of a leg. His leg got amputated due to diabetes. Everything happened suddenly and we are all unprepared. I need practical tips on how to predict and overcome obstacles he is going to face.
posted by anonymous to health & fitness (7 comments total)

I'm so sorry to hear about your dad. When my mom became disabled, one of the most surreal things to learn was that what was so shocking and unique to our family was something that hundreds of other people had already gone through. There were many more resources, prosthetics, and tools available than I ever would have guessed. Obviously we would've preferred not to need them, but it was a relief to discover that they existed, and they did help ease the transition.

If his primary care physician doesn't take the lead to coordinate the following, the hospital should assign him a social worker who can help to arrange rehab and/or occupational therapy, possible mental health consults, or in-home care once he's back home. Asking about a support group for him and for you all would also be useful.

This NIH site looks like a pretty comprehensive list of resources, and a good starting point for you to do more research. Again, I am so sorry for your father's loss, and for what your family is going through. Good luck.
posted by truenorth at 6:50 PM on February 22, 2008

As truenorth said, he'll certainly need rehab and therapy and plenty of support. At the same time, it's absolutely vital that he get his sugars under control if they're not already, that he start seeing a doctor regularly if he's not, and that he start taking all of his medications regularly if he's not. If poor foot care was the cause of this amputation, ask for a referral so he can get trained and educated about foot care--nail trimming, inspection after bathing, orthotics, etc. He's unfortunately likely to be at high risk for losing the other extremity, knowing what we know about the severity of his disease already.
posted by gramcracker at 7:14 PM on February 22, 2008

If he choses to get a prosthetic leg, it takes a great deal of physical adjustment for your body to become accustomed to balance and movement, and your muscles adapt over time. This means that a prosthetic may need to be tweaked over time to make it as useable and comfortable as possible for an amputee.

Where do you live? I've worked with a truly outstanding orthotics/prosthetics guy in CA, and he may well be able to recommend colleagues in other states. MeFiMail me if you'd like.
posted by foxy_hedgehog at 7:18 AM on February 23, 2008

My dad hasn't lost his leg (yet, but definitely could happen soon due to his diabetes), but I'm betting my dad's adjusting to life confined in a wheelchair suddenly due to stroke is similar.

If I could look at the last few post-stroke years for my dad and point out the biggest mistakes, I'd say do everything you can to make their home accessible to someone in a wheelchair. My parents are cheap and also lazy, so in the weeks that followed the stroke they sold their old house (with bedroom on the 2nd floor) below market and just bought the first mobile home in a retirement park they could find. It's not very wheelchair friendly. It's hard to get into, move around in, and get use of appliances. My dad can barely do anything on his own, and he's left alone for hours when my mom goes to work.

If he can continue living where he currently is, make sure all the floors are not carpeted (just lay $2/sqft cheap laminate flooring that looks like wood) and have a contractor put in proper bars into the bathrooms and along the halls so your father can pull himself along and get himself out of a wheelchair and onto say a toilet and back without much help.

As long as he stays independent, he has the best chance of being happy. I've found depression is one of the worst parts of a sudden illness with my dad and he never really did anything about it because he thinks psychology is hocus-pocus.
posted by mathowie at 9:13 AM on February 23, 2008

Sorry to hear about your dad. Mine had the same situation thrust upon him five or so years ago-- it's a hard thing to deal with.

I don't know whether it's above the knee or below from your question, but your dad will probably have to get his prosthesis looked at often by an orthotics guy-- my dad has gone through I think three or four legs already-- he's had problems with them and over time they do need to be maintained. Be forewarned that these are not cheap--if I remember correctly, my mom told me each leg cost between $8-10,000 (for a half leg. I imagine it's got to be more for full?). Hopefully insurance will cover some of that. I'm not sure how it works entirely for above the knee, but my dad wears a rubber 'sock' which has a pin on it that connects into the prosthesis. He has to always keep an eye on the area covered by the prosthesis, because sometimes he gets sores. And the socks sometimes lead to irritation or allergy reactions, but they can make those out of different materials, I'm pretty certain.

He definitely needs to keep his diabetes in check-- and hopefully he doesn't drink or smoke much. Mine did (and really went into overdrive on both after he lost the leg) and suffered a heart attack, then a stroke. If my dad can be a role model for anyone anymore-- it's on what not to do when you have diabetes. Diabetes is a rough disease that can lead to so many other complications-- so he should try and think about that-- lessening his sodium and fat intake are smart. He should be fastidious with doctor's appointments--diabetes is playing for keeps here. Another thing he will want to keep an eye on is the other leg. My dad's former leg originally had a slew of problems-- he kept getting sores on it, kind of a club foot, then one toe got amputated, and then he couldn't feel anything in the foot.

Give him lots of support. He'll be bedridden for a little while, but anything you can do will help. Don't dwell too much upon the loss-- but if he needs to vent his upset let him. His phantom limb pain will probably lead to a lot of upset feelings. He might feel helpless at first. But don't baby him-- help where you can but treat him with respect so he doesn't feel like he lost a lot of self-worth with that leg. He may get depressed. I don't know what his job situation was like (retired? working?) but when it happened my dad was a physician's assistant, and while at first the hospital he'd worked with was supportive, they ultimately let him go. He found some per diem work, but it was never steady enough for him to stick with it and he had to retire. If this is any way similar to your dad's situation-- he may get really down or bored. I really hope he has hobbies. Or maybe you can teach him a new one to keep his mind fresh and off the obvious problem?

It'll take a while for him to regain the balance and use the leg and obviously he won't walk like he used to-- but the body learns to accomodate. He'll have to get used to rebalancing-- my dad has a slow steady walk because of it. Also, you may want to think about things to improve his home situation-- my dad at first had to use a walker to work with balance and getting around in case he ever was without his leg. He uses a cane for balance now too. And this is something I doubt you're going to think of right off the bat (I didn't consider it at all) but you may want to look into aids for the bathroom. We have installed a raised seat on the toilet in my parent's house, and we have this thing -- I believe it's called a shower seat? Basically it reaches over the bathtub as a bench-- your dad can sit outside the tub and then slide into it. Without the leg, it'd be really hard to shower upright-- I know it's a lifesaver for my dad. Another thing to consider-- if you're in a climate where it gets icy, get him a pair of YakTrax-- ridiculous name, but they'll help keep him from slipping.

Make sure he doesn't slack on his rehab-- there's a chance he might find it easier to lie in bed than try, but he'll recover so much faster if he is trying his hardest.

I got a little long on this, so sorry, but I guess I learned a lot over the years this way! My sympathies are with you and yours-- I hope that you all get through it easily. Fortunately there's a lot out there to help-- and you aren't alone in it. Hopefully you all find enough useful things to keep him on his feet and recovering. Good luck!
posted by actionpact at 9:24 AM on February 23, 2008

By the way, adding to actionpact's answer, and from my own experience: Make sure everybody responsible for your dad's care (including him) is making sure he doesn't get a pressure sore anywhere. It's easy for everyone to overlook something so seemingly minor in the face of such a major medical issue, but any attention you give to prevention will be well worth it. They require weeks to heal, especially with the complications of diabetes, and in my mom's case more than tripled her recovery time from a planned medical procedure.
posted by truenorth at 11:13 AM on February 23, 2008

I've found depression is one of the worst parts of a sudden illness with my dad and he never really did anything about it because he thinks psychology is hocus-pocus.

I would second this -- my brother's friend had his foot amputated, and the physical challenges were much easier for him to deal with than the changes to his self-image, vision of his future, and so forth. He did a lot of crazy things as a way of dealing with his anger and other feelings. (Of course, he was 23, so that's different than your dad.)
posted by salvia at 11:28 AM on February 23, 2008