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Sub Acute Stage: The first couple of days following a traumatic amputation injury.
There are a number of possible complications that may occur immediately after the injury. And, you can rest assured the emergency team will keep an eye out for all side effects throughout the acute process. At any rate, it is important for you to understand the physical consequences your loved one may experience. Below are some possible complications:
Severe blood loss: It is common for traumatic amputation survivors to suffer from severe blood loss. This must be closely monitored and treated immediately because it can lead to further complications and result in death. If severe blood loss does occurs, your loved one will receive a transfusion, which replenishes lost fluid through an IV.
Hypovolemic shock: This reaction occurs as a direct result of severe blood loss. When the body goes into shock, the heart does not receive enough blood to pump to the rest of the body. As a result, major organs stop working and the body shuts down.
Nerve damage: In severe cases, nerves are destroyed which means the amputee can permanently lose feeling in the affected area. The surgeon will opt out of a replantation surgery if a sufficient amount of nerve damage has occurred because the extremity will not function.
Infection: Amputees are highly susceptible to infection because the open wound is like a welcome center for bacteria. If an amputated body part is not treated quickly, the chance of an infection is likely. This is why seeking immediate medical care is crucial.
There are some side effects to keep in mind during the rehabilitation period:
Phantom Limb Syndrome: Many amputees continue to feel pain in the lost limb. While the exact cause of this symptom is unknown, some experts believe it is the brain’s attempt to re-establish the nervous system. The experience is painful, but usually doesn’t last for a long period of time.
Infection: If the limb was not saved, there is a chance your loved one will experience an infection. Often times, it is the result of poor blood supply or excessive moisture. If the infection is too severe the remaining part of the extremity may have to be amputated. The medical team understands the emotional and physical distress an infection can have on the survivor. An infection can typically be avoided through antibiotic treatment and proper care of the wound dressings.
Deep Venous Thrombosis (DVT): You may be wondering why your loved one has been administered blood thinners. This is done to avoid the formation of blood clots in the deep veins. Deep venous thrombosis is more likely to occur in patients who have had a lower extremity amputation. There is an increased chance of this if the leg is tied during surgery or the body part has been immobilized.
Pulmonary Embolism: If your loved one complains of shortness of breath or chest pains he or she may be suffering from a pulmonary embolism. This is a direct result of deep venous thrombosis. It is essentially a blood clot in the lung that occurs when the clot in the veins breaks off and becomes lodged in a pulmonary artery of the lung. Treatment for this will last a minimum of six months.
Contractures: Another common side effect for lower limb amputees is the permanent tightening of muscle, skin, tendons or ligaments. A contracture, which results from improper positioning during immobilization, can have devastating effects in the future. The amputee may not be able to fit the prosthetic and mobility can be impaired. Movement and stretching is encouraged immediately after surgery to avoid this very complication.
A traumatic amputation does not only affect the survivor. It is a life changing event for friends and family, as well. As the primary care giver, you will be with your loved one through the ups and down for every aspect of the recovery process. You will likely be involved by monitoring them for complications, learning to clean and dress the wound along with providing emotional support.
This can be daunting at times, but know there is outside support you can turn to in times of need. You may also feel guilt or stress about getting back into the daily routine. But, you can’t let this stop you. While your loved one needs you for support, you also need to carry on with your life and allow them to regain maximum independence. You must find a balance between the two. Don’t be afraid to ask professionals on how to deal with your emotions as well. There are also support groups out their dedicated primarily to caregivers.
Poor circulation is common among amputees. Your loved one needs be especially cautious in cold weather because this seems to reduce blood flow to the residual limb. Poor circulation can be painful for the amputee and may take hours to cease. Many amputees have turned to massage therapy to treat poor circulation. This form of treatment essentially forces the blood flow by kneading the fluids in an out of the residual limb.
If it isn’t treated, poor circulation can have long term effects. The lack of blood flow can increase the risk of infection in the residual limb. In effect, your loved one has a higher risk of experiencing more serious complications. An infection can lead to surgery or even death. So, it is important to monitor the residual limb to prevent any form of infection.
Proper treatment for a lost limb is critical because the residual limb is prone to infection. During the hospital stay, professionals will treat and monitor the wounded area. But, it is important for you to understand the wound care process for home treatment. Medical staff will wash the wounded area and anything that contacts it with mild soap and water. They will also use softening lotion that doesn’t contain alcohol to moisturize the infected area. Any other kind of lotion will dry the skin out and cause it to crack, which increases the chance of infection. You will also want to monitor the fit of the prosthetic because pressure sores can occur if it doesn’t fit just right. If your loved one begins to lose sensation in the residual limb, take the prosthetic off and check for pressure areas.
As caretaker, you should always keep an eye out for signs of infection. The Amputee Coalition of America has provided list of symptoms. Below are signs that require a physician’s care:
The following are symptoms that require emergency care:
The first step is to contact a caseworker at the hospital to begin the process of gathering the necessary paperwork to apply for government programs, such as Medicare/Medicaid, Social Security and programs through the Department of Rehabilitation. Also, there are state health insurance programs in place for patients under the age of 18. It varies state by state, but pediatric patients may also qualify for Supplemental Security Income. For more information, visit the benefits section of our website. You may also consider a legal counsel.
A traumatic amputation is a life changing event, and it is likely your loved will experience some emotional side effects. Initially, it may be hard to accept the new physical appearance. Some may become fearful or depressed at the thought of their new, more dependent, lifestyle. Others may respond to the injury with aggression and anger. Often times this aggression is geared towards those who are trying to help them. When dealing with the negative emotional aspects of a traumatic amputation, it is important you seek professional help for proper treatment.
Although there are many emotional pitfalls, not all amputee survivors will react negatively. Fortunately, many accept what has occurred and the changes that have to be made. Some may react with optimism in the beginning and most will come to a place of acceptance after some time. Rather than focusing on the negatives, traumatic amputation survivors should try to find a sport, activity or interest in which they can gear their attention.
A support network can be family and friends who commit to playing a role in the life of the amputee and even in the lives of caregivers and immediate family. It also extends to support groups that are often available while in the rehabilitation phase and after discharge. There are many support networks online that offer advice and share stories. Groups help the amputee survivor, along with family and friends, deal with the physical and emotional aspects of the injury.
It is important for amputees to join support groups because they assure an amputee that he or she is not alone. Amputees will find out a support group is a place where they can relate to others. This is helpful not only through the rehabilitation period, but throughout life.