Author Topic: To amp - or not to amp? Elective amps  (Read 9645 times)

Offline KenBlimp

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To amp - or not to amp? Elective amps
« on: July 16, 2009, 11:00:54 AM »

Offline chrysochloridae

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Re: To amp - or not to amp? Elective amps
« Reply #1 on: July 16, 2009, 01:59:59 PM »
Hi ken

I'm a prosthetist, and i've seen quite a few people who have faced similar dilemmas.

Best thing to do is try get your local limb centre to arrange for you to meet someone who has been through the process and get their perspective on it.

I'n my experience, arthrodesis of the ankle can be really debilitating and painful; I've seen a lot of people who have put off amputation for years after the ankle fusion and nearly all of them say that they are better off with the amputaion.

A few points to note:-
 1 - i only see the worst case scenario, so i've got no idea what % of fusions are successful - there may be many people out there who have a great quality of life with an ankle fusion
 2 - You would almost certainly need to see an Orthotist for the rest of your life to get rocker soles
 3 - revision surgery on the fusions seems to be quite common - i had 1 chap who had 17 ops in 6 years!
 
Having a symes op has advantages and disadvantages
 - it would be good cos you should be able to end bear, but you'd be really limited with your choice of prosthetic components due to limited ground clearance. Hi activity feet for symes amputees are almost non-existant.

Most of my elective patients feel they have made the right choice and don't regret the amputation. Functionally, a below knee prosthesis would probably replicate normal foot function better than a fully fused ankle.

It would be improper for me to give you a clear cut 'yes' or 'no' as every case is different and in the end it is up to you. My advice would be to get as much info as possible on all the options (sounds like you've done this already) and talk to as many people as possible who have been through both - your local prosthetics centre should be able to put you in touch with some people who could help....
 

Offline Mitchee

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Re: To amp - or not to amp? Elective amps
« Reply #2 on: July 16, 2009, 03:41:03 PM »

I'n my experience, arthrodesis of the ankle can be really debilitating and painful; I've seen a lot of people who have put off amputation for years after the ankle fusion and nearly all of them say that they are better off with the amputaion.

Most of my elective patients feel they have made the right choice and don't regret the amputation. Functionally, a below knee prosthesis would probably replicate normal foot function better than a fully fused ankle.

 

I agree with what I've quoted from Chrysochloridae.
 
Over the years, I had my ankle fused several times.  The last time involved a dozen giant screws.  Due to chronic pain and the inability to walk without the use of an Air-cast removable walker/cast, I elected to amputate my lower leg.  I struggled for 21 years and endured numerous unsuccessful reconstructive ankle surgeries before I decided to amputate my lower leg.  For me, amputation was the right decision.  I do more as an amputee than I did with a fused ankle.  I am an avid cyclist and I also rollerblade.  I do not run because I do not have a cheetah foot.

I am asked if I wish that I had amputated my leg sooner.  My answer is yes and no.  Yes... because I am painfree and I do everything that I want to.  No... because I needed to know that I did everything that I could to save my leg.  I don't have any regrets or what ifs.  I have peace of mind because I know that I did everything that I could before I elected to amputate my lower leg.

If you are going to do some research about elective amputation, I would recommend researching the Ertl procedure.  I am an Ertl amputee.  The Ertl procedure is usually very beneficial for below the knee amputees.  Please feel free to send me a PM, if you want to learn more about the Ertl procedure. 

As you know, amputation is a life changing and permanent decision.  Please carefully consider all of your options before choosing amputation.  I hope you find a solution that works for you.

Michelle
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline frank

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Re: To amp - or not to amp? Elective amps
« Reply #3 on: July 17, 2009, 01:15:06 AM »
Ken,
There was an extensive article in the Oct 08 Runners World about Tom White's elective amputation. I'm not sure I agreed with his take on everything but it was a good read.
http://www.runnersworld.com/article/0,7120,s6-243-297--12959-1-1X2X3X4X5X6X7X8X9X10X11X12X13X14-15,00.html


Offline pegleg jack

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Re: To amp - or not to amp? Elective amps
« Reply #4 on: July 17, 2009, 08:52:53 AM »
Ken B. i for one didnt have any choice in my amputations, am a bilaterial below the knee amputee, had blood clots and gangarene, that cause me to loose both legs below the knee, and i am doing roughly 95% of what i could do before i lost them.
As Mitchee, has stated if you do decide to have it done and also before you do check out the ERTL procedure, for many that have had it done really have had great sucess with it, my stumps are too short to have it done.
Right now i am wearing a system called the OHIO WILLOW  WOOD LIMB-LOGIC VS, with RENEGADE FEET, and am loving every minuite of it,

This is something that you yourself will have to make the dicession and it will be a hard one to make, espacially if you go with the amputation, because there is no going back and trying something differant, once the leg is cut it is gone forever.

Here is a couple of other sites that you may want to going into

AMPUTEE-ONLINE.COM
STUMPS.ORG      (has a good article on the ERTL procedure there)
AMPUTEE COALITION of AMERICA
you-all have a great day.

Offline Mitchee

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Re: To amp - or not to amp? Elective amps
« Reply #5 on: July 18, 2009, 12:06:38 AM »
Ken,
There was an extensive article in the Oct 08 Runners World about Tom White's elective amputation. I'm not sure I agreed with his take on everything but it was a good read.
http://www.runnersworld.com/article/0,7120,s6-243-297--12959-1-1X2X3X4X5X6X7X8X9X10X11X12X13X14-15,00.html



In addition to reading the Runner's World article, another source of information might be Dateline NBC's website.  They also did a story about Tom White.  FYI...Tom White is also an Ertl amputee.
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline herb

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Re: To amp - or not to amp? Elective amps
« Reply #6 on: July 18, 2009, 09:09:38 AM »
Hi Mitchee - good article

Offline naseigfried

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Re: To amp - or not to amp? Elective amps
« Reply #7 on: July 19, 2009, 02:38:02 PM »
Hi Ken. It is a difficult decision to make. I know because I did it. I was able to meet an amputee before my amputation. When I saw him walk into the room and step over me and my crutches and I still couldn't tell which leg he was missing, I knew that was what I needed. My heel had been blown off in a shotgun accident. They saved my foot, though I needed more surgery to replace some muscle, skin and to fuse the ankle. I was fearful of infection as well as walking the rest of my life. Without a heel and a fused ankle would mean a very slow, sloppy walk as there would be no striking point as I stepped. I was also doubtful about continuing my lifelong occupation, hairstyling. I chose amputation for a number of reasons. Walking was at the top, but I was also able to get on with my life sooner. My accident was Mar 8, they amputated on April 5. I was back at work on May 4 and walking on May 20.

There are many days in the first year when you think you've made a mistake. The pain and frustration of those early days with a prosthesis seemed unbearable. Relearning how to do the easiest tasks also seemed daunting. I began to see it as a good challenge after awhile. After getting the hang of the prosthesis and how to add socks to allow for shrinkage I was able to push myself. Now, after 5+ years, I don't even think about it. My leg was amputated 6 inches below my knee. I've gone through 5 legs and I'm on my 3rd foot. I put the leg on around 4AM and take it off around 8PM. I do anything I want to do. The leg doesn't keep from doing anything. If you want to see amputees doing anything, let me know. Running, rock climbing, surfing, skiing(water and snow), snowboarding, wakeboarding, etc. There are also competitive amputees into all kinds of sports. Some have records very near those of able-bodied athletes.

In short, you have to make an educated decision. Michelle gives good advice. Make an appointment to see a prosthetist. Ask in advance if they can arrange for you to talk with an amputee. If you are able, I would consider an Ertl amputation. There are only a handful of docs who use this method. It creates one solid bone from the two bones in the lower leg. It allows weight-bearing on your stump. Much less pain as it enables a more active lifestyle. I don't have this type, but wish I did. Even without it, I've never regretted the decision I made.

Good luck,
Neal
LBK since April 2004

Offline snowbear

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Re: To amp - or not to amp? Elective amps
« Reply #8 on: July 22, 2009, 10:21:07 PM »
If I had a choice I would not amputate. No matter how bad the leg is. Also if its a  pain issue some amputees experience greater pain after amputation and phantom pain..its not a easy thing to go through. I had a bone infection due to a birth defect and many surgeries on my leg. I had a ankle fusion and developed a bone infection from the pins holds that nerve closed or healed. I did not have a choice.

Offline Tigertatts

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Re: To amp - or not to amp? Elective amps
« Reply #9 on: July 22, 2009, 11:34:12 PM »
 I have to agree with Mitchee, I feel very fortunate that I know that I did everything possible to save my leg first and after I did decide to amputate I had ZERO regrets and I NEVER wonder if I did the right thing. Not sure I would of gone though with the amputation if I could not have gotten the Ertl procedure though.  I had my Ertl amputation done by Jan Ertl on Jan 18 2008 and have never once had a phantom pain.

Offline snowbear

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Re: To amp - or not to amp? Elective amps
« Reply #10 on: July 23, 2009, 01:35:16 PM »
I did everything possible too. As did my parents when I was a child. It only lead to a major bone infection and I had no choice after all that! ::)

Offline ann

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Re: To amp - or not to amp? Elective amps
« Reply #11 on: July 25, 2009, 04:05:02 PM »
If I had a choice {which I didn't} I would never amputate....not until the pain and suffering were too much to bear.  Don't get me wrong, now after 7 yrs, I finally have a great fitting prosthesis...I definately must have had the wrong legman... but if given a chance or choice it would be the last thing I would have done.

The mental anguish and money spent trying to get a good fit is enough to test anyone.

Offline snowbear

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Re: To amp - or not to amp? Elective amps
« Reply #12 on: July 25, 2009, 06:03:44 PM »
If I had a choice {which I didn't} I would never amputate....not until the pain and suffering were too much to bear.  Don't get me wrong, now after 7 yrs, I finally have a great fitting prosthesis...I definately must have had the wrong legman... but if given a chance or choice it would be the last thing I would have done.

The mental anguish and money spent trying to get a good fit is enough to test anyone.

WOW you sound like me..It has been a road of hell for 6 years and prior I endured many operations since infancy..Nothings like the real thing No matter how crap it is. :( Ann I too wasted a full year with a really poor legman..

Offline ann

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Re: To amp - or not to amp? Elective amps
« Reply #13 on: July 25, 2009, 08:11:17 PM »
If I had a choice {which I didn't} I would never amputate....not until the pain and suffering were too much to bear.  Don't get me wrong, now after 7 yrs, I finally have a great fitting prosthesis...I definately must have had the wrong legman... but if given a chance or choice it would be the last thing I would have done.

The mental anguish and money spent trying to get a good fit is enough to test anyone.

WOW you sound like me..It has been a road of hell for 6 years and prior I endured many operations since infancy..Nothings like the real thing No matter how crap it is. :(

Ann I too wasted a full year with a really poor legman




Should we string them up by their {Heels} ;D ;D ;D ;D

Offline snowbear

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Re: To amp - or not to amp? Elective amps
« Reply #14 on: July 25, 2009, 08:43:21 PM »
If I had a choice {which I didn't} I would never amputate....not until the pain and suffering were too much to bear.  Don't get me wrong, now after 7 yrs, I finally have a great fitting prosthesis...I definately must have had the wrong legman... but if given a chance or choice it would be the last thing I would have done.

The mental anguish and money spent trying to get a good fit is enough to test anyone.

WOW you sound like me..It has been a road of hell for 6 years and prior I endured many operations since infancy..Nothings like the real thing No matter how crap it is. :(

Ann I too wasted a full year with a really poor legman

I know it really angers me very much..He set me back by making me wear 20 ply socks!! Live and learn I have learned sooo much about amputees. >:(


Should we string them up by their {Heels} ;D ;D ;D ;D