Cristian 00 7/6/05 9:40 AM Page ii Cristian 00 7/6/05 9:40 AM Page i Lower Limb Amputation A Guide to Living a Quality Life Cristian 00 7/6/05 9:40 AM Page ii Cristian 00 7/6/05 9:40 AM Page iii Lower Limb Amputation A Guide to Living a Quality Life Adrian Cristian, M.D. Assistant Professor, Rehabilitation Medicine Mount Sinai School of Medicine and Chief, Physical Medicine and Rehabilitation Bronx VA Medical Center New York, New York New York Cristian 00 7/6/05 9:40 AM Page iv Demos Medical Publishing, LLC, 386 Park Avenue South, New York, New York 10016. Visit our website at www.demosmedpub.com. © 2006 by Demos Medical Publishing, Inc. All rights reserved. This book is pro- tected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Library of Congress Cataloging-in-Publication Data Cristian, Adrian, 1964- Lower limb amputation : a guide to living a quality life / Adrian Cristian. — 1st ed. p. cm. Includes bibliographical references. ISBN 1-932603-24-7 1. Leg—Amputation—Popular works. I. Title. RD560.C75 2005 617.5'8—dc22 2005008843 The purpose of this book is to provide information to readers so that they can make more informed decisions about their own healthcare. It should not be construed as medical advice and readers should always consult with their doctors. COPYEDITOR: Jessica Bryan PRODUCTION/TYPESETTER: Patricia Wallenburg, TypeWriting PRINTER: Transcontinental INDEXER: Joann Woy, Freelance Editorial Services COVER DESIGNER: James Reyman, Reyman Studio Made in Canada Cristian 00 7/6/05 9:40 AM Page v To Eliane, Alexander, and Chloe—the joys of my life. Cristian 00 7/6/05 9:40 AM Page vi Cristian 00 7/6/05 9:40 AM Page vii Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2. The Causes of Lower Limb Amputation . . . . . . . . . . . . . . . . . . . . . . 7 3. Prevention of Additional Amputations . . . . . . . . . . . . . . . . . . . . . . 13 4. Amputation Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 5. The Early Post-Surgical Period of Recovery . . . . . . . . . . . . . . . . . . 23 6. The Rehabilitation Unit and the “Rehab” Team . . . . . . . . . . . . . . 33 7. The Prosthesis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 8. Walking with a Prosthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 9. Returning Home with a Prosthesis . . . . . . . . . . . . . . . . . . . . . . . . . . 73 10. Problems Commonly Encountered by Lower Limb Amputees . . 77 11. Follow-up Visits to the Rehabilitation Clinic . . . . . . . . . . . . . . . . . 81 12. The Older, Frail Amputee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 13. The Bilateral Amputee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 14. The Child with a Lower Limb Amputation . . . . . . . . . . . . . . . . . . 93 15. Sports and the Lower Limb Amputee . . . . . . . . . . . . . . . . . . . . . . 101 16. Coping with the Loss of a Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 vii Cristian 00 7/6/05 9:40 AM Page viii viii | Contents Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127