Health Blog

Challenges for amputees

Published on 2017-03-21 07:03:30

Overcoming physical barrier and psychological trauma

Challenges of amputees

It was yet another morning for the para-cycling silver medallist at the Kempegowda International Airport, Bengaluru. While leaving for Hyderabad, Aditya Mehta, the 2013 Asian Para-Cycling Championship winner, was left with severe ‘psychological scar’ when he was forced to remove his prosthetic leg and behaved rudely and ruthlessly. In name of security check, the CISF personnel were merciless and callous while treating the nationally reputed Para Olympian. “Yet again I was forced to remove my prosthetic leg at KIA, Bangalore. Possibly a generous Dussehera gift from CISF - Central Industrial Security Force. Sarcasm aside, in my earlier posts, I have already mentioned how painful the procedure is to remove the prosthetics and wear it back. Worth mentioning is the psychological scar that it can leave on a physically challenged person's mind” recounted in the social media post, about the psychological trauma he faced.

This has been becoming common to observe the pitilessness and insensitivity the handicapped or differently-abled people face today. They have been mercilessly left with social stigma, psychological trauma, and with a sense of the dependency. But in many cases, the strong will power, mental strength, psychological boldness make them standout from society and create a self-image and recognition. They have been encouraged by many governmental, non-governmental and NGOs to convert their challenges into opportunities by emphasising on their positive qualities.

Reasons that leave people disable

Unexpected situations, unfavourable conditions and unprecedented accidents many times leave the people with fractured limbs and later amputated. Severe injury due to accidents such as road accident, burns, falling from highland, injuries due to war and military exercise in case of soldiers are common reasons why people get fractured limbs such as legs, hands, foot, palm and other body parts. In extreme conditions, doctors go for amputation to avoid worst cases of damage. The most common reasons for amputation are cancer causing tumour in the affected bone or limbs due to severe injury, serious infection that does not respond to the antibiotics or treatments, thickening of nerve tissue, called a neuroma and frostbite. Doctors prefer amputation as a method of removing limbs by a surgical measure to subside pain in the affected limbs.

Challenges the physically injured people face

Physically injured people and people with lost limbs have been facing physical, psychological problem and facing social stigmas in day to day life. They have been suffering from low self confidence because of the valuable loss to their body. Most frequently, they experience a sense of inability, pessimism, incapability, insecure, dependency etc. Their lives get affected severely due to the loss which impacts them emotionally, psychologically, physically and spiritually. However, it has been observed that the advent of modern science and technology has left us with glorious records of improvement because of the physical and psychological support which helps them to reviving their spirit and self confidence. Emotional support from family and loved ones, social respect and values, and psychological guidance and inspiration of similar people who excelled in their lives lead to speedy recovery from the traumatic experiences.

Physical and psychological challenges:

Starting from getting up from bed to going to bed in the night, physically challenged people or the people with prosthetic limbs need help. The sense dependency is more when they feel depressed about the loss of the limbs. They predominantly depend on the family members, friends, colleagues, neighbours, and so on. It is challenging and difficult to adjust with the day to day life. For every small requirement they need others’ help with respect to movement and physical work. Whether to go the bathroom, crossing busy road, dressing up them, attending office works and schools, and be present in the social gathering, they need help from the family or the people around.

If the people are with prosthetic limbs, they need to be very careful with respect to self-care and care of the prosthetic limb. For better conform and skin protection, they need to wear the clean socks daily, avoid using worn socks, and wipe the sockets with damp cloth. They need to refrain from using oil or lubricants on the prosthesis, losing the screw, and modify the socket. Improper management of the prosthetic can lead to bleeding or fracture.

Psychological Challenges:

The social worker, psychologist and psychiatrist have been observing the difficulties they face treating the people who lost limbs. The treatment must holistically consider the family, work life, health, age, gender and self esteem. Depending on the characteristics of the people, the psychological and emotional stress may differ to a great extent. But the common feelings are denial and isolation, anger, depression, and acceptance.

They mostly carried out by the feeling of hopelessness, worry and anxiety, depression, and suicidal ideation which become common barriers for their psychological adjustment and rehabilitation efforts. The people with traumatic injury often experience post-traumatic stress disorder (PTSD), and rates of clinical depression reported in outpatient settings range from 21 percent to 35 percent.

Psychological trauma and social stigma

The people with lost limbs or with prosthetic limbs face social stigma and a sense of loss.

According to Omal Bani Saberi, LCSW, CCHT, and transfemoral bilateral amputee, the cycle of grief does not flow easily. “Emotional recovery is the same as physical recovery; it is based on one’s own timetable,” she said. It is all same for the young woman Jana who lost her leg due to cancer. “When I woke up from surgery, I felt an incredible sense of loss. It felt so awkward to be lopsided and I felt so unwhole and freaky. I wouldn’t even look at my residual limb for several days, much less try and walk on the temporary leg.”

When they see people around them paying, walking, doing house hold jobs, they experience anxiety and worry about the loss. They feel left out of the group due to the loss. They experience a sense loss, pessimism, dependency, low self respect and socially backwardness. They feel shy and cynic to meet people and join social gathering.

Overcoming Social Stigma and psychological trauma

A careful association, wholehearted emotional and physical support, psychological encouragement and advanced treatment can help a speedy recovery of the psychological trauma the amputee or the limbless people suffer from. The mental and physical help from the social worker, doctors, psychologists and psychiatrists help them a great extent to cope up with the physical and psychological challenge they face.

Psychological support and hope creation:

The free-floating worry and anxiety about the unknown and the future persists at a great deal with amputees. Psychological support with coping mechanisms must be inevitable provision. Hope for normal life, verbal and non-verbal assurance by the doctors and staffs can help in adapting the disability. The strong determination of not discussing the problem with the amputees by the family members or the staff can create positive feeling to accept the loss and avoid the grief and stress. Creation of awareness and acceptance of the self images before the society can help acceptance of the loss.

Many national and international organizations, government, NGOs are providing help and support to the amputee in India. The ‘Jaipur Foot Center’ in Rajasthan, is one among the organizations who provide high quality custom-fitted limbs to over 20,000 amputees and cripples, free of cost. It also provided 65,000 others with hand-pedaled tricycles, wheelchairs, or crutches. Mukti, a Chennai based organization has provided 300000 artificial limbs and callipers free of cost since 1986. These kinds of initiatives help boost the morale of the amputees and overcome from the psychological trauma.

Support from family and friends:

The support from the family and loved ones considered to be very crucial for the regaining psychological coherence. Love and affection and physical care and mental support during the traumatic period create enormous impact the patient’s overall psychological upliftment. Creating positive atmosphere, providing emotional support, and not discussing with patients about the loss create inspiring feelings.

The role of spouses and parents are vital handling amputees. Revathi, the 55 -year old woman with transfemoral amputation due to bone cancer was supported by her husband and other family members. She was getting emotional recounting her traumatic experience. “My son and husband were scared and upset hearing about it,” she said. “My husband was so supportive though he was stressed. He was depressed and worried about my future. He helped me there day and night. Eerytime he was beside me when I was in terrible pain. My son treated me with utmost love and he and my husband help a lot in household work”.

Getting back to work as soon possible after amputation tremendously enhance will power, and self-confidence among the amputees. It gave a sense of the satisfaction, self esteem and overall wellbeing of the amputees. Those who indulge in less physical work and more desk work, they can regain their confidence and free themselves from the feeling dependency after amputation. The support from their family is crucial here.

Getting inspired by famous amputees

The amputees should be inspired by the great personalities who are amputees in the field of art and culture, science and technology, sports etc. They must be inspired with the thought that disability is state of mind. The famous classical dancer and television persona Sudha Chandran is an amputee with an artificial leg, but excelled in her career in classical dancing. The famous climber Hugh Herr enjoys climbing a cliff with both the legs amputated after an accident in a climbing expedition.

Regaining spiritual and mental life after the traumatic limb loss and amputation experience is challenging. Scientific and psychological research have been emphasising on the emotional impacts that has on the person’s life. However, psychiatrist, psychologists and doctors attempted to formulate a structured therapeutic module for amputees. More emphasis has been given to overall psychological and physical development of the amputees through various initiatives by NGOs, government and other organizations.

Prosthetic people are no different from the general people. They are not dependable; they are not at others mercy. Love and care from society, family and fraternity can help them to come to the mainstream and lead lives like general people.