The loss of a limb will be devastating and will most definately cause a significant change to many aspects of your life. In addition to the predictable consequences on your mobility, independence and participation in day-to-day activities, it can also have a significant impact on your employment, personal relationships, community and recreational activities. In particular, for some, an amputation can disrupt previous plans for the future and affect how they view themselves and the world. Amputees are often required to cope with ongoing health issues (eg. pain), learn new skills and sometimes even modify their expectations in relation to their capabilities. Therefore, the loss of a limb requires major adjustment, both for the person and their family and friends.
In general, feelings of shock, anger, frustration, sadness, isolation and grief are all very common and normal, particularly, in the early period after suffering an amputation. People experience increased stress and anxiety (e.g. due to financial pressures), along with a sense of a lack of control and a feeling of isolation. Given the challenges amputees face following a loss of a limb, it is not surprising that depression and anxiety are common. It is reported in research papers that that after an amputation the prevalence of depression and anxiety is up to 41%. Therefore, it is vital that amputees take steps to tackle head on the symptoms of depression and anxiety, as if untreated they can adversely impact on an amputees recovery and rehabilitation, and physical and mental state.
There are a number of things an amputee and their families can do that may help to facilitate the process of coping utilising some of coping strategies referred to below.
An amputee can experience various challenges and will have different reactions and needs dependent on where they are at on the stage of their journey. For example, the challenges after extensive surgery will vary compared with the challenges faced by a person learning to use a prosthetic limb.
In the early stages, an amputee may experience emotions such as sadness, shock, despondency and anger. It will certainly be useful to discuss such emotions with family and friends. This could be with a trusted family member, friend, or a medical professional. Moreover, reminders that such reactions are normal and will typically pass with the passage of time are critical to bear in mind.
The early stages can also be extremely stressful. Therefore, practical strategies for self-care are very much recommended. This includes ensuring you have adequate sleep, rest and are maintaining an adequate diet. Furthermore, relaxation, breathing and mindfulness exercises are very beneficial when experiencing increased stress. Should stress begin to disrupt your life, it is vital that you seek support from a qualified professional. And, the earlier the better as mental health issues such as depression are very much treatable.
When you are faced with health issues and associated life changes, extensive research has shown the significant role that social networks play in facilitating coping. This is also true for people following an amputation. Therefore, staying well connected to family and friends is extremely valuable. Family and friends can often provide practical and emotional support, and can reduce the sense of isolation that is commonly experienced following trauma. Additionally, peer support, whereby you can observe and talk with other amputees who have “successfully” managed challenges, will also help you to cope and reduce your fear of the unknown.
A lack of control over your new situation is also often experienced following an amputation or other traumatic injury. A useful tip to manage this is being involved in your care and rehabilitation by asking questions of the doctors, nurses and therapy team treating you.
This allows you as the amputee and your family to gather the information required to tackle any concerns, reduce uncertainty and plan for the future, thereby creating a greater sense of control. Remember there is never a silly question!
Certainly, having goals to work towards, particularly during rehabilitation, is imperative. Goals should be meaningful to your life but also attainable and realistic and your therapists will be able to help develop such realistic goals. Setting and achieving goals often provides people with a sense of purpose, structure, and improves confidence and self-esteem.
Similarly, having a daily routine and planned activities is a useful strategy that helps you to cope. It will keep you occupied, acting as a distraction, and prevent you from dwelling on your situation, which over time can be detrimental to physical and mental health.
However, one cannot always keep themselves busy. There will be times when worries pop up and may cause distress to you. Helpful tips for dealing with worrying thoughts include problem solving, taking action if able, relaxation, mindfulness and “letting go” strategies. It may also be useful to try to adopt an attitude of “taking things as they come”.
Amputees have found that maintaining a positive and optimistic attitude can help with coping. “Put things into perspective” and reminders of one’s achievements (both relating to rehabilitation and recovery and life in general) can encourage a helpful attitude. It is also beneficial to engage with a professional, such as a psychologist, to develop further coping strategies to help you manage day to day life.
Finally, a key area in facilitating coping following an amputation is to ensure that you are able to again participate in meaningful life activities, to re-establish a sense of normality and self-worth whether that is in sport or returning to employment. This includes important life roles, such as caring for yourself, being a family member and returning to work, driving and social activities. Having a prosthesis can assist with your integration back into such activities. Furthermore, we know from mental health research, participation in pleasant, community and social activities along with having a general purpose in life, are beneficial to your physical and emotional wellbeing. Lastly, re-engaging in life’s activities demonstrate to the amputee and their family that the loss of a limb does not define them.
Adjusting to an amputation takes time and people experience a variety of emotions throughout the journey. Utilising practical strategies such as self-care, staying in touch with support networks, such as us and being informed and involved in the recovery process can all facilitate the process of coping, leading to positive health outcomes.