By Margaret Williams
In 2015, I underwent surgery at a Toronto hospital to amputate my left leg below the knee. This was because of poor circulation and extreme diabetic neuropathy pain in the foot. The third leg artery bypass in three years had stopped working and I was out of options. Pain management was the only other alternative, but merely existing from one pain pill to the next is no way to live. I chose amputation because at least here is the possibility of walking again and leading a reasonably normal life.
After a week of post-op recovery, I was transferred to Providence Healthcare for rehabilitation (rehab). What a difference! It was almost like being in a hotel – the room was spacious, the view out over Warden Woods fantastic. The Physiotherapists and Occupational Therapists (OTs) got me working right away. First, I had to learn how to hop and balance on one leg without falling over. My initial goal was to get from the bed to the bathroom in the middle of the night using the wheelchair and a walker without having to call a nurse. It’s incredible how much that little bit of independence mattered to me. All the other challenges seemed insignificant after that – and there were several.
Unfortunately, while I was making good progress with the exercises and manipulating the wheelchair, the wound was not closing. It became infected. I had to go back to the previous hospital for more surgery. This time they amputated above the knee as there was too much necrosis in the lower leg. After two more weeks of post-op recovery in the hospital, they transferred me back to Providence.
If ever there was a low point in my recovery, it was when I awoke after the operation and realized that an above-knee amputation is a very different kettle of fish from a below-knee. For one thing, I had to learn all over again how to balance; for another, it would be much harder to use a prosthetic device. Apparently it is 10 times harder to adapt to an above-knee prosthesis than a below-knee one. On the plus side, I no longer needed a special wheel-chair with a pull-out tray to support what was left of the leg. I could manage with a regular wheelchair.
I christened the stump ‘Jaws’ at first because the stitches looked just like a shark’s teeth. But after a while the stitches faded, so now it looks more
like a baby beluga. It has healed over beautifully, so the danger of another infection has passed. Whenever the ‘phantom’ pain strikes – and it’s not as bad as the pain I used to have before surgery – I massage the stump and tell it over and over, “You are now the end of my leg. You are now my foot.” This will hopefully reprogram my brain to stop sending signals like pins and needles to the foot that no longer exists.
Coming home in August was bliss. Despite unforeseen pitfalls, like not being able to get the wheelchair through any of the bathroom doors and falling over furniture, it was a delight to be in my own space and able to do things at my own pace. It was only possible thanks to my long-suffering husband (who well deserves the ‘Caregiver of the Year’ award). It took a while to adjust to the fact that everything – dressing, getting into the car, loading the wheelchair – takes twice as long as it used to take, so we were often late for appointments, but we always got there in the end.
ADJUSTING TO THE BIONIC LEG
In September, I was fitted with a temporary prosthesis. It is quite a complicated contraption, consisting of a harness that straps around my waist and hips holding a plastic socket into which the stump fits, with a titanium knee and lower leg. We figured out how much it weighs by the simple expedient of weighing me with it on and then with it off. The difference? Seven pounds. Putting it on takes almost 15 minutes, but at least taking it off is much easier, only a minute or two.
Learning to walk again has been an eye-opener. I had no idea how difficult it was going to be! Fortunately, I went to Providence’s inpatient Rehab for two weeks and worked with a Physiotherapist every day to develop good technique. Even something as seemingly simple as turning a corner or sitting down is a major operation for which there is a right and wrong way to do it. The key at all times is to be safe.
Now I’m in Providence’s outpatient program at the Orthopaedic and Amputee Clinic, two mornings a week with physio and OT, practicing my gait and learning how to manage stairs, use a rollator rather than a walker and, most important, get up after falling. Meanwhile, I practice at home by doing endless circuits of the house – thank goodness we have a bungalow as stairs are a problem. I once bumped my way down to the basement on my bum and back up the same way, just to know I could do it in an emergency, but I wouldn’t want to make a habit of it. It is getting easier to do things like cook, bake, wash dishes, etc., with the leg on. These days, I average wearing it for seven or eight hours a day.
The new leg has its advantages. For example, the plastic socket makes a perfect music stand while I’m playing the harp and it is ideal for resting a book or laptop. Wearing it requires a little wardrobe juggling. Tight trousers are out because of the heavy plastic socket covering the thigh and the harness around the hips, but long skirts are definitely in.
What was good about the whole experience? The people I met along the way were wonderful – the doctors and nurses, the rehab team, my roommates. I learned a lot from everyone, especially from patients who were in far worse shape than me but were philosophical and even cheerful about it. I found I had greater reserves of patience than I would have thought, although there were definitely moments when it all became too much for me. That’s when I really needed the Serenity Prayer… being a “one-legged wonder”, as a friend calls me, gives a whole new meaning to “putting your best foot forward.”
I’m looking forward to meeting more goals in the near future such as walking with a cane, driving my car, perhaps even cycling again. A few years ago, I published my memoirs entitled, ironically, “Slowing Down to a Gallop.” There may well be a sequel down the road – it will probably be called something like, “So Far, So Good…”
About the Writer: Margaret Williams is an outpatient in Providence’s Orthopaedic and Amputee Clinic and author of the self-published memoir, Slowing Down to a Gallop. She lives in Scarborough with her husband Richard.