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Thread: amputation after paraplegia

  1. #11
    The whole "legs serve a pivot point for balance" and are absolutely necessary for safe and productive transfers argument is so overused and spoken as truth in the SCI community, I find it ridiculous. Of course, you hear that by individuals with legs, because they don't know any different. Positioning of your hands and upper body strength is far more important. You have greater transfer range and distance abilities without the legs. All my transfers have been cleaner and safer, and with less episodes of shearing.

    Both my legs were amputated AK over 2 years ago now, was the best decision I made post injury. If you're adept with upper body coordination, your transfers will become easier. It'll take a week or two to get used to weight distribution, but everything about ridding yourself that dead, lifeless weight is a benefit.

    Less cumbersome transfers, faster transfers, quicker movement when out of your chair, no repositioning of your legs, easier to get closer to objects and roll straight up to things, etc, etc, etc Would do more harm then good? Hardly.

    The only 'negative' is losing a lap to balance objects on. I just have to get more creative now with how I carry things.

    I can see it being difficult to wrap your head around after 55 years post. I waited 4 and wish it was done right away. If you find the few other SCI here who have had their legs cut off, every single one says the same thing I have.
    Last edited by paraparajumper; 06-07-2018 at 11:54 AM.

  2. #12
    Quote Originally Posted by paraparajumper View Post
    The whole "legs serve a pivot point for balance" and are absolutely necessary for safe and productive transfers argument is so overused and spoken as truth in the SCI community, I find it ridiculous. Of course, you hear that by individuals with legs, because they don't know any different. Positioning of your hands and upper body strength is far more important. You have greater transfer range and distance abilities without the legs. All my transfers have been cleaner and safer, and with less episodes of shearing.

    Both my legs were amputated AK over 2 years ago now, was the best decision I made post injury. If you're adept with upper body coordination, your transfers will become easier. It'll take a week or two to get used to weight distribution, but everything about ridding yourself that dead, lifeless weight is a benefit.

    Less cumbersome transfers, faster transfers, quicker movement when out of your chair, no repositioning of your legs, easier to get closer to objects and roll straight up to things, etc, etc, etc Would do more harm then good? Hardly.

    The only 'negative' is losing a lap to balance objects on. I just have to get more creative now with how I carry things.

    I can see it being difficult to wrap your head around after 55 years post. I waited 4 and wish it was done right away. If you find the few other SCI here who have had their legs cut off, every single one says the same thing I have.
    What about your center of gravity on a wheelchair? I guess my legs probably don't weigh all that much, but I'm already annoyed by how far back my wheels have to be to keep me from wheelieing every time I push forward, if I chopped off 20 or 30 pounds of lower leg I'm sure I'd have to do something to move the back of the chair even further forward, because my ZRA already has the COG set forward as far as possible and is still annoyingly tippy.

  3. #13
    But now that I think about it, it would definitely make climbing stairs easier and probably make for quicker transfers in and out of the car because I could shave off the three steps of adjusting my legs for the transfer each way.

  4. #14
    Quote Originally Posted by firewheels View Post
    And since the left leg is apparently of "no use", the surgeon is of a mind to amputate that one also.
    Do you know one definition of a PhD? Someone who knows more and more about less and less. Doctors often have blinders on and need to widen their scope of consider. I would explain to him that it is of use. It provides balance, off loads pressure, and enables a base for transfers. Then I would find a different doctor who doesn't need to be told this. Because you have to wonder what else this doctor doesn't get.

  5. #15
    Quote Originally Posted by funklab View Post
    But now that I think about it, it would definitely make climbing stairs easier and probably make for quicker transfers in and out of the car because I could shave off the three steps of adjusting my legs for the transfer each way.
    Yup. Getting around on the bed or the floor or any surface is so much easier. Every movement you have to make requires repositioning of your legs. Without them, it's so much faster.

    I think I lost 18lbs when my legs were cut off. Mine were completely atrophic, so if you have a lot of muscle they may weigh a bit more, but I doubt they will be 30lbs.

    My COG is 1.5"which is honestly not too far back. What you can also do, which I used to use but don't actually use anymore, is have a local welder fabricate a foot rest plate as heavy as you need it. I came up with the following design:









    You can drill two holes in your footrest which correspond with the two pegs in the plate. This can serve as a counterbalance if you want to keep your COG close to 0 and you can quickly remove it and place it on the footrest when you're transferring in and out of your car or whatever.

  6. #16
    We used to respond to orthopedists who just wanted to amputate "because you aren't using your legs anyway" by saying "so should we cut your head off at the neck since it doesn't appear you are using your brain!".

    An AK amputation will definitely effect your sitting posture, balance and cushion needs. Your posterior thighs should be off-loading your ischiums if you are properly fit with your cushion, and if you have less thigh, you have less ability to do that. This is aside from the cosmetic issue of an amputation (or two), and people with paralysis are not usually candidates for prosthetic legs, even cosmetic ones. Yes, you will weigh less (duh!) and it may be easier to transfer, but the trade off with significantly more risk for pressure (sores) injuries needs to be considered as part of the decision.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  7. #17
    Quote Originally Posted by paraparajumper View Post
    The whole "legs serve a pivot point for balance" and are absolutely necessary for safe and productive transfers argument is so overused and spoken as truth in the SCI community, I find it ridiculous. Of course, you hear that by individuals with legs, because they don't know any different. Positioning of your hands and upper body strength is far more important. You have greater transfer range and distance abilities without the legs. All my transfers have been cleaner and safer, and with less episodes of shearing.

    Both my legs were amputated AK over 2 years ago now, was the best decision I made post injury. If you're adept with upper body coordination, your transfers will become easier. It'll take a week or two to get used to weight distribution, but everything about ridding yourself that dead, lifeless weight is a benefit.

    Less cumbersome transfers, faster transfers, quicker movement when out of your chair, no repositioning of your legs, easier to get closer to objects and roll straight up to things, etc, etc, etc Would do more harm then good? Hardly.

    The only 'negative' is losing a lap to balance objects on. I just have to get more creative now with how I carry things.

    I can see it being difficult to wrap your head around after 55 years post. I waited 4 and wish it was done right away. If you find the few other SCI here who have had their legs cut off, every single one says the same thing I have.
    thanks for the helpful prospective, PJ. As usual in CC there are two or more answers to any question because the context of our lives & injuries are different. As in this case, where I've had to weigh all the anecdotes (including mine) against each other & against clinical and research data. Comorbidities, age, past lifestyle and future expectations have all to be taken into account. - fw

  8. #18
    Damn, I just noticed the error in the heading of my update. The fracture was femoral, not tibial. A thousand apologies to anyone this has led astray! fw


    Quote Originally Posted by firewheels View Post
    Jun 6th '18 (6 weeks later): Thanks to my daughters and a PA here at the rehab, I've gotten new x-rays and a consultation with the Chief of orthopedic trauma surgery at BWH in Boston. The fracture is still complete but apparently more stable.

    Contrary to the advice given by his Fellow, the Chief agrees that given my particular situation, amputation would do me more harm than good. The fracture is right above the femoral condyles & I'm supposed to flex the leg on the break rather than on the knee itself. We've tried this and it seems to work, the job right now is to reestablish safe transfers between bed and wheelchair. It's going to be an interesting process.

    I've been very lucky to work with this crew of surgeons. They know everything about leg trauma in ABs but nothing about handling it in paras, and were very appreciative of my helping them to educate themselves about that. The process is collaborative for once and even if I can't manage the rehabilitation, all concerned are learning things.

    My review of posts relating to leg trauma in CareCure was invaluable in getting me up to speed about talking to clinicians about leg trauma and SCI. My thanks to all those posters! - fw
    Last edited by firewheels; 06-11-2018 at 03:47 AM. Reason: typos, typos. Damned difficult writing on an iPhone.

  9. #19
    Last edited by firewheels; 06-11-2018 at 04:23 AM. Reason: Mistake, can't kill. Please ignore.

  10. #20
    Senior Member smokey's Avatar
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    Firewheels, I see you are from MA. Get a second opinion from Dr. Malcomb Smith at MGH Orthopedic Trauma Center. He is a little hard to understand as he speaks with a heavy UK accent. Pretty sure he is British but he sounds Scottish, lol. Funny guy, nice guy, straight shooter.

    https://www.massgeneral.org/doctors/...aspx?id=17426#

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