As Delores Revie lay in her hospital bed, the surgeon looked down at her and said, "You have two options: loose the legs or loose your life." That was all she remembers being told until after both legs were amputated above the knees.
Forward Motion
by Tracie Estok, PT, DPT
Amputee Specialist,
Florida Hospital Waterman
For two years, Delores, who goes by the name Dodie, fought ulcers in both legs, which, due to vascular issues, and even with hyberbaric treatments (the medical use of oxygen at a level higher than atmospheric pressure), would not heal. Because of these non-healing ulcers, she eventually contracted gangrene in the wounds, which led to the amputation of her legs.
I first met her three years ago in my capacity as the Amputee Rehabilitation Specialist at Florida Hospital Waterman. I worked with her prior to and after her amputation. While in rehab, Dodie learned how to transfer on/off a table/bed into her wheelchair and from the wheelchair to her car with only the use of a sliding board. Once she started outpatient physical therapy, she received her first set of prosthetics, called "stubbies." These prosthetics have no knee joints, which allow the above-the-knee amputee to learn to balance and walk while giving use to the sockets that the "residual limbs" or stumps fit into, without initially having to manage knee joints. Petite 100-lb. Dodie quickly mastered the stubbies in the clinical setting, but, because of severe rheumatoid arthritis, was unable to use the stubbies at home. Between her arthritis and an older rotator cuff tear, she lacked the shoulder strength needed to lift herself into her wheelchair.
Dodie was more than ready to get her prosthetic knees.
Getting knees was not as easy as she thoght it would be. She was having extreme shoulder pain from her arthritis, and her mid-torso strenghtening, which is critical to being able to stand and walk on prosthetics, was not inproving quickly enough. Dodie was placed in aquatic therapy. In this environment she could perform her exercises relatively pain free, facilitate her core strenghening, and build her upper-body strength, which would allow her to improve her ability to support herself on her prosthetics.
Most of Dodie's core weakness was due to a surgery she had in February of 2008 to repair a preforated colon and peritonitis, which resulted from a routine colonoscopy. She subsequently had to have another surgery in May 2008 to repair an abdominal hernia that resulted from the stomach muscles being weakened by the colon surgery. This surgery, however, was not successful and in the middle of her rehabilitation, in August of 2009, Dodie had to have another surgery to repair the abdominal hernia that was now so large, it was directly affecting Dodies ability to balance herself on her prosthetics, as well as impacting her ability to get a proper fit of the prosthetics.
In November of 2009, Dodie finally received a new set of prosthetics that fit - a pin system prosthesis using an Alpha linerthat looks like a screw coming out of the bottom of it that "clicks" into a locking mechanism to hold the prosthesis in place.
These new legs were so much easier to use than her first set of prosthetics; applying a former set was a time-consuming process, and one she could not perform on her own.
We thought these new legs were just what Dodie neede. "This is great," she exclaimed when she used the new Alpha liners for the first time. After some adjustments to imiprove the fit of the new sockets and taking her first steps with the system, Dodie began to cry. They were tears of joy... anf tears of frustration.
During conversations I had with Dodie and her partner, Dallas Dickmyer, we talked about their frustrations with the entire process. "I had no manual for having my legs amputated, and I had no idea what to expect after that," Dodie lamenated. She feels a lot of her frustration could have been avoided had she had a peer mentor, someone like her, who had lost both legs; someone who tried all the systems out there and could guide her in the search for the perfect system.
She inspired me. Our talks began the seed which gave birth to our amputee support group called WALK - Waterman Amputee and Limb Loss Konnections, with this mission statement:
"To empower all amputees and people with limb loss to live quality lives, achieve active lifestyles and to continue to be productive members of society." The hospital agreed to offer meeting space, and to provide three amputee facilitators, one care giver facilitator, one member at-large, one physical therapist faciliator and one prosthetist facilitator."
One of the goals of the group is that all interested amputees who join will become peer mentors through the Amputation Coalition of America (ACA). Floida Hospital Warterman is a facilitator member of the ACA and looks forward to offering this training session sometime in January of February of 2010. The group meets the last Monday of every month from 6-7pm in Conference Rm C on the ground floor level of Florida Hospital Waterman. Special meetings are held for any caregivers that come as well, as their issues are different from those of the amputees. For more information, you can contact the Rehabilitation Institute of FHW at 352-253-3892.
At a recent meeting of WALK, one of the attendees looked at Dodie and said, "You have the right kind of attitude." And she does. With her "no problem" determination, she makes us all want to try harder to achieve our goals.
