Amputation: The First Year
March 2003 Issue
Amputation. That one simple word changes everything, doesn't it? I considered this recently as I spoke with a man who is facing the difficult decision between an amputation and his 16th surgery to restore mobility to his damaged left ankle. I could relate to that dilemma.
While listening to him weigh out loud the pros and cons of this decision, my mind wandered back to the day just over a year ago when I first heard the word "amputation" spoken concerning my own future. Since then, many things in my life have changed. The world and my place in it looks very different.
In the short months that have passed since that day, I have experienced fear, depression, and guilt. I have faced hard choices and challenges and have found that I somehow possess courage I cannot explain. I have learned to set goals and to reach and surpass them. I have recovered from the physical trauma of surgical amputation. Slowly, I am piecing my emotional and spiritual life back together.
My story began in the fall of 2001 as I sat listening to the orthopedic surgeon quietly informing me that, after three minor corrective surgeries, there was little more he could do to give me more mobility or relieve the pain in my badly shattered right ankle. Two plates, 13 screws, and an odd pin or two held it all together. In only two years since the accident, the cartilage in my ankle was worn out and the bone-on-bone pain would only get worse.
Amputation: A Solution?
He suggested that an amputation might be a solution to my pain and referred me to The Hanson Foot and Ankle Clinic in Seattle, Washington, for a consultation with the highly respected Dr. Sigfried Hanson. Today I realize that my local doctor placed me on a road leading to some of the finest medical care available.
Entering this world of excellent health care started with the first hour-long meeting with Dr. Hanson. The length of our meeting itself was a surprise. I was used to the quick ten minutes with a doctor who had three other patients waiting in other exam rooms. During this hour, Dr. Hanson led me through all the possibilities open to me. In short, I had two choices: spend the next three to five years having multiple surgeries with about a 25 percent chance of getting better-or amputate and move on with my life. On my eight-hour drive back to southern Oregon, I decided to go ahead with the amputation.
My wife and I researched amputation and prosthetics. I joined a newsgroup of amputees on the Internet and from them learned what this new world was about. I cannot stress how important communicating with other amputees was then and still remains. From strangers I learned about the new life I was facing and found acceptance, strength, and support, as well as a forum for my many questions. I found the courage to contact Dr. Hanson again.
Undergoing an Ertl Amputation
My wife and I drove back to Seattle the first week of February 2002 to meet the doctor who would perform the surgery. A young, calm, confident surgeon appeared and introduced himself as Dr. William Ertl. I had researched both Dr. Ertl and his procedure commonly called an "Ertl amputation." Dr. Ertl made a contract with me. I was going to have to work hard in my recovery, follow his advice, and have a "can do" attitude. In turn, he was going to, in effect, rebuild my leg. But the leg would be different, since I would not have an ankle or a foot. His confidence instilled trust, and I immediately decided to have the surgery in two weeks.
Waking up from the five-hour procedure I steeled myself for the shock of looking down and not seeing the rest of my leg. I had read the stories of others waking up and experiencing this life-changing moment. I was ready! I lifted the sheets and saw a neatly wrapped residual limb. That was it. There was no heart-stopping moment, there was no flash of an epiphany. I was simply still me. It was almost a letdown. I remember thinking, "Well, that's not so bad-piece of cake!" Grief set in later.
Recovery: Physical and Emotional
Five days of hospitalization passed, and my wife drove me home to our changed life. I feared I was going to be a cripple. I felt loss, grief, and an overwhelming desire for a sense of normalcy.
I found myself on an emotional roller coaster, which, however, gave me the fuel to return to work. Within three weeks I was back in my art gallery, greeting customers. I rarely ventured beyond the sales counter. I saw how uncomfortable the average tourist was while being served by a one-legged man on crutches. (The Ertl amputation generally requires eight to twelve weeks of non-weight bearing to heal, but mine took four months, due to a slowly closing wound.)
I worked alone each day, feeling that all eyes in this small town were on me and my progress. I longed for the day I would get my first leg and be "normal" again. But a funny thing happened in those intervening months. I began to forget what life was like before my surgery. Living life on a pair of crutches became normal, and I was adjusting to it. I noticed the stares less and less, and my sense of humor slowly returned.
In June 2002, I was fitted with my first leg. "Go on with life," Steve, my prosthetist, said. Therefore, with this in mind, I went to the Amputee Coalition of America (ACA) Conference in Anaheim, California. I was fortunate to have met so many nice people via the Internet discussion group and spent a week with many of them talking, laughing, and not feeling different. I had not seen another amputee, except for a support group meeting I attended during my hospital stay. Faces were put with names of friends I had only known in cyberspace. It had been two and a half years since I had laughed as much and enjoyed myself as much. These kind people helped bring me back to living a full rich life that is different, but no less fulfilling.
During that week I met many amputees who struggled with poorly fitted prostheses and residual limbs in need of revision surgery. Until then, I thought all amputations were like mine. I began to understand just how much my life had been improved by having an Ertl amputation. Dr. Ertl fulfilled his part of our contract, and I would like to think I fulfilled mine. The benefit from this type of reconstructive surgery is evidenced in my daily life. I can cycle up to 40 miles daily. I have minimal phantom pain. I take no medications. I have a very normal gait. I look forward to the future; for me, 2003 holds a myriad of possibilities.
Eight months after my surgery, I moved 3,000 miles from Oregon and began a new life on the coast of North Carolina. I thought all this while listening to a frightened man about to embark on his own adventure. What would his first year hold in store for him? I wished him well, as I wish us all well. It will be nothing if not interesting, eh?