After Foot Amputation — What’s Next?

Foot Amputation

A foot amputation can be a scary procedure to face. But, completing a successful operation is your surgeon’s job. Your work begins after the procedure.

Knowing what to expect after a foot amputation can help you toward a speedy, healthy recovery. Your hospital staff will give you medications to alleviate pain and fight infection, but you need to know more. Here’s what you can anticipate:

In the hospital after your foot amputation

After moving to your hospital room post-recovery, nurses will change your bandages and will teach you to do so, as well. You will also start the early stages of physical therapy with stretching and some gentle exercises.

Perhaps, most importantly, you will receive information and guidance about your prosthetic foot (if you’re choosing to get one).

At home 

If your healing progresses well in the hospital, you’ll likely go home after a few days. Once there, be sure you follow your surgeon’s instructions about bathing, activity level, and physical therapy to ensure your best recovery.

Physical therapy starts with gentle stretching and will progress to exercises that will improve your muscle control, enable you to resume daily activities, and help you regain independence. It will also include practice with your prosthetic or assistive devices.

Only take pain medications prescribed by your doctor. Even taking an aspirin can increase your bleeding risk.

If you experience swelling, redness, bleeding, worsening pain, numbness, or tingling, contact your surgeon immediately. These symptoms could be normal, but they could also indicate a need for immediate attention.

Inpatient rehabilitation

If you have additional health problems or you’re not recovering your mobility quickly, your doctor might recommend an inpatient rehabilitation facility.

Healthcare providers will focus on wound healing, rebuilding your strength, preparing your leg for the prosthetic, and improving your mobility. They will also teach you how to care for your new prosthetic.

Ongoing rehabilitation

Prosthetics: If you opt for an artificial foot, you’ll need to be fitted properly, learn how to care for it, and how to walk.

It’s possible your leg will still be swollen when you get fitted for your first prosthetic. If so, you’ll receive a temporary one, getting the permanent one within six to 12 months.

Mental health: Losing a limb can be emotionally traumatic. You can develop feelings of depression, anxiety, grief, denial, and suicide. If you feel any of these emotions, contact your doctor immediately. Your care team has support resources.

Complications

Even successful surgeries carry risks. Blood clots and infections can occur with amputations. If left untreated, these problems can cause nerve pain, phantom pain (pain felt in a removed limb), and bone spurs at the end of your leg.

Contact your surgeon if you experience any complications. While it might be possible to correct the problem with medication, there’s a chance you could need additional surgery.

Ultimately, going into your amputation surgery with a clear understanding of what your next steps will be could put you on a path to a quicker, healthier recovery. If you know what to expect, you can be better prepared.

If you have any questions about a foot amputation, contact the Amputation Prevention Centers of America.

Protect Yourself from Charcot Foot

Charcot Foot

If you have diabetes, you face the possibility of developing many foot problems, including ulcers, non-healing sores, and even amputation. But, there’s another condition you should know about and watch out for: Charcot foot.

Also called Charcot arthropathy, this condition weakens the bones in the feet of people who have peripheral neuropathy. It also attacks the joints and soft tissues. Over time, it can cause painful sores and actually change the shape of your foot.

Why does Charcot foot happen?

Your bones naturally lose calcium when injured, and, according to the Cleveland Clinic, that makes the bones weaker and more susceptible to further damage. The numbness from peripheral neuropathy increases the danger. If you can’t feel a sprain, a break, or an infected or lingering sore, you’re more likely to continue walking on your foot normally. In some cases, slow healing from a foot surgery can be responsible.

What happens?

Prompted by injury that often doesn’t get timely treatment, your bones lose the calcium that keeps them strong. At that point, your foot can start to lose its shape, and your arch can drop below your toes or heel. Doctors often call this “rocker bottom.”

Additionally, your toes might curl, and your ankle can become twisted and unsteady. Any misshapen bones can also press against your shoes, creating new sores that can also get infected and lead to amputation.

What to look for?

Diagnosing Charcot foot can be difficult, according to a study published in American Family Physician, because it mimics other conditions, including cellulitis and blood clots. Initial X-rays and lab tests can also often look normal.

However, there are some symptoms, other than the fallen arch, that can make you suspect Charcot foot. If your foot becomes reddish, warm to the touch, or swollen, talk with you doctor. You should also be concerned if you have instability in your ankle, any misalignment of the bones that form the joint, or a strong pulse in your foot.

Can you prevent it?

Yes, you can do things to potentially side-step Charcot foot. Follow this list for better foot health:

  1. Get regular check-ups with a foot doctor who has experience treating diabetic foot problems.
  2. Check your feet daily for swelling, redness, warm spots, and sores. Check between your toes, too.
  3. Wash your feet daily, and dry them thoroughly.
  4. Always wear socks and shoes.
  5. Keep your blood sugar levels under control — between 80-130 mg/dL before eating, under 180 mg/dL after.
  6. Take extra care to avoid injury, particularly while exercising.

 
Overall, if you begin to see these changes in your feet — especially if your foot begins to change shape — contact your doctor immediately. Any delays can result in further damage to your foot that could lead to infection or amputation.

For questions, please contact Amputation Prevention Centers of America.

Inherited Neuropathy — Can Numbness Be Hereditary?

Inherited Neuropathy

Eye color, shoe size, and height all have one thing in common — they’re hereditary. It turns out inherited neuropathy can be, too.

While it’s rare, children who have a parent with heritable neuropathy have a 50 percent chance of developing the condition, as well. It can show up as early as birth, but it’s more frequently diagnosed in middle- and older-age. Type 2 diabetes and obesity are also risk factors.

According to an Annals of Indian Academy of Neurology study, there are more than 30 genes that are linked to inherited neuropathy. A neurologist can diagnose whether you have the condition via nerve conduction studies, nerve biopsies, or genetic testing.

There are two common forms of inherited neuropathies — Charcot-Marie-Tooth (CMT) and Hereditary Neuropathy with Liability to Pressure Palsies (HNPP). Overall, they share many similar symptoms. Individuals experience pain and tingling in their hands and feet, muscle weakness and loss of mass in their feet and lower legs.  They also experience impaired sweating, low blood pressure upon standing up, and physical deformities, such as high foot arches, hammertoes, and curved spine.

What Happens With CMT?

CMT affects approximately 1 in 3,300 people. There are many CMT subtypes, but CMT1A is the most common. It affects 20 percent of people who seek medical attention for undiagnosed peripheral neuropathy.

Patients with CMT have difficulty lifting their feet, weak ankles, drop foot, and have unsteady balance. They also exhibit poor hand coordination, making it harder to hold pencils, button or zip clothes, and turn door knobs. Additionally, they can be hyper-sensitive to cold temperatures. Muscle weakness and poor circulation can turn hands and feet cold, as well as lead to ankle and foot swelling.

Sometimes, individuals with CMT can also lose their knee-jerk reactions and experience hand tremors. This is called Roussy-Levy Syndrome. Additionally, weak breathing and shortness of breath are rare, but they can be life-threatening. If those symptoms appear, a respiratory specialist might recommend a ventilator.

What Occurs With HNPP?

HNPP is even more rare than CMT, appearing in 2-5 individuals per 100,000.

Affected individuals are extremely sensitive to pressure, and they can have difficulty carrying heavy bags, leaning on their elbows, or sitting in chairs. Frequently, they experience tingling, numbness, and loss of sensation in areas impacted by the neuropathy. These symptoms typically strike the hands, arms, feet, and legs.

Often, HNPP episodes last for several months. Long durations can lead to permanent muscle weakness and sensation loss.

Prevention & Treatment

There’s no way to prevent inherited neuropathy, but genetic counseling is available to parents who worry about passing the condition on to their children.

Additionally, there’s no cure, but ongoing management techniques can greatly improve quality of life. For example, pain medications, physical therapy, corrective surgery, therapeutic shoes, braces, and support devices can greatly reduce the impact inherited neuropathy has. A balanced diet and exercise are also beneficial.

Be sure to seek medical attention as soon as symptoms for inherited neuropathy appear. The earlier the diagnosis, the better prognosis and outlook you’ll have.

For more information, contact the Amputation Prevention Centers of America.

Causes for Leg Amputation

Leg Amputation

Having diabetes doesn’t mean you’ll definitely face a leg amputation, but it does increase your risk. In fact, nearly two-thirds of limb amputations in the United States are diabetes-related.

According to the American Diabetes Association, while the number of amputations has dropped by half over the past 20 years, there are still 73,000 amputations performed annually in adults with diabetes. Foot ulcers are largely the ultimate cause. Ulcers develop in 15 percent of diabetics, and, of that group, 24 percent end up losing a limb. The risk is two to three times higher for black, Hispanic, and Native American patients.

But, what causes the ulcers that lead to losing your leg? There are several factors that put you at risk, and being aware of these problems can help you minimize their impact.

High Blood Sugar

Blood sugar levels that are too high prompt nerve swelling and scarring. Damaged nerves have trouble sending messages, so you’ll eventually go numb in your lower extremities. Without feeling, you’re less likely to notice sores and wounds on your feet. Left untreated, these spots can become ulcers that develop infections that reach down into your bone and impact your entire foot and leg.

Peripheral Artery Disease (PAD)

PAD is more common in individuals with diabetes. The condition, also called atherosclerosis, clogs your arteries and decreases your blood circulation. Poor circulation makes it harder for any ulcers to heal. Without the proper blood supply, your ulcers will continue to worsen, opening the door that leads to infection and potential leg amputation.

Compromised Immune System

If your diabetes isn’t well controlled, your immune system can’t function properly to fight off the infections that lead to leg amputations. Without white blood cells and sufficient blood supply to attack infection, good, healthy tissue dies. At that point, a life-threatening infection can spread quickly to your bones and joints, making an amputation the only treatment option.

Skin Changes

Researchers from the University of Bristol recently discovered ulcers happen in the lower limbs of some diabetic patients because the connective tissue in the skin actually changes. The tissue renews at a faster rate, making collagen abnormal and skin weaker. Weaker skin breaks down faster and forms ulcers more easily.

Although more research is needed to figure out how common the problem is, the researchers said maintaining low blood pressure, blood sugar, and cholesterol levels is a good way to treat the skin changes. The skin alterations can be undetectable for a long time, though, so don’t wait to control your levels until you see problems.

Reduce Your Risk, Control Your Blood Sugar

There are things you can do to limit your amputation risk, however. The biggest step is controlling your blood sugar — keep it at 80-130 mg/dL before meals and 180 mg/dL after eating. Include lean meats, fruits, vegetables, fiber, and whole grains in your diet, and avoid sugar-sweetened juice and soda. Exercise 30 minutes daily. Maintain a healthy weight and blood pressure (less than 120/80), and take your diabetes medications as directed.

Contact Us to Learn More on Causes for a Leg Amputation

Overall, remember that having diabetes doesn’t mean you will lose a limb. Work with your doctor to keep your diabetes under control and ensure your feet are as healthy as possible. If you have any questions or concerns, you can also contact us at Amputation Prevention Centers of America.