Your understanding of the prospective procedures and the order in which they will occur is very important. You need to be aware of the risks and benefits of each treatment step.
Unless the amputation is being performed as an emergency, your doctor, physiotherapist and other hospital staff will be available to discuss all aspects of having the surgery, including the reasons for and the proposed level of the amputation.
You should ask any questions you may have prior to the operation and ensure any concerns that you and your family have are addressed.
Your general health and fitness is also important and the physiotherapist will initiate a program for you to ensure the best possible outcome for you. The exercises prescribed for you are to prevent the formation of contractures (tightening of muscles), to maintain good joint range as well as maintaining muscle strength.
A modern surgical amputation is nothing like the past when doctors were known as ‘saw bones’ for good reason. The goal of successful prosthetic use influences the surgical techniques used and in modern medicine an amputation is performed with precision.
The surgeon must sever many tiny nerves and blood vessels and close off their ends causing them to retract into the muscle. The bone will be filed so that it has no sharp edges to form a comfortable point for weight to be applied when using a prosthesis. The surgeon will close the opening by folding a flap of skin over the open area and stitch or staple the area closed.
After the surgery the residual limb will be very rounded on the end and swollen. This is normal as the healing process and surgery will make the stump swell. Wearing stump shrinkers will reduce this swelling.
When you wake from the anaesthetic you will feel like your limb is still there. This normal, painless sensation is called a ‘phantom limb’ (not to be confused with phantom pain) caused by the brain ‘remembering’ the lost limb. This will initially be confusing but phantom limb sensations are needed for prosthetic use.
What happens to the limb that was amputated?
Under Queensland legislation any part of a person removed during surgery must be stored and disposed of under clinical waste guidelines. These rules are very strict as such waste may carry disease and create a risk to public health. Unless you make specific arrangements the limb will be disposed of at the hospital; this means it will be incinerated with other human tissues as that is what the law requires. Once the tissues are incinerated they are disposed of according to government policy.
If your religious/cultural practices prohibit cremation; discuss the situation with the hospital as you may be able to organise collection and burial of the limb by an appropriate member of your faith/culture. Discuss any special requirements with your doctors well before the surgery so that appropriate arrangements can be made. If the hospital disposes of the limb in a way that contravenes your beliefs; consult representatives of your faith/culture so they can advise you.
In Australia it is possible to organise a private cremation of an amputated limb through a funeral director. Some people choose to do this for symbolic reasons or they are uncomfortable with the idea of part of them being disposed of as a waste product. If you would like to have your limb interred or buried it may be difficult to arrange as cemeteries are mostly operated by local councils who create their own guidelines for burials.
If your amputation was due to infection it will not be possible to have the limb released for private cremation due to the risk to public health. This includes meningococcal and staphylococcus infections. In these cases the hospital is required by law to dispose of the limb.