Loss of a Limb—Could It Happen to You?
Benjamin was outside enjoying the spring sunshine that warmed the city of Sarajevo when he stepped on a land mine. His left leg was blown off. “I tried to get up,” recalled Benjamin. “I couldn’t.” Benjamin is just one of the 20,000 people a year who are killed or maimed by land mines.
ANGOLA is littered with as many as 15 million land mines—more than one for every man, woman, and child in the country. Angola now has 70,000 people who have suffered limb loss. With its eight million to ten million sown land mines, Cambodia has the highest percentage in the world of persons who have lost limbs—an estimated 1 out of every 236. Bosnia and Herzegovina reportedly contains over three million mines—152 per square mile. [59 sq km]
But it is not only in war-torn lands that people suffer limb loss. For example, there are about 400,000 sufferers of limb loss in the United States. Among most of the adults in that number, the loss of a limb is the result of a chronic condition loosely termed “peripheral vascular disease,” or PVD. This is a general term covering a number of disorders. Taber’s Cyclopedic Medical Dictionary defines PVD as an imprecise term covering “diseases of the arteries and veins of the extremities, esp[ecially] those conditions that interfere with adequate flow of blood to or from the extremities.” A leading cause of PVD is diabetes. According to The World Health Report 1998, “diabetes cases in adults will more than double globally from 143 million in 1997 to 300 million by 2025.”
In the United States, trauma—including accidents involving vehicles, machinery, power tools, and firearms—is the second leading cause of limb loss, accounting for 20 to 30 percent of all amputations. Other causes of limb loss include tumors (about 6 percent) and birth defects (about 4 percent).
The thought of losing a precious limb is unsettling, to say the least. Is there any way of reducing that risk? And if you have already suffered the loss of a limb, how can you enjoy a good quality of life? The following articles discuss these and other questions.
Loss of a Limb—How You Can Reduce the Risk
MOST cases of limb loss can be prevented! And that is true even for people who suffer from peripheral vascular disease (PVD). As mentioned in the previous article, PVD is often the result of diabetes.* Happily, diabetes can often be controlled.
“Diet is the cornerstone of diabetic treatment whether or not insulin is prescribed,” says The Encyclopædia Britannica. Dr. Marcel Bayol, of Kings County Hospital in New York City, told Awake!: “If diabetics take their condition seriously, watch their diet, and submit to medical supervision, they will reduce their risk of having to lose a lower limb.” Type II diabetics who follow this advice may even see their symptoms improve in time.*
Exercise Is Vital
Exercise is also important. It helps the body maintain glucose, or sugar, levels within the normal range. When PVD is in evidence, exercise helps maintain vital strength, flexibility, and blood flow to damaged areas. Exercise also helps to minimize intermittent claudication—the pain PVD sufferers may feel in their calf muscles when they walk or exercise. However, such ones should avoid exercises that stress and jar their legs. More suitable exercises include walking, bicycling, rowing, swimming, and aqua aerobics. One should always consult a doctor before dieting or beginning a special program of exercise.
Smoking, of course, should be taboo to anyone who wants good health. PVD is just one of a long list of medical problems that smoking either causes or aggravates. “Smoking is a big factor in amputations, especially when the smoker has diabetes and PVD,” said Dr. Bayol. How big a factor? A rehabilitation guide for amputees says that “amputation is 10 times higher among smokers than non-smokers.”
Care for Sick Limbs
PVD can decrease circulation to the lower limbs, which can bring on a condition called neuropathy—a deadening, or numbing, of the nerves. Limbs then become vulnerable to injury, even while a person is simply resting in bed. For example, because he cannot feel any pain, a sufferer could receive a serious burn if his electric blanket or heating pad were to overheat! For this reason, manufacturers caution diabetics to be careful when using these products.
Sick limbs are also more prone to infection. Just a small scratch can lead to ulcers, even gangrene. So foot care is vital, and this includes wearing comfortable, well-fitting shoes and keeping legs and feet clean and dry. Many hospitals have foot clinics that educate patients in foot care.
When PVD has advanced to the point that surgical intervention is required, surgeons will usually try to avoid amputation. One alternate procedure is balloon angioplasty. A vascular surgeon inserts a catheter with a balloon tip. The balloon is inflated, which then stretches the constricted artery. Another option is bypass surgery—the replacement of badly diseased blood vessels with vessels taken from another part of the body.
Barbara, who is 54 years old, has endured Type I diabetes since the age of four. After she gave birth to her first child, she developed PVD in her feet. Some doctors advised her to have them amputated. However, Barbara found a reputable vascular surgeon who used angioplasty to improve blood circulation to her feet. Angioplasty worked for a time, but eventually Barbara needed a bypass, which was successful. Barbara now takes meticulous care of her feet.
Trauma is the second leading cause of limb loss. Less discriminate in its choice of body members, trauma can result in the destruction of any body part. However, a godly view of life can do much to reduce a person’s risk of trauma. Whether working, driving, or enjoying recreation, Christians should treat their bodies as a gift from God. Thus, they would want to respect all safety requirements and avoid taking foolish risks.—Romans 12:1; 2 Corinthians 7:1.
What is being done to reduce the risk of trauma in lands sown with mines? Government-sponsored mine-awareness programs are in place in many countries. According to a report of the United Nations secretary-general, these programs teach “populations at risk . . . how to minimize their chances of becoming victims while living and working in mined areas.”
Sadly, “people become accustomed to the presence of mines and grow careless,” says a United Nations report. “Sometimes religious factors encourage [people] to adopt a fatalistic attitude towards such dangers.” A fatalistic attitude, however, finds no support in God’s Word. On the contrary, the Bible encourages caution and safety.—Deuteronomy 22:8; Ecclesiastes 10:9.
So by exercising caution and taking reasonable steps to protect your health, you can greatly reduce your risk of losing a limb. But what about those who have already lost limbs? Can they still enjoy a good quality of life?
Vascular problems in the lower extremities can also be triggered or exacerbated if a person wears tight clothing on the lower body or ill-fitting shoes or sits (especially with his legs crossed) or stands for long periods of time.
People with Type I diabetes are prescribed daily insulin injections. Those with Type II diabetes (non-insulin-dependent diabetes) can often control their condition by diet and exercise. In the United States, 95 percent of diabetics have Type II diabetes.
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Smoking greatly increases the risk of loss of a limb, especially for those with vascular disease
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Suitable exercise and a good diet promote a healthy vascular system
Quality Life Without a Limb
“CLIMBER is back on top.” So declared one newspaper when Tom Whittaker reached the top of Mount Everest. Many have ascended that lofty peak before, but Tom Whittaker was the first amputee to do so! Whittaker lost his foot in a traffic accident. But an artificial foot, a prosthesis, made it possible for him to resume his sport. Similar devices are allowing thousands of other amputees to enjoy a high quality of life. In fact, it is no longer unusual to see amputees sprinting, playing basketball, or riding bicycles.
Early versions of artificial legs and hands were crude wooden pegs and iron hooks. But improvements came as wars left thousands mutilated. Not surprisingly, it is an army surgeon—16th-century Frenchman Ambroise Paré—who is credited with introducing the first generation of true prostheses. Today’s prosthetic devices utilize hydraulics, sophisticated knee joints, flexible carbon-fiber feet, silicone, plastics, and other high-tech products that enable many people to walk and move more naturally and comfortably than was ever dreamed possible. Advances in microelectronics allow artificial arms and hands to be manipulated more naturally. Prostheses have also improved in appearance. Modern artificial limbs incorporate fingers and toes, and some even appear to have veins. In fact, a female model who lost a leg because of cancer was fitted with a prosthesis so natural looking that she was able to continue her modeling career.
Mental Attitude Is Important
Nevertheless, mental-health expert Ellen Winchell cautions: “When you undergo a personal crisis such as amputation, you are profoundly challenged on every plane of your being—physical, emotional, mental, and spiritual.” Consider William, who lost a leg to gangrene following an injury. He says: “One of the keys to overcoming any challenge in life is our mental attitude. I have never viewed my disability as a liability. Instead, I have kept a positive outlook regarding any setbacks that I have had since my accident.” Ellen Winchell, herself an amputee, concurs, saying that people with a positive outlook are likely to adjust better to limb loss than pessimistic people. As the Bible says, “a heart that is joyful does good as a curer.”—Proverbs 17:22.
Awake! spoke with a number of Christians who have adapted well to losing a limb. Most suggested that amputees avoid being overly self-conscious or secretive about their disabilities. “It would bother me more if others had the feeling that this was one of those forbidden subjects,” said Dell, who lost his left leg below the knee. “To me, that just makes everyone uneasy.” Some experts recommend that if your right hand is missing and you are introduced to someone, you should go ahead and initiate a handshake with your left hand. And if someone inquires about your prosthesis, tell him about it. Your being at ease helps the other person to relax. Usually, the conversation will soon drift to other topics.
There is “a time to laugh.” (Ecclesiastes 3:4b) One woman who lost a hand says: ‘Most of all, keep your sense of humor alive! We must always remember that our attitude about ourselves largely determines the world’s attitude toward us.’
“A Time to Weep”
After losing his leg, Dell initially said to himself, “This is it. My life is over.” Florindo and Floriano both lost limbs to land mines in Angola. Florindo says that he cried for three days and nights. Floriano similarly had a battle with his emotions. “I was only 25,” he writes. “One day I could do everything, and the next day I couldn’t even stand up. I was depressed and discouraged.”
There is “a time to weep.” (Ecclesiastes 3:4a) And it is only natural to go through a period of grieving when you have suffered a serious loss. (Compare Judges 11:37; Ecclesiastes 7:1-3.) “The way out of grieving is by going through it,” writes Ellen Winchell. Expressing one’s feelings to an empathetic listener is often quite helpful. (Proverbs 12:25) But grieving does not go on forever. Some individuals may temporarily become more volatile emotionally, critical, anxious, or withdrawn after the trauma of limb loss. However, these feelings usually subside. If they do not, clinical depression may have set in—a malady generally requiring medical intervention. Family members and friends should be alert to any signs that their loved one is in need of such help.*
W. Mitchell, who is paralyzed in both legs, writes: “We all need people who care. Almost anything can be borne if one feels surrounded by a network of friends and family, whereas a minor setback can derail a person who is trying to muscle through life alone. And friendships don’t just happen, they must be actively started and actively maintained, or they wither.”—Compare Proverbs 18:24.
Quality Living, Without a Limb
In spite of their disability, many with missing limbs lead quality lives. Russell, for example, was born with only the top part of his left leg. At 78 years of age, he still exercises regularly and lives a full life, although now he uses a walking stick. Cheerful by nature, Russell confessed that his long-standing nickname is Happy.
Douglas, who lost a leg in World War II, walks with the aid of a modern prosthesis. As one of Jehovah’s Witnesses, he has enjoyed serving as a regular pioneer, a full-time evangelizer, for six years. And do you recall Dell, who thought that his life was over when he lost his leg? He too lives a satisfying life as a pioneer, and he is able to support himself.
How, though, do victims of limb loss fare in poor or war-torn lands? Says the World Health Organization: “The reality today is that only a small percentage of people with disabilities get assistance.” Many have to rely on canes and crude crutches to get around. Nonetheless, sometimes help is available. Floriano and Florindo, the Angolan land-mine victims, both obtained prostheses through the International Red Cross and the Swiss government. Floriano happily serves as a ministerial servant in the local congregation of Jehovah’s Witnesses, and Florindo serves as an elder and full-time evangelizer.
An association that cares for the disabled puts it well when it states: “The only handicapped people are those who have lost heart!” Interestingly, the Bible has played a big role in giving disabled ones heart. “Learning Bible truth while I was recovering helped me tremendously,” says Dell. Similarly, Russell says: “My Bible-based hope has always helped me through difficulties.” Just what hope does the Bible hold out for disabled ones?
See the article “How to Help Depressed Ones Regain Joy,” in the March 15, 1990, issue of The Watchtower.
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Phantom limb sensation refers to the very real feeling that the missing limb is still present. It is the normal feeling that amputees have after surgery, and it is so real that a booklet for amputees says: “Be aware of phantom sensation when getting out of a bed or chair without your prosthesis. Always look down to remind yourself that your foot is absent.” One patient who had lost both her legs went to stand up to shake her doctor’s hand but, instead, fell on the floor!
Another problem is phantom limb pain. This is the actual pain that is perceived as coming from the removed limb. The intensity, type, and duration of phantom pain varies from person to person. Happily, both phantom sensation and phantom pain usually decrease with time.
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Modern prostheses make life much more enjoyable for many disabled people
Photo courtesy of RGP Prosthetics
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Grieving is a normal reaction to serious loss
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Many disabled people enjoy a quality life
When All Disabilities Will Disappear
A QUADRIPLEGIC once said that most people have only “temporarily abled bodies.” How true that is, for sooner or later, physical flaws surface in all of us! Thus, there is a booming market for eyeglasses, contact lenses, dentures, hearing aids, electronic pacemakers, and knee implants. As Romans 8:22 says, “all creation keeps on groaning together and being in pain together until now.”
All of us can, therefore, be comforted by God’s promise to restore obedient humans to perfect physical health in a righteous “new earth.” (2 Peter 3:13; Revelation 21:3, 4) Says Isaiah 35:5, 6: “At that time the eyes of the blind ones will be opened, and the very ears of the deaf ones will be unstopped. . . . The lame one will climb up just as a stag does, and the tongue of the speechless one will cry out in gladness.”
The Bible foretells that “a great crowd” will survive the destruction of this present wicked system. (Revelation 7:9, 14; Psalm 37:10, 11, 29) No doubt soon after that destruction, those with serious disabilities and health problems will experience the instantaneous repair of their infirmities! (Isaiah 33:24) As a preview of the healing that will take place in God’s new earth, Jesus performed similar cures while he was on earth. (Compare Mark 5:25-29; 7:33-35.) One cannot even begin to describe the euphoria that people will feel and the tears of joy that will be shed as amputees discard their prostheses, crutches, and wheelchairs! Sound in body, they will then be able to shoulder their God-given assignment of assisting in transforming the earth into a paradise home.—Luke 23:43.
In the meantime, disabled ones today still have a struggle on their hands. Nelson, a disabled person in Canada, says: “When I start feeling sorry for myself, I think of Jesus’ words at Matthew 24:13: ‘He that has endured to the end is the one that will be saved.’” In spite of their limitations, disabled ones can be complete and sound in the most important way—spiritually—by enduring in the Christian faith.—James 1:3, 4.
Jehovah’s Witnesses have helped millions to embrace this faith. Dell, a disabled man quoted in the preceding article, says: “I cannot begin to express how I felt when I learned that physical problems like mine are really only temporary.” Yes, empowered by such a hope, Dell—and many others like him—can hardly be called handicapped.