Question about self-amputation

My questions is: Why would you? I mean, unless you're trapped out in the middle of nowhere, say got your leg or arm trapped among some rocks, I don't know any other reason you'd want to self-amputate.

Because really, it would be better to go at the joint. The knee or elbow. Otherwise you'd have to saw through bone.

And you'd need a tourniquet to stay the bleeding until you had a chance to cauterize it.

But I'm no medical expert. I just stayed at a Holiday Inn Express.

My first thought is that the man would more than likely pass out from the pain before he could finish the job and then bleed to death. Unless he is on pain meds or has an extremely high tolerance to pain, the pain is going to be intense.

Why mid thigh? This is an area with major arteries and an extremely thick bone. A knife alone is not going to cut through bone cleanly.

Noir said:

I'm writing a story where a man performs self-amputation on his leg (mid-thigh area? Or is there a medically better place?).

How would he go about it? I only know that you need to ligate arteries (but I have no idea what that consists of). I mean, how do you stop the bleeding? Start letting it heal into a stump, etc.? What instruments would you use if this was an at-home amputation?

Thank you in advance!

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Medically speaking the best place would be at the end of his foot, like a pinky.

However: One, he has to be one sick dude to pull it off. Extreme pain tolerance, possibly high on something or at least a local anesthetic. He also have to be in good physical shape to survive the shock. I have heard numers (unsubstantiated) that an emergency amputation that high during wartime lst century was over 75% and that was with trained doctors and equipment.

Two, he would need the following: A good hunting knife. A bone saw (electric if possible). A set of scalpels. Some surgical clamps. Surgical needles and suture thread. A length of rubber tubing and an S-formed small stick or metal rod. Rubber gloves.

3 Short version:

Clean operating surface with bleach and alcohol. Hang up sheets around the operating area taht are drenched in alcohol. Wash entire patient. Boil and Wash all tools with alcohol.

Wash leg with alcohol. Wash arms with alcohol and put on gloves. Wash gloves with alcohol.

Torniquet: you tie the rubber tube around the leg above intended cut. Use the stick to tighten it as much as possible. You want to compeltely cut off blood supply to the leg.

Cutting: You start below the intended cut and use a scalpel to flay a flap of skin which you fold back. This will fold to be the new "bottom" of the stump. Then you take the hunting knife and cut straight in to the bone. Start from the outside of the thigh and work around it. The arteries are on the inside thigh. when you hit one, blink blood out of eyes and attach a clamp to the artery. Back of leg will be tricky.

When you have gone all the way around, make another cut in a similar fashion but 5cm lower.

Now cut away the flesh between the cuts leaving just the bone. Use the saw to cut the bone as close to the upper remaining flesh as possible. The leg can now be disposed of, or pickled for sentimental value and one hell of a conversation piece.

Sewing. First sew up the arteries. Then close the stump by pressing the skin flap firmly against the wound. Trim the skinflap so it fits the wound and sew it together. Before you close it up, insert a small tube so that yuck can drain out. Then close and bandage.

Pictures here: http://www.primary-surgery.org/ps/vol2/html/sect0064.html

There are medically documented cases of people doing this. Its called Body Integrity Identity Disorder. That is a wikipedia link about it. They often do it without any pain medication at all, its part of the disorder. I saw a show about it once (late night tv) Also I saw a show about a guy who got his arm trapped under a boulder in the desert while he was hiking alone an ended up amputating his arm with only a pocket knife. He managed to do this and hike like 8 miles to find people. I think he wrote a book about it recently but I cant remember his name. That could give you a good idea about what is possible.

From my experience with morphine, it's not enough, no. I was on quite a large dose of it when I had appendicitis, and I was still in tremendous pain. It didn't seem to have any impact at all. I can't imagine it being sufficient dope to be able to saw off a limb. I think I'd probably pass out.

Don't know about the rest, but hope that helps. Maybe another drug would be a better choice. I was 7 months pregnant, so docs were limited with what they could give. Opiates run through your bloodstream quickly, so that was fine.

Baby was cool, appendix got out.

Gar, wouldn't want to saw off a leg.

Aron Ralston's the dude who cut off his arm after a hiking accident. 127 Hours was based on his autobiography, and it was up for a couple Oscars this year.

I don't know how accurate the movie was, but in it, he broke his own arm instead of going through a joint to avoid the bone. He then went to town with a dull knife after tying it off with a tourniquet. Sawing through the nerve seemed to be the most excruciating thing in a whole host of excruciating things. Then he secured something around the end before rappelling down a cliff and hiking a couple miles. It seemed pretty clear from the movie that he was bleeding the entire time, but the Wikipedia article said he didn't get rescued until six hours later.

When he made the decision, he was out of water and out of any other options since nobody knew where he was. I just can't even... ugh.

There was a fairly recent (within the last year, I think) case locally (Connecticut) where a guy got his arm stuck in his furnace and had nearly managed to cut his arm off near the shoulder before someone finally found him. As I recall, he was using a hack saw - not sure if he'd actually gotten through the bone or not, but he said he'd passed out a few times while he was doing it. Should be able to google it - I remember it making the national news.

After reading the above I am, more firmly than ever, convinced that I am a giant wuss.

You're already hearing a lot about Aron Ralston, which is good-- I think that he's definitely the answer to your writer's block. Instead of just parroting what everyone else has said, I'm going to give you a link to an interview with him that focuses on the actual process and aftermath of cutting off his arm. WARNING; NOT FOR THE SQUEAMISH.
Here you go!
http://www.youtube.com/watch?v=B2XLoQ1xYB0&feature=player_embedded#at=16
Good luck, hope I helped!

I think you also need to consider the femoral artery. Sever that, and you won't want to pass out at that moment, 'cause you've got about two minutes to torniquet or it's game over.

This reminded me of the Stephen King short story Survivor Type (which, incidentally, is being made into a film) - a doctor crashes on an island, and is forced to amputate parts of his body (to cannibalize himself) in order to survive.

Ew! I thought of the boulder dude, too. Fascinating!

There was at least one man, also, who cut off a limb after heavy machinery rolled over on him (and I think a car-crash guy). Help wasn't going to come soon enough.

So there are many of these stories in real life, bizarre as that sounds. I couldn't imagine, and I'm kind of fine with pain for the most part.

I'm not an expert, but the other day I saw a BBC documentary called "Pleasure and Pain". where they interviewed a few people who'd had to amputate themselves for various reasons. They all said that they felt no pain. Once they decided it was necessary the pain vanished. They reported that cutting through the bone felt very unpleasant but still no pain.

I recommend watching it. I'm sure it'll give you plenty of ideas. There's also another BBC documentary with similar theme called the "hidden world of pain". Apparently we have quite a lot of conscious control over pain.

If you're really getting into this I suggest reading:

http://www.amazon.com/dp/097509100X/?tag=absowrit-20

It's a book for medical processionals on how pain works. It uses very basic language and anybody can understand it. I think it may also be intended for people who suffer chronic pain. But basically, science has uncovered that pain is entirely subjective. There's no "pain signals" that go to the brain. The brain collects sensory data from our senses and if it thinks that the body may be in danger then it will hurt. If the brain thinks that the pain will hamper survival, like we're stuck and starving or need to run away from a predator, then the pain stops no matter how intense the sensory feedback is.

When I read the thread title I thought of William Chester Minor who, whilst in Broadmoor Hospital*, was a major contributor to the first OED. Sadly his

condition deteriorated and in 1902 he cut off his own penis.

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see http://en.wikipedia.org/wiki/William_Chester_Minor

*a high security psychiatric hospital

BigWords said:

This reminded me of the Stephen King short story Survivor Type (which, incidentally, is being made into a film) - a doctor crashes on an island, and is forced to amputate parts of his body (to cannibalize himself) in order to survive.

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AHHHH! You beat me to it!

Another thing to point out about that story (and the concept in general) is that the doctor happened to be in the process of smuggling heroin. So the amputation wasn't that bad...

KW

DrZoidberg said:

I'm not an expert, but the other day I saw a BBC documentary called "Pleasure and Pain". where they interviewed a few people who'd had to amputate themselves for various reasons. They all said that they felt no pain. Once they decided it was necessary the pain vanished. They reported that cutting through the bone felt very unpleasant but still no pain.

I recommend watching it. I'm sure it'll give you plenty of ideas. There's also another BBC documentary with similar theme called the "hidden world of pain". Apparently we have quite a lot of conscious control over pain.

If you're really getting into this I suggest reading:

http://www.amazon.com/dp/097509100X/?tag=absowrit-20

It's a book for medical processionals on how pain works. It uses very basic language and anybody can understand it. I think it may also be intended for people who suffer chronic pain. But basically, science has uncovered that pain is entirely subjective. There's no "pain signals" that go to the brain. The brain collects sensory data from our senses and if it thinks that the body may be in danger then it will hurt. If the brain thinks that the pain will hamper survival, like we're stuck and starving or need to run away from a predator, then the pain stops no matter how intense the sensory feedback is.

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I still don't get it to a 'no pain' degree, but I'm on the spectrum at least, which makes me believe it. I have a chronic pain back problem. I had an accident recently where my hand swelled up terribly and folks thought it was broken. I swear, it hardly hurt at all. My ankle-bone tattoo hurt, but nothing at all unusual for me, so it was not a biggie in the least. It's pretty cool, really, how that works.

Shadow_Ferret said:

Because really, it would be better to go at the joint. The knee or elbow. Otherwise you'd have to saw through bone.

And you'd need a tourniquet to stay the bleeding until you had a chance to cauterize it.

But I'm no medical expert. I just stayed at a Holiday Inn Express.

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You are thinking like a butcher, not a surgeon.

To close the wound you need live skin. The way the blood vessels run it's normally better to amputate through the middle of a bone so that you can close live skin over the wound. The stories that involve guillotine type amputations don't mention the patient dying of sepsis a week later.