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View Full Version : What was it like to have a leg amputated 40 year ago



Troyen
08-22-2012, 08:27 PM
So here's my trouble... I just started working on a novel and I did some research on leg amputations, talked to a friend that's a nurse, looked stuff up about it. But now I've decided that it is neccesary to change the perspective to someone looking back on the past and it will need to be about 40 years in the past. That's not a problem for the most part, but I have no idea how the bussiness with the leg amputation would be different. My nurse friend doesn't know and when I google it, I get nothing useful. Does anyone know about that? Or even if you could tell me how to find out...
thanks all. I appreciate any help I can get.:)

GeorgeK
08-22-2012, 08:45 PM
Surgically the procedures haven't really changed much in the last 40 years. What has changed dramatically is the rehab and prosthetics.

boron
08-22-2012, 09:39 PM
Not only that leg amputation was not a big deal in the eighties; they were even able to successfully reconnect a completely severed foot or hand.

Here's a short history of amputation surgery (http://www.oandplibrary.org/alp/chap01-01.asp).

Melina
08-22-2012, 11:33 PM
I can't personally provide any insight. However, when I read your question, I remembered a woman from my hometown who had a leg amputated when I was a kid. It had to have been in the late 70s, early 80s. She wrote a book about it, and I believe she does speaking engagements still. Her name is Lenor Madruga, and here's a link to her website, through which you can email her:

http://www.rogueweb.com/lenor/index.html

Trebor1415
08-23-2012, 01:09 AM
What kind of details are you looking for?

Will you be describing the amputation as it happens? Or talking about it in general terms, but not describing it in "real time?"

Or will you be talking more about the after care and the rehab?

1972 isn't exactly the dark ages when it comes to medicine. They'll be some differences, sure, but it's going to be more like how it is done today than say how it was done during the Civil War.

If you want some telling period details, the culture of hospitals have changed since then. Back then Nurses still mainly wore the traditional white nurses uniform, with caps, and were not treated as well by Dr's and administration as they are today. (Not that today's Dr's, can't be jerks, but I'm talking about systematically).

Longer hospital stays were more common than today and the type of rehab that would wait until discharge might be started as an inpatient.

Don't forget all records, charts, and paperwork would be paper, with typewriters and handwritten notes, with nothing digital.

As to the actual procedure, it wouldn't be that different. Take the patient into the OR, have the Aneseasthologist put him under and monitor his vitals, drape and prep the area, and use a bone saw and other appropriate instruments to remove the leg.

StephanieFox
08-23-2012, 09:13 AM
My dad was an orthopedic surgeon who sewed on arms and fingers that had been taken off by saws and farm equipment as far back as the early 1960s. We're not talking some high-end research hospital. this was a small hospital in a town in Iowa helped by another doctor to assist, a nurse anatheseologist and a couple of other nurses.

In the late 1960s, he let me come in a watch a hip replacement and some knee surgery. Orthopedics were some of the most advanced type of surgery then. It was actually very cool.

There would be x-rays taken during the surgery to make sure the cut was in the right place. The doctor would make a tape recording of the procedure during and after the surgery which would be typed up later by someone in records. The x-ray plate would be mounted next to the patient and the x-ray machine would take a picture. Everyone would wait while it was developed. In the 1940s and 1950s the doctors would hold the plate while x-rays were taken, which is how my dad ended up with radiation burns on his hands.

Of course, all sorts of medicine was much more affordable back then. Most people were insured and the insurance covered almost everything. Hospital stays were much longer, too. If you were scheduled for a non-emergency surgery, you'd spend the night before in the hospital. They might give you an enema as part of the prep. There'd be nothing by mouth after midnight. After the surgery, you plan to spend a number of days, even a few weeks in the hospital to recover. They didn't kick you out the minute you woke up in the recovery room.

blackrose602
08-23-2012, 05:07 PM
If you want some telling period details, the culture of hospitals have changed since then. Back then Nurses still mainly wore the traditional white nurses uniform, with caps, and were not treated as well by Dr's and administration as they are today. (Not that today's Dr's, can't be jerks, but I'm talking about systematically).

I agree, and I would take this a step further. Hospitals were cold, antiseptic and barren. Patients weren't expected to know or understand much about their condition or treatment. Doctors gave orders, nurses carried them out, and patients were expected to just be compliant. I'm sure there were exceptions, but by and large, patient-centered care in which the patient is an active participant was still far in the future.

Troyen
08-23-2012, 05:41 PM
Thank you everyone. I really appreciate the help and insight. I guess what I am looking for (and some of you have helped with this) are the details of the hospital stay, care and rehab. Things like, how long till the patient would wake up? how long is the hospital stay? when and how does rehab start? what does the hospital room look like and when can the patient have visitors? when do the sutures come out? when can the patient get a prosthetsis? how would it feel and what would it look like? how long would it take for the patient to learn to walk on it? I don't need surgery details. That will not be in there since the MC will be sleeping through that. But the stuff you all have given me about the nurses and records (some of which I knew, but hadn't really thought about enough) has been very useful. Thank you all!:D

GeorgeK
08-23-2012, 07:00 PM
It depends. Why did the patient get an amputation and what was their age and general health before hand? A young healthy person who loses a leg from a motorcycle wreck will ahve a different course than a 60 year old smoker who loses a leg from vascular disease. Also is this a Hip Disarticulation, an Above Knee or Below Knee amputation?

Troyen
08-23-2012, 08:12 PM
Ok. The patient is a six year old girl who is losing her leg because it was run over by a car. I can make it above the knee or below. either would work. I just want to make my facts as correct as possible either way. There will not be any problems with the hip.
On another note, just in case any of you know this, the accident that causes the little girl to lose her leg also kills her brother. So what I am wondering is would they wait till she got out of the hospital to have the funeral? Or would they allow her to leave the hospital for the funeral and then return? Or would she just have to not be there?

GeorgeK
08-23-2012, 10:07 PM
It depends on the religion as to whether or not delaying the funeral is even an option. Assuming all her injuries are limited to the leg, back then they'd most likely have amputated the day of the injury and have her as an in patient about 1-2 weeks on bedrest with bathroom privileges or bedrest with the torture device known as a bedpan. Then she'd go home. Some orthopedists then would allow her out via a wheelchair on a pass to be accompanied by a nurse to the funeral on post op day 2-3, others would flat out say, "not until discharge." Then they wouldn't start rehab until the stump is most of the way healed around 6-8 weeks. Stitches would start coming out, maybe every other stitch at about one week, then the rest a week later if the wound is closing well. She'd meet with a proshtetist maybe by 3 months and go through a series of artificial limbs as the stump remodels and the rest of her grows.

Today, she'd start rehab post op day 1 and probably go home around post op day 3 with parents instructed in wound care and see the orthopod around post op day 7 in the office. Stitches still 1-2 weeks.

You could have anything in between depending on whether the orthopod then was conservative or progresssive.

Cyia
08-23-2012, 11:32 PM
My uncle was a WWII amputee, so a bit before your target range. However, if it helps - there weren't a lot of effective pain killers for something like that. It was mainly morphine - lots and lots of morphine, so much so that the guys in the VA hospitals were told they were "lethally allergic" on check out because they were all actually addicted and the staff wanted to minimize the chance of continuing use.

The kid wouldn't be conscious for days if she's doped up the way my uncle described it, which would probably be the most humane option.

The prosthetic were also, literally, wooden legs. Those gave way to fiberglass, and then the metal rods used today. Unlike the smoother gait that a prosthetic limb allows for today, the wooden variety required a "kick" to make the joint swing out, so he always walked with a very distinct gait. The bucket for his stump left blisters on his stump if he gained or lost weight enough to affect the fit. He actually used crutches as often as he did the leg.

jaksen
08-24-2012, 04:43 PM
In the 1960's it would be more typical that a six-year old girl would not attend the wake or funeral for her brother. She might be allowed to 'see him' alone (in his coffin), but that would also be a maybe. I was that age in the 60's and it was more usual (in New England, WASPY cultural background) not to have children attend funerals. I did not attend my first funeral until I was a young adult. (And the deceased was a former student of mine.)

I do know some cultures, religions, etc. view this differently and always have. But I had a wide range of friends - diff. religions etc. - and none of us were 'allowed' to attend funerals until we were 'older.' I had a friend, who at age twelve attended her grandmother's funeral and my friends and I thought this was a big deal.

The idea behind it was - it was just too 'traumatic' for a child to see a dead person. (Source person: my 89 year old mother.)

I also remember when my step-grandmother died, (I was eleven) and my mother not even wanting to say the word 'dead.' Gramma Ruth was 'away' and 'we wouldn't be seeing her again.'

Troyen
08-24-2012, 08:21 PM
Thank you all again. this is good info. jaksen, I am going for the early 70's. How much different would it be then?
Georgek, you have a lot on knowledge on this subject. Can I ask where that all comes from?

GeorgeK
08-25-2012, 08:18 AM
Thank you all again. this is good info. jaksen, I am going for the early 70's. How much different would it be then?
Georgek, you have a lot on knowledge on this subject. Can I ask where that all comes from?

I'm a retired surgeon.

Troyen
08-25-2012, 05:51 PM
I'm a retired surgeon.

Awsome! That is the most helpful person I could meet. thanks for all the info.;)

Troyen
08-25-2012, 05:56 PM
One more thing, Georgek, would you have any idea how long it would be before she would go back to school?

GeorgeK
08-26-2012, 09:54 PM
One more thing, Georgek, would you have any idea how long it would be before she would go back to school?

Once the wound is dry they'd let her go to school in a wheelchair, probably about a week post op. They wouldn't risk her on crutches at school with a stump until it's well healed, probably 2-3 months.

Al Stevens
08-26-2012, 10:49 PM
My brother had both legs amputated below the knee at different times in the 1980s. In the hospital, of course. Complications of diabetes. The first time, he was in for eight months because they kept whittling away hoping to leave as much as possible. But the stump wouldn't heal until they took it off from the knee down. The second time, he told them to start at the top, and he was in only a couple of weeks as I recall.

After the second amputation I called and asked how he felt.
"Defeated," he said.

Troyen
08-27-2012, 08:51 PM
Thanks Georgek and Al Stevens, I really appreciate the help and insight. I've gotten better help out of this then I expected. :D