Pediatric Acquired Amputation: A Personal and Professional Viewpoint

Life care planning for individuals with amputation can be challenging due, in part, to the many variables affecting outcome including, age of onset, cause, level of amputation, prosthetic needs and medical complications. This paper explores pediatric acquired amputation through the eyes of the author who has lived with below knee amputation for over a half-century. This uniquely personal perspective provides a basis for examining how the physical and emotional needs of an individual living with amputation change across the lifespan. The issues related to outcome are explored, notably access to medical and rehabilitative resources, the impact of social and spiritual connections and, most notably, what it truly feels like to be a child facing amputation. A literature review undertaken as part of this project showed a dearth of research concerning outcomes of middle age to older individuals who sustained amputation in childhood. It is hoped that by sharing this personal experience, professionals will have a deeper understanding of what constitutes a desired outcome and a broader view of what is essential for achieving such an outcome. Future studies may address the long-term physical and psychosocial effects of amputation acquired in childhood. “I fell under a lawn mower when I was 3 ½ years old.” These were the words my mother taught me to say when anyone asked the question— what happened to your leg? By the time I entered public school, I knew the response well. Knowing that I would have to face this question alone, my mother prepared me to answer simply, directly and politely, because in my southern home, being different was no excuse for being impolite. No further information or explanation was required on my part. The question was not to be regarded as rude, for people have a natural curiosity about the obvious. Children are quite approachable, even by complete strangers and it was a fairly frequent question whenever I met someone new. Frankly, I became somewhat weary of it, but I did not fear the question because I was prepared. I learned to be patient, answer the question and then move on to other—at least to me—more interesting topics. In her own way, my mother was teaching me not to run from difficulty, or attack others because of it, but to face it, with grace and dignity. That is why I became a vocational rehabilitation counselor. The focus of this article is pediatric acquired traumatic amputation, from the perspective of someone who has both lived with unilateral below-knee amputation for over a halfcentury and has worked as a rehabilitation professional for over thirty years. My hope is to provide the reader with some personal examples of life as an amputee, while addressing needs assessment and recommendations that may improve functional and emotional outcomes for those living with amputations.