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A Publication for Adult Amputees by the National Amputee Centre

es Colonist
ictoria Tim
ren Stone, V
Photos: Dar
No. 3

Publisher:
3 Seniors In Action! H. Clifford Chadderton,
CC, O.Ont., OStJ, CLJ, CAE, DCL, LLD
Combining realistic goals and motivation will help Chief Executive Officer, The War Amps
you on your road to recovery.
Karen Valley
Director, National Amputee Centre
8 Skin Care Jacqui Schofield
An ounce of prevention is worth a pound of cure... Manager, Internal Graphics

Karen Mueller
11 Feature Resource Publications Designer/Coordinator

Licence to Drive Cover photographs and On The Cover


reprinted with permission from:
Victoria Times Colonist
12 Comfort in the Bathroom For more information contact:
Ideas to make your bathroom safe and
user friendly... National Amputee Centre
2827 Riverside Drive
Ottawa, Ontario K1V 0C4

Telephone: 613 731-3821


Toll-Free: 1-877-622-2472
Fax: 613 731-3234
Web site: www.waramps.ca
E-mail: nac@waramps.ca

Living With Amputation is published by


The War Amputations of Canada. Views
expressed in Living With Amputation are

T o maintain her active those of the contributing writers and


not necessarily those of the Association.
lifestyle Laurens daily
The War Amps is a registered charitable
routine includes taking care of organization operated under the
herself as an amputee. Lauren direction of war amputees. Charitable
likes to bike and downhill ski Registration Number 13196 9628
so it is very important that her RR0001. ISSN 1708-5659.
residual limbs are in tiptop
Please direct all correspondence
shape. concerning Living With Amputation to
the National Amputee Centre.
Lauren met her boyfriend
Derek at university. He said,
Her classmates were aware
of her artificial arm but didnt
realize her lower legs were
artificial too. It has never
been an issue in our relationship. I admire her
zeal for life she just likes to go out and giveer.

2 No. 3 Living With Amputation National Amputee Centre, The War Amps
Combining realistic goals and motivation will help you on your
road to recovery.
A s a senior amputee, you have
different needs than the general
population. If your amputation was a
assist you with mobility and around
the house. Getting up and moving
around as early as your clinic team
amputees, and many products are
designed with your specific needs
in mind. Your prosthetist and clinic
while ago, you have already adapted recommends will help keep your team will help you to determine the
to being an amputee, but may be joints from getting stiff and keep best options to meet your day-to-
finding that the combination of your day needs. These will depend on
amputation and age makes certain a number of factors the level of
things, like mobility, increasingly When it comes to keeping your amputation, the number of
difficult. Later in this article, we active and remaining amputations you have, as well as
highlight some new improvements in other health conditions you have.
artificial limbs and various aids that independent, amputees
can help you. learn along the way While prostheses (artificial limbs)
that they need to use a do provide function, they can never
If you are a new amputee, you replace the function of natural limbs
may feel overwhelmed by the variety of products and and amputees also use more energy
recent changes in your life. An techniques to accomplish to operate them. An above-knee
amputation is a loss of a body part, daily tasks. amputee, for example, uses up to
and it takes time to adapt to this 70% more oxygen than someone
change physically and emotionally. without an amputation just to
Combining realistic goals and your energy levels up. During your walk on level ground. Dealing with
motivation will help you on your rehabilitation and even after youve cardiovascular disease, diabetes, or
road to recovery. At the beginning, completed it, your mobility will another medical condition is another
your amputation may be a central increase and you will learn ways to
focus in your life due to the healing do more things on your own.
time, rehabilitation and prosthetic
appointments involved. However, When it comes to keeping active and
with time it will become less central remaining independent, amputees
and you will resume many of the learn along the way that they need
activities you enjoyed before, or start to use a variety of products and
some new ones. techniques to accomplish daily tasks.
Using a combination of products
If you are currently going through and adaptations can make life easier.
the rehabilitation process, it is We will touch on some in this article
important to ask your clinic team and highlight how a combination
any questions you have when you of these allow amputees to meet
meet with them, to make the most their needs.
of your physiotherapy and/or
occupational therapy sessions and
during appointments with your
Artificial Limbs
prosthetist. Family and friends are a
Seniors make up the
great source of support during your
largest percentage of
recovery process, and can probably
National Amputee Centre, The War Amps Living With Amputation No. 3 3
important factor that your clinic level components have advantages With knees, stability is a concern for
team will consider when deciding if and disadvantages. Low-activity feet some senior amputees. Stance control
being fitted with an artificial limb and knees are typically simple and knees, often called safety knees,
is possible. If you are a multiple inexpensive. These are a good choice are popular because they contain a
amputee or have a high level if you are walking within your own weight-activated friction brake that
amputation (e.g. hip disarticulation), stops the knee from bending when
the best solution for you may be to you are taking a step, so the knee
use mobility aids regularly rather Tell your prosthetist what will not collapse when you have your
than, or in addition to, artificial a typical week is for you weight on it. If stability is really an
limbs. issue, then locking knees may be a
and what activities you good option. However, high-activity
If you are fitted with an artificial enjoy, so he or she can knees have features (air, fluid, or a
limb, your prosthetist will determine make the right choice. microcomputer) that help make the
what type is best based on your knee movement easier which is very
activity level (not age!), health helpful if you walk at various speeds.
house and short distances. On the
concerns, and how important the
other hand, high-activity feet and
look and function of the artificial Upper-limb Amputees
knees keep up better if you are very
limb is. Tell your prosthetist what
active and allow for you to change
a typical week is for you and what Upper-limb prostheses help with
walking speeds.
activities (like golfing, gardening or daily living activities. There are
playing with your grandchildren) you three main types of upper-limb
enjoy, so he or she can make the right prostheses: cosmetic, body-powered
choice. Amputees often think that the (also called cable-operated) and
best artificial limb for them is the electric (usually myoelectric). Some
most technically advanced one. That above-elbow amputees choose not to
is not always the case when all of the wear a prosthesis due to the weight
factors are taken into consideration. involved, instead choosing daily
living aids for household activities.
The weight of the prosthesis is a
concern for seniors. A lightweight Cosmetic (passive) arms are a
prosthesis may be easier to move, Medium good choice if you want to wear
making walking less tiring for energy-
an arm for appearance, but are
example. Extra components, like knee storing foot
not looking for a lot of function.
rotators or shock absorbers while Many cosmetic arms come in
offering more natural movement different skin colours for a natural
will also increase the weight of the appearance, and some come with
prosthesis. Maintaining stability on When it comes to feet, low-activity bendable fingers and can hold an
the prosthesis is another key concern, ones (like single-axis feet) are quite object when positioned with your
and it is also important that the stable. However, the multi-axis foot sound hand.
prosthesis is easy to put on and take conforms better on uneven surfaces
off. Above all, the prosthesis needs to and the added ankle motion helps Body-powered arms that operate
be comfortable to wear, or you wont to absorb some of the stresses of with a shoulder harness are fairly
wear it regularly. walking. Most feet now have a simple to use, and have a fast reaction
degree of energy storage (also called speed. For the hand function, the
Lower-limb Amputees energy return) this important harness can be attached to a hook
feature stores and then releases or a realistic-looking hand. One
There are a wide variety of artificial energy as you walk, making it easier of the disadvantages to a body-
limbs available to suit the needs of for you to walk without tiring. operated arm is that the harness
amputees with different activity can be uncomfortable to wear.
levels. Both low and high activity Alternatively, myoelectric arms look
4 No. 3 Living With Amputation National Amputee Centre, The War Amps
natural and have good function. Aids for Daily Living
New lithium batteries are lighter
weight and last longer than nickel- Daily living aids are great for
cadmium batteries, the only option helping you with common
previously available. Myoelectric activities in the house. In each Living
arms, however, are heavier and more With Amputation, we feature daily
expensive than body-powered arms. living aids for a specific purpose, like
for dressing. Aids for the bathroom
Arm amputees often have special are featured on page 12 of this issue.
devices (either commercially-available
ones or custom-made by their Both arm and leg amputees can
prosthetist) so they can enjoy their benefit from daily living aids. For
favourite recreational activities, like Folding canes (like the Dimalo one arm amputees or if you have arthritis
playing pool, golf or enjoying water here) are a great help when you are or general strain from overuse of
fitness, to name just a few. travelling. your sound hand, door knob turners
and tap turners can be attached
Liners and Socks Help Out these in issue no. 1 of Living With permanently to a door knob or tap
Amputation, so we will highlight to make them easier to turn. For leg
Liners and socks can help keep your only a few here that may be amputees, a stool in the kitchen can
artificial limb snugly and securely especially beneficial for seniors. help take pressure off your artificial
in place (suspension), reduce leg because you can sit while cooking,
perspiration problems, and provide Canes and crutches come in or even preparing food.
cushioning. While traditional liners many varieties these days, and an
and socks offer some cushioning ergonomic and lightweight one is Daily living aids also offer a safe and
to make artificial limbs more a good choice. Folding canes and convenient way to do things. To get
comfortable, there are new materials telescoping crutches are a great something out of reach, a reacher
available (like silicone) that can option when travelling, since you (a long grabbing device) may be a
provide a thick layer of cushioning can stow them easily on a bus or better option than trying to reach for
between the prosthesis and residual plane. Walking in the rain or during something by standing on a stepping
limb. This may be very useful for the winter can be a concern for stool. You can also use a reacher to
seniors who often have sensitive amputees. Canes with retractable get something that has fallen on the
skin as these types of liners help spikes can reduce your chances of floor without having to bend down.
protect against sores caused by slipping on icy sidewalks and stairs To help with getting up from bed,
friction. in winter (you can flip the spike up bedrails and clamp-on rails are a good
when walking indoors). Putting on a solution. Bed/chair risers (plastic
pair of cleats over your shoes can also risers that fit under the bed or chair
Aids for Mobility help with stability in rainy or legs) are a simple way to add a couple
snowy weather. of inches to your bed or chair and
Mobility aids can
also be beneficial make sitting and getting up easier.
for amputees. They A lightweight portable
obviously help with cushion riser can be
useful if you travel. A variety of door
mobility, but also
knob turners are
with stability and
available. This one
balance. Mobility aids glows in the dark.
range from canes to
walkers, to scooters
and wheelchairs.
We have covered
various examples of

National Amputee Centre, The War Amps Living With Amputation No. 3 5
Lets not forget that amputees also Ask yourself What is very difficult home) as well as light switches at
learn to manage certain tasks in their for me to do? or What cant I do both ends of the stairs.
own way, without the use of any anymore?, and then think about
special devices at all like using their solutions. There are many simple Seek help for tasks in and around
chin to hold things. Of course, it ways to make that task easier or the home that you find difficult or
is natural for amputees to use their safer. Sometimes all that needs that are dangerous (like changing
bodies differently to accomplish to be done is to rearrange things, a ceiling light or snow removal).
tasks, but this is not always possible like moving washing and drying Getting outside assistance for services
or even advisable. You do not want to machines up to the main floor if like laundry, house cleaning, home
put more strain on your sound limbs, going downstairs to the basement maintenance or cooking will reduce
so keeping all these different aids in to do laundry is too difficult. If your chances of injuring yourself
mind is a good idea. you use a wheelchair, removing a and will help you remain healthy and
door in a common walking area independent.
can help. Or instead, by installing
Household swing-clear hinges to the doorframe,
Adjustments you can widen the doorframe by
Exercise
two inches this is a much easier
Exercise can help you maintain
We spend a lot of time in our own alternative than having the doorway
strength and endurance. This in
homes, and we want them to be a remodelled.
turn helps you to stay active you
place where we feel comfortable,
will be able to use your prosthesis
relaxed and safe. However, your When it comes to safety in the
effectively and keep the rest of your
home may not be well designed to home, falls are one of the major
body in shape, which does extra
meet your needs as an amputee. causes of injury, especially for
Simple adaptations or tools can help seniors. A fall can give you a
make your home safer and easier to scare, or it can even injure your
get around in. hip or leg and further affect your
mobility. This is a concern for all
If you keep doing some daily chores amputees, but especially if you
and activities the same way, even are a leg amputee. Make sure that
when they become difficult, you you have a clear walking path
may end up straining yourself. Try and that furniture is not in the
to be aware of this to reduce the way of common walking areas.
risk of injuring yourself at home. This includes bundling all cords
for television, lamps, etc. to
ensure you cannot trip on them.
Also, tack rugs and glue vinyl
flooring so they lie flat. Non-slip This pool cue holder from TRS Inc. was
mats in the hallways and under further adapted by adding an insert around
rugs (to secure the rug to the the inside of the ring to more snugly hold
floor) can help prevent you from the cue.
slipping too. work to compensate for your missing
limb(s). Actually, studies show that
Stairs are a particular area to pay doing low-intensity exercise regularly
attention to. A reflective tread has similar benefits to high-intensity
can make steps more visible one training! Before getting started,
type has a non-slip, highly visible speak to your doctor to make sure
reflective strip that can be added to that you are doing exercises suitable
the edge of each step. It is important for you, especially if you have high
A non-slip tread on your stairs can stop to have railings on all stairs and blood pressure, a heart or vascular
you from slipping. steps (both inside and outside your condition, or diabetes.
6 No. 3 Living With Amputation National Amputee Centre, The War Amps
include improvements in balance, 1-800-O-Canada (1-800-622-6232),
posture, circulation, and vitality. TTY/TDD 1-800-465-7735
Customer Service agents can search
We have shared just a few examples their database for information
of activities that can maintain your on government programs and
strength and endurance, but there publications (available free of charge)
are many more activities to choose designed for seniors including ones
from. Of course, recreational on assistive devices, falls prevention,
activities like golf and gardening and healthy living.
are beneficial too. Learning a new
hobby, or restarting one that you Canadian Mortgage and Housing
did not have as much time for Corporation (CMHC)
This War Amps member says lawn in the past, will also keep you in 1-800-668-2642
bowling benefits me physically good spirits, which can benefit CMHC has publications available for
because I get exercise through bending, your health. The important thing seniors, such as information on falls
stretching and walking... Theres really is to enjoy what you are doing and prevention and home adaptations, as
no problem participating, even with a remain active! well as financial programs for seniors
disability. making home adaptations.
Exercise does not need to be time- Attitude Counts Many general household stores
consuming. Several minutes of
are starting to carry the types of
stretching every day can help keep In this article, we have outlined a
products mentioned in this article.
you limber. Simple chair exercises number of ways senior amputees
Home health care specialty stores
can be done right in the comfort can remain mobile and active. From
across the country, like MEDIchair,
of your home (you can start off artificial limbs to mobility aids and
Sammons Preston Rolyan, Shoppers
by doing a few repetitions, and daily living aids, there are many
Home Health Care and Harding
gradually increase the number as devices that can help. Modifying
Medical Supplies have a wide range
you feel comfortable, even adding your house and following safety tips
of products. Please contact us at the
resistance bands or weights for added can prevent falls and injuries. And
National Amputee Centre,
strength-training if desired). Walking exercising can improve your strength
1-877-622-2472, if you have any
is a great, low-impact activity and and endurance, and your overall
questions, or would like further
finding a partner to walk with is a feeling of well-being! Above all, a
information on how to remain active.
good way to keep your motivation positive attitude can really improve
up. your health, overall energy level, and
how you see life ahead.
There are also many options at
recreation centres. Exercising in
warm water can be enjoyed by people
Resources
of all ages since the water is gentle on
Seniors Canada On-line
joints (especially helpful if you have
www.seniors.gc.ca
arthritis). Water exercise increases
The government of Canadas Seniors
circulation, relaxes your muscles and
Canada On-line Web site provides
reduces edema (swelling). Exercises
information and links that are
like yoga and tai chi combine light
relevant to seniors 55 plus, their
stretching with soft, slow movements
families, caregivers and supporting
that can improve your fitness level
service organizations.
with little risk of injury. The benefits

National Amputee Centre, The War Amps Living With Amputation No. 3 7
An ounce of prevention is worth a pound of cure...
A s an amputee you will likely
experience at some point an
irritation or some kind of skin
you should see your doctor about
treatment and your prosthetist
about possible socket changes that
As mentioned in our previous article
on stump care and hygiene, heat
is a main cause of skin problems.
disorder on the area of your residual may be needed. However, if you Overheating can lead to various
limb enclosed within your socket. have a vascular- or diabetes-related problems: perspiration, odour,
Sometimes these skin conditions can amputation, it is important to and stump pistoning (moving
be so severe as to prevent you from contact your medical team right around within the socket) - which
wearing your artificial limb because away if you have a sore or infection, in turn can chafe the skin and cause
of pain and discomfort. In issue as it takes much longer to heal in abrasions.
no. 2 of Living With Amputation, we your situation, and will need special
covered how to keep the residual limb attention to ensure an ulcer does not Bacteria can be a problem for
clean and healthy to prevent skin develop. amputees. Skin always has many
problems; in this article we will help unseen organisms on its surface, some
you identify skin problems, mention of which are harmless and some of
products that are available to treat
What Can Cause Skin which, under certain conditions, can
them, and describe common types of Problems? cause infection. While skin usually
skin disorders. can expel bacteria when perspiration
The cause of skin conditions, such dries by evaporation, drying cant
Your activity level, age, and the as boils and cysts, may be simple to occur in the moist environment of an
cause of your amputation may discover and treat, but sometimes enclosed socket. On top of that, skin
affect what type of skin problems you need perseverance to track usually has a negative charge which
you will be prone to. For instance, down the cause(s). A combination repels bacteria, but an amputees skin,
if your amputation was the result of strategies may be needed to when bathed in salty solutions (such
of an accident and there is scarring, successfully address occasional and as perspiration) for long periods, can
you will probably be concerned even more persistent conditions. develop a positive charge which can
with abrasions and sores. If you are
an above-knee amputee, you must
consider that you will use more
Hair shaft
energy to walk and perspiration may
be your biggest concern. For those
Epidermis
with a vascular- or diabetes-related
amputation, you may have lost
sensation in your residual limb(s) Sebaceous gland
and/or sound foot so you wont feel Dermis
pain from any sores, red areas, or Hair follicle
blisters that could be developing
Sweat gland
therefore, you will need to check
Hypodermis
them every day.
Nerve
Skin disorders should be dealt with
immediately, otherwise they may The skin is the bodys largest organ and has many complex functions such as;
lead to more serious conditions. If regulating the bodys temperature, protecting the body from injury, helping to
you have a persistent skin disorder eliminate/expel harmful substances and acting as an external sensory organ. Each
square inch of skin contains up to 650 sweat glands and 65 hair follicles!
8 No. 3 Living With Amputation National Amputee Centre, The War Amps
attract more bacteria than would other options available that your Derm (moisturizing skin cleanser).
otherwise be present. prosthetist, doctor or pharmacist Cetaphil and Spectro products are
might suggest. available at drug stores.
Be careful with products you use to
reduce bacteria though extensive Some prosthetic companies have
use of alcohol may cause the skin to
Prevention skin care products that are available
become too dry and aggravate skin through your prosthetist. DERMA
problems. Another tip is not to shave Moisturizing Lotions and Skin Care (Otto Bock) includes
your residual limb as this may lead to Skin Care Products DERMA clean (anti-bacterial cleaner
folliculitis a bacterial infection of Many amputees find regular use for the stump and socket), DERMA
the hair follicle. of moisturizing lotions or creams prevent (protective coating lotion
helps condition the skin to hold up to cover and protect the skin), and
A change in the type of socket and better against abrasions. Vitamin- DERMA repair (anti-bacterial
suspension you use can affect the based creams and lotions are often lotion that relieves and repairs
condition of your residual limb. For used, such as EDAP (containing irritated skin while moisturizing
example, a silicone pin lock system vitamins A, E and D) which is it). Similarly, ICEROSS Clean and
may create a traction pull on the end available through your prosthetist. Simple (ssur) soap, moisturizing
of the residual limb that you might Prosthetists and/or pharmacists may lotion and lubricant spray are pH
not be used to at first. Different types recommend certain balanced and 100% fragrance- and
of sockets can put different pressures off-the-shelf lotions dye-free. ALPS Fitting Lotion with
on the residual limb and also provide Uremol for dry, itchy Skin Conditioner (ALPS) helps
very different environments and skin (containing to smooth dry, sensitive skin and
it may take time for your skin to urea in an emollient is hypoallergenic. Centris Cleani-
adjust. In some cases, even after an cream base), Stump disposable wipers are handy
adjustment period, the new type of Professional Care to have on hand.
socket may just not be suitable and used in hospitals to
you have to consider other options. prevent itchiness Some amputees use anti-bacterial
What works for one amputee is not and discomfort cleansers on their stumps to
suitable for all. due to dry skin, and limit bacteria that cause skin
ADAPTSKIN which is a product problems ones like Tersaseptic
There are other causes to skin made by an amptuee from his and pHisoderm are available at
problems as well. Your socket may personal experience (www.adaptlabs. drugstores. Anti-bacterial wet cloths
not fit properly if you have gained com). Even the liner donning lotion (that kill odour-causing bacteria) are
weight (causing pressure areas), or if ProstheCare Easy Donn (Cascade) also useful to have on hand to quickly
you have lost weight (causing your contains conditioners and soothing clean your residual limb during the
residual limb to move in your socket essential oils to help condition the day if needed; some contain aloe and
too much). You can also develop skin. Cleaners and moisturizers are vitamin E.
allergies to your socket, liner, sock, available for those with especially
or even a product you use on the sensitive skin dermatologists Layer of Protection on the
skin, resulting in irritation. Even often recommend Cetaphil (soaps,
Stump
long-time users of certain products cleansers and moisturizers), Spectro
If you apply a layer of protection on
may suddenly develop allergies to Jel (skin cleanser) and Spectro
the stump before putting on your
them. socket it can lessen the likelihood
of sores or abrasions developing.
Over the years, amputees have Some amputees use lotions (available
contacted us about various products through your prosthetist) like
that have helped them with their ALPS Skin Lotion (ALPS) or
skin problems. We include products DERMA prevent (Otto Bock), or
we are aware of but this is by no a self-adhesive, waterproof pad like
means an exhaustive list. There are
National Amputee Centre, The War Amps Living With Amputation No. 3 9
OpSite, (Smith & Nephew) which powder into the socket for fear it healing and protect the skin through
cushions and protects. SuperSkin would damage electrode function. a combination of medicated gel and
(MedLogic) is an easy-to-apply adhesive bandage. Tip: Normally
liquid to help with skin breakdowns Controlling perspiration is a large it is painful to pull off the adhesive
by providing a layer of protection. part of preventing abrasions and bandage that
For the prevention and treatment of reducing odour. Dehydral is an covers the gel, but
scars, self-adhesive silicone gel sheets anti-perspirant/anti-bacterial cream. soaking it under
like Cica Care (Smith & Nephew) Many amputees also find anti- water loosens the
are a good option. perspirant roll-ons help control adhesive, making
perspiration build-up in sockets. it painless to
Liners and Sockets Other products are more natural remove.
Some gel liners incorporate deodorant crystal stones which are
medical-grade mineral oil or aloe consumer friendly containing no If you are
vera in the layer that touches the aluminum. (These products are considering
residual limb, which help to sooth available over-the-counter at drug products at your
and protect the skin. ProstheCare stores). drugstore, bear in mind that a lightly
Hygiene Clean spray (Cascade) coats medicated powder or lotion (such as
the inside surface of the socket with Once an abrasion occurs, it is zinc oxide as mentioned above) can
a fine spray to keep the socket fresh time to consider a medicated help treat minor skin irritations; an
and hygienically clean. lotion. Prosthetic products like antihistamine cream can help treat a
DERMA repair can be used as pink rash over the stump (a rash that
well as over-the-counter products is not from weight bearing) and an
Treatment and available at drug stores which antibiotic cream can help treat actual
Solutions simply differ in their active healing abrasions.
ingredients. Many amputees use
Perspiration build up can aloe vera (available in creams
lead to odour problems. and gels) because of its healing
Skin Disorders
Odor Eraser can properties. Antibiotic ointments Affecting Amputees
help neutralize odour are often used to treat and
(available at JMG prevent infections in minor cuts No matter how hard you try to
Products, 1729 Norkold and abrasions some examples prevent them, sores and abrasions can
Street, Indianapolis include Bactroban (mupirocin), occur. If you experience any of these
IN, 46224, Toll-free Polysporin (polymyxin), and conditions you should consult with
1-877-601-5832). Ozonol (bacitracin, lidocaine your doctor. The following are some
Stay Fresh is another hydrochloride). Some amputees use common problems that you may
product to control triple antibiotic ointment that has face:
odour that comes in a zinc oxide as its healing agent. As
spray (available at Special Solutions, sockets create moist environments, Rashes and Abrasions
3572 Chartrand Cr, Mississauga, zinc oxide, which is an ingredient these are the most common
ON, L5L 4E4; Tel: (905) 828-4292). in many baby care products for skin disorders which may occur
Some prosthetists provide Liquid treating baby rashes, is helpful. Gold intermittently or even frequently.
Body Powder to their clients. Based Bond medicated powder also has
on the age-old healing properties of medicated ingredients. A doctor may Edema characterized by skin
potatoes, it is applied as a creamy also prescribe Betamethafone which swelling, drying and roughening
lotion but dries to a powder to can be found in Lotriderm (0.1%) at the end of the stump, can be
control chafing and odours while for persistent or more serious skin prevented by gradual compression
soothing areas of friction. One conditions. using an elastic bandage. Although
amputee found it worked well in this may seem like a minor
her myoelectric prosthesis as she Second Skin (available at drug and condition at first, it can develop
was unable to shake other kinds of sports stores) products promote into a serious complication.
10 No. 3 Living With Amputation National Amputee Centre, The War Amps
Contact Dermatitis this is of the skin. Anti-bacterial soaps circulation problems. They may
caused by an irritant, whether may cut down on the bacteria become chronic if not diagnosed
in the materials of the socket, or which cause these conditions. and treated immediately.
from an outside source, such as a
cleaning agent, powder, lubricant Fungal Infections also caused
or ointment used in amputee by the moist, warm conditions
care. Once the cause is discovered in the socket of an artificial limb,
and treated, the problem usually these require special creams or
disappears. powders, which can eventually
clear up the condition.
Cysts they commonly plague
above-knee amputees, occurring Eczema dry, scaly skin which
on the inside of the leg along the becomes moist for no discernable
upper edge of the artificial limb, reason. A cause needs to be
but below-knee amputees can established or the condition will
experience them as well. They start recur. Allergies, or secondary
as small bumps, or nodules which conditions following edema can While you will need to use certain
vanish when the artificial limb contribute to the condition. products and see your doctor for
is temporarily removed, but the treatment if a skin disorder becomes
constant rubbing of the artificial Adherent scars when there persistent, cleaning your stump and
limb can make the problem worse has been repeated infection or socket/liner daily is the best method
as cysts become larger and more ulceration damage to the skin, scar to prevent problems from occurring
numerous. Cysts can become formation may be so intense that in the first place.
infected and cause further damage. scar tissue may become attached
to the underlying layers of skin. For a free copy of the article Back
Folliculitis a bacterial infection Surgical revision to free the scar to the Basics Keeping the
of the hair follicle which produces is often necessary if the situation Stump Clean and Healthy from
small, itching, solid areas. If left becomes very problematic. Living With Amputation No. 2,
untreated, these may later develop or more information on skin
into boils in which deep-red, Ulcers these sores come from care, please contact us toll-free at
painful nodules rise to the surface bacterial infections, or from 1-877-622-2472 or e-mail
nac@waramps.ca.

D riving is an important means to independence, enabling you to carry out daily living tasks outside the
home as well as take part in social activities without having to rely on others for transportation.

Whether you are an already licensed driver who has recently become an amputee,
or an amputee going for your drivers licence for the first time, the information
contained in Licence to Drive applies to you. Will you need special devices on your
vehicle, or special driver training? What will obtaining or renewing your drivers
licence entail? Will you have any restrictions on your licence? Licence to Drive
answers the most frequently asked questions regarding amputation and driving in
Canada, and provides a list of provincial and territorial ministries of transportation
and modification centres we are aware of in all regions of the country.

To obtain a free copy of this booklet, call toll-free 1-877-622-2472 or e-mail


nac@waramps.ca, or read and/or print the booklet on-line at www.waramps.ca
using the search engine key word driving.

National Amputee Centre, The War Amps Living With Amputation No. 3 11
Ideas to make your bathroom safe and user friendly...
T here are many daily living aids available to assist
amputees with all their bathing needs. Arm
amputees may need assistance squeezing out the
Toileting Aids
Raised toilet seats and hinged arm
toothpaste or may find it difficult to wash hard-to-reach supports can be helpful if it is
places in the shower. For leg amputees stability may be difficult for you to sit down or
an issue shower and swim legs may be worn in the get up from a regular
shower but standard fittings will rust if they get wet so height toilet. Toilet aids
be certain to ask your prosthetist if your prosthesis can (reachers) can help with
be worn in the shower. As part of our ongoing series of personal hygiene. There
articles, in this issue we feature aids to assist you in the are also shower toilet
bathroom. seats or bidets that have
washing and drying features
In the Bathtub and/or Shower with control panels which provide independence in
the bathroom for amputees with multiple amputations or
Bath seats and boards allow you to take a shower while limited upper limb function.
seated. Handheld showers can be attached to the shower
head or facet and can be positioned within your reach. Location
Grab bars can be attached to the side of the tub and
throughout the bathroom To find stores that sell daily living aids, look in your
to help you safely get in and local Yellow Pages under these sections: Home Health
out of the tub. There are also Services and Supplies, Medical Supplies, Surgical Supplies or
specialized baths and showers Appliances.
that you can have installed in
your home walk-in tubs or Just a few resources (retailers who provide daily living
trackless shower doors make aids and bathroom products):
accessibility easier for those
with reduced mobility or Sammons Preston Canada, Inc.
wheelchair users. Sponged mitts Toll-free 1-800-665-9200,
and angled sponges help to www.sammonspreston.com/ca
wash those hard-to-reach places.
Freedom Living Devices
Accessories Toll-free 1-866-699-9300,
www.freedomlivingdevices.com
There are many accessories to help you
squeeze out toothpaste, dry your hair or Barrier Free Architecturals Inc.
trim and clean your nails! Tel: 1-877-717-7027, www.barrierfree.org

Clark Medical Products Inc.


Toll-free 1-800-889-5295,
www.clarkmedical.com

12 No. 3 Living With Amputation National Amputee Centre, The War Amps