Amid physical, emotional obstacles, road to recovery for amputees includes success
Thom Bloomquist's swimming leg rests on a chair in his home in Bow on May 2, 2013. Bloom elected to have his leg amputated following complications with his childhood polio and circulation. Having gone through the psychological, physical and emotional processes that accompany the loss of a limb, Bloomquist now serves as a peer advisor for the National Amputee Coalition. He also is well-versed on the reality of phantom pain and lectures about it.
(ANDREA MORALES / Monitor staff)
Thom Bloomquist elected to have his leg amputated following complications with his childhood polio and circulation. Having gone through the psychological, physical and emotional processes that accompany the loss of a limb, Bloomquist now serves as a peer advisor for the National Amputee Coalition. He also is well-versed on the reality of phantom pain and lectures about it.
(ANDREA MORALES / Monitor staff)
When Thomas Bloomquist had his leg amputated 15 years ago, it was by choice. After suffering from polio as a child, his leg had been weakened to the point where he faced spending the rest of his life in a wheelchair. In his late 40s, he wanted options that would still allow him to walk, and settled on amputation below his left knee.
He did the research, he made the choice. But the transition wasn’t easy. He had to wait three months before getting a prosthesis, and found there were many changes he had to make in his daily life. For about two and a half years he struggled with anger and grief. Learning to accept help from others was one of the hardest parts.
“I went through the usual sorts of things that anybody would go through – the grief process,” said Bloomquist, who lives in Bow. “You go through the shock, the anger, trying to make a deal with God, hating God.”
“And then, finally, acceptance.”
That process of emotional and physical recovery is just beginning for a group of about 20 people who lost limbs in the Boston Marathon bombings on April 15. Many of them are in recovery at Spaulding Rehabilitation Center in Boston, where they’re healing from amputations and strengthening their bodies
in preparation for prosthetic legs. For each of them, the path toward recovery will be marked with different physical and emotional obstacles. But for all of the differences, one thing rings true: Leading a full life and continuing one’s passions is not only possible, but a reality for many amputees.
“You can do everything you want to do again, and you can survive, and your life is not over,” said Bloomquist, who is a peer visitor through the Amputee Coalition of America, a nonprofit organization that provides education and support for amputees. The program trains amputees to work with their peers and provide an understanding ear.
Bloomquist’s main message: “They’re not alone.”
‘I can do this’
There is no script for how people should feel as they come to terms with their new bodies. For some, acceptance is quick; for others it is long and dark. Many fall on a road in between.
When Bloomquist first lost his leg, the most difficult thing was admitting that he had to depend on someone else to help him recover.
Luckily, Bloomquist was passionate about his work as a nurse anesthetist. Wanting to go to work and take other people’s pain away was a powerful motivator for him to overcome the obstacles set in front of him. Whether it’s work or another hobby or passion, having something to live for can make it easier to find strength.
“Finding something meaningful to do is crucial to the human spirit, I think,” he said.
As a peer visitor with the Amputee Coalition, Bloomquist’s job isn’t to offer medical advice or be a psychologist. Rather, he’s supposed to be a friend who truly understands. Just talking to someone who gets it can help a person feel less alone.
Bloomquist, who has worked with a few clients, said he usually begins with an open-ended, general question, such as “How’s your day going?” If his clients are talking, he allows them to lead the conversation and stay away from difficult topics they don’t want to address. If they’re quiet, he shares stories about amputees who have found success or information about support groups and educational materials.
“People get scared when they don’t see any options right away,” he said. “That’s when people get mad, that’s when they get scared. So if you give them options right away, it gets their mind working, (saying) ‘Hey, this is a problem I can solve, I can do this.’ ”
Peer visitors must go through training with the coalition, and only meet with amputees who reach out to them. The conversation could last over one visit or span multiple ones, whatever support level the amputee feels is best. Many of their questions have to do with functionality: Can I drive? Can I dance? Will I ever walk again? Bloomquist only shares his own experiences when asked.
If and when he is asked, he has a positive story to share. Fifteen years down the line, his life is just as full as it was before his amputation. He golfs and scuba dives and does yard work at the home he shares with his wife, Lynne. Several years ago, he traveled to Guatemala to provide anesthesia to children having surgery to correct cleft lips.
He doesn’t use a wheelchair. Once the prosthesis is on for the day – which he says takes about seven seconds – he goes on as normal.
“(Other amputees) might ask, ‘Can you hike?’ or, ‘Can you climb stairs?’ or ‘What can’t you do?’ ” he said. “And I have a very short list there.”
One of the most painful physical effects of amputation is “phantom pain.” Phantom pain and sensation is when amputees feel something in the part of their body that no longer exists. It’s a neurological phenomenon that can have deeply emotional effects.
“Most amputees probably experience it to some degree,” said Dr. Bruce Pomeranz, medical director at the Kessler Institute for Rehabilitation and a member of the Amputee Coalition’s medical advisory board. “That’s the feeling to some extent like the leg or the limb is still there. And some individuals will say after, they’ll think they’re kind of losing their mind. They’ll think it’s psychological when really it’s physiological.”
Bloomquist studied phantom pain while completing his master’s degree and now gives lectures on it. After a limb is amputated, nerves can adapt to make the brain believe that it is still there, and there is still no way to reverse the effects. Some doctors believe the biology that causes phantom pain may also cause post-traumatic stress disorder, he said.
“Nerve pain comes on like lightning, just out of the blue you have this very painful sensation without warning,” he said.
For most amputees, phantom pain eventually subsides.
Beyond the phantom pain, just preparing the rest of the body to work with a prosthetic leg has challenges. It takes a great deal more energy to walk on a prosthetic leg than a biological one, and more so if the amputation is above the knee, Pomeranz said. While patients are healing from surgery, they work on exercises to keep their hip and knee joints from stiffening up. Muscles will have to take on new responsibilities to do the work of the ones that are no longer there.
But for younger and healthier people, such as several of the bombing victims, making those physical adjustments can be easier because the body is more agile. Technological advancements have made prosthetics better and better, to the point that amputees have a chance of doing all of the same activities that they did before.
“When someone gets a new prosthesis, you know it’s a little bit analogous to learning how to ride a bike. There’s learning that has to happen . . . with training and practice, and a lot of that is from day to day life,” Pomeranz said.
In the ideal situation, the prosthesis can become so natural that the amputee has lost any awareness of even wearing one. Even after that adjustment has been made, there will be doctor visits and prosthetic adjustments for the rest of an amputee’s life. But, as Bloomquist says, amputees can learn to adapt.
“The greatest majority of folks find that everything that gave meaning and joy to their life is still there,” he said. “Different, yes. They’re changed. It will never be the same. It will never be like it was. But everything that brings joy and meaning is still there, with adaptation.”
(More information about the Amputee Coalition and its peer visitor program is available at amputee-coalition.org. Kathleen Ronayne can be reached at 369-3309 or firstname.lastname@example.org or on Twitter at @kronayne.)