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By Cara Brady & Katherine Mortimer
“What was the point of me being here?”
She doesn’t know what will happen tomorrow, but Sally G is determined to make the best of what happens today.
“I wish more people knew that the way it is today is not the way it’s always going to be,” she said.
Sally G (a pseudonym she uses because of her connection with Paul McCartney’s song) had always been independent and active, and particularly enjoyed kayaking and nature photography. She was retired from a longtime job and thinking about travelling. But her life changed in a way she could never have imagined when a blood clot caused her leg to be amputated five years ago.
“It was very sudden. I fell down at home and couldn’t get up. After I was stabilized in the hospital, I was told that if I didn’t have my leg amputated, I would likely be dead within a couple of days. I knew I was not in good shape. I gave my permission.”
While Sally G thinks she received good medical care, what happened afterward tested her both mentally and emotionally. A social worker came to see her regarding a different issue, but by that time she was well on her way to having things figured out.
“The worker was very helpful, but it was disappointing to have absolutely no help offered in the immediate aftermath of the amputation, even though I had expressed the wish that I wanted to die after the surgery,” she said.
The Eurasian Journal of Medicine and Investigation reports that losing a limb can trigger grief in the same way as losing a loved one, with some people going through all the familiar stages of grief: denial, anger, bargaining, depression, and acceptance.
According to The Active Living Alliance for Canadians with a Disability, an estimated 227,000 Canadians have had a limb or extremity amputated, and about 30 percent of those experience depression and/or anxiety. Other effects associated with amputation include:
- Negative emotional response to losing a body part
- Altered sense of body image
- Risk of weight gain or poor health that could make the individual more susceptible to contracting secondary health conditions
- Re-establishment of body awareness and adapting to the loss of function following an amputation
- Chronic pain, such as the sensation of pain that some people experience even after an amputation – referred to as phantom pain.
Looking back, Sally G thinks she could have benefitted from counselling and more information about community resources for learning to cope in what would often seem to be a new world.
“It was brutal. I don’t know what I would have done without the help of my sisters,” she said, adding that one sister found her a place in a long-term care residence where she could recover and plan for managing her new life. There she received physical therapy and instruction on how to use a wheelchair.
“I knew I had to get through the pain each day and get stronger, and that I couldn’t go back to my house,” she explained. “I was mentally at a very low point. I don’t think I was depressed; I was just wondering why I was still here, what was the point of me being here?”
Unknowingly, another sister helped her by example. She had recovered from cancer, but lived as if she was still sick for the rest of her life.
“Those were wasted years for her and her family, and I have seen other people do that. I just couldn’t do that. I had to figure out what to do.”
“I never felt like giving up again.”
Sally G, now 70, isn’t sure how she found the inner resources to live how she wanted to live.
When friends asked if she was crazy because she wanted to keep driving, she didn’t mind. “I took the dare,” she said. She got a car that she could load her wheelchair into herself, then modified it, and after expensive lessons was able to renew her driver’s license.
“I never felt like giving up again. When I met people I hadn’t seen in a while, I could see by the looks on their faces that they were shocked.” She’d point to the mid-thigh amputation covered by a knot in her flowered pants and say, “This is truly horrible, but it’s me. I haven’t changed.”
There were many challenges. She lost some friends due to illness, and that was discouraging. But she found a wheelchair-accessible apartment and learned how to manage shoulder pain from handling her wheelchair.
Physiopedia reports that people with disabilities and people who are ageing with disabilities are on the rise all around the world. According to a report on disability published by the World Health Organization and the World Bank, roughly 15 percent of people had disabilities in 2010. Age has a significant impact: the older you get, the more likely you are to become disabled.
“Every part of my life had to be re-evaluated.”
Another lesson was when she worried needlessly for some time about a health condition that was easily explained when she asked her doctor to put it clearly. She advises people not to be reluctant to ask questions about mental and physical health so they can make informed decisions for themselves.
“Every part of my life has had to be re-evaluated, including where to spend money on things like scooters and a new camera. My health influences my decisions, but it doesn’t influence my enjoyment of daily life.”
For example, when she was urged to visit the family cabin, she thought it through and decided that it would be too difficult, as nice as the thought was. “I told them I was not going to sit under a tree just to please them. I think they understood.”
“Some people yell or honk or swear at me.”
Sally G thinks that people with disabilities, whether physical and/or mental, may sometimes feel pressure to do what others expect in many situations. She mentioned how some people react to people using mobility aids.
“It can be hilarious, actually. People have no clue. If I go downtown in a wheelchair, people try to help. It’s well-meaning enough. They try to hold open automatic doors.
“They come up behind me and try to push me faster than I want to go. I’ve had my hand caught in the wheel and hurt from that. I will ask for help when I need it.
“If I go out on the scooter, it’s a different story. People seem to think someone on a scooter is lazy, or doesn’t deserve to be out, or is a nuisance for foot or car traffic. I am careful and considerate, but some people yell or honk or swear at me.”
Disability advocate Stella Young said the barriers that people with disability face are societal and that no amount of positivity will be able to break down those barriers.
In her 2014 Ted Talk, she said people can be extremely patronizing to people with disabilities and a condescending attitude can cause just as much damage as being purposefully hurtful.
“I’m not your inspiration, thank you very much,” said Young. “I want to live in a world where we don’t have such low expectations of disabled people that we are congratulated for getting out of bed and remembering our own names in the morning.
“I want to live in a world where we value genuine achievement for disabled people.”
“Every day is another day we have.”
Sally G will be receiving a medical update regarding a cancer diagnosis this summer.
“That will help show how much of a future I can expect, and this will influence my life decisions,” she said. “If it happens that I can’t live independently, I might feel that’s the end for me. I don’t know. If it happens, I will think about it then.”
For now, she gets out a lot, keeps in touch with friends, and continues taking pictures with a focus on the things she sees around her city.
“I don’t get bored. There’s always something going on in my brain. I’ve had to change my perceptions. It’s surprising the number of things you can see that you never noticed before. I appreciate each day more.
“Every day is another day we have. I’ve had a hell of a lot of things thrown at me and come out the other side.”
Cara Brady has been a professional writer for newspapers and magazines for more than 30 years. She has always enjoyed helping people tell their stories.
Katherine Mortimer has been a journalist for 30 years, working as both a writer and editor in community newspapers throughout British Columbia and Alberta, and as a freelance writer for corporate clients. Originally from Vancouver, she lives in the beautiful Okanagan Valley of British Columbia.
Resources for Amputees
The War Amps’ Adult Amputee Program, which provides financial assistance towards the cost of artificial limbs, is available to amputees 18 and older living in Canada. Individuals must register with the program to access their services.
Canadian amputees are often eligible for the Disability Tax Credit, which can help ease financial burdens and earn enough money to live comfortably and afford better care and treatment.
The Amputee Coalition of Canada
The Active Living Alliance for Canadians with a Disability
Mental Health Resources
There is a free and confidential service provided by the United Way that can be accessed by phone, text, chat, and online for information on government and community-based, non-clinical health and social services. You can access it in any province or territory by dialing 211 on your phone or go online to find your local service provider.
The Canadian Counselling Psychotherapy Association can help you find a certified counsellor/psychotherapist in your area for in-person counselling or to access online counselling or tele-counselling.
The Canadian Mental Health Association (CMHA) is a community mental health organization available in more than 330 communities across every province and one territory. Visit the CMHA website to find information on mental health conditions and to find a CMHA branch in your area.
The Canadian Red Cross offers support services for seniors who are living at home, including the Telephone Assurance Program which provides regularly scheduled friendly calls and safety checks. Visit their site to find senior support services in your area.
Canadian Coalition for Seniors' Mental Health
Discussion Questions
- Unexpected things happen in life. Do most people think very much about this possibility?
- Have you or anyone close to you ever had a serious, unexpected accident or illness? How did that affect mental health?
- Sally G wanted to die at one point after the amputation surgery. What do you think her mental health was like at that time?
- Why was she disappointed with the mental health and other help offered to her then?
- Sally G found her own way of managing the sudden changes in her life. How might things have been different for her if she had had more information and assistance available to help her make decisions?
- In general, what services for mental health and daily living could be helpful to people when their health conditions change how they live?
- Sally G says that the amputation changed the way she thinks about everything in her life, not just the physical challenges. What are some things that might have changed that she hasn’t mentioned?
- What do you think is the connection between mental and physical health?
- Sally G had a supportive family. Might the outcome for people without this be different?
- What does her mental health seem to be like now?
- What do you think about some of her friends’ reactions to her after the surgery?
- What do you think about the way some people perceive her and others with physical disabilities when they are out in public? How do you think this might affect the mental health of the person using mobility assistance or prosthetics of any kind? Could it make them hesitant to go out?
- What do you think about Sally G’s attitude to the upcoming update on her cancer diagnosis?
- She says that she appreciates each day and notices everything around her more now. Do you, in general, appreciate each day?
- Did reading about this experience change anything in your thinking about unexpected changes, mental and physical, in life?
- Is there a person or particular group of people who would benefit from you sharing this story?
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Disabilities Among Seniors Increasing
The Mental Health Commission of Canada reports that during the next 25 years, the proportion of Canadians over 65 will nearly double as the entire baby boom generation turns 65. As a result, by 2036 nearly one out of every four Canadians will be a senior, outnumbering children for the first time in history (Statistics Canada, 2010). At the same time, this demographic shift will have, and is already having a significant impact on Canada’s health care system, and the mental health care system is arguably particularly vulnerable.
The federal government’s website, reports that about 43 per cent of Canadian seniors live with a disability, with rates higher for senior women than for senior men, and an estimated 200,000 Canadians are amputees.
Although living with an amputation presents challenges, health care provider PAM Health, said positive coping strategies can help amputees find a new path in life and overcome difficult emotions. If you or a loved one have recently undergone an amputation, know that many people live a fulfilling life once they adapt to changes. The first step to healing from limb loss is acknowledging your feelings and the various factors impacting your mental health. From there, you can apply coping strategies that work for you.
An amputation significantly affects a person's life and psychological state for several reasons. First, the amputee must handle the sensation of losing a limb and a loss of function. They may experience challenges with mobility and need to depend on others until they adapt and regain independence.
Canadian Mental Health Association Ontario has explored the link between mental health and physical health, reporting that people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population. Co-existing mental and physical conditions can diminish quality of life and lead to longer illness duration and worse health outcomes.
Both mind and body are affected by changes to physiological and emotional processes, as well as by social factors such as income and housing. These three pathways of biology, illness experience, and the social determinants of health can increase the likelihood of someone living with a mental illness, or chronic physical condition developing a co-existing condition.
Canadians who report symptoms of depression also report experiencing three times as many chronic physical conditions as the general population (Canadian Institute for Health Information, 2008).
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