“Someone comes in and they’ve just had an amputation and they see a guy down the hall who’s been here for, say, three weeks and he’s got his prosthesis, he’s up and walking around, he’s going home for weekends,” he says.
“So your more recent amputee says: ‘Okay, I’ve seen Joe Blow down the hall and this is what my future might look like, and it doesn’t look as bad as I anticipated.”
Physical recovery has its own trajectory, and it’s one rehab professionals want to start as soon as possible, in part to help mitigate the psychological blow delivered by the amputation.
Devlin says that depending on how much residual limb exists and how well the site is healing, fittings for a prosthesis can start as early as five to seven days after amputation.
Most amputees have lost a lower limb, so rehabilitation initially involves learning to walk again, first along hospital corridors, then outside on the grounds, going up and down stairs, and getting in and out of a car.
A patient can be home wearing their prosthesis and walking with the aid of a cane, crutches or a walker within an average of four weeks, returning as an out-patient to work with physios, occupational therapists and other rehab team members on optimizing function.
“There’s multiple little steps and multiple little goals which can be checked off and you can say: ‘Hmm, did that.’ And each successful goal you achieve, it’s one more feather in the cap,” says Devlin.
Jason Naval opted for amputation after his lower left leg was mangled when a car collided with his motorcycle in 2009.
“For me it was the logical choice because I wanted to still run and play ball, and I knew that if I kept the leg I would be cradling it. I would have to take care with every step I take.
“But with the prosthetic, I would just put it on and go as normal, as far as normal can be.”
Naval, 27, has not let his amputation stop him: he is a member of Canada’s national sitting volleyball team, rock climbs and runs using a prosthesis like those used by Olympian Oscar Pistorius.
Still, as with any amputee, there are discomforts: blisters and bleeding in his stump caused by chafing from his artificial leg, fatigue that can lead to muscle weakness in his sound leg from being overworked.
“You have to constantly take care of it. You’re very careful not to injure it since you only have one.”
And cruelly, it seems, there’s the ghost-like reminder of what has been lost – what’s known as phantom pain or sensation in a limb no longer there.
“It’s not as bad as it was in the beginning,” Naval says of the pain. “In the beginning, it was almost constant. It would be like electricity running through my leg. But now it’s every so often I will get a shock here and there. And I know it’s going to go away after a few seconds or a few minutes. So you just take it.
“It’s like you can trace your foot, your toes where the pain is.”
Devlin says amputees describe the sensation variously as an ache, sharp pain, squeezing, burning or numbing, and though it diminishes over time, it rarely disappears. Certain medications can help, but he admits they aren’t very good.
That’s because the pain or sensation is being “felt” by the brain, which is not getting any input from the missing limb and keeps on “firing more frequently or at a higher level.”
“Mostly they describe that as ‘I feel my leg is still there.’ And they can wiggle their toes, they can move their ankle up and down,” although the anatomy no longer exists, Devlin explains. “If you ask them to move their ankle up and down, you can see the muscles in the residual limb contracting.”
But it’s often the little things that amputees find most frustrating.
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