Search Engine Grab Bag: Dress Your Stump in Leather and Garbage Bags! But first...

Okay, where was I?  Oh, right.  Sick.  Still kind of sick, truth be told, but I just ate my first solid meal in a week because I just could not face another can of vegetable soup as my entire day's ration of semi-substantial chow.  We'll see how and where I re-experience that meal before we draw any conclusions about my wellness, shall we?

Before I got sick, I was working up to a huge burst of writing here.  I speculate as to whether this is what actually made me sick.  Besides whole passages of my novel-in-very-slow-progress suddenly coalescing in my head, I had so many ideas in me.  Maybe it was too many at once, developing together in my tiny little brain all fast and hard like a psychic cyst, and maybe they were all way too intense.  Or maybe my feelings about them were too intense.

I'm talking about something like eight days' worth of posts, posts about insurance and the Massachusetts plan (and me with the PTSD around insurance and medical establishment bureaucracy!); about religion and atheism and how atheism in my case translates to a kind of spirituality; about yoga on one leg; about the way being possessed by a disease that progresses over years has the potential to rob you of your adulthood as well as your body piece by piece and more about exactly what kind of cancer I have (metastatic malignant melanoma), the treatment path I've chosen over the years, and how various people in my life deal with that path, some accepting and supportive, some not so much.  I wanted to talk as a feminist and a female amputee about female body image for amputees and how it can be both supported and complicated by the mere existence of celebrity female amputees, and how this seems to differ from what it's like for men.  There was something I wanted to say about a Gray's Anatomy episode and the "amazing things they're doing with prosthetics nowadays."  I was hoping to throw in a couple of Love Thursday posts in all that, too.

Oh, and I wanted to talk about graffiti.

But instead, there was fever.  And red-hot-poker-grade cramping.  And vomiting, in a little white bucket.

The cool thing is, whether or not the intensity and quantity of all these crazy, roiling, complex mazes of emotion, medicine, experience, and law that I was trying to work through all at once in my head are what combined to lay me low, even after so much physical trauma that I feel as though a human-sized Rock 'em Sock 'em Robot has been pummeling me from sternum to pudendum without letup since about 5:00 Thursday afternoon, I still somehow remember a lot of what I wanted to say.  And I'll get to all that.  But first, I have to answer a few of search engine queries.

These are all kind of related in my mind, so I have chosen to answer them all here, even though it's going to make for another long and ungainly post.  The logic may not be immediately obvious to others; please bear with me.

As usual, I have translated each query string into English.

1. Can you bathe with sutures?

Short answer:

Not until your doctor tells you so.

Longer answer:

This has been an issue for me my entire life as a surgical patient.  I am one of those people who simply must bathe every day.  No, I won't die if I don't, but when I don't my misery quotient as a person trapped in an unclean body is well nigh intolerable.  It's a big reason I don't camp anymore, and why my fantasies around adventures like hiking the Appalachian Trail involve driving and hotels at the beginning and end of every day, even though I really really hate driving.

Consequently, one thing I have begged for after every surgery is leave to bathe as soon as possible.  However, since my very first surgery 18 years ago, the leave I have begged for has been qualified by a commonsense precaution which has made the prospect far more attractive to my surgeons, not to mention safe for me.

My first surgeon was a brilliant, compassionate guy named Robert Seipel.  I was one of his last patients before retiring.  He had been practicing so long by the time I popped up in his waiting room that he knew frickin' everything.  He taught me the magic of garbage bags.

The thing is, you see, that what you're really not supposed to do is get the sutures or the wound or whatever dressing envelopes them even the slightest bit wet.  But as long as you are able to keep all that perfectly dry while you do it, you should be able to bathe the rest of your body just fine.

I don't know how a person with sutures on the torso can protect the sutures from exposure to water while bathing except to resort to sponge bathing until the surgeon says it's safe to do otherwise.  However, if your sutures are on a limb, or what's left of a limb, what you can do -- again, only after you've cleared it with the surgeon -- is stick the sutured limb in a big plastic trash bag and tie or have someone else tie the bag closed tightly -- not tourniquet-tight, but as tightly as you can without harming yourself -- so that the entire sutured area and dressing is completely sealed away from water.

Be very careful.  Do not leave any slackness.  Do not leave so much as a corner of tape exposed; some types of tape can wick water to the wound and rot it.

If you are still in a hospital while doing this, take advantage of the availability of nurses to help you with this.  The ones at Emerson were very helpful, and even helped me round up some waterproof tape to make the bag opening perfectly skintight without possibility of stretching or sagging (and thus leaking).  Thus I was able to shower the first day I could get up after my amputation, standing on one leg, holding my garbage-bagged stump outside the water stream, but not having to frenzy myself over a few drops hitting it here and there because it was so very well protected.

Caution:  Since garbage bags are created usually with far less stringent leakage standards than condoms, it would be wise to double-bag.

One more caution:  Do not use this technique to protect sutures on the head or neck. 

I really hope I didn't need to say that.

2. Lower extremity amputation, how to get dressed

I have to confess something, and not just because I like the idea of openness and honesty wherever possible, but more because I think this confession might ultimately prove encouraging to others. 

Three and a half years post-amputation, when I first read this query, my first reaction was, "What a stupid question!  It's your leg, not your arm.  You just get dressed like you always do."  And then I stopped short, remembering, remembering that it is different and how the differences can be challenging.

What's so encouraging about this?  This is proof that while getting dressed is indeed going to be another one of those Things That Will Be Different From Now On, you can get so used to it the new way that someday you, too, won't even remember immediately how frustrating it was at first.  You may be surprised how quickly this happens.

Now, to answer the question:

Because every amputation is utterly unique, and because every amputee is as unique as every person, this is not something I can answer with complete authority.  However, I can tell you my experience and list out the basics.  Since my experience is limited to life with a single transfemoral amputation, I can't really say whether it will apply to you unless you are also a transfemoral amputee.  Also, I will assume that you already have a prosthetic, because it is the inflexible, inorganic, nonintuitive prosthetic which complicates the process, not the missing parts.

The most basic difference between dressing as a fully limbed person and dressing as a person with a transfemoral amputation is that usually one dresses one's fake limb before one dresses one's body.  You still put your pants on one leg at a time, only this time there's a step added in the middle.

Just to be thorough:

First, put on all your underwear.  That part hasn't changed.

Next, though it might not seem logical, consider your shoe choice.  Unless you have a turntable knee, putting shoes on fake feet at the end of transfemoral prosthetics can be somewhat arduous, depending on things like the style of shoe, the size of the socket, and the fitness of the wearer.  I almost always find it far too difficult to change the shoe on my prosthetic while I am wearing it.  Boots are more complicated and time-consuming to don than lace-up tennies.  Either way, I and most amputees I've spoken to on the subject find it easiest to shoe the fake foot before proceeding with the rest of dressing ourselves, and we are also inclined to leave the same shoe on for days and days unless there's a really good reason to change it.   I can wear my L. L. Bean Comfort Mocs a lot of places, for example, pretty much everywhere I go throughout most of my life, and I've chosen colors that go with nearly everything else I own.  However, even the lovely dark red ones (with the splattered coffee stains) are not my best choice for a night at the Symphony.  And then, of course, there are sandal days.

A word about socks:  Sometimes you want to wear a sock on your remaining living foot for its health and comfort, and sometimes you want to wear cute socks on both feet to achieve a certain look, like when I wear lace-trimmed ankle socks with my TUK mary janes.  When I worked at Whole Foods, I was required to wear close-toed flat shoes with socks, and maybe your job has similar requirements.  The sock thing is some kind of health regulation that I didn't understand because I wasn't handling people's food with my feet, but it has something to do with sweat.  Consequently, I was not required to wear a sock on my prosthetic foot, and you probably aren't either.

At first, I used to anyway.  I was trying to stay "normal" in spite of this terribly abnormal (to my mind) thing that had happened to my body.  This is one of the ways that played out.  Yet I wore the same shoes to work almost all the time, so by wearing two socks every day, I was giving myself extra unnecessary work every day by forcing myself not only to always find two clean, matching socks that went with my outfit as if I still had to but to un-shoe and re-shoe my prosthetic foot every day so I could change its sock.

At some point I got a clue.  I realized that my life would be easier if I only wore a sock on my living foot except when I wore my TUK mary janes to work.  I realized that people really would not notice that my fake foot wore no sock, that I could just leave the same shoe on for days at a time without bother, and that I would have twice as many socks available for work this way and could spend less time getting dressed.  Thus I learned to -- forgive me for this -- think outside the socks.

Getting back to dressing, now that you've shod your prosthetic, if you are going to wear a skirt but no stockings, you can go ahead and put your other shoe on your living foot.  Then don your prosthetic.  Then stand up and put on the skirt or dress by pulling it down over your head until it is properly placed.  Now you can continue to dress the rest of yourself the way you always have.

Stockings are a whole other issue.  If I have to wear some, I put them on right after my underwear, of course.  I wear pantyhose off of which I have cut one leg.  It was very odd doing that, by the way.  I didn't know where to cut, so I put the pair on, then took scissors to the stump side.  It felt like I was symbolically reenacting my own surgery, at home, with my own hands.  Truly odd.  But that's the best way to get the right amount off.  You want to leave enough to fit into your socket, to minimize chafing and bunching at the crotch, and to avoid circulation-threatening banding or rolling, but not enough to interfere with the your socket's fit or, where appropriate, its suction.

The biggest surprise for me has been that I haven't had to do anything to the cut side to keep it from running.  I've been using the same pair of pantyhose* for years (I lead a very casual life, remember, with very few formal occasions), washing it in the washing machine and everything, without a run yet, even when the formal occasions were outdoors.  It's just a pair of your basic black, opaque, L'eggs, control top pantyhose from the drugstore.

Now all that said, I have to confess that I don't wear skirts or dresses very often.  I find them uncomfortable now; my socket is not glossy smooth to the touch, so the flesh of my big left thigh sort of drags as it passes back and forth across it while I walk.  It feels gross and sometimes leads to chafing, especially in warm weather.  Usually I just wear pants.  So let's talk about pants, and putting them on one leg at a time.

As explained above, unless you are planning to wear skinny-legged jeans, when you go to put on your pants in the morning, one of your shoes may very well already be on your fake foot and you may very well not feel like changing it and decide to wear the same pair today.  Before attempting to pull pants on over the shod artificial leg, though, make sure the bottom of the shoe is clean.  Otherwise, well, yuck, whatever's on it is going to get wiped all over the inside of your pant leg all the way down.

Assuming you've checked the shoe sole, go ahead and put your artificial leg in its appropriate pant leg.  Line it up nicely at the ankle and seam; without normal sentient flesh and muscles, a lot of little adjustments you used to take for granted aren't going to happen anymore once you're dressed and moving through your day, not the way they used to.   So dress the leg like you'd dress a doll leg, a gigantic doll leg.  Then stand up and put your nicely dressed prosthetic leg on.  Then put your living leg in its appropriate pant leg.  Then just finish getting dressed normally.  And then go off and have a nice day.

There.  I think I've covered everything I know about getting dressed when you're a lower limb amputee.  If I've left something off, or if you know something I don't and want to share, please step right up and leave a comment.

I will just add that I would be embarrassed to tell you how often I stick my artificial leg into the wrong pant leg and don't discover it until I have the pants pulled all the way up and am ready to stand up and put my leg on.  We will say no more about this.

3. Wearing a prosthetic leg under leather pants

Now, I'm not embarrassed to tell you my initial reaction to this query:

"Dude!  Why?"

And then:

"Have you ever worn leather pants?"

Leather is thick.  Leather is heavy.  Leather is hot, and I most certainly don't mean attractive.  If you are already wearing a prosthetic leg held on with a big, hot, plastic socket, why on earth would you want to bake further for a few steamy hours in a pair of leather pants?

Are you trying to lose weight?  Because this is a bad way to do it.  You will need to replace those fluids you sweat out.

Also, I promise you, it will not smell very nice in there when you unzip the pants to take them off.  No, not very nice at all.

Then I realized on reflection that one very good reason a person might ask this is because maybe s/he's a one-legged motorcyclist.  Motorcyclists wear heavy leather pants to avoid or at least minimize road rash.  A motorcyclist with a transfemoral prosthetic would wear them to minimize road rash on one side and severe damage to very expensive artificial body parts on the other.

If this is you, I would say that there's no reason you can't wear leather pants to ride just as you always have, but would strongly recommend that you invest in having a pair of motorcycle pants custom made to fit you while wearing your transfemoral prosthetic.  Things just aren't shaped the way they used to be, your knees might not even be parallel anymore, and this is going to affect not just your comfort and ability to move but the way the pants wear over time.  If proper allowances are tailored in, your pants are going to last longer and be far more comfortable for you to ride in.

I've only addressed the transfemorally amputated prosthetic wearer because I'm not sure it's really an issue for anything from the knee down.  Whether it's for vanity or practicality, the worst problems fitting leather pants happen from the waist through the crotch.

Now, on the off chance that the question was asked with fashion in mind, let me just point something out.  The worst problems with fitting tight pants of any fabric over a transfemoral prosthetic might also look something like this if you are a curvaceous woman:

Hot!  Sexxxxxxxxxxay!  Right? Right?

Let's check out the rear view.

The effects would be mitigated if I were to iron before shooting next time, but you get the general idea.  The first time I saw this, I cried and threw things.  I suspect because most of the people who make prosthetic limbs seem to be men, no one ever warned me this could happen, so the fifth time I put these pants on, ever, which also happened to be the first time I put them on after getting a prosthesis, was the last time I put them on, hence the wrinkles.  I really should just give them away.

But getting back to the topic at hand (or wherever), now imagine this look in pale or bright leather or pleather.  If you have worn leather skirts or pants before and remember the way the leather stretches over time and use but does not contract, so that ultimately a full-figured gal who chooses ever to sit down while wearing it eventually ends up with a big leather bubble around all the parts that demand the most out of a below-waist garment, perhaps you understand why I do not recommend leather pants for transfemoral prosthetic wearers unless they have to be leather to be functional for safety.   It won't feel good.  It won't look good.  And when you figure in the cost of animal lives to create such a garment, it hardly seems worth it unless you are going to lose life or, well, limb without it.

I believe this really exhausts my advice to other transfemoral amputees with prosthetic legs on how to clothe yourselves, whether you're dressing new sutures against the slings and arrows of delicious hot, cleansing water, deciding whether or not to wear socks, or not sure what to wear when you join an '80s hair band tribute group.  Anyone who has experience to add should feel free to speak right up.

As always, I hope this has been helpful for someone.

Moving right along...

__________

* I question whether this is actually still technically a pair of pantyhose.  Sometimes I am tempted to call the garment a "pantyho."  This seems wrong, though, somehow.  You know how.

(back up)

Comments

[Kay]

Thus I learned to -- forgive me for this -- think outside the socks.

Oh, ouch.

[Sara]

Punnitis hurts everyone.

hee hee

[Rachel]

Very informative blog! I have always had trouble putting on my pair of women's pants ever since I got my prosthetic leg. I will have to follow your advice on how to carefully slip into my pants with ease. I always look on the bright side if I ever get upset about my situation and then I think 'I only have to shave one leg'.

[David Willliams]

I have worn a ak prostheses for about 45 years now ... the first one cost $250 the last one $40000 ... but they're basically all the same thing ... a pain to wear ... as a male I don't have the pantyhose thing to go through ... and I wear two socks every day ... I just put the dirty one (regular foot) on the artificial foot and vice versa ... thus 1 pair every other day ... cosmetic effect plus I find the artificial foot tends to squeak in a shoe without a sock ... I was googling trying to see what was new in the field of prosthetics and ran across your blog ... good luck .... dmw