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Home / Thoughts / Other's Thoughts / Chloe's Thoughts / Almost an Amputee

Almost an Amputee

Written by Chloe on Tuesday, December 23, 2008

In September 2007 a physician offered me an elective amputation. I had not seen this coming. It seemed quite entertaining for someone with BIID to be offered an amputation. Too bad he wasn’t offering paraplegia.

I had been on one of my megahikes; alone, off-trail, scrambling, 6000ft vertical to a peak. On the way down I slipped and fell backwards. I knew instantly I had done something pretty bad to my finger. I got up and stared at my left hand. When my partner saw it, she described it as an "alien claw". I couldn’t move the little finger or ring finger of my hand. Everything seemed to be at strange angles, and it hurt a lot.

There was still another 4000ft to descend to my car; nobody else around, out of cell phone reach. I drove home, and my partner took me to the emergency room at the hospital. Five hours after the injury I saw a physician. I don’t remember this well, but my partner says the emergency physician summoned a bunch of colleagues to view the highly entertaining dislocation. It turned out that only the little finger was injured. Two of the joints were very badly dislocated, there was a fracture, and all of the ligaments were torn. I was sent home with a splint from finger tips to elbow.

A week or so later I saw the orthopedic hand specialist. He also brought in some colleagues to enjoy the spectacle. Apparently nobody had ever seen, or heard of, a finger dislocation as bad as this. After the other physicians had left, the specialist looked me in the eye, my partner by my side. He said "The best option is probably to amputate your finger. I can do it for you". I wasn’t prepared for this. I had no idea that the treatment for a dislocated finger could be amputation. I didn’t say anything; cogs were turning in my brain. The specialist said "The alternative is long painful physical therapy to try to restore some function. It may cause you pain for the rest of your life. Come back in two weeks and let me know what you decide". It wasn’t quite as terse as this. We had a good conversation actually.

I thought about it a lot. There’s something a bit weird about the way I relate to my left hand. I don’t really care if it’s there or not. I discovered this after my failed deliberate attempt to break my back when I was nine years old. At that time I started imagining and simulating all sorts of other impairments besides paraplegia. The only one that felt in any way authentic to me was amputation of the left hand. I don’t remember giving this much thought prior to my injury attempt. But maybe I just don’t remember.

I’ve simulated finger amputations too, just the left hand in terms of long term interest. One time when I was doing this, at about thirty years of age I think, a stranger in a store kept quizzing me about how I lost the finger. It seemed very obnoxious and rude. Besides I hadn’t thought of a good story.

The hand thing would not fulfill diagnostic criteria for BIID. I don’t have a burning incessant need to lose the hand. It’s not like the paraplegia. On the other hand (ha ha) it’s not exactly normal to feel indifferent as to whether the hand is there or not. I often imagine it not being there. It was only after Tom’s post "A Hand for A Life" that I suddenly realised why I use a single crutch with the "wrong" arm. I would hold it with my right hand regardless of which leg was screwed up. I don’t like using my left hand for things. From a practical point of view I would rather keep the hand though, in order to make living with paraplegia less difficult.

Back to the dislocated finger: I was certainly tempted by the amputation. If it had been the whole hand I would have gone for it. In fact I fantasised about asking the specialist to do the whole hand; but no I didn’t ask him. Removal of a finger would have done nothing for my BIID. Eventually vanity persuaded me to keep the finger. I like people to think I’m normal. I know quite a few people missing a finger, and it seems normal enough to me. However, it’s not normal for my self image, less normal than missing the left hand in fact. By contrast, myself being paraplegic seems entirely normal to me.

I started the painful physical therapy, twice a week for the first month and then once a week for another couple of months. I really enjoyed the social interactions at the hand clinic. I had a very nice cute physical therapist who caused me lots of pain. She was very talented at reading one’s face to know when to stop. Then there’s the automatic conversation starter with the person next to you being similarly tortured: "How did you mess your hand up?"

The spring loaded splint I was using after the first one came off wasn’t enough to prevent the substantial progressive flexion contracture, so the hand therapist made me a customised rigid splint. It keeps the little finger and the one next to it, as well as the whole hand, in full extension. I had to wear it most of the day and all night for the next six months. Often the pain from it would wake me up in the middle of the night. Sometimes I would take off the splint and fling it across the room so I could get some sleep. Now I only wear it at night. This will probably be forever.

Wearing the splint prevents using my left hand for much except picking up things between thumb and forefinger, with difficulty. I enjoyed this a lot for six months! The first morning with a wheelchair I immediately discovered after the transfer from bed that I couldn’t wheel with the splint on. A couple of weeks afterwards my partner surprised me by completely rearranging the bedroom furniture to make things more wheelchair friendly. Now I have an easy tranfer from bed, which I can do with the splint still on. Then I take off the splint, put it on a table the other side of the wheelchair, and have a straight shot into the bathroom.

The finger did get pretty well rehabilitated. I probably have about 80% function now. The most exciting step was being able to bend it by itself to touch my hand. That took a few months; I hadn’t expected to be able to do that again. It is still painful, mostly a dull ache. Once in a while there is a very sharp shooting pain for no apparent reason. It’s painful to bend or unbend the finger. It’s particularly painful to do the daily half hour tapings to maintain flexion. The splint does not cause pain any more except when first putting it on. The finger gets cold very easily. I suppose the blood supply is compromised.

During my last visit with the specialist, he said that any time I got fed up with my finger I could come back and he’d amputate it for me. Interesting.

So here I am… with BIID… and a standing offer for an elective amputation… hmmm….

Tags: Amputation, BIID, Crutch, Dislocation, Hand, Normal, Pain, Paraplegia, Splint, Transfer, Wheelchair

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