As the world marks Mental Health Day on Tuesday a spotlight has been shone on the psychological aspects of people — many of them diabetics — undergo when they make the heart wrenching but life saving decision to amputate a lower limb.
Lower limb amputation is a procedure often necessitated by conditions like diabetes and septicaemia.
Dr Vinesh Padayachy, one of South Africa’s leading vascular surgeons has seen first hand the effects this has on his own patients.
Padayachy, who practices from Lenmed Ethekwini Hospital and Heart Centre in Durban said that when confronted with the necessity of a limb amputation, patients are thrust into a whirlwind of emotions, ranging from shock and denial to fear and sadness.
“The prospect of losing a part of oneself is overwhelmingly distressing, often leading to anxiety and depression,” Dr Padayachy said emphasising the importance of approaching such patients with empathy and providing psychological support to help them process this life-altering information.
Pre-surgery anxiety is a common and significant hurdle, with many patients unwilling to let go of the limb despite understanding the life-threatening risks involved.
Padayachy and his team employ a multidisciplinary approach, involving psychologists, counsellors, and support groups, to help patients cope with the impending loss and understand the necessity of the procedure.
“Clear, compassionate communication about the procedure and its outcomes is crucial to alleviate fears and facilitate acceptance,” he said.
However, delays in decision-making can lead to severe, sometimes fatal consequences due to the progression of conditions like septicaemia.
Early intervention and counselling play a pivotal role in reducing the time taken for acceptance and decision-making, potentially preventing further complications and loss of life.
Diabetes complicates the scenario further, impairing healing and increasing infection risk during both the surgery and recovery.
Specialised care plans and additional mental health support are indispensable for diabetic patients to manage their conditions effectively post-surgery and navigate through the complexities of their medical journey.
Padayachy said that patients undergoing multiple surgeries or bilateral amputations face heightened challenges, grappling with feelings of burnout and reluctance.
He stressed the importance of holistic care, addressing both physical and mental well-being through regular counselling sessions, support groups, and personalised care plans.
“The loss of independence post-surgery can be psychologically devastating. Empowering patients through adaptive techniques and equipment, occupational therapists and psychologists work closely with the medical team to help patients regain autonomy and foster a sense of control and self-efficacy,” Padayachy said.
Adjusting to a new reality post-amputation is a monumental task.
Comprehensive rehabilitation programs, including physiotherapy and training with prosthetic limbs, are crucial in enabling patients to relearn daily activities and regain independence.
“These programs facilitate the transition by focusing on physical recovery and psychological acceptance of the new body image and altered lifestyle,” Padayachy explained.
Changes in body image post-amputation significantly impact self-esteem.
Counselling and support groups where patients can share their experiences and coping strategies, fostering a supportive environment to rebuild their self-confidence are important in the road to recovery.
Padayachy said long-term mental health support is crucial for sustained well-being and adaptation to altered lifestyles.