Sarena Gerard, Bethany Roper, and Olivia Lullie10th Honors World Lit/CompMrs. Lester16 April 2012 Are Amputations the Defining Crisis of War Today?Thesis:Are amputations the defining crisis of war today?Thousands of soldiers are injured duringwar, and the percentage of amputees is well over 40 %. Many enlist in war knowing that there isa risk of being severely injured, but some surface with different injuries, one of them being anamputation. Amputations can cause grave psychological effects on the human body. Discoveringhow and why an amputation occurs can aid in understanding a better road to recovery. TS:What does an amputation occur from?CD: War amputations are caused by stepping on hidden bombs, or being shot in a limb.Amputations can also come from well-known war diseases, such as gangrene, or decreased bloodflow to an area of the body due to a tumor or hardening arteries, known as Peripheral ArterialDisease (PAD).CM1: Hidden bombs can be found anywhere on open ground in a war. Bombs are hiddenunderground, under objects, and in sand.CM2: Gangrene is an infection in an open wound where bacteria causes lack of blood flow.Gangrene most commonly affects toes, fingers, and limbs. A soldier is most likely to contract
gangrene if he has an open wound, or decreased blood flow from underlying diabetes oratherosclerosis.CM3: Peripheral Arterial Disease (PAD) affects the limbs because blood is unable to flow tothem due to narrowed blood vessels. PAD usually affects the legs and prevents the veteran fromwalking. There are no treatments for Peripheral Arterial Disease.CS: Overall, a veteran needs to be aware of hidden bombs and the diseases that he can acquirefrom war. TS:How do field surgeons determine when an amputation is necessary, and whatmeasures do surgeons take before the amputation procedure?CD1: Before an amputation, a surgeon will first check the patient for fever, cold skin near thewound, exceedingly tender skin, wound odor, or significant infected areas of skin.CM1:Blood tests are arranged to check the blood flow to the limbs, if any.CM2:The human body depends on a constant supply of oxygen and nutrients from blood. If anarea of the body, such as the leg, does not receive blood and oxygen it can begin to change colorranging from yellow to green to blue.CM3Surgeons check for bacteria that can enter the blown open wound and cause a seriousinfection.CM4:The infection will generally emit fluid in signs of the immune system fighting off thebacteria.
CM5:Signs of a serious infection can include a fever higher than 102 degrees, coughing,headache, and nausea.CS: Amputations should be taken seriously because they may become life threatening within justa few hours. TS:How does the amputation surgery happen?CD: Choosing the correct site of incision for the amputation process can be a tricky situation forpatients who need leg amputations. If a surgeon removes less skin then he/she should, then thewound may never heal, and has a greater risk of becoming infected.CM1: The first process in an amputation is for an anesthesiologist to check vital signs beforeputting the patient under.CM2:The anesthesiologist may give a regional anesthetic or sedative to calm and numb the areaof incision.CM3:Another option is to be put fully under with assistance of brain and heart monitors, bloodpressure machines, and temperature observations.CM4:The next step is for precise incision of the amputation site. Once the patient is fully under,or the regional sight has been numbed, the surgeon will cut off the rest of the severed limb whileleaving enough healthy skin to surround the wound in order to heal itself.CM5: Third, the surgeon will shape the muscles of the stump as well as the nerves, so that theywill be protected in the healing process. This process also allows for correct fitting of aprosthetic limb.
CM6:After bleeding decreases, it is safe for the surgeon to shape the bone in tandem with thepatient’s muscles and nerves by grinding the bone till it is smooth.CS:Amputations are serious surgical procedures, and should be carried out by a professionalmedical team with overwhelming experience in the subject for a better surgery and recovery. TS: What types of healing processes are available after the amputation?CD:There are two types of ways for the patient to heal after an amputation. The first is an openflap amputation, and the second is a closed amputation.CM1:In an open flap amputation flaps of skin are kept open around the incision siteso that themedical care staff can clean up any dead or infected tissue around the amputation to minimizerisk of infection.CM2:The closed amputation refers to sewing the flaps of skin together immediately after surgeryonce the surgical site has been declared free of infection.CM3:The sign of a closed amputation proves that the amputee tends to be a better healer thanmost.CS:Depending on the veteran’s situation, the surgeons will make a medical reference as towhether or not they believe the veteran will heal better with a closed or open amputation.
TS: The psychological effects on an amputee are beyond what one would expect.CD: It is common to experience negative thoughts and emotions after an amputation.CM1:Negative thoughts are especially prevalent in people who have had an amputation due totrauma (usually members of the armed forces who were injured while serving in Iraq orAfghanistan).CM2:The traumatic event that the veteran endured can eventually lead them into developing apost-traumatic stress disorder (PTSD).CM3: Many common emotions that amputees are exposed to are depression, anxiety, denial,grief, and thoughts of suicide.CM4:Additional treatment may be required, such as, antidepressants or counseling to improve anamputee’s ability to cope with living after an amputation.CS:In final consideration, amputees are at a huge disadvantage because they are at risk ofanything, whether it is PTSD, depression, or embarrassment. The psychological effects of anamputation can lead to anything and everything which is why amputations are the defining crisisin society and war today. TS: The embarrassment felt by an amputee can cause them to exclude themselves fromsociety.CD: Several amputees become very ashamed of their bodies after their amputation.
CM1:The appearance of the remaining limb makes the individual feel self-conscious and he willeventually become embarrassed to be seen in public.CM2: Amputees may convince themselves that their stump is ugly, and try to avoid looking at itas much as possible to prevent any depressing thoughts.CM3: Veteran’s with amputations often fear others will look at their amputated limbs beforelooking at their face in conversation.CS:All in all, amputees are apprehensive about how they will be viewed by other people. TS: The psychological response to an amputation is determined by many variables.CD: The three most important variables include the amputee’s personality style, the support fromtheir loved ones, and the economic and occupational sides of the individual.CM1: The first factor is personality style. If the amputee is self-conscious and is very concernedabout their social standing, they are more likely to suffer psychologically from limb loss thanthose who are self-confident. Individuals who are extremely invested in their physicalappearance tend to react more negatively to the loss of the limb then others.CM2: Also, how much support the amputee has at home takes an extremely large toll on howwell the amputee adapts to his new body. Single and widowed individuals suffer morepsychological distress and difficulty in becoming accustomed to the amputation than those whoare married and already have a family. Usually, if the amputee has a supportive spouse, it isespecially helpful. A supportive partner is one who has a flexible approach, takes over functions
when needed, cuts back when the amputee is able to manage, and maintains the amputees self-esteem at all times.CM3: Typically, if an amputee earned his living from skills that were lost with the amputation heis more likely to experience an unpleasant response. Unlike others who have a wide range ofskills, or whose main line of work was not mainly dependent on the function of the lost limb mayexperience less emotional difficulty. If the amputation causes unemployment, it creates a muchgreater degree of psychological stress.CS: In conclusion, how the amputee responds to an amputation is entirely dependent on wheretheir life currently stands at the time of the amputation. Whether or not they have a secure job, asupport system, and confidence within themselves are all factors that will determine thepsychological effects that the amputee will experience. TS:What effects has this war had on the advances of prosthetic limbs?CD:Thanks to the advances in prosthetic limbs today, veterans are able to add personal touchessuch as tattoos, or chrome plated details.CM1: Scott Summit, who is an industrial engineer, creates synthetic limbs.Synthetic limbs havebecome a standard for self-expression based on customization made possible by moderntechnology. Synthetics are now a bold blend of modern science and fashion statements.CM2: In earlier prosthetics, the “Cairo toe” was discovered on a female mummy. It was a piratestyle limb made of bendable wood and leather.
CM3:Scott Summit uses the cutting edge suspension hard ware on titanium rods and carbonsprinting legs. When it comes to amputees, few really want flesh toned silicone limbs with fakeveins. Scott Summit creates the most up to date and modern prosthetic limbs designed tofunction with as little discomfort as possible.CM4: Today, amputees can get different designs such as chrome plated legs, leather coated legs,and some are laser etched with tribal tattoos.CS:The designs of prosthetics are advancing rapidly to enhance an amputee’s comfort with thelimb. TS:Prosthetic limbs can show personality not just practicality.CD: Prosthetic limbs have always focused on functionality. However, today scientists have takenthe same design of a typical smart phone and taken prosthetic limbs to a whole new level. Nowprosthetic limbs are not meant just for limiting amputees’ disabilities.CM1:Soldiers who typically have an amputation are between the ages eighteen and forty. Manyof these soldiers afterwards are considered veterans, and unable to return to war.CM2: When unable to return to war, veterans with amputations choose to acquire prostheticlimbs with personality, such as these designed by Scott Summit.CM3:Scott Summit created these limbs to show that if a limb is attractively created it would notjust change the point of view of the veteran’s, but hopefully change the way society sees anamputee.CM4: When retired Army Sgt. Matthew Sullivan, whose right calf was blown off by a land minein Afghanistan went to the San Diego VA’s prosthetics lab to see his new device, his jaw
dropped out of amazement. Sullivan’s new limb mirrors the outlines of his good calf. On thechrome-plated prosthetic leg is a laser-etched logo of the San Diego Padres. Whenever Sullivanwears shorts people will greet him to marvel. “Kind of in a weird way”, Sullivan said, “you feellike you’ve gotten a part of you back.” Scott Summit has changed a generation of prostheticlimbs by making them out of the best titanium to not only function well, but have self-expression.CS:Modern technology allows veterans to not feel like they have fully lost a part of them whenthey are still able to custom it as they would an actual limb.C: Over all, an amputation can affect a person’s life from all stand points. The surgery can alterthe way that the human feels emotionally and physically, as well as the way people view them insociety. Prosthetics can help improve their self-esteem and change the outlook that other peoplehave on amputees. Despite how the surgery happens, and why, the veteran will have to live witha stump for the rest of his life. Imagine the anxiety of the way people will perceive them or thenerves before surgery. Amputations have become the defining crisis of war because they take atoll on the way a human will function for the rest of his/her life. The amputation procedure alsoplants a strain on the amputee’s family because of time consuming medical care. The surgerymust be precise and accurate according to the wound site for an adequate healing process.Amputations change lives in many ways, therefore advantaged people should reflect on what anamputee may feel physically and mentally before judging them.