Permanent paralysis , why not amputation?

I always think about this when in in bathroom at work. It has the bar for someone in a wheelchair to use to get them from the chair to the toilet.

It always occurs to me that if a person was permanently paralyzed from the waist down, wouldn’t the limbs be constant hindrance? Don’t they make it more difficult to swivel to the toilet seat? To get in and out of the chair? To get in and out of bed? To get dressed?

Wouldn’t atrophied limbs increase the risk of infections, blood clots and other possibly life threatening diseases?

Do people choose amputation? Or do the risks involved with amputation outweigh any possible benefits?

I know of a guy who was in an accident that left one of his arms paralyzed and useless. For a while, he had it strapped to his torso and lived his life like that, but like you say, it was just hanging there useless. After a while, he chose to have it amputated. So it does happen sometimes.

What factors go into the decision beyond the obvious, I’m not sure.

Medical science marches on. Who knows if paralysis might be reversible in another ten or twenty years?

Also, surgery is risky; there’s always a chance of some bad reaction that will kill you. People sometimes die from cosmetic surgery, much less cutting limbs off.

I think amputation of a non-diseased limb is probably seen as doing harm. The lack of motor control of a limb is a deficiency of the limb, but it doesn’t rise to the level of being a health threat like gangrene or risk the rest of the body. Amputation doesn’t cure the lack of motor control.

And in time, with intensive physical therapy, some “permanently” paralyzed people get some kind of motor control back. Plus there’s always the very rare chance you might get some kind of spontaneous or unexplainable recovery – a lot of paralysis is the result of trauma and healing can be time consuming, amputation just guarantees you won’t have it.

Plus amputation has its own risks since you use general anesthesia. And it has non-trivial side effects, like phantom limb pain. I’ll bet losing an arm completely plays havoc with your balance to some degree; even if you can’t use a dead arm its mass means something.

I would say most surgeons would only agree to do it with extensive review of the patient’s history, the details of their condition and maybe even a psychological evaluation to make sure they are not suffering from depression or some other mental illness that would cause them to want to mutilate their body.

I can see if you were a military veteran with a war wound, say an arm with disfiguring severe burns, catastrophic nerve damage and shattered and unusable elbow joint that resulted in the arm being “very unattractive” and a social impediment, uncontrollable and unusable due to the joint problem they might consider it.

It’s a strange idea if you think about it. Nobody advocates digging the eyes out of blind people or cutting the ears off deaf people or cutting the noses off people who can’t smell, why amputate someone because they can’t walk?

Well, for me personally, I would NEVER, EVER, in a million, billion years think of amputation. While I am permanently paralyzed from the waist down, they are my fucking legs! It would be unimaginably traumatic to me to go from a whole body, albeit a whole body with non-functioning parts, to basically an upper body on stumps. Plus, the biggest reason is probably the fact that I have full sensation throughout my body. So, fuuuuuuuuuuuck that.

^ Yeah, what he said (can’t beat the voice of experience).

Most people don’t want to cut off parts of their body, even if those parts aren’t perfect.

Quite a few people with paralysis still have some sensation in their limbs. It’s not universal, but more common than most people would assume.

Having limbs permits, with clothing, a more normal profile than if those limbs were missing. For some people it’s important to look as normal as possible, even if that appearance isn’t perfect.

Then there’s the hope of future restoration of nerves, or use of braces/powered devices to restore some movement/mobility. This can also lead people to want to hang onto their limbs as long as possible.

In addition to the above…I wonder (but do not know) if there’s an increase in prevalence and severity of pressure ulcers with amputations over with intact but paralyzed limbs. Balance must be different, and therefore where exactly your weight is going to press on. While I’ve seen some heinous pressure ulcers on both people with paralysis but intact limbs and people with amputations, more of them and the worst ones are on folks with amputations. But I have to be honest, I haven’t been a nurse long enough to have any idea if this is a real phenomenon or just a sampling error or if it’s due to the underlying condition that called for amputation in the first place.

I can definitely understand why someone with an arm that does not function might feel that the quality of their life might improve without the arm needing to to be strapped to their body. Not so much the examples of ears or eyes of blind and deaf people.

One advantage amputees have over paralyzed people: they always seem to dominate wheelchair races. It’s because they don’t have legs to interfere with the ‘cockpit’ of the racing-wheelchair, making it much easier to use and maneuver.

I am on another board for spinal cord injuries and there is one guy there who chose to do a double, above-knee amputation after his spinal cord injury more than 11 years ago. He is quite happy with his decision and doesn’t seem to suffer much from complications resulting from the amputation.

The majority of one’s RBC (red blood cells) come from the marrow of the Femur (thigh).

Unless the damage has already destroyed that function, that is one thing you don’t mess with.

Will now await the professionals telling me my info was obsolete 20 years ago - another curse of age.

Yeah, even for those without any sensation in their paralyzed limbs, wanting to maintain the ‘humanoid’ shape of four limbs is still incredibly strong. Because the expectation for people to always see others looking like this is even stronger. Its practically (or maybe actually) embedded in our DNA!

Not to make light of the idea, but think about how in science fiction when writers want aliens to look more & more ‘evil’ they always make them look less & less ‘humanoid’. And vice versa.

I have friend who is paralysed from the thighs down, so some of one leg has some sensation. Having said that, he does have occasional infection issues, that a few years got so bad that amputation was a possible consequence. But in the end they found the problem and managed it, and he still has both legs.

At the time we talked a bit about it, and there are things like balance that factored into his opinion of whether to keep his legs or not, but mostly it’s as others have said, they’re parts of his body that he doesn’t want removed if he can avoid it.

Less dead weight to shift too, surely?

Grand Bull Moose Winner of the Ironic Username/Post Content Award!

We execute felons without knowing (or caring) if they can be rehabilitated later on.

And… what, exactly, does that have to do with a paralyzed person deciding whether or not to keep a paralyzed limb?

Moderator Note

jtur88, let’s keep political commentary out of GQ. No warning issued, but in I note that you are lapsing into your previous bad habit of making inappropriate comments in GQ. Don’t do this again.

Colibri
General Questions Moderator

The medical reason I was given for most circumstances was circulation. Leaving the circulatory system intact and as per original design beats removing part and having some “dead ends” and rerouted.

(A relative went through this and that was the doctors explanation)