The advice I am offering here is for people who are facing amputation, NOT for those who have already had limbs amputated and are now experiencing phantom pains. If you haven’t yet had your amputation, these ideas might help you avoid future ‘phantom’ pains.

I had a lower leg amputated in 2005, and received much good advice at the time which I believe helped me avoid phantom pains. Phantom pains might be ‘all in the mind’, but they can be even more devastating than ‘real’ pains, just as painful, and they can ruin your life - and you can’t solve the problem by having your limb cut off again. In fact, the division between ‘phantom’ and ‘real’ is not a good one, as it implies that the first don’t exist. They do!

The course I followed is fairly simple, but does require the co-operation of your anaesthetist and hospital. Essentially, what you must do is convince your brain that your foot/ankle/leg is free of pain, at the point where you go to the operating theatre. Somehow, this helps.

The alternative, being wheeled into the theatre with your leg still throbbing in pain, will be remembered vividly by your brain - and hence you will get phantom pains. And this can happen even if you have general anaesthetic - your brain isn’t fooled - it knows your leg still hurts.

Most hospitals admit you the day before your operation. At this point, you should be fitted with an epidural drip - a morphine drip, which slowly and gently numbs the lower half of your body. You should also continue with oral pain relief, to its maximum dosage (as discussed with your anaesthetist).

In the past, many hospitals just take you in, give you a general anaesthetic, and cut your leg off. In these circumstances your brain often remembers the original pain in your leg, and you end up with phantom pains.

The second part of the plan, which is entirely optional, is to have a local (sometimes called ‘regional’) anaesthetic as opposed to a general anaesthetic. Why a local is better than a general is hard to explain. It seems that your brain accepts the amputation more easily if you are awake throughout the process. Somehow, you are still ‘in charge’ of your body - it is not a question of Them doing things to You.

What’s amputation like under a local? Tedious, I suppose. It lasts longer than you’d expect (mine took an hour and a half), and although the anaesthetist will sit and chat to you throughout, in case you change your mind and want fuller sedation, my operation did get a bit boring. They put up a screen so you can’t see what’s being done to your leg, although there is a television monitor if you really want to watch (I didn’t!), and apart from the chatter of the medics, the only sounds of note were the buzzing of the saw, and then the tapping of a hammer and chisel. I asked the anaesthetist what they were doing with a hammer and chisel, and apparently it was quite normal, to round off the exposed bones so as not to leave a sharp edge.

After the operation, they wheeled me into the recovery ward, and within half an hour I was back on the main ward, drinking tea and tucking into a plate of chips (very healthy).

And afterwards I skipped off into the sunset.

No, not quite. I have had my share of problems since then with badly-fitting prosthetic legs, which my limb-fitting centre try their best to solve for me, and the lack of exercise has helped me get fat - partly ‘comfort-eating’ of course. But I  walk, I cook and clean around the house, I still cycle (alright, it is an electric bike, but it helps), and, most of all: I do NOT have phantom pains.

Once or twice, when my stump has been hurting for some reasons, then I have had tiny twinges of phantom feelings, bordering on pain, in my missing foot. And the fact that you can’t reach down and rub it better made it feel worse. But over 99 per cent of the time, whatever my problems, phantom pains have not been around.

It is possible that you can go to hospital, NOT have an epidural, have an amputation, and never experience the agony of phantom pains. If that is your experience, then be thankful for it. But I have encountered many amputees over the years who have been plagued with phantom pains, so I would urge you to consider this simple method of fooling your brain - it worked for me.


A.