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What Does Evolve Mean to You?

Growth is a part of life. We are constantly evolving, and the journey never stops. Evolution can be scary, but out of it comes resiliency, personal growth, and perspective to help in the next phase of life. Below are quotes about personal evolution. Feel free to tear them out and put them where you can feel inspired.

Optimism is the most important human trait because it allows us to evolve our ideas, to improve our situation and to hope for a better tomorrow

~ Myles Jury

I will never apologize for who I am. I’ve worked hard to evolve and I’m proud of my triumphs

~ Alex Elle

Look around you. Everything changes. everything on this earth is in a continuous state of evolving, refining, improving, adapting, enhancing, and changing. You were not put on this earth to remain stagnant.

~ Dr. Steve Mataboli

The evolution of man is the evolution of consciousness, and consciousness cannot evolve unconsciously. The evolution of man is the evolution of will, and will cannot evolve involuntarily.

~ IG.I. Gurdjieff

She understood that the hardest times in life to go through were when you were transitioning from one version of yourself to another.

~ Sarah Addison Allen

THE NEXT GENERATION: Evolving with the Help of Peer Networking

By Lobna Abdllatif

Ken KojiKen Kojis, a 22-year-old below-the-knee amputee from Milwaukee Wisconsin, lost his leg on April 15, 2021, to a construction accident near his house. Since then, he has faced many challenges, but this does not deter him from pursuing his interests in photography, videography, and riding his one-wheeler board. He has good and bad days, like everyone else, and manages to power through the bad days and show up where it matters.

At the beginning of his limb loss, Ken was introduced to the Amputee Coalition by his doctors who later connected him with an amazing peer visitor named Sean Fizer, a below-the-knee amputee for nearly 20 years. Sean drastically changed Ken’s perspective about what to expect as a below-the-knee amputee and seeing him gave Ken hope for better things to look forward to on his journey.

Sean told Ken about Amputee Coalition’s National Conference and how people with limb loss and/or limb difference attends as well as clinicians, prosthetists, and exhibiting companies with their technology. Ken became intrigued and desired to find out as much as possible, so he attended the 2021 virtual annual conference. His experience piqued his interest to attend the event in person, so he registered for the 2022 National Conference in Palm Desert, California.

Ken is one of several people who has experienced targeted muscle reinvention (TMR), which redirects the nerves into the thigh. He shared the benefits of TMR and pain management with others at last year’s virtual conference, and made new friends during a conference breakout session, two of whom he stays in contact with often. He also connected with Leslie Greene, one of his favorite speakers during the virtual event, who spent extra time talking with him and his mother to provide helpful information.

Leslie expressed care and concern at a time when Ken was scared about his future because he did not know how his limb loss would change his life. Ever since, Ken has attended Leslie’s virtual support group calls and looks forward to seeing her in person at this year’s conference.

When Ken attends the 2022 National Conference, his primary focus is to network with others living with limb loss and limb difference and peers his age who share similar experiences. “I am going to the National Conference in California, August 10–13, and I recommend others to attend because you realize that you are not alone when you connect with people and ask questions face to face.”

Lera DoederleinLera Doederlein has attended Amputee Coalition’s National Conference since 2019. She was introduced to the Amputee Coalition by her clinician, who told her about Youth Camp and National Conference. She values being able to gain insights from clinicians and other amputees at conference that would have taken her a long time to discover on her own, such as how to care for her prosthesis and skin. She enjoys meeting others who share her experiences.

Lera’s limb loss journey started in June 2017 when she experienced double above-the-knee amputations due to arthrogryposis multiplex congenita, a disability she had from birth that affected both her legs and hips. The illness prevented Lera from walking upright unless she wore orthotics or used crutches.

After a few surgical complications when she was younger, Lera made the decision to double amputate at age 14. Ever since, she has never regretted her decision. During her prosthesis fittings she was introduced to someone who played sled hockey who invited her to try out the sport. Much to Lera’s surprise, she fell in love with the sport and realized there are a lot of possibilities for her in adaptive sports.

Attending National Conference has helped Lera to gain a better understanding of her new lifestyle and grow her connections. She enjoys participating in breakout groups where she can hear personal stories from other attendees and appreciates how everyone is different and yet similar. She learns more about the latest prostheses and technology by talking with exhibitors and sponsors.

Lera recommends young people to experience the largest event for people with limb loss and/or limb difference, “It’s wonderful to network with others who can understand your journey.”

LIVING WITH LIMB LOSS AND LIMB DIFFERENCE: Evolving Today to Meet the Challenges of Tomorrow

By Jerrica Thurman

Amputee Coalition is happy to present a stellar lineup of keynote speakers at its 2022 National Conference, themed “Growing Our Community to Shape the Future.” Each speaker will challenge our limb loss and limb difference community to continually grow and evolve to stay relevant and effective in a post-pandemic world. Read on for more details about the keynote speakers.

John KrieselJohn Kriesel will keynote the Opening General Session on August 10, 2022.

In 2006, Kriesel was nearly blown to shreds by a 200-pound roadside bomb in the parched sands of Iraq, but battlefield angels in army uniforms kept him breathing long enough to reach a hospital. He died three times and was shocked back to life. Somehow, he survived through four hospitals, 35 surgeries and months of recovery. He lost both legs and suffered numerous other major injuries, but it was the loss of two close friends that hurt the most. The guy who wasn’t supposed to survive and was told he probably would be in a wheelchair the rest of his life walked out of Walter Reed Army Medical Center after nine months.

Four years after his near-death experience in Iraq, Kriesel became a civilian marketing employee with the Minnesota Army National Guard and in 2012, was named Director of Veterans Services for a county in Suburban Minneapolis, MN. He also is a part-time host on KFAN Sports Radio and former member of the Minnesota House of Representatives. He was elected to the House in 2010 after a vigorous campaign where he was told he could not win in his district. He personally visited several thousand homes in all weather conditions and literally wore out the socket in one of his prosthetic legs. He won. After tours of duty in Kosovo and Iraq and a lengthy medical recovery, Kriesel’s family wanted to spend more time with him and he chose not to run for re-election. Working with author Jim Kosmo, Kriesel reveals his motivational story in STILL STANDING: The Story of SSG John Kriesel, winner of eight national book awards. Learn more at johnmkriesel.com.

Jill JacobsJill Jacobs will keynote the General Session on August 11, 2022.

Jacobs was appointed to serve as the Commissioner of the Administration on Disabilities for the Administration of Community Living (ACL) on February 14, 2022. She has more than two decades of professional experience managing disability services organizations, analyzing policy, and working toward improved health and disability programs and services at local, state, and federal levels. She also has been an active grassroots organizer, leading campaigns to depict President Franklin D. Roosevelt seated in his wheelchair in the national monument in Washington, D.C. to ensure the inclusion of disabled children in schools, and to organize disaster response efforts for people with disabilities following Hurricanes Harvey and Maria, to name just a few of her accomplishments. In addition, Jacobs brings to the role the lived experience of her own disability and as the mother of two disabled adults

Before joining ACL, Jacobs served as the executive director of the ENDependence Center of Northern Virginia (ECNV), a center for independent living. Previously, Jacobs founded and served for 16 years as the CEO of Ability Unleashed, a coordination and facilitation agency for Medicaid home and community-based services. She has held executive positions at several nonprofit and government entities and served on the boards of several disability advocacy organizations, including the National Council on Independent Living and United Cerebral Palsy of Washington & Northern Virginia. For her work advancing rights and access of disabled military family members while she was an Army spouse, the United States Army awarded Jacobs the Dr. Mary E. Walker Medal of Honor. Jacobs is a graduate of Texas A&M at Central Texas and received social work training at Army Social Work Services at Fort Hood, Texas.

Christi HoehnChristi Hoehn will be a featured speaker during the General Session on August 12, 2022.

Hoehn is a below-the-knee amputee and 11-year lung cancer survivor! She strives to be an inspiration by being her authentic self. She is known as “The Table Grilling Lady”, having developed a new way to cook and entertain. She is building her brand, “Talk of the Table Company,” and teaching people how to make meals more meaningful by cooking together at the table. Food & Beverage Magazine featured her in their March 2021 issue and again in April with a two-page feature! She has also spoken on The Moth LA stage and is active in Toastmaster. Over the last two years she has begun participating in 5k runs with a racing wheelchair. She was featured in a video series by T-Mobile and most recently a three-part docuseries with Ellen Degeneres’ digital network. The pilot series called “Next Chapter”, follows her journey to walking on prosthetics again after 16 years and training to become an inspirational speaker. An artist, mom, grandma, and happiness follower, she believes that the only limitations that we have are between our ears.

Participants will also hear from the Amputee Coalition Board of Directors during the General Session on August 12, 2022. They will present an engaging, interactive panel discussion, led by Lorraine Riche, Board Chair, and moderated by Amputee Coalition’s Interim President and CEO John Register.

Lorraine RicheLorraine Riche, MPA, serves as the president of Bloom Health Centers, an outpatient mental health organization whose purpose is to ensure that no one should ever feel alone and that societal health hinges on mental health. With more than 20 years of experience working in healthcare, Riche brings both a clinical and operational perspective from a variety of healthcare settings, including physical, behavioral, and mental health, acute care, ambulatory care, and community-based arenas.

Riche has had several leadership roles: she served as the president of Acorn Health a national ABA company providing services for children and adolescents in over seven states. She served as the chief operating officer of PT Solutions, an Atlanta-based rehabilitation company. She also served as vice-president at Clinovations: The Advisory Board Company, based in Washington D.C., vice-president of operations and later senior vice-president of operations for Prospira Pain Care (“Prospira”) in Roswell, and assistant vice-president of Ambulatory Services. Riche previously founded Physiotherapy Associates, an independent practice which served as one of the largest private practices in the community. She began her career in healthcare as a staff physiotherapist.

John Register
John Register is the acting president and CEO of the Amputee Coalition. He will lead the organization to convene its 2022 National Conference and Youth Camp, strengthen staff capacity, and deepen relationships with community members and partners. Register joined the Amputee Coalition Board of Directors in January 2018, bringing not only his personal experiences living with limb loss but also a passion for empowering the community to share their stories and enhance perception, policy, and passion. He is a Gulf War Army Veteran, a four-time track and field All-American and a two-time Olympic trials qualifier. After the amputation of his left leg, he won the long jump silver medal at the Paralympic Games in Sydney, Australia in 2000. He has appeared on national television, counseled U.S. Secretaries of State on Disability Foreign Policy, and is a well-respected public speaker and coach. He founded the United States Olympic Committee’s Paralympic Military Sports Program helping wounded, ill and injured service members use sport as a tool for their rehabilitation and is associate director of the U.S. Paralympics. He also hosts a blog talk radio show entitled “Life’s New Normal,” where listeners are introduced to and interact with guests who have overcome a life challenge.

Stephanie DeckerStephanie Decker will keynote the Closing General Session on August 13, 2022.

In March 2012, a tornado ripped through the town of Henryville, Indiana. Stephanie Decker, a 37-year-old mother of three, found herself in a life-altering moment. As her house began to disintegrate around her, she shielded her two young children with her body. Her dream home fell in, crushing her legs, but because of her heroic actions, Decker’s children were amazingly unscathed. It was a miracle that she even survived and made it to the hospital. At that point, doctors determined that parts of both legs would need to be amputated.

Decker has become a true symbol of survival and overcoming adversity. Since the accident, she has been featured on The Today Show, The Ellen Degeneres Show, ABC World News Tonight as “Person of the Week”, USA Today, USA Weekend, and People Magazine.

YOUR WELL-BEING: In-Person Clinics

First SwimFIRST SWIM

By Travis Young

Here at the Orthotic and Prosthetic Activities Foundation (OPAF), we focus on the first. The first time an individual faces a challenge they’re not quite sure they can overcome. The first time they try an activity they have potentially already performed. Does this make it not the first? No, the difference in this first is a life-changing event has likely occurred and given them a chance to experience a first all over again, but this time from a different perspective. So many fears and unknowns can overwhelm you when living with limb loss or limb difference. A skill that you may at once had conquered, can seem so hard and far from your reach that leaves you wondering if you can do this. The truth is, you can, and it doesn’t matter how big or how small a goal, hurdle, or fear may be, because with the right people, techniques, and attitude, you can always experience a first.

Let’s define swim: to propel the body through water by using the limbs, fins, tail, or other bodily movement. First Swim teaches how to appropriately apply swimming as an exercise modality and review pool safety, transfers, and prosthetic limb management around the water. Furthermore, it reviews the basic elements of swim strokes and the compensations often required for individuals with limb loss or limb difference. Because after all, the definition of swim says that using limbs is not the only way to propel yourself through the water, you can do so with other bodily movement.

Our First Swim clinic has been continually developed and adapted throughout the years to ensure current techniques are kept up to date in this course and our goal is to familiarize yourself and your support system with the knowledge and resources necessary to keep active and safe within and around the pool, which is overseen and often led by our First Swim Director, Mabio Costa.

Mabio was born in Brazil with a congenital limb malformation. At the age of 12, Mabio had his left foot amputated below the knee and in 1982 joined the Brazilian swimming team and started triathlons in 1987. Mabio became the first para-athlete to participate and be awarded in a triathlon competition in South America. He moved to New York in 1990 and played a major role in the introduction and development of rules for the International Triathlon Union (ITU) for accepting para-athletes in world championships. He then went on to win the 1996 Cleveland ITU Triathlon World Championship, representing Brazil. After the events that occurred on September 11, 2001, Mabio decided to become a US citizen and represent Team USA as a triathlete. Soon after, he won the 2004 Portugal ITU World Triathlon Championship. Mabio was also chosen to be the flag bearer for Team USA during the opening ceremonies at the 2006 World Championships in Switzerland.

Mabio started with OPAF in 2010 and has helped grow OPAF’s First Swim program nationally. He was named OPAF’s First Swim Director in 2018. Mabio has a passion for teaching new amputees and individuals with limb differences how to swim, regardless of age. Mabio brings positivity and excitement to teaching swimming that is unmatched and, with his infectious smile that lights up the room, help guide participants to improve their ability to swim. Mabio’s most recent accomplishment is participating with his Triathlon relay team, “3 Guys 2 Legs,” and are the only disabled athletes competing against able-bodied athletes. They have taken a podium stand in every race, including a first-place finish in September 2021.

We are thrilled that Mabio will be returning to host our First Swim Clinic at the 2022 Amputee Coalition National Conference. You will not want to miss this course as Mabio will be bringing two years of smiles, training, laughter, compassion, and top-notch training to every participant at this event.

YOGA EVOLVES

By Lucy Lomax

Yoga means union, uniting, bringing together the many facets of our being into a coherent whole. The word conjures up images of people in the modern world doing complicated poses in classrooms, on mountain tops, by the beach, and in other public, open spaces. The freedom to breathe, move, get strong, and expand into the fullness of the yoga pose. When Covid-19 arrived in March 2020, everything changed. Yoga studios and classrooms had to stop teaching in-person classes and all freedom was gone.

I was fortunate to teach at a large yoga studio that immediately went into overdrive to figure out how to take their 115 yoga classes online. By the end of March, over half of the teachers and classes were back teaching their regular class schedule, and a month later almost all classes and teachers had transitioned to the Zoom universe. Today, 110 classes, including our Accessible/Amputee Yoga class, and 23 teachers have transitioned to Zoom and/or hybrid classes, which are live in-studio with simultaneous live-streaming. This is the new face of yoga, a new union evolving in response to changing circumstances.

So, we moved to live-streaming and the yoga world issues were solved, right? Well, not exactly. Teaching a three-dimensional practice in a two-dimensional world has its challenges. First, the student needs to be able to clearly see the teacher, and vice versa, to see enough detail that the pose can be fully and safely executed. Second, the student and teacher need to be able to communicate with each other if there are questions about the pose or if the teacher wants to verbally assist the student in an adaptation of the pose. This is particularly crucial for those who may not be able to, or desire to do the “classical” pose, and need to be guided in a variation of the pose, which is often the case with an amputee. Therefore, many yoga teachers adopted a modified teaching strategy, especially for newer students as well as for amputees and others with limb limitations. Modifications included:

  • Teaching at a slightly slower pace to ensure all could see and safely do the poses.
  • Teaching less difficult poses until the student fully understood and could safely move to more challenging poses, if desired.
  • Teaching more breath work, range of motion (ROM) actions, and dynamic movement (breath coordinated with movement) such as cat-cow pose, and sun salutations rather than longer, static holds.
  • Demonstrating poses from several angles to ensure a better 3D understanding: from the front, side, and at an angle.
  • Demonstrating poses using pieces of furniture and other available home features, g., kitchen counters, dining room tabletops, and door frames.
  • Teaching creative use of the chair to sit or support, including doing standing poses seated on the chair (or on the mat on the floor); this approach can be particularly helpful for amputees in the home environment.

And then there’s the issue of having adequate support in the form of yoga “props,” the tools of yoga that aid comfort, stability, and flexibility. These props are particularly helpful for amputees who may need to prop body parts during a pose.

  • non-slip yoga mat — prevents slipping in standing poses; holds a yoga chair steady
  • 2-3 thick yoga blankets — support body
  • 2 yoga blocks — provide length to body parts; provide resistance
  • yoga strap — secures body
  • yoga bolster — supports body
  • yoga chair — sitting and standing support
  • wall space — standing support

Most students became creative with homemade versions of props — carpet padding (mat), thick woolen blankets or beach towels (yoga blankets), several books belted together (yoga block), cotton belt or bathrobe tie (yoga strap), thick throw pillow (yoga bolster), armless dining room chair (yoga chair), and a large piece of sturdy furniture for standing against (wall). Two years post-lockdown the yoga world continues to evolve to accommodate amputees whether at home or in the studio. Lately, some in our Accessible/Amputee Yoga Class have expressed a desire for coming to a hybrid class so we may take the class hybrid in Fall 2022. Yoga is always evolving to meet current needs.

LOOKING FORWARD: The Evolution of Emotional Healing

This content was adapted from the Amputee Coalition Fact Sheet on Emotional Recovery,
www.amputee‑coalition.org/resources/emotional‑recovery. Published September 2021. Accessed [June 15, 2022].

One of the Amputee Coalition’s main priorities is to provide amputees the resources and support needed before and after limb loss. Please attend the full lineup of educational seminars on physical, mental, and emotional health offered during the 2022 National Conference to take advantage of these resources. You may also visit the Amputee Coalition Booth at the Conference to receive the latest information to help on your road to recovery.

Losing a limb is a life-changing experience. This process often affects nearly every aspect of an individual’s life ranging from work and play to friends and family. People respond differently to the loss of a limb. How an individual responds might relate to one or more of the following factors:

  • Factors associated with the limb loss: Was it congenital, traumatic, or disease related? What is the level of amputation?
  • Individual characteristics: What is your age or health status? How will this affect you financially?
  • Personality traits: How have you coped with difficult situations before? What is your attitude about your health? Do you feel a sense of control despite the loss?
  • Physical and social environment: Do you have a support system in place? Are the services you need appropriate and accessible? What are your living arrangements, and how might they be modified to accommodate your limb loss?

Recovery is an ongoing process. Although several phases typically occur on the road to recovery, it is difficult to predict when each stage will occur and in what order. Each phase of recovery has special challenges and requires different coping strategies.

Through working with individuals with limb loss or limb difference as well as consulting appropriate evidence-based literature, the Amputee Coalition has developed a model for recovery that is specific to our community which is presented below.1,2,3 Just as the stages of grief are fluid, the stages of recovery are as well. These models are less driving instructions in which a new amputee crosses off the steps they have completed, and more like a map with major landmarks that can help a new amputee orient themselves in a process that so many have gone through before.

PhaseCharacteristicDescription
EnduringSurviving surgery and painPhysical anguish: hanging on; focusing on present to get through the pain; blocking out distress about future‑it is a conscious choice not to deal with the full meaning of the loss; self‑protection; may refuse a peer visit.
SufferingQuestioning; Why me? How will I...?Emotional anguish: intense feelings about the loss: fear, denial, anger, depres‑ sion; vulnerable and confused; return to Enduring stage; emotional anguish about the loss of self adds to the pain.
ReckoningBecoming aware of the new realityChanging roles: coming to terms with the extent of the loss; accepting what is left after the loss; implications of the loss for the future‑how will roles change; ongoing process; minimizing one’s own losses in comparison to other’s losses.
ReconcilingPutting the loss in perspectiveRegaining control: increased awareness of one’s strengths and uniqueness; more assertive; taking control of one’s life; self‑management of illness  and recover; changed body image; need for intimacy.
NormalizingReordering prioritiesRegaining balance: establishing and maintaining new routines; once again, doing things that matter; allowing priorities other than the loss to dominate; advocating for self.
ThrivingLiving life to the fullestBeing more than before; trusting self and others; being a role model to others; this level of recovery is not attained by everyone.

Sometimes the road to recovery is bumpy and filled with detours, and you might experience a range of emotions. Research has found that the common types of emotional concerns after the loss of a limb are depression, anxiety, grief, and trauma.4, 5 The following describes some of the emotional and well-being issues that could occur after an amputation, as described by the American Psychiatric Association:6

  • Post-Traumatic Stress Disorder (PTSD): PTSD can occur in anyone who experiences a traumatic event, especially if that event was life-threatening such as a military injury or car accident. The symptoms can range from reliving the event (flashbacks), to overall emotional numbness. Other symptoms include anxiety, exaggerated startle reactions, nightmares, insomnia, and extreme avoidance of reminders of the trauma. Someone may also experience dissociative features. Dissociative symptoms can include not knowing where you are, forgetting important parts of the traumatic event, or feeling as if you are outside of your body. A combination of these symptoms that occur six months after the traumatic event may be PTSD.6
  • Acute Stress Disorder (ASD): The symptoms that define ASD greatly overlap with those for PTSD, with the major difference being the time since the traumatic incident. ASD can occur in the first month following a traumatic event. ASD symptoms continue for more than a month past the traumatic event, an assessment for PTSD may be appropriate.6
  • Depression: There are many types of depression disorders, and most are marked by feelings of sadness and/or loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Symptoms can vary from mild or severe.6
  • Generalized Anxiety Disorder (GAD): GAD is characterized by chronic worry and irritability in multiple areas of life that seem to have no cause for at least 6 months. The worry is more intense than the current situation warrants. Restlessness, insomnia, difficulty concentrating, fatigue, and muscle tension are other symptoms.6 GAD can occur during any phase of recovery from limb loss.
  • Grief: Grief is a strong, sometimes overwhelming emotion for people and a natural reaction to loss. Everyone experiences grief differently, and it will be influenced by the nature of the loss. Feelings of grief and loss are common after an amputation. There are five common stages of grief that can occur in any order and last for any amount of time. They include:
    • Denial and isolation: A conscious or unconscious decision to refuse to admit that something is true.
    • Anger: An emotional or physical act in which a person attempts to place blame.
    • Bargaining: A process in which a person attempts to postpone or distance themselves from the reality of a situation
    • Depression: A feeling of loss of control or hopelessness.
    • Acceptance and hope: A feeling of stability or resignation as a person becomes an active participant in their life.

Everyone’s emotional recovery will look different after the loss of a limb. The important thing to remember is that you are not alone on this journey. Below are some tools and resources that may be able to assist you along the way.

Amputee Coalition Peer Support Programs

Whether you, a family member, or a friend is facing an amputation or has been impacted by limb loss or limb difference, the Amputee Coalition offers several ways to find useful information, support, and encouragement when it is needed most.

  • Certified Peer Visitor ProgramOften, no one is in a better position to understand about living life with an amputation — or supporting a person with limb loss or limb difference — than someone who has been there. The Certified Peer Visitor Program can match you, your family, and your caregiver with an experienced and well-trained peer who can offer encouragement and information from a place, and at a pace, that an individual in this circumstance can better absorb. To be connected with one of our Certified Peer Visitors, you can fill out the online form at www.amputee-coalition.org/support-groups-peer- support/certified-peer-visitor-program/request-a-peer- visit or contact the National Limb Loss Resource Center at 888-267-5669, option 1 to start this process.
  • Support Group NetworkSupport groups that serve the limb loss and limb difference community provide a safe and supportive environment for individuals living with limb loss or limb difference as well as their family members and caregivers. The Amputee Coalition has over 400 registered support groups across the country. To see if there is a support group near you, please use the map at www.amputee-coalition.org/support-groups-peer- support/support-group-network. You can also visit our online calendar to learn more about support group meeting locations and times at www.amputee-coalition. org/calendar-events/category/support-group-meetings.
  • Amputee Coalition Support App
    The Amputee Coalition Support App is a free resource and was designed for those living with limb loss or limb difference and their families and caregivers.
    The app embodies the power of connection to peer support and valuable resources, is HIPAA-compliant, and available via Apple App Store, Google Play, and web browser link: cpvapp.amputee-coalition.org. For Support App questions and technical assistance, please email the Amputee Coalition Peer Support Team at peersupport@amputee-coalition.org.
Improving Well-Being Program

The Amputee Coalition developed the Improving Well-Being Program in collaboration with researchers at Johns Hopkins University School of Medicine. The original goal was to assist prosthetists in engaging their patients regarding their mental health and well-being. This program has grown into a tool that is also available to the public. The Improving Well-Being Program has a self-directed assessment tool that uses clinically validated instruments to assess your depressive symptoms, satisfaction with life, and rehabilitation goals. Once you go through the assessments, the program will give you a Distress score and your Life Satisfaction score with explanations of each of those. After receiving your score, you can search for national, state-based, and local resources to help you meet your well-being goals. While the Amputee Coalition cannot make a direct referral to a mental health provider, we do provide tools to aid you in your search for one. The resources in the Improving Well-Being Program centers around the holistic approach to mental health and well-being so there are numerous resources that can potentially help improve your mental well-being and feel supported and connected.

Promoting Amputee Life Skills (PALS)

Promoting Amputee Life Skills (PALS) is a free program aimed to develop skills to improve the quality of life for individuals with limb loss or limb difference. The program consists of several modules that will help you use the skills you already have and develop new tools to manage life after limb loss. Some topics of the modules include self-management, health, and wellness, as well as the self-regulation of different emotional states. PALS was developed in collaboration with Johns Hopkins and the University of Washington.

To find mental health support in your community, visit www.amputee-coalition.org or contact our National Limb Loss Resource Center at 888-267-5669.


  1. Roy, J., & Francis, J. L. (2011). The psychological recovery of physically wounded service members.
  2. Spiess, E., McLemore, A., Zinyemba, P., Ortiz, N., & Meyr, A. J. (2014). Application of the five stages of grief to diabetic limb loss and amputation. The journal of foot and ankle surgery, 53(6), 735‑739.
  3. Bradway, K., Malone, J. M., Racy, J., Leal, J. M., & Poole, J. (1984). Psychological adaptation to amputation: an overview. Orthotics and prosthetics, 38(3), 46‑50.
  4. Singh, , Hunter, J., & Philip, A. (2007). The rapid resolution of depression and anxiety symptoms after lower limb amputation. Clinical rehabilitation, 21(8), 754‑759.
  5. Pomares, G., Coudane, , Dap, F., & Dautel, G. (2020). Psychological effects of trau‑ matic upper limb amputations. Orthopaedics & Traumatology: Surgery & Research.
  6. American Psychiatric (2013). Diagnostic and statistical manual of mental disorders (DSM‑5®). American Psychiatric Pub.