After Amputations, Continuing to Move Forward

Sometimes, Bruce Tindall feels pins and needles in his left leg, all the way down to his toes. But he doesn’t have a left leg.

Bruce lost the leg below the knee to complications from diabetes in 2016. What he feels in the missing leg is phantom limb pain.

“Your whole body is wired with nerves, and the nerves get signals from your brain,” explains Bruce, 51. “After an amputation, your brain can still think there is something to send a response to. You can flex your muscles, and it feels like you are moving your foot.”

At other times, the sensation in his left leg feels more like an electric shock, making his body twitch. “You just have to work through it,” he says. “One of my doctors who helped me with the pain told me that one way you can stop it is to very gently tap the residual limb. It sends the pain signal back to the brain and says, ‘Stop.’”

It’s one of many ways that Bruce has learned to cope, and even thrive, despite the effects of the amputations—he also had the large toe on his right foot removed in July 2022—and his ongoing treatments for diabetes and the neuropathic pain that has resulted from the disease.

SNOWBALLING SYMPTOMS RESULT IN AMPUTATIONS

Bruce, who lives just outside San Antonio, Texas, with his wife Tracy, was diagnosed with diabetes in 2001. His mother also had the disease before she died, so he knew the signs of diabetes and was able to see them in his own body. “I was constantly thirsty, and I craved sugar,” he recalls.

His symptoms came to a head one day at work—Bruce has been in the restaurant industry since he was 17—when he began to get dizzy. “I was feeling like I was drunk, and I was slurring my words, so I left work and staggered into the house and slept about three hours,” he recalls. “When I woke up, I drove myself to the hospital, and my blood sugar was 483.” The normal level is usually between 80 and 120, he explains.

Bruce began receiving treatment for diabetes and was able to keep the disease under control for the next 15 years—but as the years passed, his neuropathy symptoms began to worsen.

“I would get tingling in my legs and my hands—that feeling you get when your foot or your leg is asleep. It slowly got worse and worse over the years,” he says. And because he had limited feeling in his lower extremities, it was getting harder and harder to stand—or to notice injuries. “The neuropathy was an underlying reason why I lost my leg,” Bruce shares. “I got ready for work one day, and I didn’t realize I had a rock in my shoe. I walked around all day and it eventually punctured my foot, and I didn’t notice it until I saw a puddle of blood under my feet.”

When the puncture wound didn’t heal in six months, Bruce had his smallest toe on his left foot amputated—but before he could be fitted for an orthotic, he stumbled at work and rolled his foot, exposing a bone. Surgeons discovered that he had picked up an antibiotic-resistant infection that had seeped into his bones. They removed his left foot to stop the infection from spreading, and then later, his leg below the knee.

NAVIGATING UNEXPECTED LIFE CHANGES

At the restaurant, Bruce could no longer stand for long periods of time or lift heavy objects, and because not meeting those requirements violated the terms of his contract, he was let go.

Bruce began navigating the intricacies of finding medical insurance and obtaining Social Security Disability Insurance (SSDI), spending hours on hold and “getting the runaround,” he recalls. “I had been trying up to that point just to get help with the basic necessities—food, rent. They’d say, ‘Call this number,’ and that office would say, ‘Call that number’—I guess they try to wear you out until you give up, but I never did.”

Instead, he called the office of Donna Campbell, a Texas senator who is also an emergency room physician. “Within seven days, all the sudden, this organization that wouldn’t take my calls suddenly called me back and needed to talk to me now. [Campbell] jumped right in and got things rolling for me,” he shares. And when Bruce could not afford a prosthetic limb to replace his left leg, the foundation associated with PVA Prosthetics in San Antonio stepped in to cover the cost.

Meanwhile, Bruce tried to find a job to accommodate his physical limitations. First, he did data entry for a friend—but he wanted to return to the restaurant industry, which had been his life for more than 30 years.
As a former general manager, Bruce had trained many employees who had gone on to start successful businesses of their own, and he had kept in contact with many of them. Now, Bruce works part-time training employees for one of his former trainees who now has his own restaurant. His hours and ability to work are limited due to his disability; luckily, he continues to receive SSDI to help cover expenses and medical care.

He takes into account a promise he made to his wife. “She worries about me, and she doesn’t want me to be injured again,” he says. “But she knows I’m a workaholic. So I have a chair at work so I don’t have to be on my feet all the time, and I try to train these kids on how to do things the right way.”

LEARNING NEW WAYS TO COPE AND THRIVE

Bruce loves to cook, but the diabetes diagnosis has altered his eating habits. “I don’t eat a lot of salt, and I make healthy meals. I try to do what the doctors ask me to do,” he says.

“Exercise is the tricky part,” he admits. The pandemic ended his regular trips to the gym, and he was trying to get back into the exercise groove once restrictions were lifted, but the second toe amputation in 2022 stopped him in his tracks, at least temporarily. “As long as you make positive progress, it’s a good thing, because if you keep moving forward, you will get to your goal eventually,” he says.

Bruce takes a combination of medications to help with pain, including gabapentin and ibuprofen, and cyclobenzaprine to help relax his muscles so they don’t spasm and shake while he’s sleeping. “Sometimes [the medications] work, sometimes they don’t,” he says.

The pins and needles sensations in his leg and toes still make it difficult for him to stand, and the varying sensations in his fingers—from little feeling at all to a stabbing pain—are difficult to control. “It starts like an annoying pin prick, and then it itches,” he explains. “Your fingers start itching, and so you use your clothing, walls—whatever is around to scratch them with. But that’s dangerous.” Scratching can leave him with an open wound, and with his diabetes, wounds can be difficult to heal—and send him back to the hospital with an infection or worse.

Bruce tries to maintain a positive attitude and teach his brain new tricks to learn not to feel phantom limb pain. He moves his fingers constantly to combat the numbness. “I’ll do an exercise of touching my fingers together in a pattern to help focus my brain, so it concentrates on something else besides the pain,” he says. “Certain fingers lock and stop moving, and when you try to move them, it feels like I’m popping the joint back into place.”

He tries to be a role model—and not just for his restaurant trainees. “I want to help others keep going and not give up,” he says. Bruce belongs to a support group through the San Antonio Amputee Foundation that helps its members not only live with their new reality, but also give back to the community by volunteering at a local food kitchen and other charitable organizations.

Despite his pain and ongoing challenges, Bruce continues to look ahead. “I’m stronger than I look,” he says.

—Calli Barker Schmidt