Introduction

Hello, and welcome to my blog! My name is Paden James. At age 32, I became an amputee after decades of struggling with chronic wounds, scleroderma (an autoimmune disease affecting the skin and connective tissue), and a rare form of cancer on my foot (a Marjolin’s ulcer) that led to the below-the-knee amputation.

Life has thrown many obstacles in my way over the years. From losing my home in a tornado as a teenager to enduring several years of health issues and chronic pain, I’ve had to learn how to adapt, persevere, and find strength in even the hardest moments.

Through these challenges, I’ve drawn on the insights I’ve gained from the Enneagram and personal development strategies to cultivate a growth mindset, face difficulties head-on, and build resilience in the face of uncertainty.

I hope that sharing my story inspires you to embrace your own challenges, uncover your inner strength, and keep moving forward with resilience and purpose.

The Road to Amputation

For as long as I can remember, my health has been a challenge. When I was 12 years old, I was diagnosed with an auto-immune and skin disease called morphea (also known as localized scleroderma). This autoimmune disease causes inflammation and thickening of the skin from excessive collagen production. It is not a fatal disease, and although my condition never progressed to systemic scleroderma (affecting internal organs), it can affect a person’s quality of life due to the changes in the appearance of the skin, joint contractures that limit movement, and deformities of the face or extremities.

In my case, scleroderma caused tight, fragile lesions on my feet, legs, torso, shoulders, and upper arms. The overproduction of collagen on my skin caused a loss of flexibility and the development of chronic wounds, particularly on my left foot. Even minor friction or bumps would create open wounds that took months, or even years, to heal.

By the time I graduated high school, my scleroderma had become inactive, but the damage it had left behind—especially on my left foot—persisted. For two decades, I dealt with these recurrent chronic wounds that caused constant pain and significantly limited my mobility.

At age 32, while undergoing wound care treatment, I noticed a new spot at the top of my foot, right where the foot bends. At first, it looked just like other wounds in their beginning stages. However, this particular spot became increasingly painful. A large mass grew very quickly over the course of the next 3-4 months.

While treating it at wound care, nobody could figure out what was going on or what was causing the mass. I was referred to several different specialists until I finally saw an orthopedic oncologist, who immediately suspected it was a form of squamous cell carcinoma (skin cancer) within an open wound. A biopsy confirmed this – it was a Marjolin ulcer, a rare and aggressive type of skin cancer that develops in scars or chronic wounds.

Thankfully, the cancer was localized and hadn’t spread to my lymph nodes or organs, but my history of poor healing left few options for treatment. My doctors recommended a below the knee amputation to remove the cancer and give me the best chance at a better quality of life.

Though it was scary, I figured an amputation would likely be the next step. My doctors assured me that, though challenging, it was not the end of the world – I could still have a full and fulfilling life. I was also looking forward to not having to deal with the excruciating pain, the exhausting daily wound care routines, and the inability to do basically anything at all.

The operation needed to be done quickly to prevent the cancer from spreading systemically or leading to sepsis. The biopsy was performed on October 31st, the diagnosis was confirmed less than a week later, and I had the below-the-knee amputation surgery on November 25th at the University of Kansas Medical Center in Kansas City.

Looking back, I can see how understanding my Enneagram type (a Type 5) helped me prepare for this life-altering moment. My instinct to gather knowledge and prepare for the unknown—combined with the courage to speak up, advocate for myself, and take action in the face of uncertainty—gave me clarity, focus, and confidence during an incredibly overwhelming time. It wasn’t just about the physical challenges—it was about staying mentally strong and trusting that I could adapt to this new reality.

The Surgery

For several weeks leading up to the surgery, I was in a ton of pain. That final week before the surgery was particularly challenging. I had to stop taking Ibuprofen due to its blood-thinning properties, which increases the chances of extensive bleeding/blood loss during surgery. This was especially difficult because Ibuprofen was the only medication that could control my pain effectively. Even strong opioids like Percocet or Norco – couldn’t help. I had to grit my teeth and just get through it.

I was still doing daily wound care, and because I was dealing with so much pain, I felt completely useless. I was unable to help with anything around the house and struggled to focus on anything other than the pain and discomfort.

I was also nervous, having dealt with a long history of wounds and issues with healing. Will the amputation be successful, or will it have difficulties healing and lead to more ongoing wound care/pain management like before?

Although I had anxieties about my surgery and navigating life as an amputee, I was hopeful that a below-the-knee amputation would alleviate the pain, remove the cancer, and enable me to have a better quality of life.

On the day of the surgery, everything happened quickly. I was asked some pre-operative questions and then was given anesthesia. I don’t remember anything after they started wheeling me to the operating room.

The next thing I knew, I was waking up in my hospital room. I felt a little drowsy and out of it, but I immediately looked to see that everything was okay and, honestly, to see the reality of the amputation to begin processing it.

The relief was immediate. For the first time in years, I wasn’t in pain. Those initial days felt like a fresh start, even though I knew challenges lay ahead.

Adapting To A New Normal

After two days of recovery in the hospital, I was transferred to an inpatient rehabilitation hospital. There, I worked with physical therapists and occupational therapists to navigate walking and performing everyday tasks without my left foot.

The therapists guided me through different activities, such as:

• Mobility Training: using a walker, crutches, or a wheelchair, getting up and down curbs and stairs, getting in and out of a vehicle, and exercising and proper stretching to promote healing
• Daily Tasks: Showering, doing laundry and folding/putting away clothes, preparing meals and getting various items in the kitchen, washing dishes, taking out the trash, and other household chores
• Accessibility Setup: How to adapt and rearrange items in my home for better accessibility for my new mobility needs
• Energy Conservation: Learning how to manage and conserve my energy throughout the day

Adapting to this new normal has been a humbling and empowering experience. Every step of the process—physical therapy, relearning daily tasks, and adjusting to my new mobility—has challenged me in ways I never expected.

As a Type 5 on the Enneagram, I’m naturally driven to seek knowledge and solutions, which has been a strength during this transition. But I’ve also had to challenge myself to step out of my comfort zone and trust others when I need help—a lesson I continue to work on. While I felt that I did a great job getting through the rehab process, learning to ask for help when I needed it and realizing that things take a lot more time and energy as an amputee have been my biggest mental adjustments.

Reflecting on Life Before Surgery

Prior to the tumor development and the resulting pain and inability to walk without assistive devices, I still had several limitations.

• Simple tasks like standing or walking were very painful
• I wasn’t really able to bend, lift, or maneuver very well
• I couldn’t wear normal supportive shoes and had to wear slip-in styles of shoes were the only things that didn’t irritate my foot and cause excessive pain or new wounds to form
• I couldn’t take showers/bathe, or get into water like normal, because my feet couldn’t get wet; therefore, I had to use waterproof covers (similar to those people use when they have casts on) to keep everything dry
• I had to do daily wound care, which was time-consuming and painful
• I had several doctor appointments every week that were physically, mentally, and emotionally draining, especially the ones that didn’t give any answers or positive directions for making progress and healing

Most people didn’t understand what I was going through because the scleroderma was mostly a hidden condition. I kept my scars and lesions covered, often feeling self-conscious, and never really talked about it.

As an Enneagram Type 5, I tend to withdraw and conserve my energy when life feels overwhelming. While this has helped me survive difficult times, it also made me realize how important it is to lean into my growth path during this new journey. This surgery forced me to step into that growth mindset. By focusing on my goals and on what’s possible, I’ve been able to find optimism and purpose in the recovery process. Without the constant pain and limitations from the scleroderma and wounds, I believe I’ll be able to do more than I ever could before.

Phantom Pain and Nerve Pain

At the moment, the biggest struggle I’m currently experiencing is phantom pain. Phantom pain is caused by the severed nerves that used to send signals between my brain and my foot. These nerves are still active, but are confused about what they’re supposed to do after the below-the-knee amputation.

As they try to relearn their function and adapt to their new roles, they send signals to my brain that causes me to feel sharp pain, itching, burning, and other sensations as though they’re coming from my missing foot. The pain varies, but it most often feels like sharp pains, electric shocks, or intense pins and needles in my foot.

This has been one of the most challenging parts because it’s uncomfortable, makes it difficult to concentrate, relax, or sleep, and can be emotionally and mentally draining as well.

The Role of TMR in Managing Nerve Pain

During my below-the-knee amputation surgery, a specialist also did a procedure called Targeted Muscle Reinnervation (TMR). This procedure involves redirecting the severed nerve endings to nearby muscles. Essentially, the nerves are being given a new job or ‘target’ to communicate with. By giving the nerves a new functional connection, TMR can help reduce nerve pain in the long term, but it is not an instant fix.

In the short term, I’ve been working with my doctors to utilize medications that help with nerve pain, such as Gabapentin or Lyrica, to help reduce the discomfort and pain as I continue the healing process.

Moving Forward

Throughout this journey, I have experienced so much generosity, support, and encouragement from family and friends. I’m also grateful for the expertise of the medical teams I worked with. I’m truly blessed to have every one of them in my corner.

I’m still adjusting to this new chapter of my life. At the time of writing this, it’s been just over two weeks since my below-the-knee amputation surgery, and I recently returned home and am working on getting back to a sense of normalcy.

Right now, I’m primarily using a walker, occasionally switching to a wheelchair as needed. Once I am fully healed from my surgery, I will be getting a prosthesis and learning to walk again. My biggest goal right now is to be up and walking for my wedding in September 2025, and I’m optimistic that I’ll get there with time and effort.

Staying positive and maintaining an optimistic outlook has been paramount. I’ve also been working to educate myself about the below-the-knee amputation post-surgery and recovery process, listening to the stories of other amputees and how they’re living fulfilling purposeful lives.

This journey has deepened my understanding of how self-awareness and resilience can help us grow, even in the face of uncertainty. As a Type 5, I’ve learned that balancing research and preparation with action is essential to navigating challenges like this.

By sharing my story, I hope to remind others that even the most demanding challenges can lead to growth. With the right mindset, we can find strength in our struggles and move forward with purpose and intention. Thank you for joining me on this journey!

This journey has strengthened my desire to help others with personal growth, overcome life’s challenges, and to live with purpose. By sharing my story, I hope to remind others that even the most demanding challenges can lead to growth. With the right mindset, we can find strength in our struggles and move forward with purpose and intention.

If you’re interested in learning how the Enneagram can guide you on your path to growth, stay tuned for more insights—or reach out to connect. Thank you for joining me on this journey!