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Q: Prosthetics ( Answered 4 out of 5 stars,   1 Comment )
Question  
Subject: Prosthetics
Category: Miscellaneous
Asked by: dogsbollocks-ga
List Price: $5.00
Posted: 24 Jul 2003 09:42 PDT
Expires: 23 Aug 2003 09:42 PDT
Question ID: 234655
For a book I am trying to reconstruct what feelings / pain a person
who lost a leg will have (above the knee, about the thigh area)–
“phantom limb symptom”, emotional distress etc.
Information that will bring this to life is welcome.
Answer  
Subject: Re: Prosthetics
Answered By: andrewxmp-ga on 24 Jul 2003 10:20 PDT
Rated:4 out of 5 stars
 
Hi dogsbollocks!

Obviously it is almost impossible for an amputee to express exactly
what they are feeling as far as a "phantom limb" is concerned.  The
emotional feelings are probably easier to describe and relate to, but
I found some information and descriptions of both that I hope will
prove useful.  I've pulled specific quotes from a number of documents,
but I encourage you to read them in full, as they are pretty loaded
with descriptions.  Also, I've tried to keep cited cases to leg
amputees only, although I'm pretty sure that an arm amputee would be
experiencing similar physiological and emotional feelings.

"Sensations from an amputated limb can manifest themselves in many
different ways, such as sensations of touch. For example, some
amputees are able to feel their arm resting on a table, their fingers
able to feel the texture of the table. Other times they can feel the
absent limb in movement, possibly reaching for a glass. Some report
that the limb is drastically deformed or forshortened, or that it
remains rigid. "
[ http://www.macalester.edu/~psych/whathap/UBNRP/Phantom/phantompain.html
]

Another patient describes "itching and tingling" as well as the
feeling that her foot had "fallen asleep".  Please see:
[ http://www.macalester.edu/~psych/whathap/UBNRP/Phantom/casestudy1.html
]

This next case was remarkable because the patient had a deformed leg
before it was amputated, thus she never had toes in the 'normal' place
at any time in her life.  Nevertheless, she felt as though she had
another set of phantom toes where they 'shoud' have been.
[ http://www.macalester.edu/~psych/whathap/UBNRP/Phantom/casestudy5.html
]


As for the emotional feelings of these patients:

"People with either of these losses [either a body part or a loved
person] were preoccupied with feelings of loss: bereaved people were
missing the lost person and the amputees were missing the loss of
physical attractiveness (loss of body image) or the occupational and
other physical functions that could no longer be carried out (loss of
function), or both of these."
[ http://www.cirp.org/library/psych/maguire/ ]


A very good personal account can be found at:
[ http://www.oandp.com/edge/issues/articles/2003-03_15.asp ]

From that document:
"Five days of hospitalization passed, and my wife drove me home to our
changed life. I feared I was going to be a cripple. I felt loss,
grief, and an overwhelming desire for a sense of normalcy.

I found myself on an emotional roller coaster, which, however, gave me
the fuel to return to work. Within three weeks I was back in my art
gallery, greeting customers. I rarely ventured beyond the sales
counter. I saw how uncomfortable the average tourist was while being
served by a one-legged man on crutches. "



Interestingly, this next report indicates that depression and anxiety
levels in amputation patients were not significantly greater than
normal.
" Phantom pain (mostly mild) was reported by 29 patients. Fifty three
of the remaining 64 patients reported non-painful sensations in the
phantom limb. Mean scores on the anxiety and depression scale were 3.9
for anxiety and 2.9 for depression. Whereas 10 patients scored in the
clinical range for anxiety, mainly about falling, only one patient
scored in this range for depression. No patient gave a history of
previous or concurrent psychiatric treatment.

The patients were divided according to whether they experienced pain,
and their anxiety and depression scores and time from amputation were
compared with non-parametric statistics. The table shows that the time
from amputation, and anxiety and depression scores did not differ
between the two groups. Time from amputation was not strongly
significantly associated with distress, so anxiety and depression do
not seem to vary consistently over time. "

"The prevalence of depression was low, suggesting that it is an
uncommon reaction to amputation."
[ http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=28494 ]

The emotional response and condition during recovery seems to be very
heavily influenced by the psychological condition of the patient
during the whole ordeal.  A positive outlook on their ability to lead
a normal life seems to be an important aspect of their emotional
state.

I hope these resources will prove useful to you.  If you require any
clarification, please request it before rating this answer.  Thank you
for bringing this inquiry to Google Answers!

Sincerely,
Andrewxmp

Search terms used:
phantom limb feelings
phantom limb feelings emotional
amputation emotional
dogsbollocks-ga rated this answer:4 out of 5 stars

Comments  
Subject: Re: Prosthetics
From: journalist-ga on 24 Jul 2003 11:08 PDT
 
Greetings __:

Here are a few links on the management of phantom pain in amputated
limbs that may be helpful for you book:

What Causes Phantom Pain
http://www.a-z.org/dis/phantom.htm

Phantom sensation and Phantom pain [about midway down the page}
Pain Management: Post Amputation Pain
http://www.amputee-coalition.org/inmotion/mar_apr_98/pain_mgt/page1.html

Research: Post-Amputation Pain Study - A Controlled Clinical Trial
http://www.hopkinsmedicine.org/rehab/research/paps.html
It includes the statement:
FOR MORE INFORMATION
Please call 410-614-2010
or send correspondence to:
Srinivasa N. Raja, M.D.
Johns Hopkins Hospital
600 N. Wolfe Street
Osler 292
Baltimore, MD 21287

You may want to contact Johns Hopkins for a more detailed version of
the study.  Hope this helps.

Best regards,
journalist-ga

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