In my previous post; a crash in a short real life story and 'that moment' of a person
Amputation in history, shortly:
The word amputation comes from the Latin word amputatio and means; 'to cut around'.
Historical and archeological studies are showing us that amputation has been practiced since the Neolithic age ( Padul PA, Friedmann LW. Acquired amputation and prostheses before the sixteenth century. Angiology. 1987;38(2):133–141.) In excavations, rocks, knives, and saws have been found together with amputee skeletons
“Sometimes the extremities become gangrenous…you must cut off that limb as far as the disease has spread, so that the patient may escape death or greater affliction, greater than the loss of the limb.” –Albucasis, c. A.D. 1000
After the American civil war Physician S. Weir MItchell identified 'phantom pain' after his studies of many amputee soldiers' complaints.
“I had begun to suffer the most acute pain in my left hand, especially the little finger; and so perfect was the idea which was thus kept up of the real presence of these missing parts, that I found it hard at times to believe them absent,” Dedlow recounts. “Often, at night, I would try with one lost hand to grope for the other."
In 1866, a short story called “The Case of George Dedlow”.
In old times, amputation happened in wars, later it started happening in cases of trauma and circulatory system diseases. Most commonly known one of these diseases is Buerger's disease.
What is Phantom pain?
Feeling severe pain in the empty place of a lost extremity is called Phantom Limb Pain.
Although this pain which can be very severe right after the amputation decreases in years, it causes very big problems for the patients. The pain could be increasing and decreasing from time to time. While at night, the pain could be in form of cramps, numbness, and pain it could continue all day long increasing from time to time.
Because the pathophysiology of Phantom pain cannot fully be understood the treatment approaches are limited.
Phantom pain is not seen in patients with absence of congenital extremities and in patients who were amputated at early ages. Also in patients who had pain before the surgery, it is more common to feel phantom pain after the amputation surgery. At this point, it was seen in studies that starting treatments at algology clinic before the amputation surgery was helpful for the prevention of phantom limb pain.
Even though the idea of PLP being just inside the patients head, experimental studies of PLP patients' physiological characteristics have shown that these patients had a normal physiological profile.
Treatment
According to the patient's condition; medical treatment, re-operation, and also various physiotherapy methods are used.
During the rehabilitation process; many therapies like TENS (transcutaneous electrical nervous stimulation), Mirror therapy, Biofeedback and recently, 3D augmented reality therapy approaches are practiced.
Next article will be about these approaches…
Thanks for reading…
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