Responses to Phantom Limb Pain

Responses to Phantom Limb Pain

Vincent Gest

4/21/2006

Thank you to all who responded to my request for info regarding the Medipro
Night Relax product. I de-identified the posts for anonymity and product
solicitation. If you would like to know the product info from a specific
response, I'll forward it on to you individually.

Have a great weekend!
Vince

ORIGINAL POST:
I know we've had several emails regarding phantom limb pain and what works
for your patients. Here's another regarding a specific product.

Anyone have any experiences with the medipro Night Relax stocking? It's
supposed to block electromagnetic waves. I'm not going to get into whether
or not I believe such things can actually affect phantom limb pain. I'd
rather just ask What have you seen with your patients? My patient is
desperate and I'm willing to look into it.

Thanks for your time. I'll check back later for responses. I have to go and
replace the straps on my aluminum foil hat. I broke one last night while
adjusting the arial antenna on my house.


RESPONSES:

From an O&P Technician:
I have been an amputee for 20 years and have run the gamut of phantom pain
and phantom feelings. The best thing, I have found is to OFTEN massage the
limb to keep nerve stimuli working. And the biggy, when the pain hits, you
have to go into a meditative type state and reassure yourself, this is not
REAL pain, it is a nerve bundle gone wild. There is no new injury, it is in
my HEAD�, just a short circuit in the 'ol spinal nerve system. It is not
real it is not real it is not real. I can continue because it is a short
circuit and there is nothing really wrong. Just a short circuit, it will
go away. Takes practice but WORKS!

Has your patient seen a physical therapist? As much as there might be ill
feeling between prosthetics and PT, I would think that trying a PT (or two)
would be more fruitful than this hocus pocus stuff! Not to make disparaging
remarks about the medipro Night Relax stocking, but -- Some tried and true
methods used by PTs include ultrasound, diathermy, infrared, massage,
trigger point therapy and/or acupressure, relaxation techniques, and so
forth. There are a lot of tricks up a PT's sleeve!

I just had a conversation with the Medi reps and I also called the Ferrabloc
people. If it works it�s going to be great. I am going to try it on several
pts at the VA. But I keep thinking if it works for that, shouldn't people be
wearing hats out of the stuff? What about epileptics and other neurological
conditions? So you aluminum hat is a good idea. I bet you can think faster
than ever before!

Hard to say about the blocking of electromagnetic waves settling pain
issues. What we know is happening, though, is that these types of socks can
contribute to a few degrees increase in warmth in the residual limb, and
this increases blood flow to the area. The increase in blood flow can
settle down the nerve pain related to venous congestion and ischemia.

One of the reps from a well-known supplier/manufacturer had this to say:
(De-identified info for list-serve purposes. Email me if you want to more
info.)
We have had anecdotal evidence that our socks made with silver fiber do help
with phantom limb pain. I would suggest that your patient wear one of our
shrinkers when sleeping at night to see if it helps. If you would like a
sample, please feel free to call or e-mail me.

I posted a similar info request several months ago; the responses were few
and split between absolutely they work to not working, to one very long
response about nutrition and mineral supplements. Everyone agreed, they are
expensive with no ins. coverage.
My patient decided to try wearing the silver sheaths from comfort products
under her bk shrinker at night. She is 2 yrs post-op but feels increased
comfort wearing the shrinker when not in her prosthesis. Not much
difference the first week of wearing the silver sheaths, so I asked her what
kind of electronic devices were in her bedroom (desperate for options to
help).
The room was loaded with TV, 2 radio/alarm clocks, air purifier, humidifier;
the list went on. What I found of greater interest was that she puts her
alarm clock on the bed next to her and she often falls asleep with the TV
on. We got rid of everything electrical except for her TV and alarm clock.
  I advised getting the clock off the bed, but found out later she did not
break this habit until after another week of pain.
She reports her phantom pain &/or incidence of pain has decreased by 50%.
She is using a wind-up, traveling alarm clock and she makes sure the TV is
off before she falls asleep.
Psychosomatic or physiological, I don't know. It's working for her.

One practitioner didn�t have a good experience:
I ordered Medipro Night Relax from (XYZ supplier) The product has no
instructions on usage. The company I ordered the product from, did not have
a practitioner, not even a sales person to talk too. I even went to the
Medipro night relax web site. The web site did not have instructions.
After e-mailing the staff (two months ago).

I was recently told of a relatively new drug for phantom pain called Lyrica.
According to a physician I checked with it has fewer side effects than
most.Might be worth a try if the antenna doesn't work.

I have tried it on several patients and all have had some measure of relief.

I have a patient who I gave a silver textile sheath. They wear it under the
shrinker at night. They have told me it helps a great deal, and also now
use it under the liner as well. You may have to have a waist suspension to
keep it on during the night. Like I said it worked for her to help reduce
the phantom and she is happy for it.

I'm not a nut job either, but I have used the medi relax gel and night
versions and my patients have all reported relief. Even some that hate the
bulky gel liner report a significant reduction in phantom sensation. Good
Luck

AND FROM THE PEANUT GALLERY WE HAVE:

Hey Vince, use elastic for the straps. Elastic takes a higher degree of
punishment. 8-)

Don�t forget to hang paperclips from your earlobes. I find it helps keep
your ideas organized when they come to you.

The aluminum foil won�t do you any good if you have metal fillings. Have
them all drilled out and replaced with porcelain. And don�t let them fool
you into using anesthesia. Otherwise you won�t notice if they try to implant
a radio transmitter in one of your molars. I know. They did it to me. If I
listen real close, I can still hear the voices�.




Vincent Gest, CP
Prosthetic & Orthotic Group, Inc.
805-278-8120

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