October 3, 2021 10:54:06 am
FOR the past six months, the Amputee Management Group at PGI has been striving to create a paradigm shift from ‘survival of amputee’ to ‘giving a life’ to them. “We have made great strides in the management and rehabilitation of patients with amputation despite being confronted with the catastrophic second wave of Covid-19. Since its inception in February, we have registered more than 200 amputees and it is hugely satisfying that we could make a visible difference to their lives through a focused approach and holistic care at the clinic,” stated Prof MS Dhillon, Head of Department of Orthopedics, PGI.
The patients are broadly from Punjab (45 per cent), Haryana (25 per cent), Chandigarh (8 per cent) and Himachal Pradesh and Uttar Pradesh (10 per cent). Professor Dhillon says that the intent of the effort is the belief that the management of these cases does not end with amputation surgery, but requires the involvement of various specialists to cater to the social, emotional, and psychological problems, as well as a need for vocational counseling and social support for full rehabilitation into society as a functional member.
“It has evolved into a one-of-a-kind specialised clinic involving faculty members from the departments of Orthopedics, Physical and Medical Rehabilitation, Psychiatry, Occupational therapy, Physiotherapy, Nursing care, and Prosthetists, all working as a cohesive unit to help patients to return to society as healthy individuals with satisfactory physical, emotional, and mental well-being,” added Professor Dhillon.
Shrishti was six when she sustained right transhumeral (above elbow) and left transradial (below elbow) amputation after severe electric burn due to contact with high-tension electric wires.
“At the time of presentation, the child had discontinued schooling and was completely dependent on her mother. The financial condition of the family was not good, with both mother and child abandoned by the father following the accident. We, here at PGI, after amputation, started rehabilitation with counselling and Srishti was trained to use her feet for self-care activities and drawing. After a month, she was encouraged to begin writing alphabets and numbers with her foot,” says Dr Somya Saxena, Associate Professor at Department of Physical and Rehabilitation Medicine, PGI. She fondly looks at her patient Shrishti, who is now 12, and is studying at Kendriya Vidyalaya– growing up to become an inspiration for many, including her own mother.
“I can eat, dress, bathe, draw and write all on my own,” says Shrishti, who is from Baltana, and was at the Amputee Clinic on Thursday to share her story. Dr Saxena adds that after a year, Srishti required stump revision surgery and was given body powered right transhumeral and left transradial prosthesis.
“She has intelligence, positivity and determination, and there are many like Shrishti, who can lead a fulfilling life, if they are given proper treatment and rehabilitation,” adds Dr Saxena.
Most patients registered at the Clinic had to undergo amputations due to road accidents or railway track injuries; while a few had undergone amputation due to cancer or congenital deformities. “As more than 85 per cent of our patients are male, drivers, farmers, labourers, factory workers and a majority of them are at the peak productive years of their life (25-50 years), the loss of limb becomes not only a personal loss but also a financial loss to the family, especially when it loses the services of its sole bread earner. More than 90 per cent of these patients belong to low to middle socio-economic strata and a majority of them have no social security or insurance.”
Endorsing the need for community engagement to take forward the initiative, Professor Dhillon elaborated that with the support of the institute’s authorities and some philanthropic industries such as Micron Industries, in a significant move, PGI has begun to fabricate in-house prosthesis (artificial limbs) at its prosthetic center and now, patients do not need to spend huge amounts for procurement of prosthesis from outside.
Professor Dhillon added that complications related to surgery have drastically reduced (<10 per cent), and this is due to a special orthopedic team prioritising emergency care. “Patient support from our nursing staff and social supporters has led to increased awareness about life after amputation, and possibility of prosthesis application. The PMR department provide pre-prosthetic and post-prosthetic care, necessary for the success of prosthesis fitment and prevention of complications. So far, none of our patients have rejected his or her prosthesis, which is commendable, as compared to the western and European countries, where the rejection rate ranges from 50 to 80 per cent,” said Dr Dhillon.
PGI has fitted more than 20 prostheses to patients over the last six months and talks are ongoing to offer job provisions to some of these amputees.
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