TMR: helping amputees with chronic pain

Healthwatch

Diabetes, trauma, and cancer are among the reasons why amputation becomes necessary for tens of thousands of people every year.

Now surgeons are using a procedure to lessen chronic pain after limb loss.

Emilee Lester has come a long way in two years. Just four days before her college graduation she was driving her car back to school when a large piece of debris was suddenly on the roadway. 

She says, “Even though I know you aren’t supposed to, I swerved to avoid it and hit another car head on.” 

The impact crushed Emilee’s right foot between the ankle and toes. 

She says, “My family, we like to describe it as taking a handful of chips, crunching them with your hand, putting em on the table, and trying to put them back together. Too many pieces. Pieces don’t exist anymore. It’s just way too hard to put them back together.” 

Emilee made the decision to have doctors amputate. During the surgery, doctor Ian Valerio also performed another procedure designed to eliminate stump pain and phantom limb pain: the feeling of pain in a limb that is no longer there. 

Doctor Valerio is pioneering the use of primary targeted muscle reinnervation or TMR, rerouting the nerves that are cut during amputation into surrounding muscle, lessening the pain.

He says, “By hooking the peripheral nerve up to the motor nerve, it sends new signals as the nerve regrows, thus reinnervating the muscle.” 

One week after her amputation, Emilee’s college held a graduation ceremony for her in the hospital. 

Three months later, Emilee went to Parris Island for her brother’s graduation from Marine Corps boot camp, walking five miles on her new prosthetic leg. 

Doctor Valerio says when TMR is done at the same time, most patients will be off pain medication within three months.

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