Targeted muscle reinnervation (TMR) is one of the most exciting developments for amputee patients in several decades. Not only does the procedure help patients to use a prosthetic arm more efficiently, but it has also been found to cut down on limb pain and phantom pain. Gregory Dumanian, MD, FACS, is the originator of the TMR surgery and he first performed it 20 years ago. Here, he shares some information on the benefits of this important innovation.
What is TMR Surgery?
TMR was developed, with Dr. Todd Kuiken, a rehabilitation physiatrist, to provide arm amputees more control over their prosthetic arm. Compared to earlier, comparable procedures, patients find that they can move their arm, hand and fingers more smoothly and easily. They also experience less mental fatigue afterwards. TMR requires neither wires nor batteries to function.
TMR takes the amputated nerves and re-attaches them to smaller muscle nerves in the amputated limb. When successful reinnervation occurs, the amputated nerves are once again connected to living tissue, rather than acting like a “live electrical wire.” The amputated nerves have been given “somewhere to go and something to do.” A happy nerve is a nerve that forms a circuit with brain. The brain once again receives signals from the amputated nerve, and by this mechanism, phantom limb pain improves.
Expect Rehabilitation
Amputees need to work with their prosthetists for optimal limb rehabilitation. This is true with or without the TMR procedure. TMR makes moving the prosthetic limb more intuitive than standard prosthesis, but some rehabilitation work is still required. Prosthetists will work with the amputee to keep the socket well fitting and in the device in good working condition.
Consider the Timing of TMR
Research suggests that TMR is most successful in patients who have yet to experience nerve pain. What that means is that patients who are planning to have an amputation may want to schedule TMR immediately or soon after to maximize its benefits. They should discuss this option with their doctor as well as Dr. Dumanian.
Am I a TMR Candidate?
With that said, you may still be a strong candidate for TMR even if you have already had an amputation of your arm or leg. Dr. Dumanian has helped many patients to overcome existing nerve and phantom pain with TMR, including patients who have dealt with this pain for nearly a decade. Early treatment may be preferable, but TMR can still help to alleviate your pain and phantoms well after an amputation. It can sometimes take six months for an established phantom pain to improve or even disappear.
Interested in the Benefits of TMR?
No one knows how to perform and optimize TMR better than its creator, Dr. Dumanian. To make an appointment to discuss having an efficient prosthetic with minimal pain, call his office at Northwestern at (312) 695-6022.
Hernias are common among both men and women. An abdominal hernia occurs when an organ or tissues protrude through the abdominal wall. Most abdominal hernias are treated with surgery.
If you have undergone abdominal hernia surgery, then this article is for you. Dr. Gregory Dumanian is a hernia specialist. Here, he uses his expertise to provide five tips for easier abdominal hernia recovery.
1. Follow Your Surgeon’s Instructions
The easiest and best way to recover from any surgery is to follow your surgeon’s instructions. Physicians provide post-surgery instructions for the benefit of the patient. If your surgeon tells you to do something, or to refrain from doing something, follow their instructions. If you have questions about your abdominal hernia recovery, contact your surgeon or doctor.
2. Create a Recovery Plan
Before your abdominal hernia surgery, you should create a recovery plan. A recovery plan ensures that you have everything in place to help you heal. Consider the following when creating your recovery plan:
- Where will you recover after your surgery? Different surgeries have different healing requirements. Consider where you plan to recover after your surgery, including where you are going to sleep and where you will spend your days.
- How will you allocate your recovery time? Recovery involves rest and patience. If you have a busy and active lifestyle, you should plan on slowing down as needed.
- How will you eat? This may sound silly but it’s important to have healthy and easy-to-prepare meals after surgery. You may not be feeling your best so you may not be able to prepare complex meals or go out to eat like you usually do. If you don’t have someone helping you, you should plan your meals ahead of time.
- Plan on who will drive you to the hospital and the doctor’s office. How would you get to the hospital if there is an emergency?
- Move as much of your work schedule to be completed before surgery, or else a week or two after surgery via the internet.
3. Alleviate Constipation Early
Constipation following surgery is a very common problem. It is a common byproduct of taking narcotic pain medicines such as oxycodone. Unfortunately, constipation can impact your recovery. You can take steps to alleviate constipation by doing the following:
- Drink water
- Eat fiber-rich foods
- Take short, slow walks
- Take the stool softeners as prescribed
4. Take Care of Your Body
Your body responds to how you take care of it. After abdominal hernia surgery you should be especially kind to your body and do the following:
- Stay positive
- Drink water
- Rest
- Care for your incisions as directed
- Walk as allowed
- Exercise per your surgeon’s instructions
- Use your arms and legs when getting up from a sitting or lying position, rather than trying to engage your core abdominal muscles
5. Seek Medical Care If Needed
Sometimes recovery doesn’t always go as planned. If you have issues after your abdominal hernia surgery, you should seek medical care immediately. Prompt medical attention can help avoid serious complications. You should seek medical care for any of the following:
- New swelling in the surgery site
- New redness in the surgery site
- Inability to keep down fluids, with emesis (vomiting) being particulary worrisome
- New difficulty breathing
- New calf tenderness or foot swelling
- Symptoms of an allergic reaction such as new face or lip swelling
- Pain that doesn’t subside with pain medication
- Nausea that does not seem related to one of your medicines
- Diarrhea requiring multiple trips to the bathroom
- The inability to drink fluids
- The inability to pass stools or gas
Schedule a Consultation
Dr. Dumanian is an experienced and patient-focused hernia surgeon. If you have questions about hernia surgery, call (312) 694-2428 today to schedule a consultation with Dr. Dumanian.