The ‘fantastic’ Ninewells rehab team helping folk cope with losing limbs

Occupational therapist Ann Marie Crawford puts Hilda through her paces at Ninewells. The use of a mirror can fool the brain into thinking the limb is still there

The life of Hilda Stagg and her husband Garry changed forever in July.

While riding their motorcycle on the A9 just north of Dornoch Bridge, they collided with another vehicle and the couple were both left with catastrophic injuries.

Hilda, 68, was left with a broken hand, broken clavicle, a broken left leg and an above the knee amputation to the right leg.

She is just one of the patients being treated by the amputee rehab team at Ninewells — whose painstaking work helps patients cope and adjust to having had limbs removed.

Occupational therapist Ann Marie Crawford puts Hilda through her paces at Ninewells. The use of a mirror can fool the brain into thinking the limb is still there

Her husband, motorsport legend Garry, is known as the “voice of Knockhill”, having commentated at racing circuits for 30 years.

He had part of one of his legs amputated and is currently still recovering from his injuries at Ninewells Hospital.

An above the knee amputation is much harder for patients to recover from and only one in four such amputees are able to be fitted with a prosthetic leg.

Thankfully — Hilda was one of them.

She said: “After the accident and my amputation it was incredibly difficult.

“I went through a lot of denial about how much my life had changed.

“I am getting used to my prosthetic leg now and the rehab provided by the team here has been fantastic.

“I was very active before the accident. I was a very fit and active person and would often do a lot of hill walking.

“Once I had my amputation my main goal was to walk again and be as active as possible.

“I am now managing to be much more active and I’m able to walk with my prosthetic for much longer periods now.

“We are both just very lucky to be alive.

“The accident and my recovery has just really put life into perspective — your whole life can change in a split second.”

Amputee rehab team leader Ann Marie Crawford said the occupational therapist’s work begins well before the patient undergoes the amputation surgery.

She said: “We visit the patient and go through the whole process of what will happen following surgery.

“Of course, they have lots of questions so we are there to try to put their mind at ease before surgery.

“We also set goals with them for what they would like to be able to achieve post-surgery.

“Most people’s first goal is to be able to go to the toilet themselves — small things like that which make us feel independent.

“It is especially hard for people who are losing a limb through a trauma such as a car accident. They have not had the same amount of time to come to terms with the change as a planned amputation patient would.”

On the first day after surgery the occupational therapy team begins the rehab process with the patient.

Ann Marie said: “It is a lot to take in when patients wake up from surgery.

“So we really support them along with the nursing team to make that first manoeuvre from bed to wheelchair.

“When they come down to the gym we really work on wheelchair training.

“We go over all the safety aspects to ensure they will be able to safely get themselves around.

“The first stage of any lower limb amputees rehab is core transfers such as being able to get from bed to wheelchair.

“We also work with patients on pain management.

“We focus on goals created by the patients themselves and make it a very person-centred rehab programme to ensure they can have the best quality of life and maintain hobbies and interests that they had before the surgery.”

A JustGiving page which was set up to help Hilda and Garry pay for anything that they may need in the future has now raised more than £13,000.

Helping patients with phantom limb pain

One of the challenges amputation patients face is phantom limb pain.

Ann Marie Crawford

This refers to on-going painful sensations that seem to be coming from the part of the limb that is no longer there.

The pain can feel like a variety of things, such as burning, twisting, itching or pressure and is often felt in fingers or toes.

Researchers don’t know exactly what causes it.

Amputee rehab team leader Ann Marie Crawford said: “Following an amputation patients will — as expected — suffer from pain in the stump and also some patients may suffer from what is called phantom limb pain.

“We want patients to effectively manage their pain on their own.

“When there has been an amputation, the muscles in the stump have moved from where they used to be, nerves have moved position and the skin around the stump is now doing a different job than it used to.

“We look at techniques such as gentle massages of the stump to ease the pain.

“Phantom limb pain is when the brain thinks that pain is coming from the missing part of the limb.

“To help, we use a very simple technique using a mirror.

“The patient will place their remaining limb next to the mirror with the reflection making it look as if both legs are there.

“Whilst looking in the mirror, we will massage and stretch the remaining limb.

“This then makes the brain think we are relieving the pain in the missing part. It is really effective.

“We will then begin work on strengthening the remaining limb to help ensure the patient will be able to be fitted with a prosthetic limb.”

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