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The study, funded by the U. Department of Defense, included two sites: Kyle Potter "In addition to being effective, the beautiful thing about TMR is that there are low barriers to adoption -it requires little specialized equipment and can be performed in university hospitals, in military medical settings, and more," Dumanian said.
One of the study participants treated at Northwestern, Keith Philizaire, said he lived through years of anguish and pain medication to address severe PLP following the amputation of his leg. I'm able to take my daughters to the park and the movies, and I even rode a bike with my prosthetic leg. It was like torture," she said. Thankfully, after about four or five months it was manageable enough for me to go back to work. Now, I am proud to say that I am completely off all pain medications, I've earned my master's degree and have been working at a hospital in the suburban Chicago area.
Although he was not a study participant, he cites his TMR surgery performed by Dumanian as critical to reclaiming his active lifestyle. I started competing in World Para Snowboarding last season which allowed me to travel around the world.
Being a professional snowboarder has been a dream of mine since I was a little kid, and now I'm living that dream. Surgeons have devised numerous procedures to minimize or eliminate the painful symptoms of neuromas, but effective treatment has been largely elusive.
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Prevailing standard practice involves burying nerve endings from the amputated limb in a nearby muscle - essentially hiding a hot nerve ending, with limited success at reducing pain. A related condition, PLP, is thought to be a complex interplay between painful neuromas and the central nervous system - and has proven even more difficult to prevent or reverse, with no treatment regarded as universally effective.
TMR dissects the amputated nerve-the "live wire"-and surgically reroutes it to reinnervate a nearby functionless muscle, thereby "closing the circuit. Dumanian was the first to perform TMR surgery in to enable patients to control advanced myoelectric bionic prostheses.
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While the procedure's implications for prosthetics drew international attention, Dumanian also observed that TMR patients experienced less pain, making it a potential treatment for a broader population of amputees. These observations were published in a retrospective study inbut the latest findings are the first to demonstrate significant improvements in a randomized, multi-center study.
In the recently published trial, 28 amputees with chronic pain were assigned to either standard treatment or TMR. House, Cuddy, and House's team roam the area diagnosing and treating victims, until they come across the crane operator, who ostensibly fell asleep despite being overloaded with caffeine. House deduces the operator must have passed out and sends him to Princeton-Plainsboro to be diagnosed.
He attempts to go with him, but is held back by Cuddy. While taking a break, House hears a sound similar to that of a person banging on a steel pipe.
He informs the emergency officials, who attempt to communicate with anyone possibly trapped beneath the rubble, but they give up after receiving no response. House decides to go looking himself, and crawls under the mountain of rubble until he reaches a deep cavity and finds a trapped woman named Hanna. As House treats Hanna while waiting for reinforcements, he also begins the differential on the crane operator through the phone and speaks with Cuddy, who reveals that she has gotten engaged to Lucas.
House suggests that the crane operator has a brain lesion and orders an MRI. The situation is exacerbated when the emergency official realizes the support beam pinning Hanna China Shaversthe trapped woman, is also under a mountain of rubble that could collapse.
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The equipment that can free her is hours away from arriving, so the official suggests amputation. Both Hanna and House refuse. The crane operator begins bleeding from the eyes during the MRI and House attempts to return to Princeton-Plainsboro to diagnose him, but without his presence Hanna suffers a panic attack. Too much time has now passed and Hanna is at severe risk for crush syndrome. House then gets into an argument with Cuddy. Cuddy claims House is only refusing amputation to oppose her, bitter over her engagement with Lucas, at which point House calls her a pathetic narcissist.
Cuddy then tells House to move on with his life, and insults House further by telling him that she and Wilson are moving on with their own lives and the only one left behind is House, who has nothing. Hanna refuses the amputation, listening to House's earlier advice, but House soon arrives. To Cuddy's surprise, House tells Hanna she should amputate.
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He then answers her earlier question of what had happened to his own leg, by telling the story of his infarction and his own refusal of the suggested amputation. House brings the electric saw and a scalpel to the scene, and explains that he cannot give her anesthesia, since it is too risky, forcing him to amputate the leg with her awake, followed by her screams.
She is immediately taken to an ambulance, which then departs for Princeton-Plainsboro. On the ride back, House continues the differential on the crane operator through the phone and deduces that he has a spinal cyst.AMPUTEE CALF MUSCLES: Can I still control it?
Hanna suddenly has trouble breathing. House realizes she has a fat embolismcaused by the amputation. Impossible to treat, she dies before arriving at Princeton-Plainsboro. For House, it is the drop of water that makes the vase overflow. Despite Foreman's support, he cannot stand it anymore. While Thirteen leaves a leave request letter in front of Taub, House arrives home.