I’ve been driving again for about the last three months since the accident. To make driving easier we sold our manual Jeep Wrangler and bought a Toyota Prius, which is an automatic (and gets 45+ MPG!). Because I wasn’t sure of the legal situation with me driving again after the accident I wanted to find out if someone is supposed to sign me off as being safe…this was three months back.

So I started of by asking my plastic surgeon if I was safe to drive, he didn’t see any reason why I couldn’t since I had full mobility in both legs and my left shoulder…but he didn’t know who I had to talk to from a legal standpoint.

Next I spoke to my physical therapist, same thing, didn’t see why I couldn’t drive since by then I pretty much had full flexion back in my left elbow…but she didn’t know who, if anyone, I needed to legally talk to.

Given the litigious nature of people here in the US I really wanted to make sure I was legally safe, so my next stop was my insurance company. I figured if I let them know and they didn’t raise an objection then I would be legal, but that wasn’t to be. I phoned CSAAA and spoke to someone and let them know I had a left below elbow (LBE) amputation, she said she was sorry to hear this but as long as I was safe to drive the insurance company didn’t care, since she didn’t even have anywhere to record this information…so I struck out there.

I then contacted a friend I had meet who had an above elbow amputation to see who he had spoken to, unfortunately he couldn’t remember and said he just started driving again.

So, running out of avenues to pursue I phoned the DMV, I figured they must know what I needed to do. The person I spoke to kindly gave me the number for the local Driver Safety Office in Oakland. At last, progress. So I phoned them, they took my details and said I needed to get my Doctor to complete a medical evaluation. I duely printed this and took it to the business office at Kaiser, where it would take 10 working days for them to process and send back to the DMV.

By this time we’d sold the Jeep and took delivery of our new Prius. Since no one had told me I couldn’t drive and I felt quite safe driving with one hand, I started to drive again, commuting about 80 miles a day into work and back.

After about a month I finally heard back from the DMV, who scheduled a telephone call with me to discuss my case. Two weeks later I was on a very formal (and recorded) call with one of the safety officers. They asked about my condition, said the medical evaluation form sent by my doctor didn’t have enough information and then said they’d send me their determination in a month…OK I thought, I guess I’ll just keep driving and wait to hear…ho, ho, ho!

So now three months on I get a letter from the DMV informing me they have suspended my driving privilege! Why? I hear you ask, because they feel I can’t drive safely with one hand…nope. Rather they don’t have enough information to make that determination. So it took them a month to tell me they needed more info and instead of just requesting more info they have suspended me and I have to now request a hearing…which given their track record could take another month to schedule, during which time I can’t drive.

Don’t you just love these people!

Sounds like a chinese board game doesn’t it, but for those in the know it’s actually an aspect of Chinese medicine dating back over 3,300 years. I was introduced to QiGong just recently by Kerry who had been introduced to Dr. David Smith. David is the first American Medical Qigong Doctor on record in China to be recognized for using External Qigong for the purpose of pain relief and healing, you can check out his website for his background – pretty impressive and a really interesting guy to meet.

I’m a big believer in fate; things generally happen for a reason. The fact that Kerry was introduced to David recently through her work, that he lives in Walnut Creek just up the road from us, and happens to be a QiDong Doctor with 20+ years of experience who has successfully helped many amputees with phantom pain…well you get the point and so this is my first experiment in easing my phantom pain.

A couple of you sent me some great info in response to my last post, many thanks. The article by The Welcome Trust on phantom limb pain was interesting and spoke to use of mirror therapy and other techniques to try to shift the emphasis in phantom limb pain away from the site of damage – the stump – to the centre of pain processing: the brain. Another article, emailed to me by a friend, from
the Economist (requires subscription I’m afraid) talked about retracted phantoms. Patients with extended phantoms showed activity in the hand area of
a part of the brain called the motor cortex. This response is identical to that shown by un-amputated volunteers asked to do the same thing. Those with halfway
retracted and completely retracted phantoms had different responses. They showed activity in the elbow and shoulder
areas of the motor cortex respectively. In other words, a greater degree of retraction involves a greater re-wiring of the brain. And the greater the retraction, the worse the pain.

As I read this I started to realize that the sensations in my hand were in deed retracted, almost as if my hand was attached directly to my stump (sans wrist). Also, I realized that my hand felt as if  it was tightly clenched in a fist, as it was at the time of the accident (I had to prise my fingers open to get the brake handle of my glider out of it).

All this speaks to what David told me when we first met, that the memory of my injury was stored in two places; the cells of my arm and the cells of my brain. He explained that his focus would be on the cellular memory of my brain, as this was the cause of my pain.

I first met David last week during Kerry’s session with him, he had invited me to come along for the experience and I decided to go back – today was my first session with him. I like to keep an open mind, mixed perhaps with a healthy dose of skepticism and it was with this attitude that I met David. He quite happily told me that it wasn’t necessary that I believe in what he would be doing for it to work, it would work regardless. He didn’t need me to go into a trance, or meditate and he wouldn’t be dancing around me waving his hands or hitting me on the head and telling me I was cured…did I mention he’s got quite a sense of humour.

Our first session was quite incredible to be honest, hard to explain the sensations I experienced but it was both a physical and emotional release. For the first time I started to feel my hand release a little and it felt like I could wiggle my finger tips…a promising start. I’ll be going back once a week for continued treatment and we’ll see where it ends up.

Phantom pain is something that many amputees experience, and I’m no exception to the rule. For me there is a constant ache or throbbing in my arm that varies in intensity through the day. At it’s worst it feels like there is pressure squeezing my arm and I feel as if my hand is clenched tightly in a fist and I can’t open it. Every now and then I’ll feel a sharp, stabbing pain that lasts from less than a second to maybe three or four.

I’ve been taking 40mg of Nortryptline for the last couple of months, it was prescribed to help reduce the nerve pain and does a reasonable job, although I’m now trying to reduce the dosage since I’d rather not be taking any medication if I can help it.

It’s interesting that my arm feels most uncomfortable when I’m in a car, as a passenger or driving, and likewise at night when I go to bed. My best guess is that in both cases the rest of the body is pretty much resting and the pain in my arm then comes to forefront.

From reading around it seems people aren’t quite sure what the cause of phantom pain is or even how best to treat it. There are plenty of suggestions, but it seems it’s really down to finding something that works for the individual. I’m fortunate enough that the pain isn’t debilitating and I can get on with every day life and just put up with the annoyance coming from my arm, a bit like living with tooth ache. If it was my leg I can imagine it making it hard to use a prosthetic.

So my hunt is on for something that will help eliminate the phantom pain, I’ve been recommended self hypnosis…apparently it worked very well for one amputee. I’ll keep you posted as I try things out.

Last week I visited Hanger  Hanger Orthopedic again, it took a while to sort out the insurance paper work with Kaiser but it’s all systems go again.

My first visit on Wednesday was to take a molding of my arm from which they’d be able to make a test socket. A socket is the part of the prosthetic that fits onto my arm to which the hand, or other such device, is attached.

The first step was to get a gel sleeve onto my arm. This is a bit like a neoprene sleeve (except it’s silicone) that you roll onto your arm; you should be able to see it in the picture. Richard, the guy from Hanger, then used a laser to scan my arm and create a 3D image on his computer. It was pretty cool to see the image building up as he moved the laser over my arm, but, unfortunately due to software issues he couldn’t save the scan…we’ll have to play with that again another day.

The scan would have been a useful record of my arm and whilst it’s possible to make a socket from it, Richard prefers to still take a molding himself using fiberglass bandages. He first covered my arm in cellophane and then a cloth sock, he wetted the bandages and wrapped my arm, molding it carefully to fit its shape. After a couple of minutes it was dry and the cloth sock was pulled off along with the mold. From this Richard would be able to make a clear plastic, test socket.

I was back at Hanger on the Friday (they work quick) to see how the test socket fitted. Unfortunately despite several adjustments the socket was just a little bit too small. It was interesting however to see how the socket worked, using a vacuum to stay on my arm.

So it was back to square one, Richard took another molding of my arm (he had to break the previous one when he made the casting). My arm is a little bulbous in the middle, which makes it tricky to make a socket that can go on, but still be tight and fully make contact with the arm. We’ll see if he has better luck next time.