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Monday Apr 29, 2013

Lessons for Boston: FPs Can Help Amputees Move Forward

 In the aftermath of the terrorist attack on the Boston Marathon, the media has put a focus on a topic that has been part of my life for nearly two decades -- amputation.

More than a dozen people have had amputations since two bombs went off near the finish line of the April 15 race.

On a day that started with celebration, lives were changed forever. In that instant, young and healthy athletes on the road to celebration (and spectators who were cheering them on) were shocked to now face the long and challenging road to recovery.

I can relate.

Just one week before the airplane accident that eventually claimed both my legs, I remember joyfully riding my bicycle up a sunshine-splashed hill, reveling in what my body could do.

A week later, I was on a ventilator in my own ICU.

In the hospital, the questions began. "Who am I now, and what can I do in this world with this radically changed body?"

Fortunately for me, I had a team there to to help me find the answers.

There were a large number of subspecialists. Trauma, ENT, orthopedic and plastic surgeons were able to save my face, hands and one foot. But it was my family physician, Tim Dudley, M.D., who had the insight and ability to take care of the whole of me.

And of all the members of the health care team that helped put me back together, it was Tim who played the most important role in the weeks, months and years that followed.

In the short term in the hospital, Tim asked important questions about nutrition, rehab and insurance. For a full recovery, it was essential to have a family physician who knew me, would listen to me and would advocate for me. When my insurance company tried to limit the number of physical therapy sessions it would cover for multiple traumas to 10 total home visits, Tim threatened them with a different covered benefit -- six months in a nursing home. The payer listened, and I got my physical therapy, at home.

To this day, Tim writes letters when I need new legs.

Tim, you could say, stands by me. Like all patients, amputees need a physician who will help them see the big picture beyond their immediate loss.

Many well-intentioned coaches and doctors focused on what I would be unable to do with prosthetics. My family, friends and Tim helped me focus on what I could do, even when we had to modify prosthetics or sports equipment.

Yes, amputation is painful, physically and emotionally. Learning to walk again is a hassle.

But re-engaging fully in a life you love makes it worth all the pain and hassle, and that was my message to those injured in the Boston bombing during a recent(cnnradio.cnn.com) interview with CNN Radio(cnnradio.cnn.com).

Our job as family physicians is to help patients look forward and find things in their lives that are more important than their pain. By knowing them as people, we can better help them take the steps they need to have a full life after amputation, cancer or any loss.

One year after my accident, I rode up that same hill again on my bike, in the sun. And I marveled at the wonder of what my body, now with prosthetics, could do.

My wish for those wounded in Boston, injured veterans returning from Iraq and Afghanistan, and others facing amputation is for them to be as fortunate as I am to have a family physician like Tim who can help them take the necessary steps and guide them on their path.

And thanks to all of you for what you do for your patients every day.

Jeff Cain, M.D., is President of the AAFP.

Posted at 02:37PM Apr 29, 2013 by Jeffrey Cain, M.D.

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