“The parents invented a leg on which the fingers will move.” How the first child who lost a limb in the war is prosthetics in Ukraine

[ad_1]

Marina is the first patient to undergo pediatric prosthetics in Ukraine due to a limb lost in the war. In the spring of 2022, when the girl was still 5, a shell flew into their house in Kherson. Her leg was torn off by a Russian missile. In May, she was taken to “Okhmatdyt” for rehabilitation, but the girl was lying down and did not even want to get out of bed. A team of specialists – a psychologist, a rehabilitator, a prosthetist – set out to put Maryna on her feet. She couldn’t even stand without her limb being torn off, because her balance was broken. At the end of the summer, she was given her first training prosthesis, and in a few months another, personal one was created. The specialists of the “Okhmatdit” clinic told about the challenges, problems and achievements of children’s prosthetics for “UP.Zhyttia”: physical therapist Nazar Borozniuk, psychologist Tetyana Pidkova and prosthetist Oleksandr Stetsenko. Psychological barrier After the tragedy in Kherson, Maryna and her mother Natalya were admitted to different hospitals in Kryvyi Rih. So Aunt Lyuba was next to the girl. “The mother and her daughter separated, and the girl became more attached to her aunt. It is like a barrier protection, because the child could not go to the toilet, move, dress herself. All these functions were performed by Lyuba. And now it is with aunt Marina that she feels at home safe,” explains psychologist Tetyana Pidkova. Later, when the mother and daughter were sent to “Okhmatdit”, instead of improving the psychological state, there was a regression. Marina “read” the mother’s emotions: the woman felt the difference of her child due to the trauma. Marina to prosthetics. Photo: “Okhmatdit” “Marina has PTSD. This trauma is not from the war, but due to the loss of a limb. We faced the fact that the parents absolutely did not accept the trauma of their own child. After all, they saw her healthy, with two legs, physically developed.” – says the psychologist. Therefore, Maryna’s mother hoped that the prosthesis would return the child to the period before the tragedy. The girl’s psychological state was quite difficult: she was not ready to let new people in, limited communication with the outside world. Therefore, the parents decided to stay in Ukraine and undergo rehabilitation and “put their daughter back on her feet” in her native country. Tatyana Pidkova explains: Natalya saw examples of prosthetics abroad. As in the case of Kata and her mother from Kramatorsk, who came under fire at the train station: they received more aesthetic prostheses in the United States. But they have an injury below the knee, and the 11-year-old girl is not growing as actively as her 6-year-old daughter. Marina with her mother Natalya The intensive development of the child was one of the reasons to stay in Ukraine, because in the USA or Seoul they offered to replace the prosthesis once every 2 years. “It was difficult to even convey to the parents that it will be a prosthesis, but not a cosmetic one, but like a tube. For some reason, like Marina, they invented a leg on which the fingers will move,” says Nazar. Instead, they brought a prosthetic tube. It consisted of “foreign” parts, because another child walked on it. After the experience of the first prosthesis, Marina again felt her mother’s despair, so she protested and started hysteria when she saw the training prosthesis. “We got out of what we called Kesha’s prosthesis, and we will be friends with it,” says the psychologist. A few months before that, Marina did special exercises together with rehabilitator Nazar to strengthen the muscle corset. But the first fitting passed with tears. Marina in a Kuks wheelchair (the part of the limb that remains after the amputation) had to be bandaged before putting on the prosthesis. In medicine, this preparatory procedure is called bandaging. “The first time I knew that I was bandaging Marina’s leg incorrectly. But I didn’t know how to do it right. At the university, no one focused on prosthetics, on stumps. bandages The war seemed far away, but now it is breathing down the back of everyone’s neck. My English is bad, but that didn’t stop me from translating article after article, looking at pictures and learning by doing. Children’s prosthetics is complicated by the fact that children are constantly growing, and the prosthesis must be changed, constant monitoring is required,” the rehabilitation specialist notes. He recalls that just then his colleague Maria went to Norway for some kind of summit. Nazar asked her a bunch of questions, just as many – arose in the process. “Somehow Masha says: ‘I don’t feel comfortable asking.’ And I answer her: “We have a war, ask, don’t be shy. Then colleagues from France, Italy, Great Britain came, taught us, told us a lot of new things. I did half of it. In fact, it’s good and right, so they didn’t do the work missed,” says the doctor with a smile. Read also: Lost an arm and a leg near Izyum: Lviv doctors installed a bionic prosthesis on a soldier for the first time. He adds that all young patients with military amputations are first taken to the regional hospital, and then referred to “Okhmatdyt”. In this clinic, children are rehabilitated and receive psychological help, and then they are sent abroad for prosthetics. Prosthetics are free for war-affected children, both in their home country and abroad. Challenges and difficulties One of the reasons for tears during the first attempt to wear a prosthesis was a banal physical discomfort, reinforced by fear and rejection of parents. For some time, the girl continued to express internal protest: she wore the prosthesis only for rehabilitation classes. The staff tried to encourage Marina to walk with the new “leg” more often, so that she would learn to walk on it faster. “Marina needs to learn how to control the mechanical knee, because it slips out. She needs to learn how the leg moves and bends, because the muscles atrophy after the amputation, and some of them have a different shape due to the injury. It often happens that the girl’s brain sends false signals : for example, pain in the knee, which is not there. We scratched it, laughed and everything passed,” says Nazar. Balance exercise for Marina He also notes that the little patient is very emotional. During classes, Marina can be involved in a game, laugh, walk on a prosthesis. But some trifle or change of mood can cause tears, and then the lesson has to be stopped. Nazar notes that there are many factors that may cause the patient not to come. “She is very afraid of anxiety. Or if someone mentions an explosion somewhere, she immediately starts hysteria. In general, we should practice 3 times a day, but mostly it turns out to be two,” says the doctor. He notes that it is very important to find an approach to each child, because a commanding tone does not work with them. For example, almost the entire team motivated Marina to go for a walk. “They invented why it was necessary to go so far: some fantastic excuses. So if the whole of “Okhmatdit” wants to, and the family is like: “Oh, why does she have to go so far?” Marina will hear this and will not make it,” says the physical therapist. Training within the walls of the clinic Personal prosthesis A month after Kesha, Marina was made a personal prosthesis – permanent and comfortable. She named him Kesha 2.0. Prosthetist Oleksandr Stetsenko said that a silicone composition was used for the girl’s prosthesis, also called a vacuum liner. It is only gaining momentum in Ukraine, but, unlike its predecessors, it holds the prosthesis better and is more firmly fixed on the stump, because it does not require additional bandaging. “Instead, it requires “stretching”, that is, pulling the limb into a vacuum attachment. The prosthesis has a special valve that expels air and is held according to the principle of a suction cup. Modern prostheses have a modular structure, like Lego constructors. So the foot and leg are assembled separately, connecting adapters and receiving sleeve. Such prostheses are easy both in terms of operation and renewal,” explains the specialist. Due to active growth, the girl and her aunt visit a prosthetist every 3 weeks: he “adjusts” the prosthesis to the child’s needs. Because when Marina grows even a little, her leg becomes shorter compared to a healthy one. The girl leans to the other side, and this can cause scoliosis. Marina is learning to climb the stairs Oleksandr Stetsenko says that in 2-3 weeks, Marina’s prosthesis will be cosmetically “closed”. It will look more like a leg. However, at the top, where the sleeve fits over the stump, the prosthesis will appear wider than the healthy limb. According to his estimates, the girl will have to replace the prosthesis in 3-4 years. In particular, the knee joint and the foot. Some components wear out, some may still serve. “Marinka has very good potential. I think she will be able to walk freely very soon,” he says. Psychologist Tetyana confirms: the girl psychologically accepted her prosthesis, because she wears it and walks. Marina perceives her new condition “You can’t separate this child from society, so you have to help her accept herself as such and live with her specialness. We show Marina photos of models who go on the catwalk with prostheses. And we explain that they are cool and feel very comfortable That is, we switch the girl to motivation for the future. Because we cannot remove PTSD: we will not grow her a new leg,” says psychologist Tetyana. She optimistically adds about her hopes that in the spring Marina will walk on a prosthesis without a stroller. Viktoriya Andreeva, UP.Zhyttia Read also: “Sometimes it’s better to do an amputation and quickly get back on your feet”: stories of a traumatologist from a military hospital

[ad_2]

Original Source Link