When you first visit your doctor to discuss TMR, you should be prepared with the following information:
Details Regarding Your Amputation
If the doctor is unfamiliar with your case, you should be prepared to describe the circumstances of your amputation: When did it occur? Why was the amputation performed?
Your History With Post-Amputation Nerve Pain
If you are exploring TMR for pain relief, you should be prepared to describe your pain in detail: Is it phantom pain or residual limb (stump) pain? How severe is the pain? How often does it occur?
How You’ve Managed Your Pain to Date
You should be prepared to talk about all medications and treatments you’ve tried and how effective they were in alleviating your pain. Your doctor will want to understand the impact your pain has had on your life. Is your pain limiting use of your prosthetic? Is it impacting your relationships, your physical activity or your ability to work?
Your Goals for Managing Your Pain
Your doctor will want to understand your personal goals for considering TMR for pain. Would you like to be able to use your prosthetic? Get off medications? Resume an active lifestyle? Return to work?
The Questions Below May Help Guide Your Conversation With Your Doctor.
Based on my history and goals, am I a good candidate for TMR?
While many people do benefit from TMR for pain, not everyone will achieve compete pain relief. After considering your specific situation, your doctor will be able to determine if TMR is right for you.
Has TMR been effective in relieving your patients’ post-amputation pain? How long do your patients say it takes to feel nerve pain relief?
Your doctor has firsthand experience following patients who have received TMR and its effectiveness for pain.
How long have you been performing TMR surgery?
As a specialized surgical technique, you’ll want to know whether your doctor has experience performing TMR.
What do you consider a successful TMR surgery to be?
Once you and your doctor have decided TMR is right for you, it’s appropriate to set expectations for a successful outcome based on your goals.
Answers to the following questions will depend on your particular case:
How long will the surgery last?
Where will my incision be?
Will I have to stay in the hospital?
What will you do for pain management following surgery?
How often will I need to see you following surgery?
When will I be able to put my prosthesis back on?
When can I return to work following surgery?
When can I start driving again?
When will I begin to feel relief from nerve pain and phantoms?
TMR is not a treatment option for patients with spinal cord injuries, brachial plexus injuries, or who are generally not healthy enough for surgery. The procedure does present typical risks of surgery. Patients may experience a temporary increase in pain as part of the nerve healing process. Your physician will help you determine whether TMR is right for you.
Gregory Dumanian, MD, is medical director of TMRnerve.com. He is a paid consultant of Checkpoint Surgical, Inc.