Friday, May 31, 2013

Thin Wire: Heroin Addiction

I'm pleased to host author Christine Lewry as she shares from her book that deals with her daughter's struggle with heroin.
Abridged extract from Thin Wire: A mother’s journey through her daughter’s heroin addiction.

Amber’s story: Heroin Withdrawal
Living with Dave, I’ve always had an easy supply of heroin. The thought of what a long, enforced withdrawal might be like flits across my mind. I dismiss it – I’ll be okay and we’ll soon be home. ‘Sleep as much as you can, it’ll help slow the cluck. The more you move around, the more it’ll hurt,’ he says.
The journey to the station doesn’t take long. The police van pulls up into an under-cover, concrete courtyard. A policewoman unlocks the barred door of the van and swings it open. We step down, straight into a frigid, stark cage.
‘Out you come,’ the custody sergeant says as he opens the door from inside the station. He points at me. ‘You first.’ I follow him to his desk. He has a two-page questionnaire to fill in about me. When he reaches the end he says, ‘Do you need to see the doctor?’
I lift my chin. My eyes settle on his face. ‘No. I’m not a drug addict.’
‘Okay,’ he marks it on the paperwork. ‘If you say so.’
In my cell there is no mattress or pillow, only a scratchy old blanket. I pick it up and shake out the dust. It smells of old men and greasy hair, like it’s never been washed. I lay the blanket on the wooden bench and use my coat to cover me.
The mental itch for heroin creeps over me. I close my eyes and try to sleep, turning on my left side and then my right. The fake-fur collar of my coat makes my nose itch so I push it away. I take off my shoes then decide my feet are cold, so I put them back on.
It’s been ages. I ring the bell on the wall of my cell. The empty echo of the policeman walking down the corridor gets closer. He pulls back the slat in the door.
‘What is it?’
‘Can I have a cup of tea?’
‘Only after you’ve been here an hour. I’ve got too much to do.’
‘Well, I’ve been here an hour.’
‘Fifteen minutes actually.’ The slat slams shut.
Fifteen minutes! He’s having a laugh! Panic rises up inside me. I must get a grip of myself, stop the uncontrollable shaking. The itch is getting stronger and I have no idea how long the police can keep me here.
Pacing up and down the small room, I notice the heavy door is scuffed excessively on the inside, as though most of the previous inmates have leant their weight against it and kicked it continuously. One of the walls is painted yellow, the colour of sick, and the other three are brick. The floor is cold concrete and there’s a stainless steel toilet in the corner that smells of bleach. I lie down, telling myself to relax and stay still.
A heavy key turns in the door and someone opens it. A cup of tea is placed inside. My hand shakes as I take a small sip from the white plastic cup. It squashes in and I think it’ll spill over the top. The tea is tepid, not hot, and tastes of metal like it’s come out of a machine, weak with no sugar.
I’ve been walking up and down the limited space in my cell for most of the day. The windowsill has hundreds of messages, names and poems scored into the wood. I read them all, running my fingers over the surface as if it’s Braille. Do I know any of the people who have been here before me? Are they addicts? Dave’s punters?
The pain in my arms and legs is excruciating; I can’t stand it any longer. I’m starving hungry yet sick to my stomach. Freezing cold and shivering, but when I touch my skin it’s burning and wet with sweat. I’d do anything now, anything to stop the unscratchable itch for heroin.
I ring the bell again. ‘I’d like to see the doctor.’
The policeman looks at his watch. ‘Sorry love, too late for the doctor to come out tonight. You’ll have to wait until the morning.’
‘But I can’t wait till then. Please.’ My mind is frantic, searching for some reason I could give him to make the doctor come out.
‘Did the custody sergeant offer you the doctor when he signed you in?’
‘Yes, but you don’t understand …’
‘Then you should have said “yes” when he asked you.’ He shut the slat.
I sit on the cold floor and rest my head between my knees, waiting to see whether I’ll puke. The blood in my ears is roaring. The ache of withdrawal has taken over. I’m exhausted, but my speeding brain prevents me from sleeping. The pain comes like a hard punch, as if I’m a boxer in the ring being beaten, but even a boxer gets a thirty-second break between rounds. I clench my fists and knead them hard into my guts as a wave of agony flows over me. The worst part is knowing that if I just had a little heroin all this pain would go away.

Good news is Christine's daughter beat her heroin addiction and has been clean for almost a decade.
Christine Lewry lives in Hampshire, UK with her husband and two youngest children. She worked in the defence industry as a finance director for twenty years before leaving to write full-time. Thin Wire is her first book. For more info:

Wednesday, May 29, 2013

Concierge Medicine

Personally, I didn't have a lot of strong feelings about concierge medicine until my personal physician decided to convert his practice to it.

I do have VERY strong feelings about Obama Care speaking as a pediatric ER nurse. I tend not to get political here but, regardless of how you feel about the law, healthcare is changing in the US and physicians moving to concierge medicine is just one of them.

In the current state, physicians are worried about the feasibility of making a profit and keeping their practice doors open. Reimbursement is low-- particularly from insurance companies-- Medicare and Medicaid are prime examples. A doctor can only care for so many patients. So when money is cut they are required to see more patients to earn the same amount of money.

After a while, it becomes impossible to make the bottom line and provide quality care.

Concierge medicine is where the patient pays the doctor a fee for access or increased access. In my case, this was in addition to what we would pay for our regular medical insurance. What was the physician going to charge in our case? $1,800 per person. Just to see him. That didn't cover other diagnostics like lab and x-ray and likely an office visit fee.

In a letter he sent out, he was decreasing his practice from 2800 people to 400. Where will those other 2400 people go?

Realistically, the average American family is not going to be able to pay this type of money on top of their insurance premiums. What I see developing is a two-tiered medical system. A completely privatized, fee for service side and the government side-- unless changes are made to the current law.

What do you think of concierge medicine? Would you pay extra to see your current physician?

Monday, May 27, 2013

Researching a Doctor's Training

Sometimes the challenge of writing a medical scene is knowing how young or old to make your physician based on their medical training. Some specialties require many years of training and others not so much (as far as specialized fellowships, etc.)

In my current novel, I needed to figure out what type of training my physician needed to go through. He's a pediatric transplant surgeon.

Here were the basics.

College: Four years
Medical School: Four Years
Surgical Residency: Four-Six Years
Cardiothoracic Sugery Fellowship: Two Years
Pediatric Cardiothoracic Fellowhsip: One-Two Years

Why the varied length? One interesting thing I read was that surgeons were required to have a certain number of particular procedures before graduating which makes perfect sense. We can't guarantee when certain types of patients will come in but we'd definitely want a doctor to have a certain number of cases under his belt before hanging a sign on his door.

It was also interesting to learn that some hospitals are going to combined surgical residencies where the specialty they want to do is combined with their surgical residency. So, perhaps the training could be complete in six years versus the nine years above (for the cardiothoracic portion.) 

It's probably easier now than ever before to ferret this out on the internet because doctors generally list their training, where they went and how long it took.

The easiest way to approach this is to Google search the type of physician your character is. For instance, in my case, I did "pediatric heart transplant surgeon". Then looked up a couple of profiles to see what type of training they'd been through.

This could be done with any specialty.

What kind of doctors have you written about?

Sunday, May 26, 2013

Up and Coming

Hello Redwood's Fans!

How has your week been?

Mine? Crazy busy. I'm in the third round of editing the last book in the Bloodline Trilogy, Peril. Pretty soon my baby will be ready for the world-- October 1st. It's always a nerve racking time as other authors are reviewing the novel for possible endorsement and you always want to impress them.

I'm also doing a huge Facebook Party launching my new Facebook Author page. Hope you'll stop by and check it out.

For you this week:

Monday: Researching a physician's training.

Wednesday: Concierge Medicine-- just what is it?

Friday: Christine Lewry returns to share a personal tale of her daughter's heroin addiction.

Hope you guys have a GREAT week.


Friday, May 24, 2013

Author Question: Exsanguination

Heather S. asks:

I came across your website while browsing for some information for a project. I am currently a nursing student and am doing a project on arterial bleeding. I am trying to find specific exsanguination times for the major artieries in the body. I have had no luck after searching online and multiple medical books. I just need a simple answer, i.e carotid artery 2-20 minutes. I have a few times, however, I feel that they are inaccurate. Please see below:

I-stock Photo
Carotid - 2-20 min
Brachial - 5-60 min
Femoral - 5-60 min
Aorta - 1-2 min
Popliteal - 5-60 min

I would greatly appreciate your help as it seems you are extremely interested in medicine. This might go on to help your other readers as I came across the questions dated January 12, 2012 where you discuss exsanguination. Thank you!

Jordyn Says:
Your question is not an easy one.

Any major artery (and the ones listed are major) that is completely severed will likely lead to the patient's death in less than five minutes. I saw a demonstration once where a physician simulated this happening.

He took a 2 Liter bottle (an empty pop bottle) and filled it with water. He drilled a hole into it (to simulate arterial severing) and then squeezed it at a regular rate to simulate the heart pumping. That bottle was empty in a matter of three minutes. Yes, we timed it.He said the diameter of the hole he drilled equated to the popliteal artery which is behind your knee.

However, the injury may not be a complete separation which is why you have the varying time lengths. Of course, if the person gets some type of medical treatment (like a pressure dressing that stems the bleeding) they may last a lot longer as well.

I know this answer isn't a clear cut answer but in medicine . . . they usually aren't.

Heather's Follow-up Question:

Could I say the smallest time is the fastest time to bleed out without medical attention and the longest time is a small bleed from an artery?

Jordyn Says: Yes, this is reasonable. 

Wednesday, May 22, 2013

Injured Characters: Start From "The End"

I just returned from teaching at Colorado Christian Writers Conference up in Estes Park, CO. Not only is it a beautiful spot-- being up in the mountains is stunning!-- but it's also a conference close to my heart. It was this conference in 2006 where I became firm in my decision to seek publication and so much has happened in the last seven years. If you haven't considered this conference-- do so! You get FOUR appointments. It's the only conference I know that guarantees that.

I Stock Photo
While there, I taught my Medical Pitfalls lecture for authors where I teach you to maim, injure and kill your FICTIONAL characters the right way. Several people made appointments with me just to figure out the right way to do it.

It was awesome.

After doing this service for writers for almost three years, I've noticed a definite trend. People have an idea of how they want to injure the character but don't necessarily like the end result. For instance, they'll give me an injury and then want the character to be hospitalized for several days. However, often times the injury is not severe enough for the character to even be in the hospital. Sad part of today's medical enviroment is you have to be pretty sick to gain admission.

Other issue is the opposite. The author has given the character a devastating injury but wants them to be semi-fuctional in the proceeding days. Well, maybe in a fantasy world where they can heal themselves would this work but otherwise . . . no.

My suggestion for all writers/authors is to think of your character's end point by asking yourself a couple of questions.

1. Why am I injuring/killing this character?
2. Do I want them to be functioning in the next couple of scenes/days/weeks/months? If so, how well? Fully? Partially? With great incapacitation?
3. Do I want my character to be in the hospital? If so, for how long? Keep in mind the longer a person is in the hospital the more issues physically they will have-- particularly with muscle atrophy, loss of strength, and potential for infection. The longer they are in the hospital the more likely they will need rehab.
4. Do I want this character's injury to have surgery?

Let me give an example of how I as a medical consultant for writers can help knowing the end point first.

Example A:

Author: I want a pediatric patient to have what the parents think is a fracture that sends them to the ER but I don't want it to be a big deal. I'm using the ER visit as a moment for them to come together as parents in concern for their child to maybe remember some of the reasons why they came together. However, I don't want the child to really have injury. Be fine. Able to play and be normal by the end of the ER visit.

Impossible? Why, no, actually.

Injury: A nursemaid's elbow. A nursemaid's elbow is a dislocation at the elbow caused by pulling or tugging of a child's arm-- say to prevent them from darting into traffic. It is a VERY common injury among toddlers and parents feel very guilty when they bring them to the ER because they think they've broken their child's arm. Not even an x-ray is required for diagnoses. A simple maneuver will pop the arm back into place and the child is happy and on their way with no restrictions. Back to normal life.

However, let's take the other end.

Example B:

Author: I want a child to be injured in a fall. I want it to require surgery. Maybe a few days in the hospital.

Injury: Hmm... ideas? I have the perfect one. A supracondylar fracture. This fracture is just above the elbow. Any fall-- generally onto the elbow can cause it. Other than a Type I-- they generally require surgery to fix. Give a surgical complication-- and your child character is in the hospital.

See how knowing the end point is helpful? So-- consider this when you consult a medical expert for your writing. It will also open up possibilities you didn't think of.

Monday, May 20, 2013

Author Question: Ankle Injury

Elaine Asks:

I have a medical question on my WIP that I was wondering if you can help me with. I have a 72-year-old woman who falls and hurts her ankle. It swells and throbs and her family brings her to the ER. From my research I gather that she can have a sprain as opposed to a break. I need her to be somewhat mobile because she needs to rush to a caving site where her son is trapped. Is it feasible to think that she can use crutches, can drive, pushing aside that she'll pay a price afterwards? Any suggestions?

Jordyn Says:

Ankles are 95% of the time sprained and not broken. So yes, this is feasible. If you want her driving-- I'd probably injure the left foot so there wouldn't be major difficulties with driving. Crutches/air splint/or ace wrap for 7-10 days and then re-evaluate after that if her pain is not improved.
Elaine Stock is a former RWA member and has presented several writing workshops. Presently involved in ACFW, she was a 2011 semi-finalist in the prestigious Genesis Contest in the contemporary fiction division. She is also active on several social networking groups. Her first short story was published on Christian Fiction Online Magazine. New to the blogging world, Elaine started a blog this past April, Everyone’s Story. Since then, the blog has been graced by an awesome international viewership that totally pings her heart. Everyone’s Story features weekly interviews and reflections from published authors, unpublished writers…and just about anyone who wants to share a motivating story with others that may lift their spirit. She has also been the guest of several other blogs, helping to further grow her presence on-line.
She and her husband make their home in an 1851 Rutland Railroad Station they painfully but lovingly restored.

Sunday, May 19, 2013


Hello Redwood's Fans!

How has everyone's week gone?

Mine . . . amazing.

I got to spend the week up in Estes Park and it was GORGEOUS except for one brief sleet storm. You know it is Colorado and for some reason this year the state does not want to give up winter.

I was part of the faculty for the Colorado Christian Writers Conference. If you want a smaller, amazing conference this is one to book for next year. I got to take a suspense class from Bill Myers and he was awesome. Hope you'll check out his books sometime. 

The WINNER of Lynette Eason's latest novel When A Secret Kills is Kristie Porter!

Congratulations, Kristie, and I'll be e-mailing you shortly on how to claim your prize.

A big THANK YOU to Lynette for coming and visiting Redwood's. It's always an honor to have you.

What amazing thing happened to you this week?


Friday, May 17, 2013

Author Question: I Need a Medical Condition!

I often get questions from authors who just need a medical condition for their characters. Here are a couple of options for Cheryl's scenario. Can you think of any more options?
Problem: 18y/o with congenital heart defect whose condition has been controlled by medication. Develops sudden need for surgery. What kind of surgery? How long? Recovery Process?
Cheryl: I think there are a couple of ways you could approach this scenario.
Option One: Endocarditis
Is he an IV drug user? If so—you could give him a viral infection of the heart itself called endocarditis versus a congenitial heart defect.
Here are a couple of links that would go over symptoms, diagnosis, and treatment. It might be easier to deal with an illness in your writing versus a heart surgery. He’d still need to be hospitalized and the course can run the gamut from mild to serious.

Option Two: Atrial Septal Defect
This is an actual congentital heart defect. You heart is split in half from top to bottom. The top two chambers are referred to as the atria. An atrial septal defect is when there is a hole between these two chambers of the heart. As a person grows older, the heart may begin to decompensate due to this defect.
Here are a couple of links that talk about ASD repair in an older adolescent/adult.

Option Three: Congestive Heart Failure
Many of these congenital heart defects present with signs/symptoms of congestive heart failure. Signs are things we can measure. How fast the heart rate is. What is the patient’s blood pressure. Symptoms are things the patient must tell us. “I feel nauseated, lightheaded. I have pain.”

Medication to Treat Congestive Heart Failure
If his heart condition is known and he’s on medication—I’m also including links of treatment for CHF. They may have also been mentioned in the links above. It’s usually medication to get the heart to contract stronger and medication to help pull fluid off the body. Two examples of this type of medication would be digoxin and lasix.

Wednesday, May 15, 2013

Past, Present and Future with Lynette Eason

I’m so honored to get to one—participate in this special suspense author blog hop with such amazing writers and two—get to interview Lynette Eason who is a mentor and friend. I wish we lived in the same town and could sit down and have tea together (though I would buy her whatever drink she wanted!) so we could chat about the writing life.

In lieu of that—this interview will have to suffice but I’m so excited to pick her brain!

Lynette has graciously offered to give away one signed copy of When a Secret Kills. Simply leave a comment on this post that includes your e-mail address. US residents only. Drawing closes Saturday, May 18th and midnight and winner announced here at Redwood's on Sunday, May 17th!

PLUS: There is going to be one MEGA prize give away of several authors participating in this blog hop. I know both Proof and Poison will be given away. Simply formulate a tweet using the hashtag #ILoveSuspense to be entered. The more you tweet-- the more often you're entered. I've made it easy for you to do below:

Inspirational Suspense Author Blog Hop. Tons of prizes. Lots of GREAT interviews #ILoveSuspense. RT to enter! Click to Tweet.

My interview is over at Connie Man's blog so I hope you'll check it out and enter over there, too. 

If this is your first time visiting Redwood’s Medical Edge—it’s a medical blog for writers to aid them in writing medically accurate fiction. And I love helping authors injure, maim, and kill fictional characters the proper way. I field medical questions and blog on medical topics with a writing focus.

Welcome, Lynette! I’m so honored to have you here at Redwood’s!

Lynette: Thank you, Jordyn! I’m so happy to be here. Thanks for having me. And I would LOVE to live near each other. Think of all the trouble we would get into!! LOL.

Jordyn: It's probably good we don't live close for just that reason-- all the trouble we would get into. I thought we’d focus on the past, present and future for our questions.

What’s been your favorite novel that you’ve published? What are you working on now? What’s something you dream to write about that might be outside your genre?

Lynette: My favorite novel would have to be Don’t Look Back simply because it was an easy write. I literally wrote the thing in about eight weeks and it only need a few edits. Right now, I’m working on book #2 in the Hidden Identity series. Book #1 is No One to Trust and set to release in January 2014. Book #2 doesn’t have a title yet.

Jordyn: I have to say Don't Look Back was a favorite of mine as well-- plus we have the whole best-friends-may-not-fare-so-well thing in common, too. 

I’m a big Castle fan and I love his card games where he invites fellow authors to play along. If you could have such a poker night, what three authors would you invite and why? One must be deceased. One alive. And the other perhaps a new author you’re liking but may off the radar.

Lynette: Well, you KNOW I’d invite you for my new author! LOL. Deceased? Hm…Mark Twain because he would provide the comic relief we all need. And Terri Blackstock simply because I love her books and bet she’s an awesome brainstormer.

Jordyn: Those are great picks and not just because I'm on the list but I am so glad I'd get an invite. It would be like being a rookie at the Super Bowl. 

Publishing is going through lots of rapid changes. What’s one thing about traditional publishing you’d like to stay the same, one thing you’d like to change presently and one prediction you have about the course of publishing in the future?

Lynette: Oh goodness, yes, changes all around us, aren’t there? I like traditional publishing because all I have to do is write the story and do some marketing. I would like that to stay the same. One thing I’d like to change is  the amount of marketing the publisher expects the author to do.  But that will never change, lol. And one thing I predict is that e-books and self publishing will continue to rise.

Jordyn: Now, this is a little off topic but I’m curious to know if you’d ever consider self publishing?

Lynette: I have considered it. I may even do it one day. But I like traditional publishing too much to mess with a good thing while I’ve got it. Besides, I think self-publishing might be way more work than I want to do right now. That is if I want to do it right—and I do. There is a lot of BAD self-pubbed stuff out there. I don’t want to be part of that.

Jordyn: I agree wholeheartedly. Now for some quirky—One thing you had to give up. One thing you’re currently loving. One dream you have that’s not yet fulfilled. 

I had to give up scrapbooking – simply no time.
Currently loving – life.
One dream that’s not yet fulfilled – hitting the NYT’s bestseller list.

Jordyn: Lynette—thanks so much for joining me today and I have no doubt I'll see your name on the NYT's bestseller list someday soon. Truly, my joy to have you. Many continued blessing on your writing journey!

Lynette: Thanks so much!

Next on your blog hop SUSPENSE tour is Lynette! Head on over to her site. She's interviewing author Karen Barnett. Happy Hopping!


Lynette Eason grew up in Greenville, SC. Her home church, Northgate Baptist, had a tremendous influence on her during her early years. She credits dedicated Sunday School teachers and Christian parents for her acceptance of Christ at the tender age of eight. Even as a young girl, she knew she wanted her life to reflect the love of Jesus Christ.

Some of Lynette's favorite authors who influenced her writing include, Brandilyn Collins, Dee Henderson, Shirlee McCoy, Karen Kingsbury, Robert Liparulo, Terri Blackstock and Deborah Raney. Lynette loves to ice skate, go bowling, walk on the beach, visit the mountains of Asheville, NC, watch American Idol, Law and Order, A & E channel, and surf the web. She is often found online and loves to talk writing with anyone who will listen. She gives God the glory for her giving her the talent and desire to spin stories that bring readers to the edge of their seat, but most importantly, to the throne of Christ.

Monday, May 13, 2013

Author Question: Panic Attacks

Becky asks:

My MC's ex-boyfriend to come back with not-so-good-but-not-outright-
bad intentions to try to force her to take him back. He's been leading a high-stress life-style (Dental School, top of his class, used to be an cyclist but stopped exercising, angry about no perfect job post school, turned-mean, etc.) and then she leaves him because he's so awful and after almost 9 years of waiting to get married and live happily ever after, he tell her he doesn't know if he really wants to be with her. Okay. That's the back story on him.

Basically, he shows up in the throws of a nervous breakdown/panic attack that looks a lot like a heart attack. And that's my question: Can a panic attack have similar/same symptoms of a heart attack? I want him to be hospitalized at least over night, so it needs to be bad enough to have to be monitored for 24+ hours, but not bad enough to kill him or leave him there long-term.

Jordyn Says:

As far as the scene, it can work medically. I think instead of a panic attack-- you should go with an arrhythmia called SVT (supraventricular tachycardia.) I've included some links for you. At its simplest, SVT is a super fast heart beat. For an adult-- it would be a sustained, unwavering heartbeat over 180 beats/min.

The reason to change it to this type of medical condition is if the medical team determines he had a panic attack-- he will not be observed overnight. However, if he had an arrhythmia for which he was hemodynamically unstable (low blood pressure)-- then observing overnight is warranted-- particularly if they converted him out and he went back into it.

When you have SVT-- it can feel like you're having a heart attack. Many of the symptoms can be the same. Chest pain. Pain down the left arm. Jaw pain. Difficulty breathing. Low blood pressure. Sweating (diaphoresis). Pale, cool, clammy skin.

I don't know if this is the direction you want to go but would be my suggestion.

Sunday, May 12, 2013

Up and Coming

Happy Mother's Day to my mom and ALL the great moms I know. Hope you enjoy your day.

WOW! What a great couple of weeks it's been here at Redwood's. Jocelyn Green's post were AMAZING and I thank her from the bottom of my heart for all her great posts, great guest hosting and hard work.

The WINNER of Jocelyn's book Widow of Gettysburg is Marissa!! I'll be e-mailing you to let you know how to claim your prize.


And-- we have another great week coming up! I'm so excited!!

For you this week:

Monday: Author Question. You know these are my favorite to answer. This one deals with panic attacks. I offer the author an alternative medical condition. Can you guess what it might be?

Wednesday: Lynette Eason (yes, you heard me!!) is stopping by for a very special author interview. I'm participating in a special Suspense Author Blog Hop and there're going to be TONS of giveaways so I hope you'll stop by and check out all the interviews. I'll be over at Connie Mann's blog and I'm so excited to meet her and her readers.

Friday: I Need a Medical Condition! And I give this author some ideas. Another one of my favorite things to do.


I'll also be up at Colorado Christian Writers Conference this week May 15-18th serving as faculty so if you're there be sure to come up and say "hi". It was one of my first conferences and I LOVE it (four appointments for attendees!) and am so excited to be serving there this year.

AND-- on May 19th I'll be participating in Douglas County Libraries Author Showcase! Starts at 2:00pm at Parker Library in Parker, CO. Would love to see some of you there. Registration is required.

Hope your week is as awesome as mine will be!

I KNOW-- too many exclamation points.

Friday, May 10, 2013

Phantom Limb Pain: 2/2

Today, author and Christy Award nominee (two nominations!) Jocelyn Green concludes her two-part series on phantom limb pain. You can find Part I here

As an added bonus, Jocelyn has graciously offered to give away a personalized copy of her latest novel, Widow of Gettysburg, to one commentor. To enter, leave a comment on any of her posts WITH your e-mail address. Must live in the USA. Winner drawn midnight, Saturday, May 11th, 2013 and announced here at Redwood's on May 12th, 2013.

Jocelyn has also graciously said she'll send you a signed bookplate if you have any of her novels and would like one. Again, MUST have your e-mail. 

You can view Jocelyn's previous posts at Redwood's here and here.

Welcome back, Jocelyn!

What We Know Today

The study of PLP continues with today’s generation of amputee veterans. Most contemporary studies confirm what Mitchell found, but add to it some new information. Most recent studies report PLP at rates of 50% to 80%. A few of these are in constant pain, but for most, the episodes can last a few seconds or one to two hours.

Since the beginning of the conflicts in Iraq and Afghanistan more than 1000 amputees have been treated at Walter Reed Army Medical Center in Washington, DC. Almost all experience PLP, either within the first 24 hours of amputation, or within two weeks. The following insight comes from an article in a 2010 issue of The Neurologist:

“As part of routine treatment efforts, the patients are asked to describe their experience with phantom sensation and phantom pain. There have been a plethora of responses regarding the onset, duration, description, and location of phantom sensations and phantom pains from those queried. Furthermore, some explain they have volitional control over their phantom, and can move their phantom at will, while others report their phantoms being fixed in a specific position. Some even report the inability to make movements with the phantom, despite the presence of a strong sensation or pain emanating from their residual limb. For example, one service member reported that his phantom hand was in a distinct position: he felt he was pulling the trigger on his rifle with his index finger, and was unable to move his hand to a different position. He also felt cramping pains in his hand muscles. Another service member, a bilateral, above knee amputee, described the feeling of heavy legs, asserting that the feeling was similar to weights attached to his calf muscles. He also described that it felt as though his combat boots were on too tightly.”

There are multiple theories as to the cause of PLP, all of which can be read in this online article []. 

The most successful treatments have been with opioids and mirror therapy, the latter considered the most promising treatment plan.

In this treatment, the patient views the reflection of their intact limb moving in a mirror placed between the arms or legs while simultaneously moving the phantom hand or foot in a manner similar to what they are observing. The virtual limb in the mirror appears to be the missing limb.

Patients have reported a relief of cramping and “frozen limb” phantom pains as a result of even one session with the mirror. In one study in which patients used mirror therapy for 15 minutes each weekday for four weeks, significant decreases in pain were reported. More about mirror therapy can also be found in the online article hyperlinked above.

For further reading:

Mitchell, Silas Weir. The Case of George Dedlow. (fictional account of quad amputee) New York: The Century Co., 1900. Read it online at Google Books here, and begin on page 115.
Gunshot Wounds and other Injuries of Nerves. Philadelphia: J.B. Lippincott, & Co., 1864. Read it online at Google Books here:

 A former military wife, Jocelyn Green authored, along with contributing writers, the award-winning Faith Deployed: Daily Encouragement for Military Wives and Faith Deployed . . . Again. Jocelyn also co-authored Stories of Faith and Couragefrom the Home Front, which inspired her first novel: Wedded to War. She loves Mexican food, Broadway musicals, Toblerone chocolate bars, the color red, and reading on her patio. Jocelyn lives with her husband Rob and two small children in Cedar Falls, Iowa.