ARTICLE - MIRRORS AND LIMBS

MIRRORS HELP HAITIANS MOVE THEIR MISSING LIMB
(CNN - AC360°) - By - Sarah Ryley

Parts of Rose Monsillac's body seem locked into place, even though she's not paralyzed.

On January 12th, the earth convulsed beneath her and her neighbors homes in Carrefour, Haiti, burying her beneath both. Her leg and finger were crushed, her head gashed open, and she anguished in the hospital hallway for five days before it was her turn to see the doctor.

Now Monsillac, 56, lives inside a tent in the Adventist Hospital's front yard, her muscles rock-hard from being cot-ridden for six months with an external fixator bolted to her leg in three places. More perplexing, her right ring finger has become the source of constant pain even though it no longer exists. It was amputated a week after the earthquake.

"It feels like the bone is empty,” she told Dr. Eric Altschuler, a neuroscientist from New Jersey Medical School, as she struggled to make a fist. “I can’t even wash my face with this hand anymore.”

Dr. Altschuler flew into Haiti on Monday with the group Unified for Global Healing, towing 200 one-pound mirrors that cost $16 each, to demonstrate how the low-tech equipment could be used to relieve what’s known as “phantom limb pain.”

Thousands of Haitians had amputations in the weeks following the earthquake. Studies over the past 15 years indicate that around 80 percent of them could be feeling painful sensations like itching, tingling, cramping or burning where their limbs used to be.Pharmaceuticals often do little to relieve the pain, and are impractical in a disaster-ravaged country where so many people live on zero dollars per day.

“At the moment, we’re just trying to explain why they’re getting the pain,” said Ruth Cross, a physiotherapist with Christian Blind Mission (CBM), an international non-profit working with disabled Haitians.

Veterans at Walter Reed Army Medical Center use the mirror therapy with a high success rate, so Dr. Altschuler thought, why not Haitians?

Instantly, when Monsillac watched the reflection of her “good hand” opening and closing in a mirror balanced in front of her “bad hand,” she felt like that stubborn finger had finally clasped shut.

Stunned, she did it over and over again, clenching her fist in relief. “It feels like the pain has finally gone away,” she said.

Neuroscientists like Dr. Altschuler and Dr. V.S. Ramachandrin are still studying what exactly causes “phantom pain.” But they think it arises when the brain receives no response to movement commands sent to position sensors in the missing limb.

Dr. Altschuler explained that the therapy works because “vision is more powerful than the proprioception, or the position sense of our body. It’s not surprising, in a certain sense- half the primate brain, whether in humans or monkeys, is devoted to vision.”

He said the therapy works really well for people with cramping or spasm sensations, but for unknown reasons isn’t very helpful for people with burning sensations.

Irese Dossa, an octogenarian whose left leg was crushed by her house, then amputated, said she prays to God when it cramps up, knowing there was nothing she could do physically to alleviate the pain.

Pumping her hands in cheer, she instantly recognized her lost limb when she saw it in the mirror for the first time on Tuesday.

“It feels like both of my children are together again,” said Dossa. “If I have a cramp in my missing leg, I’ll rock my good leg back and forth.”

Frustrated at having few other solutions to amputees’ complaints about phantom pain, over the coming days therapists in Haiti with two major disabled advocacy organizations, CBM and Doctors Without Borders, will learn mirror therapy from Unified for Global Healing volunteers.

“This will enable the therapy to continue when we leave,” said Dr. Altschuler.