Recently in Psychological Consequences of Burns: Acute Stage Category

August 9, 2011

A Survivor of Severe Burns Beats the Odds and Gets Back to Living

A recent article in the San Francisco Chronicle offered up the amazing story of Derek Thomas, a 19-year-old athlete who for the past year has endured indescribable pain during the process of healing from third-degree burns so severe that he was given a 1 percent chance of survival by doctors.

But he has made it through the ordeal, and is working not only on getting stronger but also on becoming just another person with a normal daily routine, which is a blessing too many of us take for granted.

One day in August 2010, Derek sat in an SUV that was returning him home to San Diego from athletic training in the mountains. As he dozed off, the driver swerved the SUV, and it skidded across lanes of traffic, rolled over, and grinded along on its side. It then burst into flames.

When Derek arrived by emergency jet at the Grossman Burn Center at West Hills Hospital & Medical Center, he had third-degree burns across more than 85 percent of his body.

The hospital doctors had seen terrible cases before: firefighters burned on the job, students burned in chemistry labs, toddlers scalded with boiling soup. But Derek's case was among the worst--his burns penetrated to the muscle, threatening to shut down his kidneys and liver. He also could have started bleeding uncontrollably at any time.

For the next four months, Derek lay in a medically-induced coma to spare him excruciating pain. Every inch of his burned skin had to be scraped off to protect him from infection. His body swelled to more than twice its normal size.

Derek's parents and two sisters sat in a small waiting room during each of the many surgeries. Doctors had to peel skin from the few areas where Derek wasn't burned (his inner thighs and lower abdomen), stretch the skin with a machine, and then graft it a little bit at a time onto Derek's body.

Every few days, doctors repeated the process, trying to fight against infection. Derek's fever often reached 105 degrees. He also took in 7,000 calories a day through a tube, which is how much his body needed just to stay alive. He still lost more than 60 pounds over the months in a coma.

But about four months after the accident, Derek started to emerge from the coma. He learned to swallow again, and to tighten his left hand. He also learned to speak using a special tube. And on December 11 he spoke his first three words: "Happy Birthday, Mom." His family was overjoyed.

After five months, Derek was no longer in critical condition. He was alert enough to ask about his girlfriend Amanda, who was also riding in the SUV when it crashed. His parents had to tell him that she had died, which caused Derek so much psychological stress that it threatened his physical recovery.

His family and mental-health specialists helped him with the grief, but even today, it hurts Derek too much to discuss Amanda, his girlfriend. But Derek often talks to her, and he talks to God. "I channel my bad thoughts toward Him. I look to Him," he said. "It's not easy, but I try."

For Derek, the hardest part is finally over. But he will face difficult issues for the rest of his life. Here is just one of them: Before the accident, Derek was a very good-looking boy, said his friends. Now, he will never look anything like he did before the accident--but his inner strength plus counseling will help him make peace with his new appearance.

In fact, Derek's recovery will last for the rest of his life. But Derek the survivor is an inspiration to others who are severely burned. As they endure the physical and emotional pain of their injuries, other burn survivors have Derek's outstanding example to look to when they need strength.

April 26, 2011

Burn Survivor Stories: Children Getting Another Chance at Life

This month, a young Iraqi boy disfigured by a car bomb in Iraq came to Long Island, NY for surgery that could give him a chance at a normal life. Zeenabdeen Hadi, now four years old, was barely a year old when the blast burned part of his face down to the bone.

The Global Medical Relief Fund helped bring the boy and his uncle to the United States. The two are staying at Ronald McDonald House in New Hyde Park, NY and are expected to be there for several months. In addition to reconstructive surgery, doctors want to close a wound in Zeenabdeen's forehead that could lead to a brain infection.

This is not the first time that young victims of severe burns in Iraq have been brought to the U.S. for life-altering and even life-saving treatment of injuries resulting from third-degree burns. In 2007, a six-year-old Iraqi boy, who was horribly scarred after he was set on fire by insurgents outside Baghdad, underwent surgery in Los Angeles to repair his badly burned face. The boy, known only as Youssif, will need almost a year and several more surgeries to recover. The American public responded generously to his needs, donating $300,000.

One month before they were brought to Los Angeles, Youssif's desperate father approached a CNN television crew in Iraq and said, "Look what these monsters did to my boy." Donations poured into the Sherman Oaks-based Children's Burn Foundation. The foundation covered visas, plane tickets and medical costs.

Dr. Richard Grossman detailed the plan: First, some scar tissue was removed from the forehead and nose area and replaced with temporary grafts.Two skin expanders were inserted too. The following week, a full skin graft was performed with skin from Youssif's abdomen. Later, the expanded skin replaced the surrounding scar tissue.

The surgeries can never completely undo the disfigurement, but Youssif's spirits were very high about the idea of living a normal life.

Here's a similar story: In 2010, after a year in the U.S. where he underwent five surgeries to treat severe burns, an Iraqi boy landed at the Baghdad airport to reunite with his family. 13-year-old Mohammed wore a Detroit Tigers baseball cap and a T-shirt reading "Property of Michigan State" -- the university where his surgery was performed.

Caught in a house fire started by rebels when he was only two years old, Mohammed was severely scarred. Then three years ago, his father was gunned down by insurgents for working as translator for U.S. troops. When his uncle went to the morgue to claim the body, he too was killed by militants, who warned Mohammed's mother they would kill her and her children if she ever contacted the U.S. military.

Instead, Mohammed went on his own to an army checkpoint outside Ramadi in November 2008 and asked a Michigan Army National Guard physician assistant named Howell to save him and take him to America.

It took Howell six months to get permission, but he managed to get Mohammed to Michigan, find him a Muslim host family, and set up a foundation to pay for his operations.

Black, glossy hair now grows where only scar tissue was before. And Mohammed's left hand and wrist -- deformed in the fire -- now can field baseballs. He gained 26 pounds and grew 3.5 inches during his time in America -- and he now speaks English with an American accent.

Howell said they are hoping to find a way to someday get Mohammed back to the U.S. for college, hopefully at Michigan State.

March 22, 2011

Survivor Story: Face Transplant Gives Victim of Severe Burns Another Chance

The Associated Press reported today that a Texas construction worker, whose face was completely disfigured by third-degree burns suffered when he fell into an electrical power line, successfully underwent the nation's first full face transplant in a Boston hospital last week.

Dallas Wiens, 25, received a new nose, lips, skin, muscle and nerves from a recently-deceased person. The operation was paid for by the United States armed forces, which is trying to learn more about how to help soldiers who suffer disfiguring facial wounds.

In March 2010, doctors in Spain performed the first full face transplant in the world on a farmer who was accidentally shot in the face, and could not breathe or eat on his own.

Wiens will not resemble what he used to look like, nor will he resemble the unidentified deceased donor. The result will be something in between, said Dr. Bohdan Pomahac, a plastic surgeon who led a team of more than 30 doctors, nurses and other staff at Brigham and Women's Hospital in the 15-hour operation last week. As of today, Wiens was listed in good condition, and has even spoken to family members on the telephone already.

Wiens' face was completely burned away after he came in contact with a power line while painting a church in November 2008. The transplant could not restore his sight, and some nerves were so damaged that he will probably have only partial sensation on the left side of his face and head.

Wiens' grandfather said that "he could have chosen to get bitter, or he could have chosen to get better. His choice was to get better, and thank God that today he is."

In fact, Wiens stayed motivated by the thought of being able to smile again, and to feel kisses on his face from his almost-four-year-old daughter. Wiens added that he also wanted the transplant because it gives hope to extremely disfigured people, rather than having to "look in the mirror and hate what they see," he said. Wiens also hopes to become an advocate for facial donations, and he publicly thanked the donor family for their selflessness

The healing process is not even close to being over, however. Wiens will have to take medication forever to prevent rejection of the tissue that makes up his new face. He did not have insurance when he was injured, but Medicaid paid for the several surgeries before this one. Medicare will cover him from now on, under its disability rules.

To see several videos of Wiens all throughout his ordeal, right up to the present, click here.

March 15, 2011

Inspiration and Hope Comes from a Victim of Severe Burns

From a story that makes most good people wonder why there is such evil in the world comes a lesson that anyone who is burned, injured, or otherwise ill can look to as hope for themselves.

In South Florida back in February, a 10-year-old boy named Victor was deliberately doused with chemicals by his adoptive father and left to die. Fortunately, the boy was spotted in the front seat of his father's pickup truck by a passerby, who called police. Victor had third-degree burns from the chemicals, and it did not seem likely that he would live.

He spent weeks at Jackson Memorial Hospital in Miami, at first barely conscious but over time responding to treatments and making progress. Almost as important, his mental state was aided by the bonds he made with other patients--and in return, those bonds also aided the psyche of each patient who interacted with Victor while he was in the hospital.

"The boy's about God. The first thing he told me is, 'God gave me another chance to live,'" a patient who was in the hospital room a few doors down from Victor told a WSVN television crew. "He also asked me, 'Why did God put us in this position?' I told him, 'It's not God. It's some people who do evil things.' Then victor asked, 'Why do people do evil things?' I said, 'I don't have the answer to that, but everything that you're going through, you have to pray.' And then, the next day, he came up to me and said, 'I prayed,' and I said, 'Just keep praying.'"

The patient says that he and Victor became friends quickly, in part by doing card tricks together. Victor also asked the man if he played football. "I said, 'Yeah, I used to play football in college.' He replied, 'You're a big guy.' And then, one of the nurses came by and said, 'You could be Victor's bodyguard.'" This made Victor smile.

Many in South Florida have been praying for Victor's recovery, and the video that WSVN obtained shows a small glimpse into his life as he recovers from the abuse he suffered. In the cell-phone video shot by another patient, Victor can be seen rolling on a skateboard down a hallway in the hospital. Victor is trying to make friends and find normalcy in the midst of the continuing medical treatment and other chaos in his life, now that he is out of the hospital.

But Victor's positive spirit has helped not just him, but those around him. "I think that God put me in the hospital for a reason to show me that somebody else could have something worse than you in your life," said the patient who befriended Victor. "I think the abuse was horrible because he's so innocent. Why would somebody do something to this young boy that is so loving? All Victor did was make me smile."

To read more about this story, and to see the video of Victor, click here.

April 20, 2010

Psychological Consequences of Burns: Acute Stage

Acute stage:

This stage of recovery follows the resuscitative stage. In this stage the patient begins the healing process both physically and emotionally. Patients in this stage are still going through the painful procedures and treatments. They will start to be aware of the impact of the injury and how their injuries have changed their lives. Some have lost loved ones; some may have lost everything they have worked for.

Patients in this stage may experience sleep disturbance due to many factors: being in a hospital environmental with factors such as lights, staff awakening the patient for medication and to check vital signs. Anxiety and depression plays a major role in sleep disturbance. Nightmares, agitation and pain may also affect sleep. Acute stress disorder which occurs in the first month and post traumatic stress disorder which occurs after the first month manifest during this stage.

Psychological issues (pre-burn) such as depression may have an adverse effect on the outcome of the patient. These patients may stay in the hospital for a longer time and may have more severe psychological consequences after the injury.

Anxiety and depression counseling may be helpful to reassure the patient that after a trauma like this, it's not uncommon to experience these symptoms and that they may disappear on their own with time. Sometimes medication may be needed in addition to counseling.

Drugs, in the form of Opiates, may be used to treat pain. They can be either long acting or short acting. Long acting opiates are used for pain caused by the burn injury while short acting opiates are used for pain due to procedures performed such as wound care.

Non drug methods include hypnosis and cognitive behavioral therapy. A new technique called virtual reality can be helpful in burn patients, these patients often experience excruciating sensations of pain, and this will distract the attention of the patient from the painful procedures as a person can only focus on one stimulus at a time.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.