Skip to Content

An Unexpected Loss

Healing Through Rehabilitation and Virtual Reality


Author(s)

John M. Baratta
Department of Physical Medicine and Rehabilitation
University of North Carolina School of Medicine
john_baratta@med.unc.edu
Tracie M. Addy
Center for the Integration of Teaching, Learning and Scholarship
Lafayette College
addyt@lafayette.edu
Maura O. Stevenson
Department of Biological Sciences
Quinnipiac University
Maura.Stevenson@quinnipiac.edu

Abstract

This clinical case study follows the progress of a diabetic patient, “Joe,” who develops an infection and ultimately undergoes a lower extremity amputation. While recovering and undergoing rehabilitation in the months following the surgery, Joe experiences phantom pain in the area where he lost his limb and takes medication and participates in experimental virtual reality therapy to ease the symptoms. The story line provides opportunities to discuss the topics of inflammation, glucose regulation, diabetic neuropathy, and phantom pain syndrome. The case was developed for the second semester of an undergraduate anatomy and physiology course following units on the nervous, skeletal and immune systems. Prior to completing the case, students should be familiar with neural communication, pain perception, and the peripheral and central nervous systems. Students should also have a basic understanding of the inflammatory response. Implementation is flexible; the case may be guided by using the case study handout or by showing a set of video vignettes produced by the authors (or both).


Objectives

  • Explain the cardinal signs of inflammation and apply basic immunological principles to bone inflammation/infection.
  • Interpret basic laboratory blood test results as they relate to infection.
  • Apply basic principles of blood glucose regulation in diabetes mellitus to the patient’s signs, symptoms, and laboratory results.
  • Apply principles of diabetic neuropathy to the patient’s signs and symptoms.
  • Distinguish between phantom and residual pain, and identify treatments for phantom pain.

Keywords

Infection; inflammation; diabetes; amputation; phantom pain; virtual reality; clinical; residual limb pain; neuropathy; prosthesis; rehabilitation

Topical Areas

N/A

Educational Level

Undergraduate lower division, Undergraduate upper division

Format

PDF

Type / Methods

Interrupted

Language

English

Subject Headings

Medicine (General)  |   Physiology  |   Nursing  |  


Date Posted

03/24/2020

Teaching Notes

Case teaching notes are password-protected and access to them is limited to paid subscribed instructors. To become a paid subscriber, begin the process by registering.

Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

Answer Key

Answer keys for the cases in our collection are password-protected and access to them is limited to paid subscribed instructors. To become a paid subscriber, begin the process by registering.

Videos

The following video(s) are recommended for use in association with this case study.

  • An Unexpected Loss (Complete Video)
    This is the complete video that may be used to support the case study, “An Unexpected Loss.” It follows the progress of a diabetic patient, “Joe,” who develops an infection and ultimately undergoes a lower extremity amputation. Produced by Firefly Films. Running time: 11:27 min.
  • An Unexpected Loss (Part I)
    This is the first of four segments supporting the case study, “An Unexpected Loss.” Produced by Firefly Films. Running time: 3:24 min.
  • An Unexpected Loss (Part II)
    This is the second of four segments supporting the case study, “An Unexpected Loss.” Produced by Firefly Films. Running time: 2:46 min.
  • An Unexpected Loss (Part III)
    This is the third of four segments supporting the case study, “An Unexpected Loss.” Produced by Firefly Films. Running time: 3:24 min.
  • An Unexpected Loss (Part IV)
    This is the fourth of four segments supporting the case study, “An Unexpected Loss.” Produced by Firefly Films. Running time: 3:52 min.

Comments