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February 25, 2015
K8, Mind Over Matter
How Kate Jorgenson is doing since losing her left arm at the elbow a year and five months later
|Kate Jorgenson shows how she uses Mirror Box Therapy to keep her brain focused on her left hand |
|Tom Mercchant photo|
WESTBROOK, Minnesota (STPNS) -- westbrook — For most people, young and old, getting up in the morning, showering, shaving, brushing teeth, dressing and having breakfast are things we do without really giving much thought to it.
For Kate Jorgenson, that is not a really thoughtless procedure to go through. Since the accident, that happened in June of 2013, while driving a 4x4 side by side utility vehicle, life changed in a heartbeat for Kate.
After being stabilized at Westbrook Sanford Medical Center she was airlifted to the Twin Cities where surgeons worked tirelessly to reattach her arm. After a couple of weeks infection set in and the difficult decision was made to amputate the arm.
From that day forward Kate and her parents, Jim, Nikki, and her brother, Jack, have made many trips working to help Kate get a prosthetic arm to help her with those everyday chores.
Since that time Kate has had to go through several follow up operations and procedures. She has had to learn to do many daily tasks using only her right arm. If you see or know Kate, she is a very courageous young lady who does not let her disability interfere with her participation in school, and school activities such as volleyball and basketball.
Her family is blown away with how she handles difficult tasks and her “can do attitude” in general. Kate is also involved in music and is a part of the percussion group in junior high band.
Kate also studies piano learning music composed for persons with only one arm. Her mom said, at her last recital she gave a really great performance.
Almost a year after the accident, was a big day for Kate, when she and her dad travelled to Mayo Clinic for TMR (targeted muscle reinnervation) surgery. Dr. Brian Carlsen was one of only three Doctors in the nation that performed the surgery at that time.
People who undergo this TMR surgery will be fitted with and trained to use a commercially available myoelectric prosthetic arm.
The surgery reconnects the nerves that control arm, wrist, and hand functions. The procedure is pretty much a day long process to find the places to see where to reconnect the nerves.
According to Jim, without this procedure the brain will start to tune out the messages meant to control the missing hand.
When they began the process Kate was given therapy to do at home to help keep the brain from forgetting the functions of the left hand. If no therapy is done, the brain will begin to tune out the left arm function assigning it to another area.
She also did physical exercises using large rubber bands to strengthen her left shoulder and upper arm.
One interesting test she did was to identify pictures of hands and identify whether they were left or right. When she first started doing it she could only get about 30 percent right, as the brain was already losing its ability to recognize the left hand. After doing the test over time, her score more than doubled within a few weeks.
Another simple therapy, that was only recently developed, is called Mirror Box Therapy. Kate sits in a chair with a large mirror against the left side of her body. As she watches the right hand it somehow tricks the brain into thinking there is a left hand there. She also does exercises using her mind to connect with the arm in the mirror imagining it is the same as the right arm.
In August Kate and her father traveled to Maple Grove to the Advanced Arm Dynamics. They tested Kate to evaluate how well the TMR surgery had worked. Doctors were amazed that four of the six sites were connected, and they felt that with more work all six sites could be used. Jim said they were hopeful that all six sites would be firing by their next trip. He said, “if all six sites get connected it will be the first time they have had anyone connect all of the sites. Doctors told them right away it can take up to a year for all of them to connect.”
The sites are a very important part of myoelectric prosthetics, the more sites you have the more dexterity you can have with the arm.
The next step was fitting the prosthetic socket to Kate’s arm the Friday before Thanksgiving in 2014.
According to Jim, that was a tough couple of days for Kate. After driving up to Maple Grove the doctors began around nine o’clock in the morning making a cast of her arm using gauze and plaster. From the arm cast a plastic mold was made, then they heated plastic and poured it into the mold so a socket could be attached.
Then the mold is fitted with sensors and attached to her arm to connect the temporary sensors to test the sensitivity for each one. The testing took several hours to figure out the separation of the functions of each sensor. “Doctors were amazed at how well she was able to control the different functions,” said Jorgenson.
He said the first day was very long and difficult for Kate. After attaching the socket to her arm, and a day of working on it, her arm was swollen and very painful, and doctors actually had to insert lotion to loosen the socket up.
Doctors came in the next day and presented Kate with a new socket which they devised a movable flap on one side of the arm which had a latch that could be tightened or loosened — problem solved. Her doctor said we did this for you, so what do you want to call it — Kate replied, how about the ‘K8,’ — her doctor said ‘K8 Socket’ it is. The rest of the day went much better Jim said.
Two days later the rest of the family met them at the clinic where the new arm was fine tuned and programmed. The arm weighs about eight pounds and is powered by four electric motors powered by lithium ion batteries that can run the arm for about two days, and can be recharged in two to four hours.
The arm helps Kate with many routine things that most of us take for granted, like dressing, brushing teeth, putting makeup on, brushing teeth, fixing breakfast, carrying her back pack, opening books, and much more.
One of the things she had to learn was how much force to put on the hand when picking things up. Nikki said, “we don’t want her to pick up our antique candy dish!” she chuckled. The hand has up to 22 pounds of force, so she has to be careful holding things like a can of pop.
Kate has adapted quite well using the arm, and Kate feels much better when she is wearing it out in public. People don’t stare at her when she is wearing it.
This is a really uplifting story about a family dealing with a life changing event. However it has not been an easy journey to get to this point, and the family is struggling to get the new myoelectric arm approved by the insurance company Blue Cross and Blue Shield.
Jim said “it seems like they have been fighting paying for this every step of the way.”
The Jorgensons are currently fighting to get this problem resolved. The insurance company claims the arm is not needed medically.
They are going through the State Attorney General’s office to help move this ruling along in their favor.
It is hard to believe that the insurance company can say it is not needed medically. What they really seem to be saying is “we don’t want to pay for it.”
WCCO’s John Lauretson did an update on Kate’s story. It was originally scheduled for the 10 o’clock news on Wednesday. But due to a schedule change, it was aired Monday at 5:00. For those who did not see the clip, it can be found on WCCO’s web site links, at WCCO.com.
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