Psychological Therapy
Psychological therapy is another key aspect of follow-up care for hand recipients and begins almost as soon as the patient wakes up from the operation. This form of therapy is important because of the possibility that the patient will experience body image disturbances following the procedure. Thorough psychological support may be offered up to once daily during the first three weeks following the transplant, after which its frequency gradually decreases. Hallam, whose transplanted hand went through several rejection episodes as a result of his negligence in taking his immunosuppressive drugs and maintaining contact with his doctors, also experienced psychological problems related to his hand prior to his request for its removal. He claimed that he had become “mentally detached from it,” and went on to say, “As it began to be rejected, I realized that it wasn’t my hand after all. If this is what I’m going to have for the rest of my life, I’d rather not have it.” The role of psychotherapy in the mental recovery of hand recipients is important and should not be overlooked.
Perspectives on the importance of psychological therapy for graft
recipients
• In one study of 50 patients following replantation surgery (operation
to reattach a severed limb, etc.), 28% exhibited evidence of pre-accident
psychopathology, 54% reported a recent stressful life event predating
the accident, and 54% were assessed as having an adverse postoperative
emotional reaction
• Even for a patient without preexisting psychopathology, it may
not be easy to live with a transplanted hand, which remains constantly
in view
• One study that examined the long-term effects of heart transplantation
found that five years postoperatively, in contrast to physical status,
emotional complaints such as irritability, depression, and low self-esteem
had increased significantly
(Perspectives taken from Hatrick and Tonkin, Australian
and New Zealand Journal of Surgery)
