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Rehabilitation care for civilian blast victims differs from military victims

Wednesday - 5/1/2013, 12:32pm  ET

WASHINGTON - More than 200 victims of the Boston Marathon bombings are healing from injuries sustained in the blast. Several victims are working to re- build their lives with the loss of a limb.

Physicians and specialists at military hospitals know that recovery process all too well.

Dr. Paul Pesquina, chair of physical medicine and rehabilitation at the Uniform Services University and Walter Reed National Military Medical Center, has cared for many military service men and women who have lost limbs. He explains that it is hard to determine how long it will take for the victims to recover from their injuries. He says healing will require attention to physical and behavioral health needs.

"When you look at some of the challenges that they face, I think it's important to recognize that a blast injury often times leaves both visible and invisible wounds," says Pesquina, who mentions that blast injuries can include damage to soft tissue, fractures, loss of limbs and brain injury.

Military members injured in service are treated with a holistic and integrative approach. Pesquina says this approach to care ensures that doctors don't skip over any of the physical or emotional wounds.

"Rehabilitation means more than just physical rehabilitation; it means mental rehabilitation, as well," he says. "It's always difficult for anyone in any circumstance to adjust to a disability. Particularly in an event such as what took place in Boston, we can only imagine the risk that these individuals are at for post-traumatic stress disorder, potentially depression and anxiety."

Pesquina says that since the wars in Iraq and Afghanistan began, military and civilian physicians have collaborated on treatment for blast victims. But while the victims of the Boston Marathon are receiving health care treatment similar to those injured in combat, the rehabilitation experience may be completely different.

Seth Messinger, associate professor of anthropology at the University of Maryland, Baltimore County, says that unlike those wounded in the military, civilian amputees are not often offered full salaries during rehabilitation. In addition, they have to pay their own medical bills.

"The question is whether or not civilian patients are going to be able to have the kind of time in therapy or in rehab that military patients take for granted," says Messinger, who explains that a lot of the financial and rehab difficulties are transferred to the patient's family members.

"I think in the civilian world, (financial disaster) is likely the case," he adds. "It's not clear how many people who were injured have or do not have health insurance, whether or not they will have disability insurance, and whether or not they are going to need help with their health at home."

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