Steps to Heal

Unique mobile app offers burn survivors help toward healing

Aspects Volume 38 No. 4

Written by Rebecca Budde • Photography by Jason Johnson

Kari Elliott was only five miles from her parents’ home in Macomb when the accident occurred.

“I don’t remember the crash, but I will never forget the pain,” says Kari Elliott. The October 2014 accident engulfed her car in flames upon impact. Elliott survived a long list of injuries, multiple surgeries, including skin grafts for second and third degree burns, and a lengthy hospital stay.

Elliott was in St. Francis Hospital in Peoria for a month and then transferred to Memorial Medical Center’s Regional Burn Center where Nicole Sommer, MD, associate professor of plastic surgery, and second-year resident Lauren Hutchinson, MD, performed skin grafts on her foot and bottom. “I was very anxious about going home to my parents’ house,” says Elliott who was still in a neck and back brace, had a broken arm and was using a walker at the time of her release.

Many of the burn center’s patients are far from home, and most need some sort of help when they leave the hospital. “Going home tends to be a frightening time for burn patients,” says Thereasa Abrams, PhD, LCSW, research assistant professor for the Institute for Plastic Surgery at SIU School of Medicine. “They’ve had help with almost everything during their time in the burn center. They have to learn to adapt to restrictions that come with burns, and they need support to transition from burn patient to burn survivor.”

A burn survivor herself, Dr. Abrams knows all too well the struggles and fear that accompany the healing process. The healing of burns is unique from the healing of other wounds: proper dressing changes, physical activity and even eating a high-protein diet are crucial.

“Going home tends to be a frightening time for burn patients...they need support to transition from burn patient to burn survivor.“
- Dr. Thereasa Abrams

Drawing from her expertise and the experiences of other burn survivors, Dr. Abrams has created a one-of-a-kind tool to help burn survivors leaving the burn unit take healing to the next level.

PRACTICAL APPLICATION

Dr. Abrams learned about a mobile application (app) that provides personalized health information for pregnant mothers who are at risk and for new parents during the first year of their child’s life. It inspired her, and in the summer of 2013, with the help of grant funding from the Memorial Medical Foundation, she created app content specifically designed for burn patients and their caregivers.

Thousands of health-related mobile apps are immediately available to consumers, but the free, password-protected HealthySteps app platform by Infield Health with SIU’s content is unique to the industry. Integrating components that reinforce care that burn patients receive in the burn center, HealthySteps customizes messages and information to the needs of the patients and the caregivers based on the stage of the healing process and severity of their burns.

Without a nurse or doctor readily available, the process of caring for a healing burn may raise questions for burn survivors and their caregivers at home. “I was in a safe bubble in the hospital and the nurses did my dressing changes, so when I got home my parents and I had to figure it out on our own,” says Elliott. Though she was through the most critical part of her recovery when she began using the app, Elliott says she wishes she would have had earlier access.

Videos showing wound care and dressing changes provide reinforcement of proper care for patients and caregivers, while photographs show healthy and unhealthy wounds so that patients can be proactive in keeping infections at bay. “These would have been a reassurance that we were doing everything right when I came home from the hospital, but I didn’t start using the app until later,” Elliott says. “We would have known better what to look for in dealing with infection and pain.”

Instructional exercise videos led by physical therapists show patients safe ways to stretch their skin to keep scar tissue from becoming stiff and to improve range of motion. The videos are even specific to the location of the burn on the patient’s body. Most patients find the videos useful as they attend outpatient physical therapy after release from the burn unit.

“A number of years ago, I had surgery to have a burn scar removed and revised so that I could turn my head,” Dr. Abrams says. “They didn’t know then what we know now about burns. If I could’ve had the physical therapy videos at home like this app provides, I may have avoided the surgery.”

EMOTIONAL SCARS

Dr. Abrams knows of the emotional scars left in burn survivors. “When they go home, they’re mentally and physically exhausted. I built the app as a tool to help build their self-efficacy, reduce anxiety, set goals and direct them to re-entry into their social and work life.”

Patients answer questions such as, “How’s your pain?” or “How’s your mood?” Dr. Abrams will collect the data from patient responses to refine the messages and their timing. By suggesting “Schedule a time to have a cup of coffee with a friend this week.” or asking “What three goals would you like to accomplish this week?” the app encourages users to take care of their mental well-being. It also encourages productivity and returning to work by asking questions such as “Have you contacted your employer about working again?”

Dr. Abrams has also taken the emotional support beyond the mobile device. Her combined experiences as a social worker and burn survivor led her to begin a support group to improve the psycho-social outcomes for burn survivors. Her focus is getting individuals in the group to develop their coping abilities and to build on individual strengths. “Hearing other people’s stories and their successes after being burned has helped tremendously,” says Elliott, who attends
the group.

“When frustration took over, I went to the app,” Elliott says. “Even though I had a great support system at home, nobody understood the pain and healing process of burns. The positive messages of support reminded me to look at the positives of how far I’d come from day one but kept encouraging me to do more than I had the previous day.”

The support group members have reviewed the app’s features. “I wanted to have the stakeholders involved in the process; we have more than 100 years of burn experience in this group,” Dr. Abrams says. Many members of the support group, including Elliott, had little knowledge about the care and healing of burns prior to their experience. “I want the app to have the tools survivors believe they need, not just what the health care professionals think they need.”

Currently SIU holds a copyright on the burn-specific app content, which is only available to patients treated at Memorial’s Regional Burn Center. But it has immense potential for the future. Dr. Abrams submitted a grant pre-proposal to the U.S. Department of Defense to test the app with the United States Army Institute of Surgical Research (AISR) at Fort Sam Houston in San Antonio.

One year after her accident, Elliott has made great strides in her emotional and physical healing. She left the burn unit barely able to walk down the driveway of her parents’ home, but now has have five bib numbers signifying her participation as a runner in five different 5Ks. “I ran my first 5K, the Color Blaze to benefit the Memorial Burn Unit, six months after my accident,” she says. “More important than anything, burn survivors need to know it is possible to get better. I am living proof that it is possible.”