Category disability

Mallet finger: week 10-ish

Angel Ackerman Leave a comment

I had an 8 a.m. appointment with my occupational therapist at The Institute for Hand and Upper Extremity Rehabilitation. I cannot say enough nice things about them.

I arrived around 7:50 a.m., and ended up walking into the building with my therapist. The receptionist wasn’t there yet. My therapist grabbed my file and started my appointment before her computer fully engaged for the day.

I told her the story of losing my splint. She made me a new one and I didn’t even have to pay extra.

For more info on losing my splint, click here.

The finger is “holding up” and this week, when I take the splint off to do my exercises five times a day— which I might do seven, just based on my routine— I can leave the splint off for one hour five times a day.

It sounds like if my finger maintains its posture through this week that I am more-or-less out of the woods. It’s very exciting.

Why do I do my exercises seven times a day? For exercises like these— physical and/or occupational therapy exercises that require little bits of effort multiple times a day— I find attaching them to logical parts of my routine helps.

So in my case:

I left my appointment at 8 a.m. They are so efficient!

4:15 a.m. Wake. Remove splint. Use bathroom. Wash hands. Start coffee. Do exercises. Replace splint.

6:15 a.m. Use bathroom at work. Check hair. Remove splint to wash hands. Return to main cafeteria to chat with friends. Do exercises as warm-up for the intense folding of clothes to come. Retape splint. Head to time clock.

8:50 a.m. Remove splint. Go to bathroom and take morning break. Do exercises. Have morning yogurt. Replace splint. Fold more clothes (about 175 pieces of clothing every two hours). Yes, I fold and package clothes. I work for Stitch Fix doing Quality Control for the subscription boxes. My side hustle is my book company, Parisian Phoenix Publishing.

12:10 p.m. clock out for lunch. Remove splint. Use the restroom. wash hands. Do exercises while heating lunch. Eat. Replace splint.

3:10 p.m. Final 15. Remove splint at work station. Go to wash hands. Do exercises while enjoying a cup of coffee or snack in the main cafeteria.

5 p.m. Clock out of work, remove splint, wash hands, stretch fingers, replace splint.

5:30 p.m. Get home from work. Fight off very excited large dog. Remove splint. Wash hands. Do exercises. Replace splint.

7:30 p.m. Remove splint. Shower. Gently use fingers to wash hair. Do exercises in shower. Dry off. Replace splint with fresh tape.

And this way if I miss one, it’s okay. Or if my hand isn’t doing as much in one session we make it up in the next.

For more about my injury, click here.

Freedom was nice while it lasted

Angel Ackerman Leave a comment

So, as directed by my doctor, I went to see my friends — the occupational therapists at the Institute for Hand and Upper Extremity Rehabilitation.

They fitted me with a custom splint molded to my finger (for $50) that despite my doctor’s recommendation that I wear the splint at night only, they want me to wear the splint 24-hours a day for the next week, which for me will be nine days because that’s the day I can get there again.

I am to remove this splint when I bathe, when I wash my hands, and five times a day to do physical therapy exercises.

The exercises are 10 reps of basic hand gestures: straightening the hand, lightly bending the top of the hand, and making a loose fist.

If the hand loses progress instead of gains it, then the cast will be reapplied.

In pondering this, I realize several opinions of mine that may be greater truths:

  • Had I accepted my doctor’s solution of “cheaping out” and reusing my stinky cast as a splint, my recovery from this mallet finger would be more direct versus gradual. I believe gradual, supervised steps toward healing are better and I wonder if there are statistics about patients and the long-term success rates with these injuries with various treatments. How many patients would hear that insurance won’t cover it and end the conversation there without considering that the $50 might provide more than just a splint, but also guidance and expertise.
  • Are my occupational therapists just over-cautious or it is a case (as I think it is) that the therapists see more of this injury and in the same manner than nurses often know more than doctors, do occupational therapists understand more about function than fancy specialized surgeons?

Free the Finger! Cast-free after 9 weeks

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I was very apprehensive and so excited to see my doctor at OAA today to get my damn cast off for an evaluation of my mallet finger.

The teenager texted me as I sat in the exam room.

“Free the finger!”

They had a devil of a time cutting it off— apparently after even five weeks in the same cast it was firmly on.

Both the hand/orthopedic specialist and the hand rehab office it’s unusual for patients to maintain a finger cast for so long. That doesn’t make sense to me, because why wouldn’t you do everything in your power to maintain agility and strength in your finger?

Free the Finger!

the Teenager

And don’t give me that “it’s too hard” or “I need my hand to do stuff.”

I work in the Stitch Fix Bizzy Hizzy warehouse folding clothes. And after my brief stint on short term disability to deal with my balance and hip issues stemming from cerebral palsy (and made more complicated by now not being able to rely on the left side of my body with this temporary injury), I went back to work and performed at 100% and higher with my finger in a cast and restricted hand movement.

That finger had so much caked dead skin and here’s the really fascinating part— my knuckle no longer has wrinkles because it has not bent.

In the beginning of my treatment, I found my doctor cold and impersonal but as he gets to know me I like him more and I get more personable interactions from him.

He told me I should gradually increase my finger flexibility with care not to hyperextend it (otherwise known as don’t bend it backwards) and splint it at night. For the splint, I could take my cast back. And tape it in at night.

“It’s cheap, but it’s dirty,” the doctor said.

Yeah, no thanks. I lived with that grimy thing long enough.

“The other option is to return to the Hand Institute and they’ll make you a splint.”

(Which, coincidentally Cigna, my insurance, does not cover. But as I do not cheap out on my medical care, I will pay for. Because right now my HSA is empty because having a disability and doing everything you can to keep yourself ahead of that disability is expensive. So please, consider this and how lucky I am that I can support myself because if I had to really on family and government benefits to subsidize my care, I’d be crippled.)

I imagine there’s a third option— buy an over-the-counter splint. And I was going to consider that. But to me, the cost of the custom splint comes with the knowledge and enthusiasm of the people at the Institute for Hand and Upper Extremity Rehabilitation. These people love and know hands.

And if I can only teach others one concept about your health, it is this: invest in yourself, meaning, find the right medical providers for your team that understand your needs and share your personal philosophy and concerns. This requires being vulnerable in a way that might be uncomfortable and it might mean having difficult conversations with people you don’t like. But it may also lead you to better understanding of yourself and of those people who seemed like callous know-it-alls disinterested in you.

I peppered my hand specialist with questions today— rapid fire as he typed my splint referral into the computer. And he respected them. The questions.

How much movement is okay? What should I watch for? I pack boxes and fold clothes and put things on conveyer belts. Should I splint the finger at work if it starts to feel weird? Is there certain motion I should avoid?

“There are no rules,” he said. “Just be careful and the occasional splinting wouldn’t be bad. I’ll see you in a month.

He made eye contact with me as if to say, “you know your body. Follow your gut.”

But he also knows I’m the patient who kept a finger cast on longer than the average Joe. So maybe, just maybe, he trusts me.

For previous installments on my finger injury: click here.

Also: a YouTube video

Babbling to Andrew Gurza

Angel Ackerman 1 Comment

One of the very first things I did when I opened my bank account for my business, Parisian Phoenix Publishing, was to buy my art director Gayle a pastry at my favorite pie shop. But the next thing I did was head to Patreon and support Andrew Gurza, a queer man with cerebral palsy who records the podcast “Disability After Dark.”

I requested to join him on the podcast, thinking it would be a great way to promote my business and share my experiences. I wanted Andrew to know how much his honesty means to me and how much I leaned on his support– even though he didn’t know me– in my journey to accept my identity as a person with a disability, in this case spastic diplegic cerebral palsy.

I had to reschedule once due to a doctor’s appointment with my current hand injury, and he had to reschedule once due to his IBS flares. He even started a podcast to talk about various GI issues and he called it, “This Shit is Real.” And I admire him for that openness. A recent and very occasional complication with my CP has been incontinence. Sometimes I can’t feel when I have to pee until it’s the very last second. And that is scary.

We finally had our chat today, and we barely scratched the surface of what both of us could say, and I know by the end I was talking too fast. Nala even behaved, but then my parakeet Yo-yo starting singing.

I hope he can salvage the audio.

I was so excited to have that chat with him as I have listened to the podcast for more than a year now. And he asked if he could contact me again so we can talk about book publishing.

Andrew can contact me anytime! The world needs more people that force discussions that we all need to have. We need to release ourselves from sensations of shame, anxiety and insecurity and accept each other and the perspectives we bring to the table.

I had a notebook because I wanted to write down the brilliant insights I knew we would have together and we had a great, great talk. But I babbled. And now I don’t have much to share with you.

So I guess we’ll have to wait for Andrew to release the episode.

Rebuilding

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No fancy title. No big announcements . Just some subtle realness.

Though I do have a little good news. Misty came home today. He’s wobbly, but he’s his sweet-natured self. Video here.

Touch of Grey is still in the hospital.

If you missed that harrowing tale, you can read it here.

The world often seems twisted in an eternal loop of one step forward, two steps back. It makes me miss my dad.

But I noticed today amid the cat drama and everyday life— I worked with my blind friend Nan this morning— that I still have trouble with my right leg, mostly stiffness and lack of control, but no pain.

So when I headed to Apex Training for my session with Andrew, I felt anxious and emotionally exhausted but physically ready to go.

Every session Andrew challenges me more today— and I did a mixed grip barbell deadlift at 100 lbs. And for the first time, I felt like I nailed the form.

As if that weren’t enough, he had me do something I never heard of: a plank up. He wanted me to do 5, but I only did 4 1/2. Well, Greg was willing to give me credit for 4 3/4. And as the teenager says, Greg doesn’t hand out credit easily. Speaking of improvements, in Saturday’s session, I surpassed 60 seconds in a plank.

My strength, at least the physical kind, is coming back.

Dinner was a flat bread pizza — a vegetarian delight of random cheese I found in the fridge, a radish sliced thinly, and some honey with red pepper flakes.

Final step in my medical journey?

Angel Ackerman Leave a comment

Tuesday, May 31, 2020.

It’s been about a year. It’s the end of my birth month. In some ways, I started this journey in December 2020 when I contracted Covid-19.

I remember standing in the Bizzy Hizzy warehouse, at 11:45 p.m., placing the last extra small clothing item in my pick-cart. I leaned against a nearby pole, my joints all screaming.

And I thought to myself, “I’m one month into my job at Stitch Fix. Maybe I can’t do this. Maybe I’m too old and my body can’t take it. Maybe I can’t do anything anymore.”

I was chilly that night, and it was December in the warehouse, so I didn’t think anything of it. Until that moment. Leaning against that pole almost too weak to stand.

I was sweaty. My hands were clammy.

I had a fever. The system at work — the nurse, the temperature checks— had missed it because I normally run low. My fevers don’t numerically look like fevers until they are very high.

And in that moment, I released a breath of relief.

I was probably the only person in America grateful to suspect that I had Covid-19. (And I did.)

Because Covid-19 was easier to deal with than the prospect that I might be too disabled to provide for myself.

I would have to read these blog entries, check my medical portal and review my podcast history to tell you the exact journey of the last year and a half, and if that interests you— I’m considering writing a memoir (Upright! Gravity is a Harsh Mistress). My husband thought of the title.

I listened to disability podcasts (such as A is for Abled, Disability After Dark, Stompers in Love and various titles from the BBC) while working at the Bizzy Hizzy as I grappled with my own identity. Am I disabled? Do I pass as normal? Do I make my body do more than it can? Or should?

These questions, and recovering from Covid, and comorbidities like anemia and weight gain, as my spine and hip problems started to bother me more and more, led me on a journey to recommit to fitness and to gain more knowledge and collect doctors that would be an asset to my medical team as I age.

I have blogged about that entire journey— from my first session at Apex Training to finally finding a local doctor that understands cerebral palsy.

She expanded on my previous diagnosis of spastic cerebral palsy and added the term diplegia, which means it only impacts my legs. She frequently told me that I self-correct very well and added that while my gait was inefficient, it was functional and it was mine… so that makes it beautiful.

My new doctor is a neurological physiatrist— with her initial training in spinal bifida which she then expanded into seeing cerebral palsy patients.

She listened to me, reviewed my x-rays with me, gave me an exam, watched me walk, and studied my shoes as if she were reading my fortune with tea leaves. She described my walk as her fingers traced the wear on my shoes.

She also complimented my “taco Tuesday” days of the week socks.

My recent disability leave from work has improved my fitness and my health greatly, so I had no pain to report. But I told her I was looking to educate myself and to know what doctors to call and when.

And she told me a lot of things I already knew— not to let myself get too tired, for one. And that I need to continue strength training and improve the mobility in my ankles (and today at Back in Line Chiropractic, Dr. Jensen gave those puppies a work out).

I also knew and understood the domino theory of my own health, that injuries like what happened to my ringer finger impact all of me, but she explained why. I’m not sure I have this 100% correct (just like I previously misused hemiplegia, which refers to right or left side of body vs. upper and lower body), but she said my brain tells my lower half not to do anything until given a signal, but as a person, I start walking (for example) and now my legs and my brain aren’t working together.

Because of this, if anything goes wrong in my body— even something as minor as constipation or an ingrown toenails— my entire system can go haywire. So, if I’m having issues, I need to examine my whole self. And if I don’t find the problem, I need to call her.

Cerebral palsy is a static condition, meaning it doesn’t get worse, but as I reasoned earlier, the decades of wear-and-tear on a body not used in the mechanically proper way can create new issues.

So what are my options if I find myself in decline?

  1. First step would be to use muscle relaxers. I currently have a prescription for flexeril, which doesn’t seem to do anything. She would try Baclofen or Tizanidine next.
  2. If that doesn’t help, she would inject Botox into my muscles.
  3. And if I still had issues, she would move to bracing.

But as of right now, I have good muscle tone and self-correct so she doesn’t want to mess with things.

I feel like I found the final link on my medical team.

I am so relieved.

First day back to work at the Bizzy Hizzy after my cerebral palsy-themed leave

Angel Ackerman 1 Comment

First off: 89%

For those of you who know me or follow me regularly, I performed at 89% today after a month of short-term disability leave.

Short answer to how my day was: good. I felt pretty good and my aches and pains at the end of the day feel pretty normal.

Now, for those who want more detail, let’s start at the beginning.

On April 15, I ruptured a tendon in my left ring finger taking my socks off. The nickname for the injury is “mallet finger” because your finger looks like a mallet or “baseball finger” because if you catch a baseball wrong you can sustain this injury.

You can read a more concise summary of those events and my treatment here.

I worked with my hand like that for a week at the Bizzy Hizzy folding clothes for Stitch Fix’s clients, performing at a solid 90%. But… I realized I rely on my left side for balance and stability and using my right side to do everything exacerbated problems I was already having with my right hip and spine as complications of my lifelong battle with cerebral palsy. That has been another journey of mine— learning about my body and how I can work with it to age well.

I often wonder what I could accomplish if my body could do what other bodies do.

So I asked my family doctor if I could take a short-term disability leave from work and focus on building core strength and stretching my hips. Because with this silly finger cast, on top of all my other issues, I was falling twice a week.

Today I returned to work— one ten-hour shift in my home department (QC) before the holiday weekend. I work Sunday. We have a paid holiday Monday. And I have a doctor appointment Tuesday afternoon with the neurological physiatrist.

Returning to work today gave me a way to ease back into it, and allows me to gather data on how my body performs. I can give that info to the physiatrist. If I hurt again by Tuesday, it’s a sign that either:

  1. I am moving wrong, or
  2. I shouldn’t be doing this kind of work with my body.

I arrived at work for my 6:30 a.m. shift and friends greeted me that I haven’t seen. At first I went to the wrong table, but caught my mistake, and corrected myself.

I had a right table, good for my hand injury, and one at a good height.

But then they shut the line down and I moved to a left table that was a tad high for me.

For the first 60-90 minutes, I hit all my numbers.

Eventually, I got a text from Mr. Accordion. I hope he doesn’t mind but I’m sharing his photos because:

  1. They made my day.
  2. I love halupkis.
  3. I don’t have other art for this post.

I don’t think he knew it was my first day back to work but his periodic cooking updates made me smile. Mr. Accordion and I shared an office at my last non-profit job. And yes, he not only plays accordion but usually has it in his car.

Mr. Accordion’s ingredients
Mr. Accordion at work
Mr. Accordion’s Halupkis ready to go in the oven

A couple times today, I had to answer phone calls regarding the toilet explosion that happened in my house yesterday. The insurance adjuster will be here Tuesday and meet with the teenager. I am working on getting water remediation people in to make sure everything is dry.

At the end of the day, I have a weird uncomfortable feeling in my left wrist and the kind of typical aches and pains that come from being older than 40 and working in a warehouse ten hours a day.

I attribute some of my success today to my personal trainer Andrew at Apex. We did an exercise yesterday that was something he called a variation of a good morning. This had me holding a weight across the back of my shoulders and “hinging” at the waist while using my hips for most of the motion.

I tried to replicate those techniques when I bent down to get items out of the bottom of my carts.

Then, when I came home, the teenager had dinner in the oven. I received a lovely message from a former editor at The Morning Call’s short-lived weekly editions, Chronicle Newspapers.

He said I was a truly good person (for all my work fostering cats) and that he missed seeing me every day.

I thanked him and said he made my day.

He replied that there were many times when I had made his and my boss’s day.

That was my favorite job ever, and one I was very good at.

Also, I tried the blueberry muffin flavor of ready-to-drink Supercoffee. My initial reaction was that it was gross. Will give a more thorough review later.

2nd visit to the hand institute… and some cats

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If you read my post from earlier today, then you already know my hand specialist/orthopedic surgeon cut off my cast.

No more man with hat.

This meant I had to schedule an appointment with the very amazing staff at The Institute for Hand and Upper Extremity Rehabilitation for a new cast.

This also meant I had to cancel my session with Andrew at Apex Training.

At the time I should have been sweating, the teenager and I were cruising down the highway.

The staff member who originally wrapped my finger anxiously stood by as a newer staff member removed the temporary splint.

“You look like you’re waiting for someone to open a present,” I said.

She was that excited to see how I was healing.

My finger is straight, which means the tendon is growing in the right direction. It does not have enough tissue to have any strength yet, so another cast was put on.

I was in and out in 15 minutes, including my trip to the bathroom.

FURR Louise

In other news, our remaining two foster who needed shots made it to the vet today. While I was rocking temporary splints.

We also took one of our personal cats, Opie.

Louise did not stop yowling (video).

Four week mallet finger update

Angel Ackerman Leave a comment

My soul, although surrounded by so much goodness and spring happy vibes, trembles in stress most of every day.

2022 has challenged me.

And that’s okay.

Today I visited my hand specialist for my first monthly follow-up of my ruptured tendon in my left ring finger, an injury known as “mallet finger” or “baseball finger.”

Here are some of my previous posts about the injury:

My specialist removed my cast tonight and announced my performance at holding my finger up is halfway there.

Then he also announced I’d need a splint or a new cast.

I made the appointment for my follow up at the office close to home only to have him call me and tell me I need to see the hand institute by his office on the other side of the valley. 30 minute drive.

At the end of a very busy week that includes my birthday.

I have to take some foster cats to the vet at 1, and run over to my occupational therapist’s office for a 3:30 appointment. I called from the parking lot of the specialist.

Then I had to come home and crate 3 cats for their vet appointment so now my temporary splint is very fuzzy.

I’ll update later based on what the next phase of treatment is. Whatever it is, I hope we can wash my hands first.

Another day, another fall

Angel Ackerman 3 Comments

Tomorrow I visit my hand specialist for my one month check up. Tuesday I see my family doctor/primary care physician about going back to work.

The increased sessions at Apex Training have shown me how weak my core has gotten as I struggle with issues in my S1 joint, lower back (retrolisthesis) and hips (femoral anteversion). But the uptick in training has helped me with balance, range of motion, and eliminating hip pain.

But I’ve also learned motion is crucial, as being active, on my feet and doing things is the only way to prevent intense stiffness.

And then after a great workout with Andrew at Apex, I fell on the way home. It’s the second time in a week I just randomly fell. Did I trip over my own two feet? Maybe. Did I just lose my balance? Maybe.

But these are the types of incidents I worry about, especially when I have a cast on my finger and work in a warehouse.

I fell a block away from home. I managed to throw myself into the grass instead of the sidewalk. That saved me scrapes and bruises. But I fell on my face and bent my glasses.

Luckily, the teenager could bend them back.

This time, the disability leave from work, is about gaining strength, learning more about my body and giving myself time to heal. But it (more of it than I expected) also is teaching me about the balance between fighting and surrendering.