Free the Finger! Cast-free after 9 weeks

June 22, 2022June 22, 2022Angel Ackerman Leave a comment

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

Pain and performance (and a high school graduation!)

June 7, 2022June 7, 2022Angel Ackerman Leave a comment

So first things first— let’s embarrass the teenager.

She graduated from high school Friday night. (Above, pictured, left to right: me, her father, her, her paternal grandfather and grandmother and my stepmom)

The weekend that followed included several dinners with family members and we have a party planned later this week.

The other updates:

I have been killing it in the gym. My plank time is more than a minute now. My strength is improving and for the first time ever, I did exercises with a 30-lb dumbbell.
It’s been seven weeks since I got my first cast to treat my mallet finger. Two more weeks until it comes off. Remember that when I mention that I am hitting milestones like the one mentioned above.
I hit the goal for Freestyle on Sunday at work in the Bizzy Hizzy. I shipped 500 items in, if I remember correctly, 363 packages. What makes that amazing is that we also had a one-hour training — so 500 items is the goal for a full day. Taking the training into account, that puts me at 110% for that day.
Yesterday and today I worked at the same left side table in QC. Even with pushing boxes to the left with a bum finger, I did 166 fixes yesterday (102%) and 169 today. (104%).
But here’s the weird part— i was in pain but it didn’t impact my movement. I started each day extremely stiff and with a little bit of back pain, but not in the low or upper back, in between. And as I eased into my shift, my hip hurt deep in the socket, up near my groin, but in the front in a very small but specific spot. And my quad would feel intense pain that sometimes went into my knee but for the most part didn’t. Tylenol doesn’t help. It gradually subsided over two hours. It happened in exactly the same way today.
I combat this my paying extra close attention to all my movements. I plant my feet on the floor and hold my core and glutes tight. I force out my toes and my knees and as I move my body to retrieve clothes below my waist I bend with my hips and stretch them. Is this what helps? Is something out of whack (like my femur) and stiff by morning and I force it back into position?
In very sad news, Charles Ticho, the nonagenarian author who penned the Parisian Phoenix book Stops Along the Way died today. I will be addressing this soon on the Parisian Phoenix blog.

2nd visit to the hand institute… and some cats

May 18, 2022May 18, 2022Angel Ackerman Leave a comment

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.

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).

Mallet finger update: my doctor is a good one

April 29, 2022April 29, 2022Angel Ackerman Leave a comment

If you haven’t heard my saga of rupturing a tendon taking off my socks, you can catch up here:

Today I went to see my family doctor as I am concerned about the interaction of my mallet finger and my list of comorbidities from cerebral palsy. My crooked gait makes me a fall risk and the last five years or so— more or less since I entered my forties— have included broken bones, SI joint pain, back pain and hip pain.

All of this have led to a more-than-one-year journey to understand my body and how cerebral palsy impacts it.

I have visited doctors and specialists and neurologists trying to understand what I can do to minimize further issues as I age.

And it has worked!!!! My pain levels and chronic issues have dropped from daily pain of 5-8 to pain levels.

So I had a long visit with my primary care physician and told him not only about my injury, but also updated him on my fitness and improvements. I explained how I have been learning how muscles are supposed to work with my friends at Apex Training. I also told him I fell onto the brick wall of my house yesterday. I showed him the abrasions on my left arm.

Then I pointed out that traditionally my left side has been my anchor and by removing that from the anchor position, my walk has become more asymmetrical (according to my iPhone) and my hip is out of whack and uncomfortable all of the time and it’s only getting worse in these conditions.

Unlike the specialist— he filled out the paperwork himself and in front of me requesting that I have an FMLA leave until he sees me again after my specialist.

On top of all of that attention, he then gave me a full physical.

It was very hard for me to be vulnerable and ask for help, and my doctor and his staff made me feel heard, valued, and as if they truly cared about me.

I brought the paperwork home and started the claim process to initiate a short-term disability leave. It took about an hour and I realized my doctor missed one of the pages and on another he misread the questions. (So I added post-it notes.)

And if I’m 100% honest, despite everything I deal with, I still harbor feelings of guilt for asking for this time— much of which I intend to use doing work with my personal trainer and chiropractor to strengthen this hip and improve my walk so I can return to my warehouse job with a strong core and a better understanding of how normal legs work. I’m going to try to teach them. But, with my femoral anteversion, I know there is only so much I can do.

I deserve a chance to make myself strong and healthy.

Treating my mallet finger

April 19, 2022April 20, 2022Angel Ackerman Leave a comment

It’s Tuesday and my life has been turned upside down by my “mallet finger” injury acquired Friday night, taking off my socks as I chronicled here.

I filed for short term disability leave based on what Patient First told me about the injury. Since my work week starts on Sunday, and the accident happened Friday night I thought it best to get the incident in the system as soon as possible.

The original injury left me with a finger that would not straighten

With it happening on Easter Weekend, I was told by the doctor at Patient First to make an appointment with an orthopedic hand specialist Monday.

The doctor at Patient First explained that I had pulled the tendon out of my knuckle and that I needed a specialist to determine whether it would heal or if I needed surgery.

And I did my best to work around my enormous splint and changed the tape once Sunday night.

Even on Sunday night, I had no pain, minimal swelling and no bruising or discoloration. The nail was fine, too. And I was amazed at how the angle of the finger had improved.

Some recommendations came my way from friends and everyone recommended the same doctor at OAA Orthopedic Specialists. Unfortunately, he was booked into July. So I accepted an appointment with one of his colleagues, at an office 18 miles from my house. I called at Monday morning 8 a.m. and the only appointments they had this week were Tuesday at this office in the Allentown area.

That was today. The splint Patient First gave me is enormous— and I was very anxious to get not only news and a treatment plan, but also something more reasonable.

I filled out all the paperwork I could online, and headed out of the house for the 30-minute drive to the doctor. On Monday, I had already gathered my x-rays and reports from Patient First, a release of medical information form, my return-to-work form for the Stitch Fix Bizzy Hizzy and the FMLA/short-term disability insurance paperwork.

(I also tried to clean the Tupperware cupboard, loaded and unloaded the dishwasher and made an enormous homemade Crunchwrap with homemade tortilla chips.)

I cried all the way down the highway. I miss my dad, who passed away in December, and I’m struggling with a lot of life right now. And I snapped driving to the specialist.

But when I arrived— h*ly sh*t. The orthopedic office shared a plaza with the Lehigh Valley Hospital Cancer Center and the Steel Fitness Premier Facility. The scheduler told me they had free valet parking but damn I did not expect that. It was a big hospital facility.

I went in, read the directory and discovered my office was on the second floor. And when I got to the second floor, I saw about ten check-in/ receptionists. Damn.

One checked me in and I was told to proceed to waiting room seven. The whole arrangement vaguely reminded me of the Beetlejuice scene where the dead people wait to see their counselor.

But they moved me right along and I met my doctor very quickly. And I was told getting dressed and undressed is a common way of getting injured.

The doctor produced a brochure from a nearby drawer. And it was the same information from the same hand specialist professional organization I had found online.

He explains that there are two tendons in each finger, one running along the top from knuckles to fingernail, and another running under the finger. I overextended the top tendon at that tip-top knuckle, tearing it from the joint.

Because I did not damage or break free any bone, this means I don’t necessarily need surgery. That immobilizing the finger at the top knuckle will allow the scar tissue to reconnect the tendon. And then occupational therapy will get that tissue usable.

The doctor said there are three treatment options:

Splint
A surgically-placed pin
A finger cast

He recommended the finger cast. For eight weeks. And that he will see me in four weeks.

Paperwork and work release proved to be more complicated. He simply gave me a note asking me not to use the finger and that I could return to work today. I don’t think that’s enough for the folks at the Bizzy. So I asked the staff to please fill out the two forms— the one for the Bizzy Hizzy and the one for disability insurance— and told them I had read the sign and would gladly pay the $10 per form.

They wanted fax numbers or for me to pick up the forms, but I’m not driving 30 minutes back tomorrow or whenever they get the forms done. I think I found the fax for the disability folks and finally reneged and let them mail the form to my warehouse.

They also told me the forms should be in my portal so when they are done I hope I can download from the portal and send them where they need to go. If that doesn’t work, I have to call the Bethlehem office and make arrangements to pick them up there.

The OAA office also called The Institute for Hand and Upper Extremity Rehabilitation (a mere mile away) and arranged for them to see me. When I arrived, they were on the phone with my insurance company.

The staff at The Institute were beyond friendly, and every staff member apologized for making me wait. But I was impressed at how smoothly they ran and how they managed to balance the walk-ins and the scheduled patients.

Even more impressive, they had a binder promoting the small businesses they have “interacted” with— I hope I can leave one next time. I forgot by the end of my visit.

The Institute has one main rehab room so I got to see other patients at work, and every therapist acknowledged me, and apologized that I was waiting. One therapist, fitting a patient with some sort of brace or sling, was chatting with me about my injury.

The casting process was fascinating as I had never heard of casting a finger before and the person helping me also explained my injury. In this day and age when medical professionals usually don’t explain things, I was amazed at how many people took time to explain.

My finger was only 15 degrees floppy today, which is a huge improvement from Friday. BUT if anything bends the injured area of the finger that could start the recovery clock back to zero as it could tear the scar tissue (which is why the hand specialist recommended the cast).

I certainly don’t relish the idea of eight weeks in a finger cast, nor do I enjoy the paperwork hurdles I now have to jump, but I’m relieved to have moved on to the next stage of the process.

The staff at the Institute also commended me for seeking treatment right away, as most people wait a week or more to address it and that causes more stress and damage to the healthy parts of the finger and can make the healing process more complicated and less successful.

My professionals:

OAA Othopedic Specialists

The Institute for Hand and Upper Extremity Rehabilitation