Monday visit with a new hand specialist at OAA

I can’t believe what a magnificent, crisp and sunny March morning today has become. I spent the weekend working on the final tidbits of Thurston Gill’s devotional coming out this month at Parisian Phoenix Publishing, visiting the Lafayette College Store to purchase Echo City Caper books for an upcoming meeting, delivering marketing materials to author Larry Sceurman and his wife Barbara, writing how-to instructions on how to leave book reviews online (do you need instructions like that? If so, read them here.), and proofreading the latest anthology from self-published author, R. (Rachel) C. Thom(pson). In between these activities, I did laundry, vacuumed my room, continued a book rearranging project, and stripped/remade my bed.

All with my pinky in a cumbersome splint.

Southern Candy came to visit yesterday afternoon. We played three wicked games of Uno with the Teenager. I won two and The Teenager won one. It felt good to laugh.

Southern Candy and I both had doctor appointments today that kept us out of work, so we met at Bethlehem Diner for breakfast before I headed to OAA Orthopedic Specialists on Centronia Road, behind Josh Early Candies, on Hamilton Street in what I think is South Whitehall Township with an Allentown mailing address. [Note on the diner: speaking of Rachel, I’ve dined with her at that restaurant before she moved to Florida and looking at the dessert case, I must go back for coffee and baked goods.]

The finger is looking and feeling much better. Discoloration and swelling has greatly reduced. The bruises on my leg look worse than and feel worse than my finger.

I saw a new doctor today. While waiting in one of the exam rooms at OAA– the same practice that treated my mallet finger last spring– I noticed a framed newspaper article on the wall by someone I know. So I texted her. We had a brief exchange and that was a wonderful reminder of how small the Lehigh Valley can be.

My new doctor informed me that the OAA offices recently had a ransomware virus and they traced it to a fake xray disc, so now they have to be very carefully how they look at images. It makes me wonder if soon we will be going back to the days of oversized manila envelopes and transporting films.

He then very kindly and patiently described my injury in a way that I wished I remembered better. He believes I almost dislocated this pinky, and probably bent my ringfinger back. The momentum probably caused ligaments to pull, and dislodged a scrap of bone like a piece of dirt clinging to the roots of a weed when you’re cleaning the garden. That’s the exact description he used. It looks like a fracture of the phalanx but it’s more like a chip off the bone where the ligament was holding on. So it’s a sprain.

He saw the mallet finger in my file from last year, and we talked about the folks at the Institute for Hand and Upper Extremity rehab, because he wants to refer me there and follow up in two months. He ditched the splint from urgent care, and said all that will do is make my finger stiff and increase the chances that my knuckle will get swollen and bulbous.

Instead, he wrapped my ringfinger and pinky snugly together with some velcro so my ring finger can be the new splint. “Wherever the ringfinger goes, the pinky tags along,” he said.

I told him the hand rehab people did a fantastic job overseeing my recovery from mallet finger so I am happy to visit them again. He pointed out that people often underestimate the importance of the pinky, and don’t realize it’s role in overall grip strength. And that injuries like the mallet finger and the one I have now have much better outcomes with swift and proper treatment, but too often people let them go a week or two before seeking care.

That made me feel a lot better, because I felt a little silly seeing a fancy hand specialist for a pinky. But, as I told him, as someone with cerebral palsy, I’m a little too aware of how quickly one injury can spiral into different complications.

Freedom was nice while it lasted

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?