The finger and the feast

Maybe the title is a misnomer.

There is no feast, but I like alliteration.

I went to the hospital yesterday for a specialty diagnostic ultrasound of the middle finger of my right hand. I’ve been having issues with it for six months. There were about four instances, about once a month where when I reached for something, it felt like the finger exploded and I screamed out. The pain only lasted 20-30 seconds, but the whole experience reminded me of when I had a mallet finger on the neighboring ring finger. And I keep expecting to see that finger drooping.

[If you would like to learn more about mallet finger: here is the blog entry about my um… accident… where I sustained an injury removing my socks. This is the entry about meeting with the orthopedic specialist.]

And every time I move the top of my finger independently of my other fingers, it clicks. Not painfully, but it’s noticeable. It’s just weird.

Today I had to go to St Lukes Bethlehem, which is the main urban campus of the hospital network because if the specialty nature of the ultrasound. I did not know that the parking deck was under construction. And for the first time in my life, I had to use valet parking. I technically had enough time to look for parking in the neighborhoods near the hospital but… I thought that stress would be higher than just using the valet service.

I checked in at the kiosk, and thinking about it now I never had the chance to check if my Able Pay was on my file because I will be paying for this test out of pocket. I have a high deductible medical plan and I have about $1,200 left of my $3,500 annual individual deductible. Able Pay gets me a discount on procedures and offers me interest-free payment plans.

Of course they asked if I might have had a fall and I had to tell them, “Of course I might have had a fall, but not one I can connect to this problem.”

The test itself involved the doctor and the radiologist– and the doctor could feel my clicking finger. BUT because of the nature of the click, remember it only happens if the finger is acting independently, he couldn’t get an image of it. The way he held my finger to get the image prevented the click. OR he couldn’t get the ultrasound into the proper place at the right time.

He found fluid around the joint, but he couldn’t say whether or not it caused or was related to the click. And he couldn’t see anything wrong.

He said he could “grill me” longer and keep trying weird things to take the image, but we both decided it wasn’t necessary. If he didn’t see anything structurally worrying AND I no longer have the pain– then I’m satisfied.

My neurologist asked if I wanted to see a hand specialist as a next step to examine the inflammation. I said no, unless the pain returns.

In the meantime, influenced by my experience at the Hindu temple and my recent overeating/ weight gain, I have done an impressive (in my opinion) job removing animal products and artificial sweeteners from my diet. I am working to reduce caffeine consumption but that has not been as successful.

So far this week, I have had no meat, milk only in my coffee, two servings of cheese, and I may have consumed eggs in baked goods that I did not make. But the main baked good in question is packaged gingerbread cookies that came from Grocery Outlet. They are GMO-free and I have eaten four small cookies (which comes out to one per day).

The scale is three pounds down, which might be because I moved the scale and this is an old house. I am also surprised that my protein levels have still been hitting 60-80 grams a day.

Eliminating animal products and artificial sweeteners is a great way to be mindful about eating. Sure, I want to promote preserving resources and eliminate animal suffering, but there is less food noise to contend with if you start with the vegan options and ask “will one of these work?” and the bonus is that I end up getting more fiber and meeting my fruit and vegetable goals because plant-based non-manufactured foods are often the most nutrient dense.

Today I visit the ENT to set up an old lady hearing test.

Treating my mallet finger

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.

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 mallet finger brochure

The doctor said there are three treatment options:

  1. Splint
  2. A surgically-placed pin
  3. 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.

Mallet finger cast

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