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.

11 weeks in with mallet finger: Discharged from hand rehab

This week marked my 11th week in treatment for my mallet finger. Almost three months caring for this injury. 9 weeks in a cast. About 9 days in a splint 24/7. One week in a splint most of the day, taking it off 5X a day for an hour.

This morning was my third had rehab appointment since the cast came off. They also did the casting so I had two previous visits with them.

Typically, I go in, they make me bend my fingers and they measure everything, tell me the following week’s directions and send me on my way.

Today I went in, the had me heat my hand for 15 minutes and then I got a finger massage. The therapist measured my finger and made me a new night-time splint and told me I no longer need to wear the splint during the day.

Because I do so much work with my hands, if it starts to droop or just bothers me, I can splint it here and there for an hour.

I have another appointment with my hand surgeon July 27, so although the general guidelines say I only have to splint at night for 2 more weeks, it is recommended that I wear it until I see my specialist.

Other wisdom from my therapist as we chatted today:

  • Completely immobilizing a mallet finger for six weeks is the minimum in his opinion.
  • The finger can continue healing for an additional six months after splinting is complete. He recommends using individual judgment and awareness of the finger to decide how long to splint at night.
  • Massage the finger, especially the joints for five minutes several times a day.
  • Understand that the finger may never resume its former shape/posture/movement but that the end of the finger itself doesn’t have that big of a role in hand function.
  • Keep bending the fingers several times a day, gradually working into a fist.

Mallet finger update: I’ve had it with this splint

Today was my last official day working with a disability accommodation in the Stitch Fix Bizzy Hizzy warehouse. It’s Sunday, tomorrow is the Fourth of July, and I had a helluva time getting out of bed when the alarm went off at 4:15 a.m.

So I didn’t.

I was in the middle of an anxiety dream where I was with an old friend that cut off ties with me a decade ago… and I think a few people I’ve lost were in that dream.

I reset my alarm for 4:45 and started my day a little off and then the Keurig decided I only deserved half a cup of coffee. As. If.

Today was my first day working in my new splint. (If you didn’t know I lost the first one in my car, you can read that story here.)

I’ve suspected since Friday afternoon that my new splint was too tight, but I didn’t confirm it until I started to see marks on my finger, deep ridges, yesterday.

During work today it got pretty unbearable— so when they let us out early I came home, heated the teapot and dropped the custom splint into a bowl.

I poured the boiling water into the bowl and reshaped the plastic. It’s not nearly as perfectly molded as the professional job, but it doesn’t pinch my finger.

Mallet finger: week 10-ish

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.

Apex 100, the strawberry Frosty and a makeshift splint

I wept tonight. I nearly wept myself into a panic attack. My guts are still fluttering. And I flung things down the stairs.

But that’s the end of the story. Let’s start at the beginning.

On Monday night, after the teenager’s car accident, I went to Apex Training for my 100th session at the gym since I started about ten months ago.

Because it was my 100th session, the my trainer picked out 6 exercises for me to do 100 times, at my own pace, breaking them into sets as I saw fit.

I was a little stiff the next day, which was yesterday, but I still managed to do 100% according to the metrics at work. But my the end of the day my right leg was unsteady.

Today I woke up very stiff, with my muscles in my lower body so tight I struggled to bend and I had even less control and stability in my right leg.

I only made about 90% today.

By the end of the day, my right quad had this dull burn to it, but it didn’t really hurt. But it was getting more and more difficult to control as my stiffness dissipated.

But the teenager and I still made it to my 101st session at Apex and celebrated by trying the new strawberry Frosty at Wendy’s. Which, by the way, is much tastier with a Wendy’s sugar cookie.

I took my custom splint off— today marks one week of wearing it and taking it off every 3 hours for occupational therapy exercises and when needed “for hygiene.” And the finger is looking steady!

I removed the splint to wipe down my hand with a wet nap before eating. I set it down carefully in my lap. And then it just disappeared. I checked the take-out bag. I checked my bra, the car compartments, the seat.

The teenager told me to stop wiggling around that it had to be in the car and we’d look at home.

We didn’t find it at home.

So I went to the kitchen and started to cry. my finger had looked so good wrapped around that Frosty cup as I smeared the Frosty on my portion of the cookie the teenager and I shared.

I checked my local CVS’s website: no splint in stock. So I checked my local Walgreen’s: no splint in stock. And so it went.

Still upset, I found a piece of wood my cockatoo had stripped from her toy and taped it to my finger.

My splint. Hopefully I’ll find a better solution in the morning.

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?

Free the Finger! Cast-free after 9 weeks

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

Four week mallet finger update

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.