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.
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.
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 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.
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:
I am moving wrong, or
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:
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.
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.
I don’t think anyone will disagree with me when I say that medical insurance and medical billing in the United States makes no sense. It’s unfair to patients, unfair to doctors and makes the lives of medical office staff ridiculously complicated.
Let me just give a disclaimer that anything I say in this post is not a reflection of the skill of my physicians or the caliber of my care as both have been excellent.
But basing medical care on the decisions of private insurance companies attached to employment is reminiscent of the “company town” days when employees lived & worked in the same place and businesses profited on and controlled the life experience of their employees. Check out the old coal mines. I am from Pennsylvania after all.
I have spent much of the last year bouncing from specialist to specialist trying to learn how my body works as a 40-something with cerebral palsy and now, almost three weeks ago, I ruptured a tendon taking off my socks.
Last night, when I was already slipping into a fragile emotional state feeling lonely and physically broken (hey, it happens. We’re all human and have moments. Mine happen after dark while binge-watching medical dramas.), the teenager brought me the mail.
I open my EOBs from my insurance company. Now, I know my recent misadventures will be expensive. I also know my therapist has recently sent me a $600 bill and apologized but said he can’t deal with my insurer anymore. But that’s another story and after almost 15 years with the same mental health professional… I will take care of it.
But this particular EOB charged me $200+ to see a specialist (fair) and a $2,000+ fee for surgery. Surgery? I walked into the office, an assistant removed my splint, he looked at me, he looked at the imaging done by Patient First, told me to get a cast and go back to work, and told me to make a follow-up for May 18 and left.
The assistant helped me put my splint back on, I left his office, went to another medical office (unaffiliated with him), filled out new patient paperwork, paid a $50 deposit, and received a cast.
Does any of that sound like surgery to you?
Being an anxious woman of a certain age with a hand injury, I did what seemed best at the time: I poured a whiskey and diet cola and grabbed the bag of sriracha pita chips and binged.
In the morning, I discovered I put my underwear on backward. I had two cups of coffee and a glass of water (I won’t eat until I get hungry) and called my insurance company.
“I’m not aware of having surgery so I’m confused.”
They arranged a three-way call to the doctor’s office.
The woman, who was polite and professional said, “so you’re not being treated?”
I said, “well yes I am.”
And she explained that’s a blanket term for tendon repair.
I replied, “Okay, so this was not explained to me. Let me just get some clarification. I paid the office fee, so the doctor could evaluate me, and he also gets an additional fee? Even though he sent me to a different doctor for the cast?
“Oh, she explained. “It covers any additional treatment in the next 90 days.”
Well then I hope that covers the office visits for all my check-ups and follow-up care.
I thanked them both— the representative of the insurance company and the billing clerk at my specialist’s office. But this is just another example of how the American medical industrial complex complicates and threatens patient care and a patient’s concern for if that care will financially destroy their stability.
** the title of this piece is a reference to me using binge eating as a coping mechanism
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.