the hand institute | Angel Ackerman

Yesterday was Monday and I went for my second full physical therapy session. I admitted to him that the weekend got so crazy that time got away from me and I didn’t do as many stretches as the paper told me to. My therapist told me that was okay, as long as I was trying to walk as we practiced on the anti-gravity treadmill and kept stretching my hips to fight the internal rotation.

And I had another great session on the treadmill.

I also did extensive editing before and after physical therapy, to the point where I think I will have Larry Sceurman’s short stories ready for his approval tomorrow and I don’t see any reason why we wouldn’t send them to Gayle for design by early early April.

Later in the day, I went to the gym where we did primarily back and shoulders but also hip and core. That right hip, in a very specific location, was very unhappy with me. It’s something I’m going to have to look into with my physical therapist and my chiropractor and maybe my neurologist. My fitness coach Andrew wondered if it might be my IT band.

I noticed my fingers have not been tingling as they had.

I texted Gayle last night–if I made it up the stairs and to bed I would have earned my “fourteen days without a fall” graphic.

It arrived today.

I went to bed at 8 p.m. last night but couldn’t fall asleep until 9. I woke up around 2 a.m. and cuddled Louise for a while. I think she woke me, and I can’t help but wonder if she senses something about my heart rhythm. I heard my neighbor start his car at 5:45 and forced myself out of bed as my alarm was due to go off at 6.

I was exhausted. My blood pressure was perfect– 115/76– which made me think I should skip the morning coffee. But I needed to drive about 20 miles in morning highway traffic. I needed my wits about me.

A handful of peanuts, my SSRI, a beta blocker and a muscle relaxer, and a cup of coffee and I was good to go.

Hand therapy is always fascinating. Today I did the exercises I did last time (read about those here) and squeezed some putty. My therapist John took some measurements of my finger, and other than the swelling, there is only one angle that still has limited motion. So he gave me a piece of elastic and a safety pin to try and stretch it.

After hand therapy I called Nan, as I had promised to take her to the bank and to CVS. I had run out of Zyrtec the day before, and CVS had texted me and said my SSRI refill was ready. Still no word on my baclofen, the muscle relaxer prescribed by my neurologist. She had called me in late February (mere days before my first fall) and said she was sending in a prescription with six months of refills. The next day, CVS texted that they had received the prescription but the medicine was out of stock. I never heard from them again. I am almost out, but haven’t been taking it because they didn’t give it to me in the hospital.

I stopped along the way at Panera to use the bathroom and grab a cookie for breakfast. Panera makes an amazing oatmeal cookie with dried blueberries and raisins. When you consider the sodium, calories, sugar and protein, it’s one of the healthier choices. And it’s delicious. So I got one for me and for Nan.

I almost got back on the road forgetting my cookies, because I ran into a fellow library board member who called to me from across the store.

Once I picked Nan up we had a great time visiting her usual teller at the bank, whom we hadn’t seen in a while; going to the Dollar Tree (or as we like to say now the $1.25 cent store) for Easter decorations and cookies, where we ran into someone who lives in Nan’s old apartment building; and the most magic place of all– CVS.

We went to the pharmacy first. My SSRI was free, and I asked about my baclofen. They said my doctor canceled the order. I showed them the text, and I was told that was very weird and that I should call my doctor. I wonder if they asked her for a refill on the old prescription at the same time she sent a script for the new one, so she said no to their request, and they canceled both.

Nancy needed ibuprofen, a hair barrette and some Lysol wipes. I needed allergy medicine.

I had a coupon for $10 off 90 count Zyrtec or the house brand was on sale buy 1 get 1 50% off, with a $4 off coupon. I got 2-120 bottles for $40-something, versus the $60 the name brand would have cost for 90.

CVS brand pain relief was on sale, the big bottle was $19.49 and the smaller bottle was $14.49, but we had a coupon for $4 or $5 off $15 purchase, AND the smaller bottle had an expiration date of this summer versus late next spring like the bigger bottle. I had a 40% off coupon. So I thought that could cover the barrettes. The Lysol wipes were also on sale and we got the 35-count, and we had a 40-cent manufacturer coupon. (All the coupons came from the CVS app.) Nan’s total started around $32 and she ended up paying $19. In other words, she got everything for the original cost of the ibuprofen.

She loves accompanying me to CVS.

I brought Nan home, and when I got to my house I discovered that MY FIRST FIX ARRIVED FROM THE BIZZY HIZZY! I have been waiting to get a fix from Stitch Fix for 12 years! Joan opened it with me via Zoom.

I then ate a massive bowl of falafel and vegetables. I sent out a newsletter on Substack. Read that here. And attended a library board meeting tonight.

And don’t forget: Darrell Parry is hosting (and served as judge) for the Jean Corrie Poetry Reading & Ice Cream Social at Lafayette College Thursday. See the Substack or Facebook for details.

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

Angel Ackerman

Writer, Editor, Passionate Participant in the World

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All of it: the medical stuff, the Stitch Fix stuff and the friend stuff

Treating my mallet finger