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.
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 straightenAt Patient First
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.
48 hours after injury The angle of my mallet finger 48 hours after original injury
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:
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.
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.
Angel Ackerman 