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

Socks pose a threat

Good morning. As you may have seen on the post from the Parisian Phoenix Publishing blog, yesterday got a little crazy with F. Bean Barker needing a quasi-emergency vet appointment for a splintered toenail.

I did some housework, unpacked my Hungryroot box, read some of an old Harlequin and basically hung out with the dog while the teenager worked.

Now, with my cerebral palsy, I have a bit of an aversion to socks and shoes. They are hard to take on and off, and sometimes they make me fall. Just like “Agador Spartacus” in The Birdcage.

The teenager got home from her last dog client of the day around 8:30 p.m. Friday night, so I was happy to head to the shower and get to bed close to my regular work bedtime.

I had on my cute cat socks my neighbor gave me for Christmas which perfectly matched the baby blue sweater which had also been hers.

I had removed all my clothes and only had my socks left, and the shower was running. I slipped my left hand into my sock. It got a little caught around the heel. And oddly, I felt this enormous pop and thought I heard something.

But my sock was still on my foot.

So I swept that off and looked at my finger. Which was a little floppy past the last knuckle.

My finger fully extended

I laughed and hopped in the shower after screaming down the stairs, “I think I dislocated my finger taking off my socks.”

I kept laughing. Stress response. I didn’t even bathe because it became apparent there was something wrong.

Which made me laugh harder because I was removing my socks.

The teenager dragged me to Patient First. I have an official diagnosis of “mallet finger.” And if I chipped the bone I may need surgery.

I emailed my paperwork to my warehouse supervisor— as I can’t go to work until I see a hand specialist. And with the holiday tomorrow, that will need to wait until Monday before I can even find a specialist and make an appointment.

It looks like the prompt splinting of the injury may save me some complications later so here’s hoping.

More on this type of injury.

Some days you just have to declare victory

This is a post about Wednesday. It is now Friday, but I made these notes after my Wednesday night when I experienced a sense of piece and hope— I was in minimal pain and did 94% of my metrics in my home department at work, folding clothes.

The air was frigid with ice on the cars, but I was wearing the teenager’s letterman jacket (and I made the wise crack to my favorite security guard that it was not my jacket, she had left it in the car, and I know it must be really hard to believe that I was not in marching band.)

I knew the end of this week would be draining, even before they announced the elimination of our shift at the Stitch Fix warehouse as they transition from two shifts a day, five days a week to operations seven days a week. (As second shift workers, we get first choice of the shifts available, so the company is trying to accommodate preferences, but every shift starts before 7 a.m. so that sounds like torture.)

So Wednesday was dentist day.

I thought the teenager and I had appointments at 9:40, which meant retrieving the child from school at 9 a.m.

She made me an offer I could not refuse. If she peeled and quartered the apples our friend Photographer Joan of Plastiqueville brought so that I could make apple butter as I promised, could she just skip first period?

I said sure. That meant I could sleep until 8 a.m.

I think she later regretted her choice as she has still not finished.

Hopefully today I can use my voluntary time off to get this into jars.

And in true Angel fashion, at 8:45 a.m., I discovered our appointment is at 10:40, not 9:40.

The hygienist and dentist gave me a disappointed talking to about my teeth— apparently my middle of the night tooth brushing has been half-assed.

But no major issues.

So the day prior my physician has ordered x-rays of my spine, si joints and hips.

I thought with the shift change, the information in those scans was more important than ever. And there is a radiology office in the urgent care across the street from my dentist. I asked the teenager if we should stop.

My doctors office had recommended one of these smaller urgent cares as they might be less busy than the hospital or the central outpatient radiology office by the warehouse.

My gut said go there.

I didn’t listen.

Instead I went to the urgent care that my PCP’s office always recommends because it is close to my home and operated by the hospital network he works for. (The Lehigh Valley is in the middle of a hospital war— both St. Luke’s and Lehigh Valley Hospital buying up and building offices everywhere.)

(I watched Lehigh Valley build a hospital near the warehouse, one I believe they have been trying to build for a decade. It opened in July. When I drive by at midnight, it looks deserted.)

Anyway. We go to the urgent care by all the good food. The teenager has a book in the car. It is 11:40 and her next class starts at 12:30. I know the probability is we’re not going to make it, but I need these x-rays and her presence will make sure I don’t procrastinate.

I have been to this urgent care once before— my si joint had locked up and was seizing and neither my chiropractor nor my doctor could see me and I couldn’t even think through the pain.

The staff at this urgent care was lovely, but I waited more than 90 minutes, got told to take a hot bath in Epsom salts, ingest some ibuprofen and the best thing for me would be a massage. And I got a $200 out-of-pocket bill.

I picked this urgent care because the location is convenient and it’s in a higher middle class suburban neighborhood. But they are always understaffed and seems to be frequented by college students with no common sense and a certain element that I hate to classify as unsavory, but let’s just leave it as there was one poor man who needed to go to the ER, even I could see that, but he didn’t want to go.

The doctor was backlogged by 90 minutes so this seems like the normal wait time. I tried to slip out of the office politely but the office person (who was honestly coordinating a three-ring circus and remaining an angel despite it) wouldn’t have it. You see radiology is a different office. I was next in line.

The tech in the radiology room was a delight. I got all the x-rays I needed.

At work, a lot of people were congregating to discuss the upcoming changes. But at this point, I don’t understand the point of wasting time like that especially since things are still getting ironed out.

The Mirena seeks to be helping with my menstrual issues as cramps where they belong and the bleeding is significantly less.

And the apple butter smells amazing.