“If A is a success in life, the A = x + y + z.  Work is x, y is play and z is keeping your mouth shut.”  - Albert Einstein

The Andover Educators conference at Iowa State was fantastic.  I had 3 Alexander Technique lessons and a session with a physical therapist who is also a Feldenkrais practitioner.  All 3 of these gentlemen zoomed right in on the unnecessary holding pattern and I now have lots of things to actually do to get rid of this.  Part of it involves just saying “No” to the muscles that are trying to help.  In my case, “No, dammit.  Your help is not required here.  Thanks for thinking of me. “  Thinking of the upper ribs pointing up at an angle towards the shoulder joint helps release the squished feeling in my upper arm.  Having my first finger lead my whole arm into extension and noticing the texture of what I’m feeling helps get my finger/hand/arm integrated back into my whole.  The physical therapist actually mentioned 3 exercises for strengthening that he said I would be doing, if I were his patient.  I’m definitely going to check with my hand therapist.  He also told me that there is a special interest group for Performing Arts within the APTA (American Physical Therapy Association).  It’s a separate group from PAMA, although many of the practitioners are members of both.

I also performed in a masterclass for Amy Likar, Director of Training for Andover Educators, in my triumphant return to the stage!  I thought long and hard about throwing my name in the lottery of people who wanted to play.  What it came down to was that I’d like to see a master teacher work with an accomplished musician who is recovering from injury.  So often, injured musicians don’t want to deal with this is public.  In this case, I was absolutely confident that there wouldn’t be a more supportive audience for me anywhere on the planet.  Quite honestly, I was ridiculously scared.  I spent 15 minutes the day before just sitting on the stage with an empty house, wondering if I can do this or not.  I could and I did.  I asked my lovely friend Molly to accompany me on piano.  Nice to have a friend right there... I told her she could start talking to me in a cartoon voice if it looked like I was freaking out.  I’ve spent lots of time laughing at her trading cartoon voice messages with her own girls.  We played the second movement of the Taktakishvili Sonata.  This wasn’t the debut performance for my new flute that I envisioned back in August, but it was a success.  I still have a key extension on the flute for the first finger, as well as the water tube stuck on there to increase the diameter of the tube.  Again, a master teacher was able to guide me into ditching this stupid holding pattern and picking the flute up like I used to before being injured.  Nice to notice that I can generate a huge sound on this flute without having to work as hard as I used to on the old flute, especially when I’m not doing unnecessary muscular work.

It was nice to appreciated by people at this conference.  Moms generally don’t get warm fuzzies... or at least this mom doesn’t.  That being said, there are always people who aren’t happy no matter what you do.  The student workers at ISU were fabulous and definitely earned their money.  Other fun conference things:  my laptop died the night before my presentation (thankful for flash drive backup), my flight home was cancelled so I had to spend an extra night in Des Moines, and my reservation at the B&B was messed up so I was left scrambling for a place to stay the last night of the conference.

I struggled with the humidity there.  Going from the super cold air conditioning to the hot, humid Iowa weather was painful.  I could feel my hand expanding as I got out of the rental car to fill up the gas tank before returning it to the airport.  Then getting back in, the air conditioning made my hand feel like it was shrink wrapped.  The pressure changes on the airplane were not comfortable either.  Plus I tried to do my exercises, but I didn’t do them as often as I should.  Same for the icing - I made my own ice packs and had one set at the B&B and one set in the freezer at the music building.

Returning back to reality was hard.  It seems that I’m on 100% - no more extra help for my hand.  Fair enough, but it’s a shock to go from just taking care of yourself for a week to being responsible for two little people and a house.  Plus I was exhausted and have a ton of paperwork stuff to sort out for the conference.  Paying bills, writing checks, etc....

Got a phone call this week to interview for the adjunct flute position at a local university, so we’ll see what happens with that!

Key things I learned during this stage of my journey:

1) It felt fantastic to perform for an audience again.  There was a time in this whole process where I felt that I may never be able to do that again.  There’s immense satisfaction in knowing that I’ve done the work necessary to get to this stage.

2)  It makes me feel better to be around other fantastic musicians who are such caring people.  They understand the vulnerability that goes along with returning to playing after a devastating injury.  Not to say that ordinary people don’t get it, but these folks GET it.  These people are at the conference because they care about how bodies are put together and how they work.  They also understand the terrible feeling of frustration and emptiness that goes along with not being able to make music.  A soothing balm for my soul.

3)  I feel so sorry for some colleagues who have other physical issues that can’t be fixed surgically.  My injury is not fun, but it was something that can be fixed.  So I was very fortunate, because there is no easy fix for some musicians.  Sounds ridiculous to say that surgery is an easy fix because there has been nothing easy about this whole process for me.

“O snail
Climb Mount Fugi
But slowly, slowly!” - Kobayashi Issa (Japanese poet known for his haiku and journals)

I’m back and slightly embarrassed about being a month late with my post!  Lots of things going on around here during the last month.  I was able to do more and more each day, but it seems to take twice as long as it should to do each activity.  Doing more activity results in more soreness and more ice.  My current exercises, in addition to the triceps and biceps curls, are flexing and extending my wrist with a 3 lb. weight.  I also do an exercise where I hold the weight palm down with arm out to the side, bend elbow and bring wrist to shoulder and then return to starting position.  I also do three exercises with a regular claw hammer - pronate and supinate (palm  up, palm down) with holding the hammer in a regular grip.  The third exercise is holding the hammer, elbow in, then pointing the head of the hammer down towards the floor.  3 sets of 15 repetitions each.  The farther away your hand is from the head, the heavier it seems.  I have a piece of blue resistance foam that I squeeze between index finger and thumb and also squeeze the whole piece into my palm and hold.  Still doing the tendon glide exercises, sideways finger dancing, hand flat on the table and picking one finger up at a time, little balls, little dowel.  The temptation is to get busy doing other things and forget about therapy.  DUH.... this is where discipline is key.  My surgeon told me that rehab is tedious and boring, and I absolutely agree.  At least it’s not ridiculously painful anymore!  My focus as a long-time weight lifter was always about more weight and pushing to the absolute limit.  This is a much different type of endurance-building kind of strengthening.  I wish there was a shortcut, but alas, there is not.  Persistance is the key.

I’m able to play some slow pieces without much finger movement on my flute.  I officially gave up on the vertical headjoint.  It was so nice to have this since it allowed me to get back to the flute two weeks earlier than I would have if I had to start back with regular flute.  10 minutes is my limit, so I don’t really get to “practice” much.  It’s playing straight through and then the timer goes off.  Again, thankful for my trusty iPhone with its timer.

Typing is better, although I recognized one aspect of of an adaptive hand use pattern.  Instead of moving my finger from F to G, I was moving my whole hand.  Hah... retraining myself to use my first finger, instead of letting middle finger and the rest of my hand help out.  I’m able to hold the hair dryer in my left hand and dry the girls’ hair with the brush in the other hand.  I can peel and chop vegetables and fruit, even sweet potatoes.  I can use the carrot peeler and the can opener!  Still difficult to wash frying pans unless they’re small enough to fit flat on the bottom of the sink.  I actually picked up my keys from a table in Dunkin’ Donuts without thinking about it!

I’ve noticed a holding pattern on my entire left side which is no longer necessary.  It’s the protective holding of an injured wing, even after the wing is healed.  I’m aware of this, but not necessarily sure how to get rid of it.  My strengthening is now geared toward the whole arm and whole hand.  I continue to think about various muscles that attach to my arm structure, trying to figure out how to get them to just calm down.  This is similiar to having to desensitize my incision site with friction massage and other unpleasantness.  Happy to report that the scar adhesion is much improved.

My husband went to California for a week, my first time as solo parent since my surgery.  It was eventually fine but there was a huge amount of stress due to family health issues, allergies and just plain exhaustion.  But I made it through.  However, my icing and exercises didn’t happen, but there was just no choice.  So, there was a bit of a set back there.

June 5, 2013 - OT #9  Everything is progressing nicely.  All the hand strength measurements continue to go up.  She said that there’s nothing much they can do for me.  I have the exercises and have to do the work.  I don’t have to go back until July 10th!

I’m looking forward to attending the Andover Educators conference at Iowa State.  It will be so nice to see friends that I only see every two years at these conferences.  I have a fair amount of work to do as one of the organizers, so it’s sure to be exhausting.  But, it’s worth it since I learn so much and get to spend time with great people.  That’s what it’s all about, just like the Hokey-Pokey.

Key thing I learned during this stage of my journey:

1) This is boring, dull, tedious, monotonous and absolutely necessary.  Just need to shut up and “git ‘er done,” to quote Larry the Cable Guy.  Some days are better than others, but the sun always comes up the next morning.

Week Seven:  May 15 - May 22, 2013

“Knowing trees, I understand the meaning of patience.  Knowing grass, I can appreciate persistence.” - Hal Borland

It’s very nice to be free of the buddy wraps (velcro straps holding index and middle fingers together), so I can do things “normally.”  I continued to do my exercises, working on recovering full range of motion and was able to start strengthening exercises.  The therapist told me my goal was 3 sets of 15 reps of 5 pounds for bicep curls and tricep extensions.  Like an idiot, that’s exactly what I did on Day #1.  Hurts... hmm, what a surprise.  My poor little atrophied arm was complaining like crazy, which is exactly the point.  Gripping the bar is the most painful part of the whole thing.  Good news is that the swelling is down enough that I can jam my official weight-lifting gloves on.  Hello, old friends... haven’t seen you since October.  Nice to be able to wash both hands without having to take off straps or splints.  If something could be done with my left hand, I tried to do it that way, as an exercise.  Part of my job is to retrain my whole hand to work as a unit, rather than favoring a gimpy finger.  This means using all fingers on the coffee cup handle, and holding the fruit with all fingers.

On Saturday, I tried to plant my herb garden and discovered that my hand was done by 9:30 AM, with only 4 plants in the ground.  So I messed around weeding, trimming,etc. all with my right hand.  Had to come back later in the afternoon to plant the marigolds, which keep the bunnies out.  Did lots of extra ice and a minimum of stuff for the rest of the day.

Spent Tuesday AM in the ER with my 5-year old with a severe reaction to cashew nut.  Food allergies are something that I’ve dealt with my entire life and my 8 year old was diagnosed with peanut/egg/banana allergies when she was 8 months old.  I spent the morning without a shower or coffee,  covered with my kid’s vomit, and hoping that the reaction didn’t get any worse.  I didn’t do my routine of soaking in hot water, exercises, strengthening, and ice.  Discovered that if you don’t do the “stuff,” then you pay the price.  Oh well.. 1 step back for me, but I’ve made that up over the course of the next few days.  I did notice that “Hey, I’m using my hand without thinking about it” in the course of the whole ER experience.  My kid needed my attention for the rest of the day and it was the first day since my surgery that I didn’t do what I was supposed to do.

Flute playing is full of ups and downs.  I like the way my index finger doesn’t have to touch the tube with the vertical headjoint, but I can’t stand the sound.  I can’t seem to find the “sweet spot” on my face for that headjoint.  I did play for a few minutes with the regular headjoint and the sound is so much better.  I was fortunate to have a Skype lesson with my friend, colleague and mentor Amy Likar, who gently reminded me that my whole body is involved with the flute and that I can’t focus exclusively on what my index finger is doing.  She asked a question about my thumb...”Umm.... don’t know what they were doing.”  Very interesting to observe this in myself when one of the basic tenets of what I teach as a Body Mapping teacher is the absolute necessity of whole body awareness.  Encouraging whole body awareness even with the weight lifting - don’t hold your breath,  stop pulling head down, etc.  Glimpses of the incredible amount work that will need to be done to integrate my wounded wing back into the whole of me.  On the other hand, I’ve come a long way from a plaster cast and Percocets every 4 hours.

May 22, 2013 - OT #8  Wow!!!  I doubled my finger strength on one of the 4 tests measuring grip strength in 1 week.  The therapists were very excited about this.  All of the grip test numbers were higher.  Last week, I was relieved to find that my right hand could grip with 61 lbs. of pressure and my left was at 27 lbs.  So there was a mechanical reason for why I was dropping things.  I was given another set of strengthen exercises for muscles in my forearm and I finally had to buy a 2 lb. weight.  Of course, it only comes in pink and I absolutely hate all shades of pink!  Bah humbug....  I bought a green 3 pounder too and am hoping to move up to that one soon.  It has a foamy grip and it’s a bigger diameter, so it’s much more comfortable with my hand.   I also graduated from weekly therapy and am now going every 2 weeks.  My therapist said there’s not much else she can do for me now that I’ve got all the exercises.  I just have to put in the time.  She also told me that scars change for up to 2 years.  The adhesion that I have is still normal for this point in time and I just have to keep up with the scar massage.

Key things I learned during this stage of my journey:

1)  Recovery continues to take lots and lots of time.  How do people do this when they’re working a full-time job?  My kids and husband get it.  There’s Mom again, sitting at the table doing the hand exercises.  Oh yeah, she takes forever to get ready in the morning because she has to soak, exercise, lift, ice before she can shower.  I understand how professional athletes do this, they have the best of the best as physical therapists and have somebody else to attend to much of the little stuff that has to be done.  Kind of like supermodels who have nannies, housecleaners, personal trainers and chefs.

2)  Slow is good.  I’m able to do most everything in the kitchen, but I’m slow.  I’m usually moving so fast, it’s not bad to slow down and be a little more mindful.

Week Six:  May 9 - May 15, 2013

“Our greatest glory is not in never falling, but in rising every time we fall.” -  Confucius

I was able to play my flute three times for five minutes!  The vertical head joint is strange, but I’m so grateful to have it.  It was made by Sandy Drelinger and so graciously loaned to me by Alexa Still.   There is a thumb rest piece that attaches to the foot joint for the right hand thumb, similar to oboe, clarinet and saxophone.  The clamp that attaches this to the tube is extremely difficult for me to close since it requires pressure from both hands.  There’s a left hand support piece that I’m not using because I don’t want any extra weight on my left hand index finger/thumb. There’s a plastic key extension, also a Drelinger creation, which snaps onto the rods for extending the first finger down the tube.  So my index finger is closer to the middle finger than a regular flute set-up.  This is a good thing because I’m still working to regain full range of motion with my interosseus muscles which spread fingers apart.  The key extension is on a higher plane than the other fingers, which is also a good compromise for now.  The right hand thumb rest piece also has a bit that rests on your knee, so in theory, your leg should be supporting most of the weight of the instrument.  My new flute weighs 2 pounds, 3 oz, which doesn’t seem that much.  In reality, that’s significant for a surgical reconstruction.  Again, it was interesting to observe how things that happen to you change your perspective.  So, with this setup,  the base of my left index finger doesn’t contact the tube at all!  Perfect for now.

Due to the way flutes are designed, the left index finger is down for all but 8 notes in a 3 octave range.  It doesn’t take much for to close the key, but the issue is that it has to remain closed.  Press and hold, as opposed to press and let go for typing on a computer.  My index finger started to wobble at shake, which is a sign of weak muscles trying valiantly to do what is asked of them.  There was no stabbing pain, just slowness, clunky movement and stiffness, all of which are normal for this point in time.

Boring old long tones never sounded so good!  Except it sounds weird.  The new headjoint and the sound coming from in front instead of right side are both strange, plus it’s the brand new flute anyway.  I can’t complain though.  It’s a start!

I’ve learned to use how well I can feel the vibration of the flute under my fingers as a way to monitor the coordinated use of my whole body.  When one clamps down on the keys, like when a fast, notey, scary part is coming up, you can no longer feel the vibration.  With the vertical setup, I don’t feel the vibration in my right hand ever.  Perhaps that’s a function of the way the thumb rest piece attaches to the tube.  So, I did a little test.  Put the regular flute headjoint on, took the other stuff off, added a chopped up piece of clear plastic water hose to increase diameter of the tube for base of index finger and played an F.  Hallelujah!There’s my flute sound, my left hand can do it and vibration of the tube is restored. It was only a test, BeepBeeBeep.

The other therapy exercises were fine.  Trying to do the dexterity balls with my palm down was difficult at first.  I figured out that this was also causing my hand to hurt.  When middle finger goes up and index finger goes down (and vice versa) it was hurting in between the two knuckles.   I dutifully did my bicep curls and tricep extensions with my 1 lb. weight.  I tried with my 2 1/2 lb. baby plates from my weight bench, but the way I was holding it (middle finger down, first finger up) was no good.  Still stuck in the buddy wraps and can’t wait to be free of them!

The swelling in my finger is down a lot, but it makes the joint look like a golf ball in comparison.  More ice throughout the day seems to be helping.

May 15, 2013 - OT#7  I hauled all the flute pieces/parts into the office for therapy and my formal appointment with my surgeon. I realized that hand therapists don’t necessarily know and understand the specific needs of a flutist.  Their job is to get my hand back to functioning.  My job is to be very clear with what I need my hand to do.  All of the therapists came to check out the vertical headjoint and all the other ergonomic bits.  All were amazed at what professional flutes cost (they asked and I told them. One said, “that’s more than my car.”  Umm... yeah.)  In fact, one of the therapists wanted to know if I had a piccolo and if I could play the thing from Stars and Stripes next week.  My response was “Are you kidding?  Next week?”  I said that I’d love to play it in another month or two and would happily march up and down the hallway annoying everybody in the immediate vicinity.  I was given more exercises for active strengthening of my finger itself and my whole arm, which I’ll write about in next week’s  post.  The doctor was pleased with what he saw.  The annoying ache between middle and first fingers was normal for this point in time, same thing for the places along the incision line where adhesion is still a problem.  My flexion at MP joint was up to 90 degrees!  Dr. H. said I can play vertical headjoint or regular as long as I “don’t be crazy and stick with baby stuff, not notey flute stuff with low load/high frequency.”  Translation - 5 minutes at a time throughout the day.  The ideal would be to leave the flute on the flute stand, come by play it and put it down.  Come back the next hour and repeat.  I can’t do that with an expensive flute and 2 young children in the house.  And the final bit of good news, the buddy wraps are history!  I no longer need to wear them unless I’m doing something where I need extra support, like raking in the garden.  That was the example my therapist used, why would I want to use my fledging hand skills for garden raking?  Sorry, garden, it’s not going to be your year.

Key things I learned during this stage of my journey:

1)  Even my children noticed the lack of flute playing in the house.  Maybe they noticed because of their mother's grumpiness?  My older daughter came downstairs one day when I was doing my 5 minutes and said “That sounds good, Mom.  I haven’t heard any flute since Halloween.  Hey, why’s your flute look like a clarinet?”  Cool... she actually remembered what a clarinet looks like.  Maybe the world is really missing my flute playing.

2)  Returning to flute playing is scary.  Random thoughts like “I hope this isn’t going to hurt” and “Is this hurting or does it just feel weird since I haven’t done it for a long time” and “How about now?”  Trusting myself is difficult because the desire to play the instrument is so high.

3)  Recognizing, yet again, the importance of my iPhone in my healing process.  At first, the alarm was set for 3 AM so my husband could get my pain meds out of the bottle, so I wouldn’t miss a dose.  As if my hand would have let me miss, ever!  Then, the timer was used for icing purposes and then for timing the hot/cold water soaks with the contrast hydro-therapy.  Also using calendar to keep track of therapy, chiropractor and acupuncture appointments.  I’ve used Siri to input much of these posts into notes which I then email to myself and cut/paste. Now the trusty iPhone keeps track of my time and I also recorded myself one day playing one of the Trevor Wye’s long tone warmups.  It’s not pretty, not in tune, and not especially musical, but to me, it’s priceless.

Week Five:  May 1 - May 8, 2013

“Rivers know this: there is no hurry. We shall get there some day.”  - A. A. Milne, Winnie-the-Pooh

Everything was better this week, I’m definitely moving in the right direction.  However, I still wish my improvement was more rapid.  Waiting has always been hard for me.  I like to be in perpetual motion, like the ever-flowing stream in our backyard.

Some cool things that I was able to do this week:

1)  I realized, while lying down on the carpet, that my incision site was actually touching the carpet and that was ok!  I didn’t feel the need to jerk my hand away from the contact.  Interesting, I guess the friction massage does work to desensitize the area.  I didn’t actively doubt my hand therapists, but it’s always nice to discover that what they said is in fact true.

2)  I noticed, while chasing the soccer ball around the yard with my daughter, that I was running and my hand wasn’t hurting!  Fantastic discovery.  I went to my regular park the next day and ran my 3.2 mile usual path.  I refused to keep track of the time, I was just happy to be able to do it.  I was also able to walk the next day, which was a bonus!

3)  While waiting for my acupuncturist to come remove my needles, I realized that my fingers were thinking dominant seventh patterns.  I say “my fingers” because I wasn’t consciously trying to do this.  My index finger was moving right on time and in the right direction.  The last time I did this was in the hallway from the surgical staging area to the actual OR and it was octatonic scales. Sometimes, I just visualize the finger movement and other times my fingers actually move.

Some uncool things I discovered this week:

1)  I happened to look at myself in the mirror and noticed the atrophy in my left upper arm.  I’ve lifted weights fairly regularly since high school and have wide shoulders for a little girl.  It’s often a problem because my arms are too big to fit in the regular size armholes on women’s shirts.  This makes total sense, another example of the effect of separate parts on the overall functioning of the whole.  It’s ok... I know how to fix this once I can grip the bar and am cleared for this by the therapist.

2)  I was given permission to try the vertical headjoint flute.  The only problem is that I can’t put it together.  I’m not able to close the little clamp-like thing that attaches onto the flute tube.  My husband did it for me, but I thought “if you can’t put the damn thing  together, then you’ve got no business trying to do this yet.”  Disappointing, but not unexpected.  The physical pull of my entire being towards the flute is so strong.  The want to pick it up and play like I know I can just hits me in the gut when I look at the case.  Patience, my friend, it’ll be your turn soon.

May 8, 2013 - OT#6  Everything was good and the therapist was pleased with my progress.  I got 2 new exercises to do, both of which are variations on previous exercises.  Now I’m supposed to roll the dexterity balls around my hand with my whole arm extended, both palm up and palm down.  Palm down is tricky because gravity is no longer working for you.  The second variation is to use a skinny marker in addition to the dowel for rolling down my palm.  The smaller diameter makes it a lot harder to do and demands more flexion in all the finger joints.  Buddy wraps need to stay on for a while yet.  I was also cleared to do 30 reps of bicep curls and tricep extensions, with a one pound weight.  I don’t even have a 1 pound weight, but I do have a can of beans which weighs 1 pound, 2 ounces.  Close enough.

Key things I learned during this stage of my journey:

1)  Patience, patience, patience, patience.  Repeat.  Don’t push the river!

2)  Any improvement is improvement.

3)  This whole process is so insignificant in comparison to what other people are dealing with.  I’ve been following the story of Adrianne Haslet-Davis, the professional ballroom dancer who lost her foot in the Boston Marathon bombing.  She was interviewed on Dancing with the Stars and she said that this is the longest time she’s gone without dancing since she was 2.  She said that she’s going to dance again.  Of course she is, it’s who she is and every fiber of her being demands this!  Her life will never be the same.  In comparison, this stupid little hand surgery is going to be one of those things looked back on as a “pain-in-the-ass”,  a stumbling block, and a temporary time-out, rather than a defining moment in my life.  I look forward to seeing Adrianne dance with Derek Hough some day on DWTS!  You go, girl!

Week Three:  April 17-24, 2013

“Let us rise up and be thankful, for if we didn't learn a lot today, at least we learned a little, and if we didn't learn a little, at least we didn't get sick, and if we got sick, at least we didn't die; so, let us all be thankful.”  (Hindu Prince Gautama Siddharta, the founder of Buddhism, 563-483 B.C.)

I guess the theme for this week would be unhappiness and frustration.  When will my hand stop hurting?  3 months from now, 6 months, never?  It was so disappointing to feel my whole hand stiffen up in a claw shortly after finishing a set of exercises.  Will this ever go away or will I be dealing with this forever?  Yes, I know... have faith, be patient, healing takes time.  I know, really I do.

I decided to quit the Tylenol/Codeine cold turkey, which was probably not the best idea.   The regular Tylenol didn’t do squat for the pain and nasty withdrawal symptoms, which included GI issues, headaches, shakes, being cold all the time, and generally feeling like I was run over by a bus, lasted for almost 4 days. The bonus was that I could drive and mental fog has cleared!  The downside was that my baseline pain rate was higher. Driving with the splint on proved to be exhausting.  Why should this have been such a problem with short little trips like to preschool and the library?  It was marvelous to regain some freedom to go where I want, although it took twice as long to get ready.

My younger daughter and I walked the mile long trail at the park, which was great to be outside in the sunshine.  I drove myself to to acupuncture.  I discovered that I can’t get the produce in the plastic bags very easily at the grocery store.  Good thing I had a little helper.   I went to my older daughter’s 3rd grade concert and had a near panic attack while seated in the bleachers in the gym.  It was one of those weird Ohio spring days, almost 80 degrees.  The music teacher part of me was thrilled to see the bleachers packed.  The mom in me with the wounded wing was panicked because there were so many people packed in like sardines and I was afraid somebody would whack my hand.   At least everybody else was sweating too, so I didn’t stand out.

There was some dissent showing up in the ranks here at home.  I still couldn’t do much in kitchen because I couldn’t grasp anything heavier than a kid’s t-shirt or dish towel.  I certainly couldn’t hold onto soapy wet dishes or food to cut with a knife.

As far as the actual exercises went, I did see improvement in range of motion!  It was nice to not have the burning sensation of the sutures pulling on the new skin.  The scar massage was definitely not fun, but tolerable and necessary.  I typically have sensitive skin and had trouble with multiple different kinds of lotion and cocoa butter on my scar.  Now I suspect that I was outside without sunscreen and my new baby skin fried in the sun.  Needless to say, ice was my friend.

April 24, 2013 was my appointment for OT#4.  This time, I was with a different therapist, actually the same one who took my cast off.  I thought the appointment was for 30 minutes, and I ended up in there for 90 minutes.  Wow..... was this appointment frustrating and painful.  No more easy stuff, now I have to really work.  My numbers were all better for range of motion.  My exercises are working for full range of motion and also using my left hand to do things like shuffle cards and squish paper.  More about that in my next post.

Key things I learned during this stage of my journey:

1)  This too shall pass.  Sometimes you just have to put your head down and just get it done.

2)  It could be worse....

3)  Hand surgeons are amazing.  There are so many small structures packed into a little space.  It’s amazing that a surgeon can go in there and fix some parts without messing up 5 other things in the process.

4)  The amount of energy the human body spends trying to heal itself is no joke.  I have a new empathy for those in chronic pain for whatever reason.

5) It’s ok to be embarrassed, frustrated and angry that you can’t pick a penny off the table.    YET!

“I never saw a wild thing sorry for itself.  A small bird will drop frozen dead from a bough without ever having felt sorry for itself.”  - D. H. Lawrence

There is no energy left over feeling sorry for myself.  The horrible situation this past week at the Boston Marathon makes it almost ridiculous to concerned about moving a finger.  Some people lost their lives, other lost their feet or legs and their lives will never be the same.  I have lost nothing, my injury was repairable and will be no big deal in a year or so.  But still, it’a daily challenge.

The weather was beautiful for part of this week.  Walking around our 2.5 acre property was a new morning activity.  We have several trails that form a loop and my younger daughter loves to do laps with me.  One day we saw cardinals, nuthatches, a gold finch, doves, blue jays, a downy woodpecker and our regular red-headed woodpecker who visits our feeder.  The bird songs are refreshing, a true sign of spring.  There must be an iPhone app that lets you record bird calls and then push a button to find out what bird is making the sound, but I haven’t found it yet.  We also came upon a medium size garter snake, sunning itself in the middle of the path.  It seems like many creatures are happy to be done with winter.  Sunlight seems to have healing properties of its own.  At one point, my daughter ran ahead and lapped me on Lap 3 of 5 and said, “Come on, Mom.  Run, it’s fun.”   I know it,  as running has been my personal opiate since I could walk.  There’s a park nearby with a 3.5 mile loop right next to the lake and I would run after dropping my daughter off at preschool 3 times a week.  I’ve  run there before kids, while pregnant, while pushing a jogging stroller,  postpartum and now finally by myself!  Another devastating effect of this injury is that I haven’t been able to exercise in the ways I like.  In the winter, they were concerned about me falling on the ice and damaging the joint that was supposed to be healing.  Kettle bells and weight lifting - all off of the table because gripping even with the unaffected fingers stimulated a flexor grasp in the index finger.  I can do the exercise bike inside, but I hate it.  I feel like a hamster, endlessly spinning its wheel.  I’m looking forward to being cleared for running again.

As far as actual rehab for this week, there wasn’t as much rapid improvement.  I noticed a tingly feeling in the tip of my thumb, index finger and middle finger that spreads down the back of my hand when doing my exercises.  It didn’t hurt and  there was no numbness.  Increased blood flow?  Nerves recalibrating themselves?  Who knows! I experienced a feeling of release in palm, sort of between the base of the index and middle fingers. In order for extensor tendons to do their thing, the flexor tendons on the other side have to release.

A pattern was noticed with my exercises.  The 1st set of the day is “crunchy”, everything is stiff.  The 2nd is best, 3rd set is ok and the 4th set sucks.   There was really no surprise here, everything seems worse at night.   My one new exercise, palm flat on table moving tip of index finger side to side, was doable without too much extra effort.  I found that I was able to get more extension by placing a finger from the other hand on bottom finger bone and just feeling the touch.  There was no pushing or helping the finger to move, just a reminder of that “there should be movement here”.  The muscles in the hand itself (lumbricals and 2 sets of interosseus muscles) work together to help with extension and flexion, as well as side to side movement.  Not surprisingly, most of these muscles attach right near the joint that was repaired.  The stitches continued to itch like crazy and pull a lot during the exercises, which is really their job, ensuring that the incision doesn’t rip open due to the stress.  I did discover a little trick, blowing air, exhaling really, onto the stitches seemed to short circuit the pain response.  I did this at the every end of the moving into as much extension as I could get.  Sounds silly, but it worked for me.  Lotion, everywhere but incision, helped with the itching as well. The huge gobs of dry flaky skin have stopped.

Two acupuncture treatments this week again helped with pain and swelling.  I continue to do the post-surgical protocol of vitamins and supplements.  I also tried some ear seeds this week, tiny metal seed stuck onto acupressure points in my ears.  The idea of the seeds is to help with pain control, so I can hopefully get off the Tylenol/Codeine soon.   I was reminded about one of the great things of acupuncture, at least for me, is that it forces you into whole body awareness.  As I was lying on the table, listening to the music in the office, I thought “what about recording a flute cd for meditation or for use with babies at bedtime.  Would anybody buy it?”  Years ago, my mother-in-law sent a CD of lullabies played by a cellist, all proceeds of which went to one of the children’s hospitals in Australia. It was played nightly for at least  2 years in my older daughter’s bedroom. This CD thought was significant because it’s the first  thought I’ve had about future flute playing.  Early in the week, even thinking about picking up a flute would send shooting pain into my hand.  I first noticed this in an odd place, the restroom at a Panera around the corner from the hand therapist.  My treat is a coffee on the way home.  My daughter needed to go wash chocolate chip cookie off her hands in the restroom.  She noticed the music playing in there and said “Mom, I like this flute song.  Do you know what it’s called?”  It was the Delibes’ Flower Duet from Lakmé, a beautiful piece of music which my flute duet partner and I have performed. The very next thing I noticed was that my fingers remembered which note comes next, at least in the arrangement I played, and that my hand was hurting.  This too shall pass.  I decided that this was my body’s way of insisting “Hey, lady, I’m not ready for that yet.”

Other rehab successes include:  1) accidentally folded a kid shirt using my index and middle fingers (I was zoning out while folding and then noticed what I was doing),  2) tied my little one’s sneakers (double knots even) for school, 3) sewed 2 buttons on the big kid’s shirt,  4) made some lunch for myself, consisting of heating up mushrooms, left-over rice, chicken, garlic in a frying pan,  5) holding toothbrush in left hand to squeeze toothpaste with right hand, and 6) holding iPhone in left hand!

Funny rehab moments that weren’t a success:  1)  bra hooks, this was an experiment that failed and I’m staying with the sports bras with no hook, 2)  skinny jeans - can’t manage the button with one hand,  3)  washing a knife to use in the kitchen - can’t hold onto wet, slippery things yet, and 4) trying to put ponytail into little one’s hair. This one was a definite failure!

April 17, 2013 was my appointment for OT#3.  I improved a little bit with flexion, but actually lost a little with extension on my index finger.  This is not at all unexpected or uncommon, as my whole hand seems to be tighter as the healing process proceeds.  All the stitches were removed, although it was a bit of work for 2 different therapists to get the little buggers free.  I’m supposed to start with gentle scar massage for 3 minutes, 2-3 minutes per day after the scabs completely fall off.  Yes, you’re actually supposed to rub the place that hurts on purpose!  The idea is to prevent adhesion.  I was given one new exercise to do involving a dowel rod about 4 inches long and 3/4 inch diameter.  I’m supposed to hold it in my finger tips and roll it down to my palm, with no help from the thumb.  Again, very specific instructions with how long I’m supposed to to this (3 times a day, starting with 1 minute and working up to 3).  I’m allowed to do typing, actually using my index finger, for 5 minutes at a time.  Now I’m allowed to use heat before doing the exercises and I’m hoping that it will really help loosen up the stiffness.  I briefly saw my surgeon, as he was walking through the therapy room.  He was pleased with my range of motion and corrected my form, on 2 exercises.  Apparently what I thought was a neutral wrist wasn’t neutral enough for him.  He’s the man though, so now I’m using my right hand to limit flexion in my  left wrist so it doesn’t cheat and try to help the gimpy finger.

Key things I learned during this stage of my journey:

1)  There are lonely stages on the path - kids and husband outside planting lettuce and kale, me inside doing hand exercises and ice.  Emails, unexpected phone calls and visits from friends make all the difference.  Now I will pick up the phone and call or send a message to people I care about.

2)  I’ve already heard from several flutists who have read my blog and are dealing with similar situations.  My experience is actually providing some help to others, which is very cool and exactly what I hoped would happen.

3)  Some days are better than others.

4)  Waiting is hard.

5)  I was given this recipe for homemade ice packs:  3 parts water to 1 part rubbing alcohol in a Ziploc bag of choice.  It doesn't completely freeze, so it's slushy and easy to form to the correct shape for my hand.  It's also not too heavy and gets very cold!