Recovery Week #2: April 10-17, 2013

“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!



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