...a P.T. farewell

Pine Street Physical Therapy in Mudville...



about 2 miles from my house...
my afternoon destination on Monday, Weds & Friday...
for about 90 minutes a day for weeks...
[24 sessions = 8 weeks...]

Monday was my last PT session...
and I took along my camera...
so I could memorialize the journey...

when I first arrived each day...
I signed-in, then came back to the "hand room"...
to wash my hands and get prepped for the hot parafin...



first, the assistant wrapped my left hand in coban...
holding down my injured finger...
after I made a fist...
[or as close as I could come to one...]



then I dipped the wrapped hand into the parafin...
5 times....



after the 5th time, my now parafin encased hand...
was wrapped first in plastic wrap...



then swaddled in a towel to sit & wait 10 minutes...
while the warmth loosened all my tendons & muscles...



after 10 minutes of lovely warmth...
off came the cocoon of wax & wrappings...

and then came the "high tech" time...



you can see the ultra sound machine waiting...
but first, in the black case, the ASTYM technique...



the ASTYM [augmented soft tissue mobilization]...
is a method developed for use on scar tissue...
resulting from injury or surgery...
the heavy plastic tools are scraped across the affected areas...
[which have been liberally slathered with cocoa butter...]
causing the breakdown of the scar tissue...
and the regeneration of new soft tissue...
that will aid healing by allowing the body...
to drain away swelling and injured cells...



the hard plastic tools,applied with some pressure...
cause pain for some...
I was lucky...it worked perfectly...
and never hurt at all...

after the first treatment...
the persistent, rigid swelling in my injured finger...
went away... and subsequent treatments helped even more...



after the ASTYM...came my favorite part...



the massage...

although, at first, when my finger was still very stiff...
all the bending & manipulation wasn't fun...
[it really hurt...]
but, eventually, the pain lessened...
and I began to have healing sensations...
[nerve burning & pain in muscles that had been numb]

that's when I knew "it",[the PT...], was working !

after the ASTYM/massage/manipulation, came the ultrasound...



first the assistant would squeeze a glob of goo into my hand...



and then using her "magic wand"...
proceed to massage my finger for 3 minutes on one side...
and then have me turn my hand over...
transferring as much goo as possible...
and spend 3 minutes on the other side...

then it was "playtime"...

[in no particular order since we all had to share our "toys"...]



there was "putty" is several densities...
[different colors were different densities...]



I started with a light violet...
but soon moved to an orangy tan...
which after squeezing and rolling into a snake...
I was to pinch, using my thumb with each finger on my hand...
fortunately, it didn't hurt me as it did some...



then there was the "velcro" checkerboard...



using my thumb with each finger in succession...
I had to pull off all the squares...
and then replace them...
a total of 3 times...

[this could hurt until I got "warmed-up"]

I amused myself by creating geometric designs...



these dowels were my least favorite thing...



I only used the 4 biggest ones...



and while bending my fingers around them...
had to do 15 reps of finger tip curls...

OUCH !!!!



the graduated cylinders could be painful too...
I had to grasp the biggest one...
lift it up & put it on the next spindle...
then stretch my hand out...

then to the next, repeat...

the smaller they got, the more it hurt...

about 9 reps...



the most annoying task was "moving rice"...



I was to grab a handful of rice...
turn my hand over [so as not to spill...]
move it over the empty box...
turn my hand back over...and drop the rice...



at first, I couldn't close my hand very much...
so it took FOREVER to empty the box...
but as I got better...it took no time at all...

that is, unless I didn't get all the ultrasound goo...
or ASTYM cocoa butter wiped-off/rubbed-in...
then it was rice everywhere...
as it stuck to all parts of my hand & fell off at will..

all in all...

P.T. was a very positive experience for me...
I'd like to thank S, the "hand specialist" & her able assistant,V...
who did more to help me heal...
than anyone, including my doctor...
had ever expected...



so today, I "wave" a fond farewell to Pine Street...
thanking all those who helped me...

I also wish the very best & speediest recovery...
to all those who are still seeking relief from pain...
and restored use of their hands & arms...

vaya con Dios...

...WHY the doctor smiled

[the promised pictures from the last post...]



as you can see, the swelling is gone...
although there will always be a thickening at the joint...
[scar tissue in the cartilage...]



this is as straight as it gets at this point...
too much time with the lateral bands constricted...
it may loosen up, or not...
only time will tell...



when I took this picture...
it wasn't too loose...
sometimes, I can make more of a fist...
but this is a big improvement...



if you look closely on the left of the knuckle...
you can see the beginnings of the scar...
it comes down, perpendicular to the knuckle...
cuts across it...



and then cuts down, perpendicular, again...
creating a large, sideways, elongated "Z"...
across the knuckle...
[it's hard to see unless you make the picture bigger...]

so there you have it...

the next 4-6 months will tell the tale...

...and the doctor smiled....

still not on-line at home...

but today was my final appointment...
with the magic hand doctor...
and he was very pleased...

when he came into the room...
and began to examine my previously dislocated digit...
he smiled and exclaimed...
"that looks much better..."
"...there's a lot more movement...
and no swelling..."

he didn't think that it would heal this well...
I could tell by his level of excitement...

he examined it closely...[which HURT !]

and said that there was more range of motion...
than he had thought would come back....
that I should do as much with it as possible...
and if it didn't completely loosen up...
in 3 to 6 months... to return for more P.T....

my physical therapist had said that she expected...
that I would regain most of the motion...
and that it would eventually be able to be straight...
[as in "flat"...] again...

there's no swelling & I can put pressure on it...

and when it's "loose"...[ie warm...]
I can bend it down into my palm on its own...
when it's stiff, I have to stretch it out...
bending it down with my right hand...

they both say to exercise my fingers...
anything that requires digital dexterity...

such as...

sorting papers, filing things, stuffing envelopes...
[hmmmm...I can hear you laughing, MM ]

typing...aka blogging...
[I've GOT to resolve my ISP issues...]

playing piano...
[HA! if they only knew how bad I am at that...]

and...

"playing other musical instruments..."
[hmm...perhaps a recorder ?]

so, I have 2 PT sessions left [Friday & Monday...]
then...we'll just have to see how it works out...

in the mean time, I'll just have to find some "exercises"...
to keep my hand "busy" & moving...

strange how things work out, isn't it ?

[there will be pictures...today I forgot my camera...]

...PT ["pain & torture" ...aka "physical therapy"...]

yes, gentle readers...
I have embarked on the road to recovery...
[aka "physical therapy"...]
and it is clearly marked...[see above...]



it brings me here...
Pine Street Physical Therapy in Mudville...
[they also have offices in...
"the sleepy village to the north"...
as well as several other towns in the area...]

my therapist & her smiling assistant are very nice & capable...
on my first visit, she gave me a lengthy interview...
and took all sorts of measurements & administered tests...



one of the tests used this device...
which measures the pressure in your grip...
[right hand 50 lbs, left hand 25 lbs...]



another test measured the "range of motion" in both joints...
both from above & below...

after all the results of the measurements & tests...
carefully recorded...
the therapy session began...

first they had me make as much of a fist as I can...
wrapped it to keep the tendon stretched out...



and had me dip my wrapped hand...
into the melted parafin wax...
5 times... creating a waxy glove...
which was wrapped with plastic wrap...
and then in a fluffy towel...

I then sat for 10 minutes...
trying to let the warm relaxation soothe the soreness...
that came from making a fist and having it wrapped tight...

I learned from this...
& didn't let them wrap it so tight the next visit...



after the waxy glove was removed, the therapist massaged my hand...
which felt pretty good even though she was "exploring" scar tissue...
and swollen joints...[the hot wax is really relaxing...]
she even got my top joint to bend 10˚ farther after the wax...



she gave me these "tendon gliding exercises" & worked me through them...
she told me that if my finger was really swollen, stiff or sore...
after doing 10 reps, to cut back to 5 [which I had to do...]

taking into account the pictures are of a right hand...
and I do them with my left...

check out my progress...







yeah, I know that my injured finger...
doesn't bend as far down...
or go as flat as it should...
what you see is really quite painful...
and is my current limit...

AND I'm discovering some lingering injuries...
to the neighboring fingers...
that I didn't recognize before...
due to the severity of the dislocation...

she also wrote down some isolating exercises...
that I can't photograph since they take both hands...
[not to mention a thumb I don't have...]



this is an example of an isolation exercise...
that is moving only the top joint...

I'm supposed to hold my slightly bent finger...
between my stump right thumb and forefinger...
just below the top joint...moving just the top several times...

then grasp in a similar manner below the middle joint...
to isolate that joint & exercise it likewise...

not easy...

as I have to concentrate on moving the correct muscles, etc...
without cutting off circulation to the finger tip...
not too bad once you get the hang of it...
and these don't hurt like trying to make a fist does...
[have I mentioned that making a fist, of any kind...
really hurts ! ?]

to help combat swelling...
and to encourage my lymphatic system...
to flush out excess fluids...
she decided to wrap my finger...
[light compression helps the healing...]
with the same brownish stuff [Coban]...
that I'd been using to keep the surgical dressing clean...



[wasn't I just here?...]

oh well, 3 times a week for a month...
[2 down & 10 to go...]

this is NOT fun...but it's better than "Frankenfinger"...
it hurt ALL the time...this...I can handle...

"...alas poor Frankenfinger", it is no more...YEA !!!

this was the last portrait of Frankenfinger...
taken about 9 AM...



here, from behind...
showing why it was named "Frankenfinger"...
[the wire sticking out...? neck bolts...?]



and one last time from "straight on"...
also showing the knuckle closures...

and now... about 10:30 AM...

tah-dah...

no more Frankenfinger...



here, in a close-up, you can see the "hole"...



the doctor used some pliers to remove the wire...
& yes, it hurt when he pulled it out...
but it barely bled at all...

my finger is feeling better for the pin being out...
though it still hurts...
& will for a while as the "hole" fills in...
[a couple of days...]



here you see the pin, "out"...



since I couldn't satisfy my curiosity by seeing an x-ray...
I asked to have the pin so I could imagine how it was in there...
it doesn't look very big next to a tape measure...



but it looks gigantic next to my finger...



so here, I'm amusing myself...
trying to guess how it might have been positioned...



I'm actually kinda glad now...
that I didn't see x-rays of it,"in"...
I think it would have really creeped me out...

the "hole" will close up in a couple of days...
until then, I still have to keep a bandage on it...
and keep it dry to avoid infection...

I'm supposed to think of my finger...
as something that is frozen solid...
and let it gradually defrost by "melting"...
and to not try to hurry it along...

so I'm to slowly & gradually...
start trying to bend it...
and I've already been able to bend it...
just the tiniest bit... but it moved...

my next appointment is on St Patrick's Day...
if there is enough progress & movement...
I won't have to go to physical therapy...
so I'm taking it slowly & gently...

oh...and I am SO glad I have the finger cozy now...
since the current bandage is much smaller...
but at the moment, keeping the entire finger warm...
is very helpful for the management...
of the post pin-removal achy-ness & pain...