Foxlily

Warning:  the following note contains some minor whinging, and could put you off your feed if you’re the sensitive sort.  The message:  be grateful for your hands, and don’t hurt them, or you’ll be forever sorry.

So here’s what happened:  late on the night of October 2, 2009, I decided to give the dogs a treat before we all settled in for the night.  A few weeks earlier, I’d put their biscuits in a heavy old glass canister, thinking that would be greener and better all around than continuing to store the treats in plastic containers.

I accidently tapped the canister against the side of the dryer, not very hard, while setting it down to remove the top.   The glass instantly shattered into guillotine-blade shards, almost as if the canister had exploded.

My husband, the engineer, says I must have struck the glass at some freakishly fragile spot.   I snatched my hand away as  broken glass  fell toward it.  This reaction saved four of the fingers, but the small finger was cut to the bone.  The sharply angled side of the heavy chunk of glass got everything:  artery, nerve, and most unfortunately, the flexor tendon.  Another flying shard nicked the enamel off the edge of the washing machine.

It looked bad.  White stuff visible.  You never want to see white stuff (especially your own bones).  Blood pulsing out.  It was immediately clear that this injury could not be fixed at home.

On the way to the local ER, I kept steady pressure on the artery, elevated the hand, tried not to bleed on the upholstery of my husband’s vehicle, and commented that I would likely lose the dangling finger.

The ER doctor took one look at the damage and phoned a hand surgeon from the Kleinert practice in Lexington, even though it was 1 a.m. The ER doctor would stop the bleeding and bandage the hand, and I’d see the hand surgeon two days later, on Monday.

There’s a window of opportunity for such repairs as can be made for these injuries, and the 48-hour wait was well within it.

I watched the ER doctor sew up the damaged flesh;  cut nerve, no pain.  We had a nice chat about etymology as he stitched.

At around 2 a.m., my husband and I got home and put the anxious dogs to bed after giving them the treat they’d not gotten a few hours earlier. While we’d been at the ER, they’d been shut into a small room to keep them away from the accident scene. Of course, they knew something was wrong.

My husband cleaned up the blood and broken glass:  considerable amounts of both.  How is it that people imagine they can cover up a messy murder?  So much blood, just from this injury to a small area of the body.  I was too upset to sleep, so I went out to the barn to check on the horses.  They are always a comfort to me.

Within 72 hours, reparative surgery had been done:  artery, flexor tendon, and even the severed nerve sewed up.  The surgeon told me that, unlike most people, who have two flexor tendons in their fingers, I have only one.  It’s a genetic anomaly, present in 12% of people.  This was a plus in that dual tendons sometimes gum up these repairs;  but a minus in that, if I ruptured this tendon again, a second repair would likely not be successful.

For the first several days, I wore a cast that immobilized the entire hand, except for the fingertips.  I kept threatening to saw the cast off myself, as it was terribly uncomfortable.  My entire hand hurt,  swollen against the cast, except for the nearly severed finger.   Cut nerve = no pain.  Always remember to cut the nerve if you must attempt to remove your own digits.

I reported to physical therapy,  where the cast was removed and I was fitted with the wicked brace shown below.   I was to wear it constantly for six weeks. Yes, those are ordinary clothing hooks, glued to the fingernails:  one of the more gruesome features of this apparatus.

The therapist who made the brace said that it was difficult to make one small enough for a woman, even a woman with fairly large, strong hands.  He said it was mostly men who tried to amputate their own fingers.  ”How?”  I asked.  A chorus immediately rose from the physical therapy room:  ”Chain saws!”  The next most common causes:  manufacturing machines,  power tools, and knives.

I could not drive for several weeks, even with the brace off.  Any sudden grasping with the hand could rupture the repaired tendon, which would then be ruined. I wore the brace for about a month, then ditched it and just bandaged the damaged hand. Although this was against orders, it turned out to be a good decision.  I believe I should have done it MUCH SOONER.

To the good:  although a grip strength of about 65 pounds in the non-dominant hand is average for a woman my age, I have an astonishing 85 pounds of grip strength in the damaged hand, compared to 92 pounds in the dominant, undamaged hand. I can fully bend the damaged finger.  Much of the feeling has returned (although this is bad, because now it does hurt), and circulation is normal.

To the bad:  the brace and the excessive mechanical pressure of those rubber bands and hooks did terrible things to the ligaments in the injured finger.  I cannot straighten it, and have a painful contracture. Both the pain and the degree of contracture are worse in cold weather.

I’ve done everything attempting to straighten the finger:  sat on it, plunged it into hot wax, massaged, pulled, and pounded it.   I’ve purchased and worn a series of medieval-looking splints and braces.  These have been painful and expensive, but have had no lasting benefit.

The best and most tolerable stretching devices proved to be a series of neoprene banana splints that provided a gentle, constant  backward pull on the tendon. These had the ridiculous name of “Dynamic Digit Extensor Tubes.”  One problem with them was fit:  the extra-smalls cut off circulation, turning the fingertip blue. The smalls slid right off.  I wish I could have some of these custom made, but know of no source.   It’s hard to find them anyway, and for what the are, they are extremely expensive.  They are also seamed poorly, so that the rough inner edge irritates the finger and creates an uncomfortable ridge of wadding inside the splint. But they are SO much better than the dreaded “Joint Jack,” a heavy, “one size fits all” device which, while not doing much for the contracture,  could ruin the joint in your upper finger unless your finger is enormous.  This is so much more than I ever wanted to know about medical devices.

Now, fourteen months later, the result I now have is probably what I will always have.  I hope pain and deformity continue to subside as time goes on.  My options are apparently limited, even if they don’t.

I had sort of liked the idea of a Harry Potter lightning bolt along the zigzag of surgical stitches, but the scar is barely visible.  It’s the contracture that’s the problem.

I’m told that if the hand were cosmetically repaired, the contracted finger could again be straight, but it would be useless, and there would be a loss of grip strength in the entire hand.  It’s my primary riding hand, and has always been my preferred hand for gross motor functions, such as carting the oat bucket or pitching hay.

Most women flinch involuntarily at the hand’s appearance and immediately suggest the cosmetic surgery. Most guys say that is no choice at all;  keep the grip strength.

So far, I’ve done the latter, but I am still quite upset about the maimed and painful hand.

I am terrified of glass containers.

I will never get another manicure, but in my case, I suppose that’s no great loss.

My injury was to the area of the flexors that hand surgeons call “no man’s land.”   Apparently the result I got was considered good;  in the past, a flexor tendon injury often meant loss of use of the affected finger.

I remain quite disappointed, given all the effort I put into physical therapy and into following orders.  I am very glad I ditched the brace when I did, as I believe the contracture would otherwise have been much worse.

I should not whine, I know.  But what a stupid, stupid thing to have done.  If I could take back anything in my life, and I do mean anything, it would be putting those dog biscuits in that glass canister.  Who could have guessed?

Guard your hands.  Be careful around sharp things.  Keep your dog biscuits in plastic containers.