Friday, January 10, 2014

Good news! Good news!

If you heard that in the voice of Rosco P. Coltrane, I automatically award you oodles of cool points.

I had OT this morning.

Even though my last evaluation was on December 23, and they're supposed to be about 30 days apart, my occupational therapist decided to do an evaluation today, because I see my surgeon on Tuesday. She wanted to be able to give him a recent and accurate progress report.

Let's reminisce a little, shall we?

I started OT on October 30, 2013. At that time:

  • I had a whole 8lbs of grip strength in my right hand. (In my left, by comparison, I had 40lbs. That meant I should have about 45-50lbs of grip strength in my right, under normal circumstances.)
  • I had a whopping 11 degrees of extension in my right hand (palm down, lifting up). Normal is 60-70 degrees. This is when I learned that I am a freak, because I have 78 degrees of extension in my left hand. And, because I have freakishly flexible ligaments, that's the reason I'm feeling like I'm in the sixth circle of hell. Any tightness is magnified times about a zillion because I'm so used to having ligaments that stretch and move like crazy. Gee. Even my ligaments are overachievers.
  • I had very little pinch strength. Pinches are kind of important; they're used to button things, put in earrings, pick up small items.
  • I had almost no lateral motion (moving the wrist side to side, from pinky to thumb).
Four weeks later, I was reevaluated:
  • Grip strength test: "Give it all you've got," my therapist said. We did this three times. I actually yelled during the last attempt. ("Well, that didn't help at all," she said.) 16lbs of grip strength. Hey, it's a 100% improvement! Still pathetic? Yes.
  • I had about 25 degrees of extension and 35 degrees of flexion. Not even approaching normal levels.
  • Pinch strength was still at less than 5-10lbs per pinch (thumb on top of fingers, one-finger pinch with the index finger, two-finger pinch).
  • Minimal range of lateral motion.
The second week of December is when my therapist decided that I needed a more "aggressive treatment" plan. That's when I got the splint. By forcing my hand back, it would help force the scar tissue and underlying adhesions to stretch more. There are two rows of bones in the wrist, see, and the scar tissue was wedged between them. (I do nothing halfway.) This actually helps in flexion; the scar tissue forces the bones apart the way they need to in order for the wrist to flex. It inhibits the extension of the wrist, because the scar tissue blocks the motion of those bones, and they need to kind of move over each other. I started out using the splint for five minutes at a time. (I'm now up to 12.) I was also started on a more aggressive set of exercises designed to improve my grip strength.

I was reevaluated again two days before Christmas:
  • I had 25lbs of grip strength.
  • I had 45 degrees of extension and almost 60 degrees of flexion. This meant I was at minimal levels for functionality.
  • Pinch strength was up to normal ranges for all (between 8 and 15lbs, depending on which pinch).
  • Lateral motion range was between 10 and 15 degrees, depending on whether I was flexing toward the thumb or the pinky.
After this evaluation, I got bumped up to the highest level of strengthening toys. I used only the highest weighted clothespins, used the rubber TheraBand balls with the most resistance, used the toughest resistance levels on the Digiflex weighted grips, and we started adding the 2lb weight to the extension/flexion exercises. And the parrafin wax treatment came first in my therapy sessions, with the addition of a hot pack and weights to help stretch out my wrist.

Are you bored yet?

Today, I was evaluated again.

We both almost jumped up and down over today's numbers:
  • 34lbs of grip strength, which she said will continue to improve as I do more and more daily tasks. That's the best therapy for that now.
  • 59 degrees of extension!!! We could not believe it. That's one degree off normal! 70 degrees of flexion! So awesome. All of that without stretching, without massage, without using The Extractor, without doing anything to improve the stretchability of my ligaments.
  • Lateral motion range about the same as before.
I got officially discharged from occupational therapy today!

I will continue to do certain exercises here at home for the next few months. I need to continue to use the splint until the end of March, at least. The scar tissue still needs to be massaged and worked on, to loosen it up as much as possible before it matures (I didn't know scar tissue did that) and won't relax any further. That won't happen until June or July.

I was so happy I almost cried. In October, I didn't think I would ever get better.

I was also so sad I almost cried. In the last three months, my therapist has become my friend. I'm going to miss seeing her.

She almost cried for the same reasons.

I'll miss going to therapy. I really will.

The $80 a week in copays, however, I will be happy to miss.

1 comment:

  1. Go you! Getting done with OT is a wonderful feeling.


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