How to host Thanksgiving Dinner with a Hand Injury

How to host Thanksgiving Dinner with a Hand Injury

The American Society for Surgery of the Hand has published some good tips on avoiding a hand injury while preparing your Thanksgiving meal (ASSH.org; Turkey Carving Safety). But…. what if you already have hand pain from a tendinitis, or arthritis, or carpal tunnel syndrome, or a recent hand or wrist sprain/fracture/injury?  Anticipating a full day of hand intensive activity when you are already in pain can be intimidating and anxiety-producing. Here are some survival tips to help those with hand injuries host the big event  without increasing pain. 

  1. Ask for help. Although this seems like common sense, it is often hard for a host to request help from his or her guests.  However, most family and friends would be more than happy to lend (a literal) hand. And don’t some of the best holiday moments actually take place in the steamy, fragrant kitchen?  Generate a party atmosphere -sipping something bubbly while chatting and sneaking food tastes- all while sharing the tasks of chopping, stirring and dish washing. Enlist someone who is strong and injury-free to lift the turkey out of the oven or perform the turkey carving. When someone offers to help with the dishes, accept gracefully. 
  2. Cut corners.  Less work=less hand stress=less pain. Thanksgiving should be about enjoying time with family and friends.  However, often Thanksgiving becomes all about the food. Large quantities of food. So much food, that we are obligated to overeat.  Be creative in finding ways to minimize the amount of work you actually need to do. Would anyone really be heart-broken if there were  fewer dishes on the table (as long as Mom’s famous stuffing is front and center)? Would anyone know if you used onions that were purchased already chopped?   Or if that apple pie was made from pre-sliced apples and prepared pie dough? Or, better yet, bought at a local bakery?  How about throwing tradition out for one year and planning a potluck?  Or purchasing a packaged dinner from the grocery store?  Could you use bottled gravy?   Can the butcher pre-cut the turkey so that smaller and lighter pans can be used for cooking?  Or, if it’s a small gathering, how about purchasing a turkey breast rather than the whole beast?
  3. Preparation is key. Plan ahead so hand intensive and possibly pain producing activities can be spaced out.  Design a menu that allows you to perform some early meal preparation over the 2-3 days preceding the holiday. Include house cleaning tasks and preparation into your Thanksgiving plan as well.  Perform heavier activities early in the week and complete only 1-2 a day.  The more you can pace your activities, the less physical and emotional stress on Thanksgiving day. 
  4. Gadgetize.  Dust off those kitchen tools. Use food processors, electric can and bottle openers, even an electric knife to reduce physical stress on the hands. 
  5. Minimize.  Ease stress on the body by following some general principles of joint protection and energy conservation: use leverage rather than grip (such as those “Y” shaped bottle openers); push rather than pull; slide rather than lift (use a dish towel on the counter to slide heavier pots and pans closer to the stove so you don’t have as far to carry them); use comfortably bigger and cushioned handles (the Oxo kitchen tool line is a good example). 
  6. Be practically festive.  Bring in some holiday cheer with a themed paper tablecloth and napkins (less laundry) and sturdy, decorative paper plates and paper or plastic glasses and stemware (fewer dishes). 
  7. Take time to care for yourself.  If, in spite of all your preparation and planning, your hands are more painful or swollen by the end of the day, sit for a few minutes, put your feet up and apply a cold pack.   Perform only the most necessary clean up. And aim to have a relaxing day the following day. Intending on carrying a bunch of shopping bags on Black Friday?….although fun, perhaps not the best timing for the hands.  

Wishing you and yours a healthy and happy Thanksgiving. 

Best, Marji

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Self-Adhering Bandage & It’s Many Uses for Hand Injury Recovery

Self-Adhering Bandage & It’s Many Uses for Hand Injury Recovery

Self-adhering bandages can be a wonderful way to hold dressings in place or to cover an open wound in a hand injury.  Because the bandage sticks to itself and not to the skin, it is an ideal choice for those who are allergic to adhesive or whose skin tears easily.

In addition to the obvious use as wound coverage, self-adhering bandages can also be used to accomplish a variety of goals during the recovery of a hand injury.

The self-adhering bandage can be used to buddy-tape an injured finger to an adjacent finger.  This provides protection for the injured finger.  Buddy-taping can also be used to mobilize an injured finger that is at risk of becoming stiff (of course, only use it in this manner if the injury has healed to the point that motion is allowed).

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When used as a spiral wrap moving around the finger from the tip towards the wrist, a light compression can help reduce swelling in the finger or a finger joint.  Be careful not to put the wrap on too tightly.  Just lightly take up the tension as the wrap is applied.  Remove the wrap if it appears to be compromising the circulation of the finger in any manner (for example, if the finger tip turns cool or purplish or if the wrap causes pain).

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Self-adhering bandage can  be used to create a stretch for stiff fingers.  Wrap the fingers that need to improve motion into a gentle bend.  Keep the bandage on for 20-30 minutes, 3-4 times a day.  Remove immediately, however, if pain increases dramatically.

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Self-adhering wrap can be used to correct for a rotational misalignment by gently spiraling the wrap into the corrected position and strapping the injured finger to the adjacent finger.

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Self-adhereing bandages come in a variety of sizes and colors.  It can be purchased through medical supply companies, pharmacies, and even veterinary supply outlets.

Paraffin Bath – Good for Scars, Joint Pain

We often use heat as a modality in the hand therapy clinic to warm up the hands in preparation for therapy.  A paraffin bath is one of the more intense forms of applying heat.

During the hot wax treatment, the hand is immersed in a “spa” of melted paraffin mixed with mineral oil.  The oil lowers the melting point of the wax (to about 120 degrees) and makes it tolerable for the body part to be immersed.  The hand is dipped 4-5 times with a brief pause in-between dips to let the wax set.  This layering creates a thicker coating of wax.  After the last dip, a plastic bag is placed around the waxed hand; then towels are wrapped over the plastic to hold the heat in for 5-10 minutes.  Because of the oil in the paraffin, it slides off the hand smoothly when the treatment is complete, leaving the hands feeling soft, moisturized and warm.

The Paraffin Bath is useful for several conditions.  

  • The intense heat is good for circulation.  
  • The penetrating heat can ease aching.  
    • It is often used in arthritic conditions with good relief of joint pain.
    • Aching from chronic repetitive injuries may also respond well to the wax treatment. 
  • Stiff joints will feel more flexible after an application of wax.  
    • Good for arthritic stiffness.
    • Also works well with stiffness caused by fractures, dislocations and other trauma.
  • Scars respond well to the heat and the coating of mineral oil, making them softer and more pliable in preparation for scar massage techniques.

Do not use a paraffin bath in the following situations:

  • If there is numbness in the hand.  
  • If you have an open wound.
  • If you have an injury that is acute, hot, swollen, inflamed.

To keep the paraffin bath as clean as possible, wash your hands well and dry them thoroughly before immersing in the wax.  If you have purchased your own machine, you can re-use the wax (however, we do not re-use wax in the clinic).  

Paraffin Baths are easily available, both online and in local stores and pharmacies.  Simple and small home units are priced around $40.  A larger, more durable model can range in price from about $80 to close to $200.  

It is possible to make your own bath at home using an old pot in a double boiler or an old crock pot set on low.  This can take a bit of time each session for the wax to melt.  Once melted, turn off the heat and monitor the temperature until the correct temperature is achieved.  It is important to use a thermometer to make sure that the wax is not too hot in order to avoid burns. The temperature should be 120-125 degrees. 

Recipe:

  • 2-4 blocks of paraffin
  • 1 ounce of mineral oil for each block of paraffin
  • drops of essential or scented oils as desired (optional)

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Reflections On Being An Angel

Reflections On Being An Angel

Last week, a patient told me I was his angel.

Being caught up in the normal busyness of everyday life, I haven’t had a chance to reflect on the meaning of his statement until now. Did I do anything special or miraculous to deserve the title? Nope. I just did my job – hopefully in a caring, compassionate and respectful manner. So why was this glorified designation bestowed upon me?

This intelligent, energetic man had his life unexpectedly turned upside down after waking one morning with red streaks heading up his arm. During a home project several days earlier, he had jabbed and cut his thumb with a screwdriver. Having been a pharmacist, this gentleman knew all the right things to do. But that didn’t stop the infection from coming. He’d just been to surgery to have the wound cleaned and then his surgeon referred him to me.

When he arrived, my patient told me that he was anxious; that his wound didn’t look good; he didn’t like the color; it was healing too slowly; it didn’t feel right. During our first session, I cleaned and redressed this gentleman’s wound, I reassured him that the wound looked healthy and not infected, I guided him in exercises to prevent stiffness, and I learned that he had a granddaughter graduating from 6th grade that afternoon.

When he returned for his second visit, this patient of mine brought his wife. The wife was excited to tell me that her husband had come home a different man after that first visit. Much of the worry about his injury was gone.

At his third visit, the gentleman was pleased to tell me that he felt 80% better than at his first visit. He also told me that he had sung my praises during a visit to his internist that morning. Although he was exuberant in his thanks, did I believe that I had done do anything angelic yet? Still, no. Just putting in a good day’s work.

All I did, in addition to providing wound care and range of motion exercises, was listen, give reassurance and hold out the hope that there would be a full recovery. Yet, I’m told more and more often by my patients that health care professionals are too busy to answer questions or to provide comfort. This isn’t surprising as reimbursement for medical services is being cut and caseloads are increasing.

Another common phrase we hear in the clinic – “Why didn’t anyone tell me these things before?” It is often left to the therapist to provide injury information and recovery education. With our health care system, physicians are just too busy. It is a good thing that we, as therapists, still have the time to develop a therapeutic relationship and be a safety net….as long as we are getting referrals. But where are the angels for those who aren’t referred due to lack of insurance or who have a high deductible; who have busy schedules and are unable to attend; or who have doctors who decide to wait, sometimes for a month or two or even longer, until a problem is large enough to warrant referral?

Our profession recently celebrated Hand Therapy Week. It was a good time to reflect on the qualities that we have that enable us to treat upper extremity injuries with skill. But we must never forget that it is the personal relationships that we develop with our clients that give us the ability to change lives.

Would my patient’s wounds have healed if he had never set foot in my clinic? Absolutely. But, it would have been a longer, more stressful, lonely journey for him. And I guarantee that he would not have enjoyed his granddaughter’s graduation as much as he did if, during the ceremony, he was as worried about his hand as he had been when he first arrived at our clinic.

So, I will try to remember, in spite of all the administrative stressors, why I became an occupational therapist in the first place. I will appreciate the hugs my patient gives me after every treatment session. And I will accept this man’s role as his angel with honor.

Best wishes, Marji