Crunched

I’m not yet convinced that my hand will ever make a fist again, or that my fingers will stand up straight. For more than ten weeks I’ve been trying to train them, but like beginner yoga students, they don’t assume quite the right position without a push. The ring finger will bend nicely at the middle joint but hardly at the tip. Its little neighbor bends somewhat nicely at every joint but doesn’t stay in its own path, preferring to lie on top of the ring finger. The hand therapist measures my progress in millimeters, and when I get frustrated, she assures me that I’m getting better even if it’s not obvious.

Due to a reckless moment on my bike in early March, my right hand has progressed from total incapacity to partial usefulness to, now, a stiff and sensitive version of almost-normalcy. It started with foolishness, pain, and regret. During the second half of a long bike ride, I came to a familiar juncture where the bike path broke continuity to cross a busy street. I hadn’t been there in a while but I knew the way to get back on the path was to ease up onto the sidewalk via the curb cut … or was it? Maybe I had to get on the street, in the bike lane, instead. With a split-second maneuver I decided to do the latter, and a moment later saw that I’d been wrong. There was a curb between me and my intended route. From a place of bad judgment came the idea that I could jump it on my steel-framed touring bike. So I tried, and speedily crashed forward into the pavement.

Not wanting embarrassment to take hold I sat up immediately, brushing off the grit, noting my position on the bike path (hey, technically I had made it!) and my bike and pannier several feet away. We were out of the way of car traffic, at least. I wanted to forget about this and start riding away from the scene of shame before I attracted attention. However, the sharp pain in my right hand begged to differ. Since I was wearing gloves it wasn’t visually obvious that anything was broken or dislocated, but I was rapidly losing the ability to move three of my fingers. I tried to appear calm as I scooted across the ground toward my cell phone. It was a rainy day, so there were few other cyclists in front of whom I would need to play cool. My facade wasn’t completely effective, anyway. As I was on the phone with my friend Audrey, telling her that I needed a ride to the hospital, a motorist pulled over and asked if I needed help. I told her it was under control, but I must have looked pale and frightened because the woman wouldn’t leave until I could say with certainty that someone was coming. I started to sob into the phone.

Audrey was coming from across town and my boyfriend, whom I called next, was coming from across the state line to pick up my bike. While I waited, I moved the bike out of the way and paced back and forth, holding my hand up to my chest and trying to curse away the pain. A man who lived across the street approached and asked if I needed water, but otherwise I was left alone until my helpers arrived twenty minutes later. I ate a double dosage of ibuprofen on the way to the hospital and apologized to Audrey for smelling of sweat and being too distracted for conversation. I continued to apologize as she gave up four hours of her Saturday evening to keep me company at the ER. Together we watched my hand, now gloveless, swell up and darken with bruises while the X-rays were developed and reviewed. My fourth and fifth fingers were visibly crooked and the middle finger hurt almost as badly. We killed time in the busy waiting room, getting snacks from the vending machine and chatted with people who saw my hand and wanted to know what happened.

It was almost 9:00 when I was called back to a room to hear the results. The nurse pulled aside the curtain and, with a pained look, said that my ring and pinky fingers were “crunched” and would need to be repaired, possibly surgically, by a specialist. (The middle finger was simply bruised.) When I saw the X-rays weeks later they didn’t look too dramatic—no splintered bones or major dislocation—but revealed a pair of thorough, unclean breaks just above the knuckles. The hospital staff sent me home in a splint up to my elbow, and with painkillers to get me through the weekend. I slept erratically with the bandaged arm propped against a stack of pillows to keep my hand elevated. On Monday I saw the hand specialist, who said the fractures were unstable enough to recommend surgery. They would try to reset the bones manually under anesthesia, she said, but more likely I would have to be cut into.

Two days later I went under, and was not only sliced but punctured. When I woke up I learned that the surgeon had inserted three temporary pins to keep the bones in place, but I couldn’t see them yet under all the bandages. I was to start changing the dressings the following day, though I didn’t know exactly how. “Just look at how the bandages are now, and try to do the same thing,” they said. So, at home one day later, I laid out all my supplies—wet and dry gauze, plus a few things that the Internet recommended to keep my hand clean—and got unwrapped. My hand, still puffy and discolored from the initial impact, sprouted three rubber-capped pins from beneath the knuckles of the last two fingers, and an inch-long incision with sutures that poked up like insect legs. Everything was coated with either dried blood or yellow antiseptic goop from the wet bandage. I was horrified. That first dressing change took about three times as long as necessary because I was trying not to faint.

I still had to wear a splint that came up to my elbow. Over the next four weeks I learned how to competently unwrap and rewrap it, how to keep my skin clean around the pins, and how to place my arm somewhat comfortably upright while I slept. For day-to-day activities I relied to an uncomfortable extent on my friends, who dropped by to wash my dishes, clean the cats’ litter box, trim the nails on my good hand, and change the sheets on my bed. When I returned to work after a week off, I found my mouse thoughtfully repositioned to the left of the keyboard and the buttons reconfigured for left-handed clicking. I worked myself up to a pretty good typing speed with one hand. Out in public, I tolerated a stream of questions about what happened to my “arm”. It wasn’t readily apparent that a case of broken fingers could warrant such an extensive bandage.

Though I was taking hydrocodone and ibuprofen, the pain and sheer frustration had me crying in bed more than once. I missed riding my bike and taking care of my own household chores. I wanted to chop vegetables and cook. I wanted to not have metal shafts sticking through my bone and flesh; they inflamed the skin on my hand, and hurt like a bitch when my muscles twitched involuntarily. Everything was itchy, too. After the wounds had healed enough that I no longer needed to change my dressings, I still unwrapped the hand every day to attempt to dry out the rash that had formed, and to “milk” (in the words of my doctor) my increasingly stiff wrist and hand. Some of my friends wanted to see the pins during these episodes, while others hurried out of the room before the bandages were undone.

One month after surgery came the day I both longed for and dreaded: pin removal without anesthetic. Neither the surgeon nor her staff had told me what to expect with that, so I did some Googling (“pins removed from hand + pain”) and watched a couple videos on YouTube (“Pins removed from Brian’s hand NO ANESTHESIA!!”). I didn’t like what I saw—there were pliers involved—but I liked the fact that it seemed to be a quick procedure. When my appointment came, I put my head down so I couldn’t see anything while the doctor pulled and twisted and coached me to breathe deeply. It was over in a minute. I felt hugely relieved, but chagrined when the doctor wrapped my arm in the same splint I had already been trapped in for weeks. Fortunately she immediately sent me down the hall to a physical therapist, who unwrapped me and disdainfully threw the big splint into the garbage. She then gave me a molded thermoplastic split that covered only my hand; and with it, some measure of the freedom I had been sorely missing.

That was six weeks ago. Although my hand isn’t operating at full capacity, I am no longer wearing a splint of any kind, and the limits on what I can do in an average day have been stripped away. I am riding my bike all over town again, and washing my own dishes with a slightly funny grip on the sponge. I do my prescribed hand exercises at least three times a day, though I should be doing more. Twice a week I see my therapist, who measures my fist-forming ability and tries to massage the scar tissue into oblivion. She tells me that someday this will be just a bad memory.

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