Monday, July 10, 2006

Adventures in Occupational Therapy

On Friday, I had my first occupational therapy appointment. The occupational therapist tested my hand and arm strength, and determined that I may have lost some strength in my left arm, but not very much, because it was still slightly stronger than the other arm. She asked me to tell her what activities caused pain, and she had me put my arm in various positions to see how it felt to me. We discussed some changes I need to make in my daily activities, and she gave me some exercises to do.

I told her some of the most important activities in my life that are painful: writing, holding things, opening doors, steering the car, sleeping (my arm wakes me up at night), cooking (in particular, stirring). She told me to keep alert for other things that are painful, and I have realized that taking a shower (especially pouring shampoo from the bottle), getting dressed, brushing my hair, and eating left-handed are also painful.

For my exercises I am supposed to stretch the affected tendon by pushing my wrist back while holding my arm out straight, eight times for a count of three seconds, then I am supposed to massage my tendon perpendicular to the direction of the fibers, and then massage it with ice for one to three minutes. I'm supposed to do these exercises three times a day. I've been trying to do them regularly but it's kind of tough to do it at work.

Another thing she did during the appointment was to give my elbow a localized medicine treatment. The shot the doctor gave me in December was helpful, but it's also kind of bad for your joints and also the medicine spreads throughout your whole body. But there's this treatment that she gave me that was totally cool and I have to describe it to you. Normally your skin won't let much of anything permeate it. That's its job, after all. But if you run a current through the skin, then molecules of this medicine can permeate through your skin and into the elbow. So she put this one patch containing medicine on my elbow where it hurts, and then she put this other patch without medicine on my upper arm right on top of a big muscle. Both patches had electrodes on them. Then she attached these alligator clips to the electrodes and hooked me up to a current for 15 minutes. She warned me that it would feel like a bee sting. Personally I thought it felt a lot like stinging nettles, which is irritating but it doesn't really hurt too much. She said she can do up to eight of these applications for one treatment. It takes more applications to work, but it's not as hard on your body as the shot.

She was impressed by the amount of scar tissue that my tendon has built up. When she looked for my medial epicondyl (the place where the tendon connects to the humerus) on my right elbow, she found it easily, but she had a hard time finding it on my left elbow because it was obscured by all the scar tissue. So I don't know how successful these treatments are going to be. But still, I plan to keep trying them and hopefully they will at least help. The surgery requires six months of recovery, and even then it might not even help. So I will go along with the conservative treatments until the doctor determines that it's just not going to work. Then I'll think about the surgery, and probably (since I am desperate) give it a try.


Grace said...

Good luck

Ginger said...

Good luck. I hope you get some relief.

Laura said...

Dude, do you have that much scar tissue because you waited so long to get it really looked at?

Not that I'm blaming you -- I know you felt you couldn't really get it seriously treated until you had better health insurance, but -- gosh, it's just too bad, and greater health care expenditures overall, if surgery could have been prevented by treating it earlier, you know? Another reason we need a single-payer system, I guess.

I hope you can get things to work out for your elbow. That really sucks, babe. Good luck!