Five months ago my right index finger was surgically repaired at the knuckle by a hand surgeon resident at the University of Colorado Anschutz emergency room. A freak accident involving a trash can, wet leaves, and my own impatience resulted in an awkward fall onto my knuckles and a torn tendon and joint capsule. (Read about the whole experience and involved anatomy here.) Although I am grateful for the care I received, and the progress my finger has shown, there have been some bumps along the way. Navigating healthcare efficiently seems to be almost impossible, even with some "insider knowledge". Without access to high quality care, good patient-provider communication, and reasonable health insurance coverage, both emotional and physical outcomes can be greatly affected.
Functional Update:
Overall my finger is better! But it still isn't 100% healed. Finger tendon repairs often have an extended recovery because of the complicated anatomy and the delicate nature of the tendon mechanisms. My recovery was complicated by a slow closing incision and a lot of stiffness associated with scar tissue. Luckily, the 30degrees of finger flexion that I am still missing doesn't greatly affect function and I can fully perform all work duties, lift heavy weights, and put my hair in a ponytail again. (But it does look a little ugly and fat.)
Healthcare Frustrations:
No one wants to go to the Emergency Room, but sometimes it is unavoidable. Overall, I was very impressed with the care I received from the intake team, nurses, radiologist, and pharmacist. My interaction with the hand surgeon resident left me in tears - not because the finger surgery was so painful, but because her poor bedside demeanor and her rough, pre-nerve block physical assessment was unnecessarily aggressive, in my opinion. My interactions at my post-surgical appointments weren't much better. There was a lot of waiting for 5 min follow-up appointments that did not provide a lot of helpful direction or information. Luckily, an occupational therapist (OT) made me a series of splints to help my tendon heal while still allowing me to work and work-out.
My finger has healed fairly well 5 months post-surgery. To get to this point, the combination of OT, my own physical therapy clinical experience, and doing my own research into my specific surgical repair, healing and progression was essential. Realistically, I still have another 3-6 months to go for full healing - a timeline that was not discussed or even remotely addressed by the surgeon. The only acknowledgement of prognosis was by the resident in the ER when she told me my finger was going to be "fine".
Moving forward:
Healing is a process, sometimes a very long process. "Fine" is not how I want my finger to function in the future, that is why I continue to help it heal by doing exercises, scar tissue mobilizations, use creams and lotions, do joint mobilizations and stretches, use swelling sleeves, tape it, and much more. Just because the surgeon discharged me from care and told me my finger was "good enough" and my insurance stopped paying for OT, doesn't mean I have to accept it. Healing takes time and effort, but it is worth it!
Helpful Hints to Get the Best Care:
Ask for recommendations from providers you trust and have them personally introduce you via email or group text
Fill out your medical history fully and accurately. Small things that seem unrelated could be a big piece of the puzzle.
Make a list of all your current signs and symptoms.
Write down all your questions before your appointment.
Communicate your expectations and needs directly.
Determine the best ways to follow-up with any additional questions or if anything changes.
Need a Holistic Care Team? Check-out the Denver Holistic Health Collective.
Sometimes outdoor activities and life lead to injuries. If you're injured, or looking to work on injury prevention skills, schedule an appointment! In-person visits in Denver, CO (Santa Fe Arts District) or virtual visits available globally.
Dr Jessica Klain PT, DPT, COMT, CSCS, OCS, CNPT
Board Certified Orthopedic Clinical Specialist (OCS)
Certified Strength and Conditioning Specialist (CSCS)
Certified Orthopedic Manual Therapist (COMT)
Certified Nutritional Physical Therapist (CNPT)
Certified Vestibular Specialist
Certified Concussion Specialist
Trigger Point Dry Needling Certified, Level 1&2
Certified Yoga Teacher
University of Florida, Doctorate in Physical Therapy (2009)
The Ohio State University, Bachelor of Science in Biology (2006)
Call/text: 720-295-0060