18 November 2010
1:40-5:40 4 hours
When I came in Tuesday Nicole was building an intricate splint to hold a man's wrist in place and make it immoble. Today she told me about this man's case and how he is a 'miracle patient'. In 2003 the patient was hit by a car in a hit and run accident where he was pushed over a fifty foot tall bridge. He recieved a terrible spine injury during the fall where he became a parapalegic in the right side of his body--he no longer had control of the entire right side of his body. He spent an extended period of time in the hospital and was told he would never walk again or feel the right side of his body. Miraculously about six months to a year later he began unexpectadely regaining nerve and limited muscle function in the right side of his body throughout his leg and arm. Certain parts of the right side of his body now function allowing him to walk, with help and a noticeable limp, and use his right hand and arm. Over time the tendons have tightened and as he moves his arm the fingers and wrist curl under. Nicole plans to build a series of splints that over time will stretch the hand and wrist at different intervals and hopefully one day in the future allow the arm to be normal once again.
Tracy used to work solely with spinal cord injuries and said it is a miracle in the first place that this man survived the incident and the fact that he can function years later is incredible. Interestingly enough, spinal cord injuries are becoming more commonly treatable through a recent discovery. They have discovered that the main issues that come with spinal cord injury are built not from the break itself but from the after math. A bone break causes immense swelling which pinches the nerves and tightens the muscles. In a spinal injury this swelling causes disfunction and often time parapalegics where the body no longer funcitons at all below the injury. However, recent studies show that giving the victim of a spinal cord break steroids or an ice bath within a certain time period after the break helps to calm down swelling which disables the pinching of nerves and stops the victim from becoming a parapalegic patient. I found this extremely fascinating; if after all this time doctors can discover how to turn around spinal cord injuries think of all the medical advances that will come to knowledge over the next century!
Besides the parapalegic patient's story, I observed a woman who broke her finger and is experiencing pain wihtin the palm of her hand. After falling and breaking the finger, the patient has pain in the palm rather than in the finger itself as a result of what Nicole believes to be a sprain. They use heat, massage, exercises, and ice to treat this.
The patient with the shattered finger that was re-entered through surgery to break up scar tissue along the top and bottom of the digit saw a doctor before coming in today. The doctor is pleased with the bending of her finger and said she can now use direct heat. The doctor wants the main focus now to be straightening the finger however without loosing the bend. Nicole says that with the middle finger straightening to a full open hand is not as important as bending it into a fist as the hand functions by grasping things with the middle finger and as long as it clears the palm, the patient will have no trouble with a less than before angle of straightening. She now wears several different splints that help force the finger into a straightening stretch. For now she is advised to only wear these splints for 15-20min as Nicole believes more could take away from her bending ability.