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Thread: Getting Hands Back?

  1. #1
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    Getting Hands Back?

    Being new around here, I don't know whether to post this in Care, or Cure or Exercise/Recovery- so I'll post it here.
    You've probably seen my posing about my (Sept 3, 2006) C-5, ASIA C incomplete fracture, to my son.
    Betheny has been most helpful in getting me some information, but I would like to know if its realistic to believe that my son (sculptor-B.S.in Art & Sculpture- welder -metal sculpture) will get hand(s) function back?

    As of now, he has upper arm mobility, can curl/pull 5lb wrist weights (thinks he can go heavier), but has no 'push' function.
    He has no wrist or hand function to speak of. He can move his middle finger (about 1/4") and thumb (same amount-same hand) sometimes, and has moved a toe- once (to my knowledge).
    He has no trunk ability to turn or twist. He's trying to bend and straighten from the waist up (on his own-not rehab training) and can do it......somewhat.
    He's learning in rehab how to manipulate things given his inabilities, but what I want to know is if there is rehab to regain hand function, not work around it? Will he move his wrists and not have to wear arm braces? Will he move his fingers and be able to at least hold a pencil or pen to write?
    Is it reasonable to for him to think these things.....or me to think it will happen? Am I fooling myself?
    I've seen a lot of posts about walking and it seems a lot of effort is in that area- & reasonably so. But an artist can still create seated. Even if it is on a computer, will he get any better than using a stick attached to an arm brace to pick out, on a keyboard? Will he use a mouse?
    What can we look forward to......and what is a reasonable time frame to come to that realization?
    I'm aware of the 1st 6 months theory, and the up to 2 year concept, and that things can still happen at up to 5 or 6 years after injury- but still would like to have an idea, as to what can be expected in a reasonable amount of time. If he has to continue to find alternative ways and work around it, well......then so be it.
    But should he be learning that, rather than working at making the hands actually function as normally as possible?
    When can we understand the priorities?
    I don't know if I'm rambling - trying to make my point, or have just
    missed something here on the site- that I should be able to find, but haven't.
    Bob B
    SCI - Parent

  2. #2
    Since he is already an ASIA C, it is possible that he may continue a fairly steep slope of return, and eventually get back some hand and wrist function. Unfortunately it is just as possible that his return may stop or plateau at any time. It is impossible to predict. Hope is important, but it must be tempered with uncertainty.

    More importantly, it is important for both him and you to get past being so fixated on one aspect of the injury, and to get past the idea that life will have nothing to offer unless that one thing comes back. Currently there is nothing that can give him back his function as far as therapy. Therapy can only maximize the use of what comes back on its own. If he gets a little return in wrist muscles, then FES can be used to strengthen it, but if he has lower motor neuron damage to the nerves that go to the wrist (C6) or hand (C7 &C8) that may not be an option either. There are also dynamic (not just resting) functional hand splints that can significantly improve hand function in those who are motivated to learn how to use them properly. Some also incorporate FES.

    There is no reason he cannot continue artistic pursuits, but he may need to learn to use different media in a different way. I have worked with several artists who had to do this, and they all eventually found an outlet that was not only more satisfying but more successful for them (both artistically and financially). It does take time, flexibility, and the ability to not see things so black and white.

    Down the road, if his progress slows down and stops, and he wants more hand function, he could look into tendon transplants that could give him wrist flexion and/or pinch. This is NOT "normal" hand function though, and such surgery should not be attempted if that is all that is going to make the person happy.

    He needs to take advantage of the entire rehab program at this point, and not get too fixated on his hands. I have seen people waste their entire rehab only wanting to work on one aspect of recovery, and missing out on learning how to take care of themselves as far as activites of daily living, mobility, becoming as independent and in control over bowel and bladder function, or not learning how to keep skin, etc. healthy. Later they run into trouble because they did not gain the skills and knowledge they really needed in rehab to be successful at home.

    He also needs to learn from OT how to properly range his hands and prevent contractures. I have seen people neglect this aspect of their care, and then later when they get return they cannot use it. Daily range to prevent inappropriate contractures is important from now on.

    (KLD)

  3. #3
    The part of rehab that teaches you all that is OT (Occupational Therapy).

    I hope he has a good one. My OT in Rehab rocked my world (shout out to Rafferty Laredo, Houston, TX!)

    At first OT tends to center on dressing onself, putting on shoes, brushing teeth, you know, surviving. Later they get to cooking, computers, writing. A good OT will ask about his interests and try to adapt to his needs. Outpatient OT continues the same way, with braces, splints, exercises, hours of finger work. There's no way to know what he's going to get back. OT's job is to help him work with what he has. Sounds to me like so far he has biceps, no triceps. Can he lift his arm UP at all?

    Real high level quads use a mouthstick to operate the computer. It is what you think it is. He's already past that stage imo. There is voice-operated word processing software some ppl use...I think most avoid it if at all possible because it's a pain.

    Some links for quads using computers, various adaptations, many mouse recommendations:

    http://sci.rutgers.edu/forum/showthr...ht=mouse+quads
    http://sci.rutgers.edu/forum/showthr...ht=mouse+quads
    http://sci.rutgers.edu/forum/showthr...ht=mouse+quads


    This guy made a website with a comprehensive gallery of gadgets for quads. It has ADL's (Activities for Daily Living), Equip, House, Cook, Tech. Check it out, it's amazing.

    http://ableminded.net/gallery-map2.htm

    A picture of my friend cspine welding: (c5-6, I think? Notice his fingers...)

    http://sci.rutgers.edu/forum/showthr...ing#post303839
    Last edited by betheny; 11-02-2006 at 05:27 PM.

  4. #4
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    Quote Originally Posted by SCI-Nurse
    Since he is already an ASIA C, it is possible that he may continue a fairly steep slope of return, and eventually get back some hand and wrist function. Unfortunately it is just as possible that his return may stop or plateau at any time. It is impossible to predict. Hope is important, but it must be tempered with uncertainty.

    More importantly, it is important for both him and you to get past being so fixated on one aspect of the injury, and to get past the idea that life will have nothing to offer unless that one thing comes back...............
    He needs to take advantage of the entire rehab program at this point, and not get too fixated on his hands. I have seen people waste their entire rehab only wanting to work on one aspect of recovery,........... Later they run into trouble because they did not gain the skills and knowledge they really needed in rehab to be successful at home.
    I'm so blessed in finding this site. So much to learn, but there's so little time. I'm a worrier. A concerned- no worried Dad. I'm worried that I'll miss something that should have been done at month 1 or 2, and here it is at month "X" and I've missed it.
    No, I'm not fixated on one thing, and want to try to make sure that Adam isn't either. I don't want to give him false hope-or on the other hand, write something off before it's time.
    I want to try to motivate him in the right directions and give him realistic advice.
    That's why I want to learn as much as possible- before the subject even arises, so I'll be prepared to have the right answers and solutions for him.

    He is worried about 'getting his hands back'. But I think that is reasonable, given his previous avenue of expression. Computers have been discussed, lightly. He knows he can use a mouth stick and learn how to do it properly, if he has to. But he doesn't want to.
    Just reading these posts and seeing that I can say to him that the OT/PT won't do it, there's no method of bringing back what won't work- they only will help work on what does come back, but that he has to try to make that happen through sheer willpower and his darned cussidness to want it to happen- then maybe it will.
    When it does, it'll be a lot of hard work to try to make it better.
    (Did I get that right?)

    I'm still anxious to hear of other success stories and timelines, to try to kindle a fire of desire and hope in him, so that he won't be despondant or depressed too much (the anxiety drugs and anti-depressants aren't what he would like to have to take). I want him to be able to get the most out of his therapies. I wish I could be there to cheer him on (and learn how to help him, too) during the sessions (they're all when I'm working) and maybe I'll be able to take off work and do so, for a time or two. I'd like to do that. Its encouraged at the hospital, so they let visiting hours during the day when there are sessions.
    I'm learning more & more every day, by reading these posts and asking questions.
    I found out that was the only way for me to find out about Peripheral Neuropathy when I was diagnosed in 1998. No one (including the docs) could answer my tough questions (& I got a lot of 'em)- except others in the same boat. I soon learned more about PN than most of my docs and suggested things to them.
    I want to help Adam that way. He can't come here, yet. He hasn't the motor control to be able to handle it, yet. But I can try to help, and that's what I'll continue to do.........cause....I'm his Dad, & I love him.
    Bob B
    SCI - Parent

  5. #5
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    Bob
    I can understand your anxiousness and being a parent I can understand the unknown feeling and the worry you are going through.
    As the nurse already said, it can be either or in terms of either getting some function back or not. I can tell you if he doesnt have the determination to at least try, he isnt going to know if it is coming back or not. I wish I could wave a wand and tell you that all this will go away tomorrow and everything will be back to normal. The waiting to see is the hardest part. If he is working some on his own then he is already ahead and doing all he can do. Realistic advice to him would be "work hard son and hope for the best" because no one (not even his doctors) know for sure. I would remain optimistic for at least five years because I was still feeling changes even after five years. If depression is a problem then by all means take some medications. I finally had to take some after 17 years. I got to the point I couldnt handle everything on my own. If the feelings of hopelessness are getting in the way of his doing his therapies then it may be time to swallow the pride and admit that he might need help to get through this. I felt the same way about anti depressants too.

    My heart aches for you Bob as I am a parent also. I cant even imagine how helpless my parents felt. Just keep reminding him that his son is his motivation. Even if life doesnt return to the way it was previous. There will always be life to live whether he is a sculptor or not, he is still a father and still a hero in his little boys eyes. My motivation came from wanting to see my daughter grow up. I realize that my wreck took alot of activities away that we could not do together but I had to realize that at least I was still here to watch her grow.

    I wish I could help more Bob......
    T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

    My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

  6. #6
    hi Bob, Rod here (notice the name change)
    just wanted to say that whan I was in patiant therapy I was blessed to have a lot of visitors ie; my parents, my wife and children, friends and family, and my pastor and his wife, they would visit and sit in on my therapy sessions, it was very incouraging when they were here with me, also when my wife was here during therapy she was able to learn things that she has been able to help me with at home. I would say that any time you and or Adam's sister can be available to sit in on therapy sessions would be a plus for all.

  7. #7
    one other thing Bob
    when I was in patiant, one thing that helped my left hand was e-stim, it did not help my right hand to much but I am able to use my left hand with out using tenodesis now, I still need to use tenodesis with my right hand although my grip in my right hand has greatly improved during this past year. you may want to have him ask his therapist about e-stim for his hands.

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