Guest Post: “You Might Think It’s Only Your Little Finger, and Only the Tip of It…..”

by Anita Superson

I had just returned from walking Muskie the Labrador and was trying to get the leash off my hand when he bolted for his friend, jerking the tip of my little finger on my right –and dominant– hand.  That was in mid-August, when I was in good shape from doing lots of (sometimes intensive) yoga, cardio, weights, 10 mile walks, gardening in three yards, and caring for two properties.  It’s just a bad strain, I thought, and figured I’d heal quickly.  Five months later, and three hours of physical therapy each day since the end of October, I am first now getting back to the things I like to do and, well, being myself.

By the time I got in to the surgeon, the bone below the fractured bone was already starting to heal over it.  Apparently, bones heal in four to six weeks, mine a bit faster.  I didn’t learn this as a biology major, nor did I learn anything about repairing fractures.  I went to my appointment thinking my finger would be in a cast for a short time and I could do everything I was doing while it was fractured.  Reading my mind, my surgeon said, “You might think it’s only your little finger, and only the tip of it, but this is major surgery and you will need lots and lots of physical therapy.  Your finger will be very, very stiff for a long time.”  I told myself he must be talking about someone else – I was in good shape, my bones heal quickly, my finger only hurt when I typed, and I could bend it a bit.

Anatomy books can teach you the names of the parts and show their connections through diagrams, but there is nothing like learning these connections by learning how to re-live your life when they are impaired.  I learned that the little and ring fingers share a tendon (which is why they “buddy tape” them together inside the cast) and the tendons from the fingers join at the wrist and then reach up to both the inner and outer bones of the elbow (which is why the cast reaches almost that high up the arm).  If you break your little finger, you lose the use of half of your hand.

Of course, I underestimated the real effects.  I couldn’t do the simplest things, for starters.  Half a hand does not give enough pressure to get your teeth clean, and you need to keep the cast dry.  Pumping a spray bottle, opening bottles and cans, wringing out towels or clothes, even carrying my French press to the study in the morning had to be done left-handed or not at all.  I couldn’t chop vegetables, but discovered that you can buy a lot of these frozen, though soups and more complex meals were not an option.  Putting change on a store counter was impossible because it requires wrist action.  Yoga, weights, machines were out of the question – no bending at the wrist, lifting, or gripping with half a hand.  I tried to go for walks but my hand would swell and I would have to hold it up which threw off my balance making me feel like a three-legged cat.  I couldn’t type or write notes, let alone sign my name, so research was out.  But I’m a professor.  I thought I could use the time to catch up on reading books and journal articles, but discovered that I couldn’t even underline because that would require holding up my arm at an odd angle and applying pressure I couldn’t.  And I couldn’t write notes in the margins, which is my usual way of engaging with the text.  I taught my classes, sometimes with a bag of ice on my hand to quell the pain after the cast came off, and managed to do some one-handed gardening, however.

When I got the cast off, my once bound fingers were square and as hard as concrete.  My surgeon pulled out the pins that looked like the ends of thick sewing needles without my feeling a thing.  I didn’t know until my excellent physical therapist told me that the pins were actually through the bones.  Thanks to my very skilled surgeon, the three fractures and torn tendon healed completely perfectly.  Apparently this kind of surgery is very difficult because in the fingers, the nerves, tendons, muscles, connective tissue, ligaments, and blood vessels are extremely tightly packed and one small wrong move can result in loss of movement in the finger.   It took two days to peel off the dead skin from my hand, and by day three, the pain set in – not in the finger, but up my arm, from the tightness of the tendons that are concreted by the connective tissue.  The nerve endings were so jumbled from the connective tissue that when I washed my hair, it felt smooth with my left hand and like sand paper with my right hand.  I learned that your immune system rushes to the casted part of your body in an attempt to heal it.  But there is nothing there for it to work on, and through some process it stiffens the connective tissue. Part of the physical therapy is to scrape the tight areas of connective tissue with a tongue depressor and lotion.  This releases fluid (the histamines), which causes swelling.  I wear a compressive glove or tape up my fingers to keep the fluid out because it contains protein that lays the scar tissue right back down again.  I will have to do this and other finger and hand exercises for about one year, which is how long I’m told it will take for the swelling to go down.  Fortunately, most of this is not painful, though working my fingers down to my palm several times daily can be, even with a lot of heating.

For active people, injuries are particularly bad because they try to infest their psyches with couch potato-ness.  Before my injury, my typical Saturday was spent doing an hour and a half of intensive yoga, followed by several hours of gardening or house projects or a 10 mile walk, followed by more gardening or reupholstering or some other chore – a 12 hour, almost non-stop day.  After the injury, my Saturday was spent watching TV or puttering around in shops.  While many people would welcome the “vacation,” I couldn’t stand it.  It was depressing, boring, aimless, making me gain weight, depleting my strength, and just not me.  People who know me say they never see me sit down – I always have some project going.  Well, I do sit, when I’m researching or preparing classes, and I’ve done a lot of this in my life, which might be why I balance it out with physical activity, which I love.  And I like being strong, and the exercise gives me the strength to do all the gardening, and so on.  I can’t be a couch potato, and no little finger is going to turn me into one!

I’m getting back into my normal routine slowly but surely.  A week after my cast came off, despite the pain in my arm I painted some awnings and railings with my half hand and a slightly bending wrist.  A few weeks later, when the pain was subsiding (ironically, because of very painful physical therapy aimed at bending the concrete fingers), I painted a couple of rooms, though I had to use both hands on the roller.  A month later I made my usual hundreds of Christmas cookies, and kneaded lots of bread dough which was therapeutic for my wrist.  I got back into yoga slowly.  Poses are coming back, but my favorite plank pose that I used to do with ease makes my thumb and wrist go numb if I hold it too long.  Stiffness from the cast lingers, and I lost some of the strength and flexibility that took so long to acquire. Gripping weights is hard because my fingers don’t bend down even half way so I’m still not using my full hand and arm.  Tightness in the whole body is an issue.  Connective tissue runs from the base of your toes to your eyebrows, and tightness is one area can make other areas tight. (Check out this excellent video: https://www.youtube.com/watch?v=BUNcQMP2gwE).  The plantar fasciitis I had in my right foot flared up three weeks after getting the cast.  Zen yoga, a new yoga for me that I would have previously written off for “less athletic types,” turned out to be just what I needed, because it stretches your body deeper than the muscles and into the fascia or connective tissue. I recently found out that I likely have a recurrence of Dupuytren’s, which is a genetic disease that causes parts of the connective tissue in the hand to knot up under the skin, eventually pulling a finger down.  That might require another surgery, but at least not a cast.

When I tell people that I broke my little finger, most of them respond as if it is a “cute little injury.”  Much like sucking your fat out with nerves and blood vessels is just “plastic surgery.”

My surgeon hit the nail on the head.  He could have added that when it comes to your body, there is no such thing as “one little part.” It all works together, and the way and extent to which you use your body defines you.  You can’t capture that in an anatomy diagram; you have to live it.

Anita Superson is a Professor of Philosophy at the University of Kentucky, where she teaches and does research in ethics and feminism.  She enjoys long walks along Chicago’s lakefront, yoga, and working out at the gym.  She refinishes and reupholsters good quality old furniture, and is an avid baker.