Thursday, December 4, 2008

Physical Therapy for the Wrist

Spend at least 15 minutes soaking your wrist in alternating hot and cold water baths before you start the therapy. Then soak again in hot or cold water (what ever feels best) after you exercises. The pre soak really helps get the wrist loosened up.

Got to at least one physical therapy session if you can afford it. Go for the whole series if you can.

The scene of my wrist breaking, wrist spraining bicycle accident
modeled by my 4 year old.

I’m in my second week of physical therapy for my wrist post DVR plate insertion. Wow this is really not fun. The therapy hurts and I have to do it six times a day. I will be really glad when this is all over.

My first visit to the physical therapy was hard on me because I was feeling very paranoid and the time and I left the place thinking that everyone there hated me. My second visit yesterday went much better for me.

No one can tell me how much this therapy will cost, not Mason General Hospital, not the therapist and it seems not even the billing department. I find this outrageous. It seems that the only way I can know it is going to cost will be when I get the bill after it is done. My therapist wants me to see her two days a week but I am only seeing her one day a week since I have no idea what it will cost.

Whatever the cost I’m sure it will be mind boggling. The same hospital ER charged over $600 for a splint plus another $64 for the doctor to put it on. I’ve looked online and see I could have bought the splint material for $25 plus shipping. Too bad I could not just show up at the ER with a broken wrist and the splint materials in hand and just paid the $64.00 to have the splint put on plus the fee for simply sitting in an ER room. The total ER bill from Mason General (a publicly funded hospital) for doing the x-rays and putting on a splint is $2,200 but that that nothing compared to what the hospital where I had the surgery is charging.

Providence Saint Peter Hospital has sent me a bill for $24,000 for my day surgery. I assume I will also receive separate bills from my surgeon and the anesthesiologist. I could have bought a really nice bicycle with disc brakes many times over for what all this is going to cost me even AFTER my insurance pays its 80% share. My insurance is still listed as terminated even though I have a letter from them saying I have on going coverage. What a shame that I was afraid to make a large purchase while manic and I was riding a cheapo second hand pawn shop bike to work off my manic energy when I crashed. I had my eye on a lovely purple bicycle with disk brakes at an Olympia bike shop but like I said I was afraid of making a large purchase while manic.

I finally got my bicycle back from Olympia today and indeed the front brakes are sticky. So the bike is mostly to blame for my crash but it is my mania that is to blame for the very high rate of speed I was traveling at when I crashed. I have “very good” bones (according to my surgeon) and I have never broken a bone before this in spite of my years of skateboarding and dirt bike riding. I had to crash at a high speed in order to do this kind of damage to my lunate fossa.

This curb does not seem steep enough to bring a mountain bike to a dead stop

I have purchased some fiberglass casting tape online so I can make an art project with it and that is how I found out how cheap the stuff really is. I assumed it would be really expensive being a medical item.

I am going to scan my physical therapy instructions so people who can not afford physical therapy will know what they need to do. I could not find instructions like this online when I searched. I would still recommend seeing a physical therapist if you can at all afford it and if you can actually find out what the cost is going to be up front. Click on the images to enlarge them.

These exercises hurt if you are doing them right. I've been told that with fractures after they have healed you are to ignore the therapy pain.

Follow up I have finally found that out the therapy cost will be about $200 per session and they want to do 2 sessions a week for 6 weeks.

Update: about 3 weeks after my therapy started I was given a wrist band to wear instead of a brace. Now about 4 weeks later I am going without the band. The band was hurting me. I do not have all my volar or dorsal flection back but I have most of my forearm rotation and I was able to shovel snow. I still have to be very careful because my wrist hurts and the therapy still hurts a lot. Even typing is hurting my right hand when I hit the backspace key.

Another update, after 5-6 weeks my therapy is over. Typing does not hurt at all. Pulling on hard to open doors causes some pain so I push the wheelchair button with my elbow when the buttons are available. Almost all of my flexibility is back and I have regained around 75% of my grip strength. When from 25 at the start to 55 where my good hand 70 at the start (but it was sprained too) I think that is a measurement of psi but I don't know.

March 30 Update, it is now almost six months since I broke my wrist. I don't have much pain now and my flexibility is good. I still don't have all my strength back. I hope my wrist will continue to get stronger. Before the fracture my husband would come to me to get tight jar lids open. I have always been very strong and it is frustrating to be weak. I mainly notice my lack of strength when I am doing mechanical things such as screwing and wrenching. Basically anything that requires rotational force. Clearly I need to screw more often.

Two year update. My wrist it great, I'm not sure if I got all my wrist strength back, but all my flexibility is back and most of the pain is gone. I have to wear a brace when I type on my laptop or my wrist really hurts. Also pounding on things with a hammer and using some types of hand tools causes some pain. So my wrist is not as good as new but it's really close.


Jo said...

Thanks for posting the physcal therapy instruction. I just got my cast off and I have to do pt on my own. (I had a radial fracture, surgical repair with plate) I hope to get enough mobility back to return to work in 6 weeks. The lack of range of motion and pain kinda freaked me out at first, but I think I can work through it.
Thanks again, Jo

Anonymous said...

Thanks as well since I start PT post same surgery today. I will only attend for a few weeks since I have to get back to work. Plus, I am extra anxious since I broke my other (writing) wrist 15 years ago and it is still weak and have limited range of motion even with months of PT. That one was fixed with an external fixator.

Anonymous said...

I also thank you, since I too had a radial break with a surgical plate repair. I had broken my dominant elbow (also needed surgery) 2 years ago and now my right wrist a few weeks ago. I also was biking. Since I needed to travel for 2 weeks, my surgeon gave me a few exercises to do (similar to the ones I did for my broken elbow) until I see her again - 3 weeks after splint removal. I will then need to go to PT. I was only in a soft cast for 1 week after surgery. I was doing the exercises 3 times a day. I see that you were doing it 6 times a day., so I'll aim for that may times. . . . then I won't have a life. Just me and my right wrist. I'm certainly wishing for full recovery. My elbow still bothers me, but it was a very bad break. I just hate the swelling, pain and lack of flexibility and strength. Your update helped to keep things in perspective for me.

Anonymous said...

I thank you for this post!! feb. I fell broke bone in my arm had a plate, screws and a bone graft. my bill is creeping to 20 thousand I have no insurance, doc wanted me to go to therapy. I can not afford it after all the other bills. once again thank you so much.

Mossy Mom said...

You're very welcome.

Do you have a public hospital nearby? Public hospitals have charity programs. Please take advantage of it and get at least one PT session!