New Thing #78 - Stupid Hamate Bone

33 years. No broken bones. It's not really that impressive, especially considering I wasn't exactly the most active kid in the world. It's a good thing reading a book wasn't dangerous, or I'd have grown up in a full body cast.

However, since I've reached adulthood, and more specifically since I started my new thing blog, I've taken more risks in my life: skydiving, zip lining, para sailing, kickboxing. So it's not all that surprising that I finally broke that record. Pun intended. What is surprising - and frankly, kind of embarrassing - is the bone that I broke and how I broke it.

Let me give you a little bit of a back story. I'm a graphic designer. So that means 15 years of my right hand curved permanently around a mouse. And with that comes sporadic pain in the wrist, the palm and the forearm. It's just the nature of the beast. I've resigned myself to the fact that I will eventually need to have carpal tunnel surgery. It's a given, but I feel like it's the price I have to pay to do what I love to do and what I'm good at.

Because of these random aches and pains, I tend not to really put much thought into them when I have them. Fast forward to last week during one of my workouts. I have a great workout partner that pushes me to work harder than I would if I tried doing it on my own. We met during our trial month of muy thai kickboxing. In chatting one day, we realized we could buy the equipment for cheap and work out together for free instead of the outrageous prices at the boxing studio. It's been a match made in heaven ever since. Besides our regular kickboxing, we throw in other cardio circuit training like jump squats, lunges, burpees, push ups, and a ton of other things. We've been introduced to the Body Rock movement and it's been awesome.

I've never been a fan of push-ups. Ever. The mere mention of them brings back traumatic memories of trying to lift my own body weight in junior high P.E. It was not a highlight of my childhood to say the least. But since starting these workouts, I've gotten better at them. I still hate them, I just don't cringe as much when they pop up in our circuit. Burpees are another vile exercise created by buff trainers trying to kill their clients. If you don't know what they are, be glad. If you want to know, check out this video. We tend to do them a bit quicker though. And not nearly as gracefully.

The past couple of weeks I've noticed that my hands didn't feel the best when I'm doing these moves. But I just ignored the twinges, not wanting to being a wuss. But let's get back to last week. I'm pretty sure our workout involved burpees, push-ups and kickboxing, and afterward, I had an uncomfortable tweak in my right palm. So much so that I asked Jen if we could eliminate any moves that required my palms during our next workout. I made it through the rest of the week with some occasional pain and a somewhat unrelenting dull throb, but mostly it was just annoying. I honestly just thought I bruised or maybe pulled something.

This past Sunday I found some compression gloves I've used in the past to alleviate pain and started wearing those. Monday through Wednesday I wore them every day at work and then iced my hand down every night. But it didn't seem to help. The pain and discomfort weren't necessarily getting any worse, but they also weren't getting any better. I picked up a carpal tunnel brace at Wal-Mart and that started to help somewhat. The pain was worse if I tried to cup my hand or squeeze my fingers together, so keeping my palm flat was a big relief.

On Thursday, I finally broke down and went to see my doctor. I didn't want to, but almost two weeks of discomfort was starting to trouble me. My doctor was on vacation, but another doctor in her practice could see me right away. After discussing my symptoms, she concluded that nothing was broken and that it could just be tendinitis or possibly an abscess that was swollen and needed to be drained. However, she didn't want to give the final diagnosis, instead opting to send me to a hand specialist.

Side note: why don't hand specialists have their own fancy name? I mean if you're a foot doctor, you get to be called a podiatrist. Hands are way cooler than feet. In putting this quandary out there, my friends came up with maniatrist, manologist and handologist. Any other suggestions? (Turns out they're just orthopedic surgeons, which is totally lame.)

Fortunately, they were able to get me in the next morning. Seeing as I'm a new patient, I had about 45 forms to fill out. So yeah, that's super fun with a bum hand. I'm sure they thought a Kindergartner filled them out. The nurse came in to get me and did a quick history on the injury and my symptoms. I told her the other doctor didn't do X-rays because she thought it was a soft tissue problem. The nurse looked right at me and calmly said, "This is orthopedics. We always do X-rays."

Okay then.

I headed down to the X-ray room to get 3 different X-rays done of my hand. It didn't take very long and wasn't all that painful. I had a twenty or so minute wait while the doctor's practitioner reviewed the results. I spent my time flipping through the only magazine in the room - Saturday Evening Post. They really still publish that?

Rick came in a little bit later (he's the practitioner) and went over my X-rays with me. Nothing was showing up as broken (whew!), so he concluded, based on my symptoms to the nurse, that I had severely bruised something. He told me to continue with the brace, if it was helping, take an anti-inflammatory and call them back in a few weeks if it wasn't feeling better.

Thank God. I let out the breath I had been holding for the last hour and said a silent prayer that it wasn't anything worse.

And then Rick started asking me a few final questions. What was I doing that might have caused the injury? "Burpees, push-ups and kickboxing." Had I had any tingling in my fingers? "Yes, primarily my pinky, but some days my ring finger as well." He furrowed his brow in concentration. Has there been swelling? "Well, yes, a little, but it's only noticeable if you compare it to the other hand." He scrutinized my palm a bit more and started prodding mercilessly until I was close to unleashing a string of obscenities at him.

"Okay, I want to get one more X-ray. You might have fractured the hook of the hand."

I stared at him like he had just asked me to put my left foot in, take my left foot out and shake it all about. What the heck was he talking about? Didn't they just do THREE X-rays to show that nothing was broken? I was 45 seconds from walking out the door and now he's changing the diagnosis? He saw my uncertainty and explained that the hamate bone is a bone in the palm of the hand that is shaped like a hook and grows straight up. It's impossible to see on normal X-rays, so he wanted one more of just my palm.

So, back down to the lab I went. This time the tech explained that she wanted my wrist face down, and that I had to pull back on my fingers to get a good stretch in the palm. What. The. F**k. She saw my look, and said "I promise I'll hurry."

She did not hurry.

Okay, perhaps she did hurry, but the searing pain in my palm was obscuring any rational thoughts. As soon as she was done, Rick had the footage on his iPad and he followed me into my room. That's when I saw it. The tiny hook shaped bone, and the thin dark line at the base of it. He explained that due to the angle of the X-ray  it could be any number of things, but it was most likely fractured. To be on the safe side, they'd put me in a cast for a couple of weeks and then get a better X-ray to be certain.

He said it so nonchalantly. "We'll put you in a cast...blah blah blah." I stopped him and said "You're putting me in a cast? Right now?" I was in shock. He looked at me like I was a 4 year old and said, "yes, we need to restrict your movement to get a better X-ray in a few weeks. I might be over-reacting, but I don't want to take any chances."

Whoa whoa whoa buddy. So, what you're telling me is that you're going to put a huge dent in my life on a hunch? I naively asked why I couldn't just use the brace I had, and he said that it wouldn't restrict my movement enough. All I kept thinking was how am I going to work? Put my contacts in? Live my life. "Don't worry, it'll be a short cast. You'll still be able to use your fingers." Lovely.

He left to go get the nurse to do my cast and I sat in stunned silence. I broke a bone. In the palm of my hand. From doing burpees and push-ups. And I'm getting a cast. This was not an anticipated outcome to my day. The nurse brought the swatches out for me to pick colors, and it still didn't seem real. I immediately thought to get yellow or maybe the light blue, but I didn't want it to get all dirty. I opted for the black because the nurse was getting impatient, and I couldn't think clearly. (And no, getting Cardinal red didn't even cross my mind.)

She came back a few minutes later to get started. All I was thinking was that I was glad I was wearing a sweater with loose arms that day. She started by putting a mesh-type open ended sock-like thing on my arm. Next came the roll of cotton, and she was going pretty far down my forearm. "I thought this was going to be a short cast?" "It is," she replied. Great, I hate to know what a long cast looks like. Next came a roll of the white fiberglass gauze that she wet slightly. As it dried, it quickly hardened into shape. Huh, I never knew how casts were made. Finally came the final black roll, and she was chatting about making sure I didn't get it wet.

Shit. I forgot about that.

Showering is going to be a bitch.

She finished quickly and told me I was free to leave. And to be sure I didn't get it wet. If I did, I needed to call immediately and come in for a new cast. I get it lady. Stay away from pools, puddles and slobbering dogs. Got it.

I made my way slowly out the door to my car and realized that I couldn't get my coat on. The arm holes were too small. I sighed. This is going to be a long few weeks.

So, it's been a week since the cast went on, and I've done a little research and have some other firsts.

Breaking the hamate bone is most common with amateur golfers and baseball players. The injury can also occur from repeatedly falling onto outstretched hands (I guarantee none of my friends will ever be doing a burpee again after this.) Fracturing the hamate bone usually doesn't show up on normal X-rays, and symptoms include pain from gripping, tenderness in the palm above the bone and irritation of the nerve. This is characterized by numbness in the pinky finger.

Nailed it!

I share an injury with Jose Conseco, Ken Griffey Jr. and a dozen or so other baseball players. So, I've got that going for me.

I won't mention what I read on another website about the necessity of surgery with this type of fracture. This is why you shouldn't research health issues on the internet.

So, first attempt at using my mouse: terrible. The pointer finger is connected to that nerve and it's a pretty damn unpleasant feeling clicking the button. Not to mention the cast won't really let me grip it anyways. So much for still being able to use my fingers.

First attempt at typing: equally terrible for the same reason as above. So, it looks like I will be typing solely with my left hand for awhile. Please disregard any and all spelling errors that might have occurred. This blog took me forever to type.

First shower: not too terrible. Until I was done. I was able to shower okay, although washing my hair was tricky. I just turned the bottle on top of my head, squeezed and hoped for the best. First attempt yielded nothing. Second attempt was like the bottle exploded on my head. Looks like I will be using a lot of shampoo in the coming weeks. The real trouble began when I tried to take all the plastic off my arm. Being a Jones, I was nothing if not thorough. Plastic wrap, followed by a small trash bag secured with duck tape, followed by a 1 gallon freezer bag over the hand. (I had started to rip the trash bag and wanted an extra layer of protection.) Let's just say that duck tape doesn't come off of trash bags. At all. I think I spent more time trying to remove the tape/bag than I did showering. I finally managed to pull the wad of tape/bag towards my elbow enough that I could get scissors under it. I really thought I was going to be walking around with a ripped trash bag around my elbow the rest of the day. I've since discovered a much better method that requires zero duck tape. Heather 1, Cast 0.

First prescription pain medication: beyond terrible. The first few days with the cast were annoying, but not unbearable. As the week went on, that no longer remained true. There has been a constant throbbing and just about any movement sends a shooting pain through my hand. I called in a request for something stronger on Tuesday. They recommended Vicodin, and I said hell no. I still needed to be able to drive and function as a human. So, the nurse suggested Tramadol since it was not a narcotic. Score. Sign me up.

My first two pills seemed to help and didn't release any side effects. Of course I was sleeping for most of that, but whatever. As Wednesday morning progressed, I felt incredibly drowsy, and am pretty sure I fell asleep at my desk once or twice. Then the heat wave hit. I threw off my sweater and turned my portable fan on high. Geez, this must be what menopause feels like. (I feel like I should clarify that I was wearing a shirt under my sweater. I was not free-boobin' in my bra in my office.) Next came the dizziness and the foggy-around-the-edges vision. That was trippy. The icing on the cake was the nausea. It hit me like a ton of bricks and I nearly passed out from the force of it.

Needless to say, I headed straight home and into bed. I slept the remaining effects off and woke up feeling moderately better. I figured maybe I didn't eat enough with the previous pill, so I ate lunch and tried one more. The relief in my hand was worth one more try.

That plan totally backfired on me. I think I made it worse. I went back to bed to try to sleep it off and was mostly successful, but the symptoms lingered through to the next morning. I don't know how people enjoy tripping on pain killers. It was a terrible experience for me. So, now I'm just on extra strength Tylenol. It seems to be helping to take the edge off a bit. (From what people have told me, Tramadol is about as weak as they come regarding prescription pain killers. Great, I can't even handle the watered down stuff. Let's hope I don't ever need anything stronger!)

I'm having good hours and bad hours, pain-wise, but mostly I'm incredibly frustrated with the whole thing, and I hate feeling helpless. Thanks to my friends and family who have done simple things like helping me with my coat, opening a pudding cup or washing my hair. I appreciate it. Stay tuned for an update after I see the doctor on the 26th!

-------10/26/12 - My trip back to the maniatrist (Not a real word, but I really like saying it.)

So this entire blog was a sham. I never actually broke any bones. But, I'll get to that. Guess my record is still intact!

The second week in the cast was more manageable than the first. The pain had lessened, whether over time or because of the tylenol, and I was beyond thrilled. It still wasn't pleasant by any stretch of the imagination, but was more tolerable. When I headed into the doctor's office, I honestly figured I'd leave with another cast. I didn't see how it couldn't not be broken based on the pain and symptoms I had.

But first, they had to remove the old cast. For those of you who've had a cast, you can snicker at my naivety, but I definitely wasn't expecting the nurse to use a saw that required electricity. When she wheeled that machine in, I'm sure I looked like some poor schmuck about to be submitted to the firing squad. I almost laughed out loud. Is this some kind of Halloween prank?

She asked me if I had ever had a cast removed, and I told her no. She said not to worry, that the saw will only slice through the fiberglass, and the cotton under-layer would stop it from hitting my skin. The only thing I'd notice is some vibrations. I believed her, obviously, but I guess I wasn't expecting that to be how you removed a cast. Not that I really had any pre-conceived ideas though. She started along one side of the cast and started slicing. Next, she went along the opposite side and made another incision. That was followed by a large pair of pliers that she used to pop the edges of the cast apart. A few more pops and she pried the two halves apart until my arm was finally free!

She asked me if I'd like to wash my arm, and I nearly knocked her out of my way to get to the sink. Okay, that's an exaggeration, but I was really ready to scrub a dub dub. It felt amazing. But, I couldn't believe how much smaller my hand was after only two weeks in a cast. I couldn't imagine what it's going to look like after 2-4 more weeks in one.

I was quickly taken down to get 4 new X-rays. These didn't hurt nearly as badly as two weeks ago. Even the one to stretch my palm didn't produce any foul language. I headed back down to my room, but didn't really think much about the lack of stabbing pains. I had never broken a bone before, so I assumed this relief was normal. I wasn't going to question it. Rick had even pushed and prodded on the area before the X-ray, and I didn't want to punch him in the face afterward. That's a good sign, right?

He came in a few minutes later, and the first thing he said was, "Well, there's no fracture."

What what now?

There's no evidence of a healing fracture. I couldn't believe it. I looked at the X-ray, and damn if he wasn't right. Not that I'm suddenly an expert on reading X-rays, but that pesky dark line we saw before was mysteriously absent. The hamate bone was still intact in all of its itty bitty glory. Rick continued to say that while it wasn't fractured, it's most likely that I severely bruised the bone. I proceeded to ask him what that line was we saw two weeks ago. "It could be any number of things, from a shadow of another bone to a nutrient vessel."

He says these things like it's no big deal. But, he put me in a cast for two weeks because of a damn nutrient vessel. A NUTRIENT VESSEL, people. Or possibly an effing shadow. Does this seem weird to anyone else? I guess the more I think about it, it's probably better than I had the cast. It did restrict my movement - in a big way, that I otherwise wouldn't have been able to do on my own. Perhaps this helped to contribute to the healing process. Dammit. I so wanted to be angry with him for putting me in a cast, and then I have to go and ruin my tirade by thinking logically.

He figured that due to my current symptoms, and how they've lessened in two weeks, that I should be fine in a few more. I'm still to limit my use while it continues to heal, and I can't squeeze, grip or push off of anything for awhile. And definitely no push-ups or burpees. Yay! The nurse fitted me for a gel brace that they give to carpal tunnel surgery patients. It's just a wrist sized brace, but it has a gel pad in the palm for comfort. He wants me to wear it for at least two weeks or until the pain goes away.

If the pain isn't gone in a month, then sh*t will get real. I'll have to go in for a CT scan, and worst case scenario I will have to have surgery to remove the bone. He doesn't think that's likely, but of course, he has to give me all the possibilities and outcomes. Since my pain is better, he didn't think it was necessary to do the expensive test right now. I agree 100%!

So, that's it. No broken bone. I went through all that, just to find out I bruised my palm. So lame. But at least the blog isn't completely false. I did get a cast for the first time. And I saw a hand specialist. I just still can't believe that I bruised it that badly working out AND that it was so incredibly painful. As my friend Brenda says, this is why working out is such a terrible idea.

Here are some photos of my cast with all the signatures I got.

Brenda drew the StL. She did a great job! Other signatures include my mom, my niece Remi and the top says Brenda was here!

Kevin is a friend from Angels' Arms, Mackenzie and Mia are my nieces (I love how Mackenzie's letters got bigger as she finished. She's 4.) The smiley face is from Stephanie, a friend from Angels' Arms, Andi is my boss's 9 year old daughter, and the Way to Go! -JJ is my brother.

My last niece signed Charlee, Love U!

I'm not really sure why she did this, but the President of my Junior Board, Sunny, put her full name followed by Esq. (she's a lawyer), along with her work phone number. I guess she thought it would be funny?

My coworker Jonathan, and my sister put "The Big Sis, Love Steph"

My friend Betsy put Bitty (Heart) JP (that's her fiance), and my other friend Julee put Bies which is an abbreviation of her last name.

This is what I have now. Sooo much more comfortable AND it can be removed for showers. Hooray!