Thursday, 20 February 2014

Discharged!

I've been discharged from my hand consultant. I found out that the point of going to see them every 4 weeks or so was so that they could see how my physiotherapy was going and to decide whether I needed to be opened up again if things were not healing properly. Other than the nice consultant running her nails along my hand scars this wasn't a bad meeting. The first question she asked was “have you been climbing?”, to which I replied “yes, but I've told my physio”, added hurriedly as an afterthought. She didn't seem too bothered. We discussed how my hand is fairing and any problems. It might seem odd to be writing about having a now almost fully functioning hand, but if you'd seen the state of it 11 and a half weeks ago (especially the inside) then you'd be as amazed as me. I'd accepted that I'd never be about to open it again, thinking of it like a withered limb. I was happily getting on with working out how I'd continue in life with this pointless appendage, despite being told it'll be all right. Six weeks ago I couldn't open my hand, four weeks ago I couldn't put my palms flat together, two weeks ago I couldn't put them flat together, with my wrists bent at right angles (same position as prayer I guess, not that I've been praying). Now all these things are within my grasp!

The only oddity is that when I make a fist my 3rd finger curls inwards slightly, rubbing against my 2nd finger. I've been told it's because the tendon has probably re-aligned to avoid the swelling creating my by now defunct A1 pully. Who cares though? I can make a fist, my hand is almost normal... heavily scarred but essential normal.

I've not been discharged from my physiotherapy though and this I am glad of. My trip to the hospital each Thursday marks the progress I'm making. Each week there is something new. A new exercise, or a new strength putty to squeeze which make me feel better about the whole process. I've mentioned that my physio knows I've been climbing. They said the normal things (“we must advise that it's a bad idea” etc...) but all seem genuinely interested to hear how I've been getting on climbing on what should (by most peoples accounts) be a weak useless bunch of fingers on the end of a withered arm. There are endless discussions each week about taping (advised by the consultant, dismissed by me, and discussed later), grip strength, how each hold is used, area of pressure and stress on my fingers and how bloody strong my thumb is (it really is amazing!). They stopped telling me not to climb on it after week 3 anyway.
(A range of homemade physio equipment)
[WARNING: the next section develops into a massive rant about climbing tape]

With regards to taping up the fingers I initially brought it up with my physio. He didn't have much of a clue about it (unsurprisingly, as taping up fingers seems to be a “climbing” thing) but suggested that if it helps, why not? My consultant then brought it up an hour later. We discussed taping, pully rings (metal rings that do the job of the pully) and if it would be of any benefit. I said no and eventually she agreed. The damaged pullys in my hand are not worth taping (my A1 is compleltely cut open, and therefore redundant) and the A2 is never in enough stress to need a back up like that. I don't want to tape my fingers up either, and here's why:
Taping up you fingers correctly is very hard to do unless:
a) you are a hand consultant, medical professional, climbing specific physio etc or
b) you've seen a flayed hand and know what you're looking at, therefore knowing where to tape.

Thankfully I've been able to either hang out and discuss taping with people who fall into category a) and, since slicing open my hand I've become interested in what's going on in there and probably fall under the category of b). I still don't see a need to tape though.

Doesn't it annoy you when you see people down the climbing wall (not usually at the crag, but you always get these types at the climbing wall) taping up all their fingers with thick hoards of tape, applied regardless of where any damage it. I might start asking people which pully they've damaged or who their physio is (having told them to tape) when I'm next down the wall? Then again I might not. One you start taping up, you've got the be very very very very very careful not to become a “slave to tape”. For one thing it looks a little silly having each flan-gee or each finger on each hand taped up. I know there are people out there who do it to impress people, to make them think they're serious climbers... who're they kidding! (bear in mind the serious climber is probably the quiet chap or lass who climbs or boulders extremely hard down the wall, but you hardly hear them say a word). Confidence is quiet, someone once said. Confidence is also not being covered in tape.

Tape is also a self-fulfilling prophecy. People tape up for several reasons but the main ones can be summed up as:
a) to support an injury (either gained before or during, depending on the severity)
b) to prevent an injury coming back (also known as “I've got it dodgy tendon mate, so I keep it taped...”)

If you find yourself falling into category a) then I'm sorry you hear you've had an injury, but you're going the right way about it. The first thing you should do is stop climbing, at least for a few days, maybe a week. People don't do this. You should also actually do something to help repair the tendon. Hot and cold treatment is one of the best things. Before you start manically applying half a roll of tape to your hand at your next climbing session, stop and think. Do you know the purpose of taping? What injury are you trying to prevent? Do you know how to tape it up properly? If you can answer all of these, then go ahead! (also if you can answer most of these, then you and me are probably already singing from the same hymn sheet). THE IMPORTANT THING IS TO KEEP TRYING TO REPAIR THE TENDON! If you spend the next 6, 8, 12 weeks with it strapped up then the tendon will heal, but it won't be fully strong. You'll have generate this tendon that is strong enough... when taped up. Therefore you'll be taping again... see?


If you fall into b) then there is probably no hope for you... only joking! The body has an amazing capacity to heal, that coupled with the NHS, doctors and medical professionals in general means that you really do stand a fighting chance of repairing that single damaged pully (or whatever it is). Trust me on this. Taping up to prevent injury is like saying to your body “don't worry, the tape will do the work for you!”. If and when you stop taping up, that tendon is now not strong. Not weak either, but not 100%. Then you expect it to perform like a fully functioning bundle of fibres and... “snap!” (or “tweak!” but it never makes that noise) it happens. In your head it's the lack of tape. In reality it's because of too much tape in the first place.

The bottom line is that you need to make sure you heal any injuries, instead of just strapping them up. In the long run they won't last.

There'll be people reading this thinking a variety of things. Probably the most prevalent is that I'm morally, medically and fully against the use of tape. THIS IS SIMPLY NOT TRUE. I tape to prevent excess damage and support, as and when I need too. It might be for one week or maybe two, but never more than that. People probably think I don't know what I'm on about. WHY SHOULDN'T I KNOW WHAT I'M ON ABOUT?. I've studied it (not academically) and discussed it and bloody well tried it. I've ruptured several tendons in my fingers over the years. I've held my hand in a lot of ice water then warm water (the process of giving yourself “hot aches” isn't fun, but it works) and I've carefully learnt how to tape up different joints for different injuries. I've asked people. The final things people proabaly think is, how did this become a rant about tape... BECAUSE IT DID and that's why.

Ironically I'll finish by telling you that I've just been shown how to tape up my ankle, with three wide strips of climbing tape for extra support. This will be an aid to full recovery... not an excuse. I'm slowly on the mend which was the original point of this post, though it will be a very long road. My ankle is in an awful state (compared to my hand) and I've not yet started any physiotherapy.

It's time to dance in the rain.

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