A journey to regaining hand function: Phil’s story
by Helen Griffiths
A split-second accident at work, when Phil’s hand slipped and was crushed by a machine he had used hundreds of times, left him seriously injured.
Surgeons and other medical staff were able to save his hand. They treated his fractures, and reattached tendons to the reduce the pressure on damaged nerves. But for Phil the hard work was just beginning. His case manager identified that he would benefit from seeing a hand therapist and referred him to The OT Practice.
Our first assessment was a turning point for Phil, he explained how he had started to feel low and very sorry for himself, he was resenting his dependence on others for such basic tasks as going to the toilet and getting dressed and was trying to manage on-going pain caused by sensitivity around scarred tissue.
My role at the assessment was to gain a clear picture of Phil’s previous daily routine, the medical situation, current difficulties and most importantly his goals and hopes for the future. Between us, we established the steps we could realistically take to improve Phil’s situation, and at every stage I needed to manage his expectations of himself and me. Hand therapy rehabilitation is hard work and takes patience and team work from the therapist and the client.
I developed recommendations based on what was realistic and achievable for Phil and his family to allow him the best chance at rehabilitating his hand and regaining function. These were all costed and I worked closely with the case manager to ensure that the funders had all the information they needed to approve the costs needed.
Phil had to learn to be patient, but slowly his range of movement and muscle strength improved. He was able to accept that how his hand looks, feels and functions was now permanently altered, but over time he became more and more independent. After every treatment session we both knew he had made progress, both physically and emotionally.
I provided splints, home exercises and daily techniques for completing every day activities like using cutlery and shaving. I also visited Phil initially every week but as his confidence increased and his pain became more manageable we were able to reduce this to fortnightly and then monthly visits to review progress and advance the programme. I wanted to keep challenging him to maximise his improvements and not let him plateau prematurely. My role became more facilitative and advisory as his became more proactive and independent
I am delighted that Phil is now at the stage where he has now returned to work, gradually increasing his hours as his capabilities have improved. When we first met he doubted this would have been possible, but it was an important part of his rehabilitation journey and a goal he worked hard to achieve. Of course he has had to make compromises and changes to the way he does things, but with the right attitude and the support in place his life is back on track. I am proud to have been part of the journey with him.
