Quick Relief

The Rice Sock! This might seem like an obvious home remedy, but I just made one and I don't know why I haven't done it sooner!!! From the microwave, it works great as a heat pack. Straight from the freezer, its a icy pack. Make two so you can do contrast therapy :D I got the specifics on how to make one from the WikiHow website here http://www.wikihow.com/Make-a-Rice-Sock
I suggest going thru the entire page, there are some valuable Suggestions and important Warnings. I've been putting a glass of water in the microwave with the rice sock when heating it to prevent fires and add a bit of moisture to the heating process. My screaming tendonitis pain is now more of a chattering pain with the help from my socks.
Even if you need help to make the sock, let your helper know that you don't need mad sewing skills or more than 5 minutes to make it.
Also, I suggest a sock that doesn't have a bend in the heel, that way the sock can lay flatter. .. I finally put that pair of toe-socks to work...

DO YOU KNOW HOW TO PROTECT YOURSELF

I found some wonderful advice in a blog by someone that was hurt on the job in North Carolina. (please note the link and visit it if you'd like!) I have only edited it to be California specific (rather than NC).

IF YOU ARE HURT ON THE JOB: __Tell a supervisor immediately. __Get the full names of everyone who witnessed the accident. __Write up an accident report. __File a DWC form with California's Division of Workers Compensation (DWC) __Follow employer's request (go to employer's doctor, follow rx orders). __If you feel that you are not being treated fairly, call the DWC. MAKE A FOLDER TO HOLD ALL OF YOUR EMPLOYER'S INFORMATION, MEDICAL RECORDS, WORKERS' COMP CORRESPONDENCE AND ALL OTHER PERTINENT INFORMATION TO YOUR CLAIM !!! Including: __Employee Handbook __All medical screening and job classification tests __Any awards, write-ups or employee warnings __A calendar of vacation days, tardy and sick days __A copy of all memos and correspondence that pertain to you and your job. __DO NOT write on any of your documents; keep a notebook, or journal, with date, time, names, companies or doctors, nurses etc. __Trust No One--get it in writing! MEDICAL CARE: __Get a copy of anything that you have been asked to sign. __Get a copy of any papers from doctor visits or doctor's report. __If you do not understand what has been written, ask someone to explain the information to you. __If the doctor's reports do not match what you have been told, you may need to secretly record each doctor visit. California Division of Workers' Compensation: http://www.dir.ca.gov/ and here is all the contact info. __If you do not have an attorney, they have a free service called the Information & Assistance Unit that has officers on hand to answer your questions pertaining to the legalities of the WC system. (link to those phone numbers here) __They cannot help you once you retain a lawyer. __Unlike other courts, it can take three months to remove your attorney from your case if you are not satisfied with the service. __Keep a record of everyone you speak with, the time, date, and the reason for the call. __Fight for your rights to be heard.

Disabilty determination exam for Medi-CAL

I had a disability determination evaluation this week at the request of the Dept. of Social Services for California because I applied for Medi-CAL (at no one's request, I just want to have general medical coverage). The purpose of the exam (as I understand it- - I could be wrong) is for them to say "Yes she has repetitive strain injuries in both her arms that affect her from working and beyond that she functions normally." I have done a Qualified Medical Examination for my WC claim when they doubted my treating physican's diagnosis. The QME was very rigorous and I totally agreed with my doctor's findings. I assumed this evaluation would be similar and because haven't improved since then. On all of my reports from my doctor it says:

IMPRESSION:
1. Bilateral upper extremity RSI.
2. Mild median ulnar neuritis.
3. Rule out TOS.

This seemed to have rubbed the examiner the wrong way. He said, "So what's you're disability?..What is RSI?" When I told him: Repetitive Strain Injuries, and then he met my bewildered look with one of his own.
"Repetitive Strain Injury isn't a medical term. That's a cause. Your doctor's notes give me no medical diagnosis of your actual disability."

Let, me back up just a tad, when I got into his office, he had no idea who I was b/c he didn't have my files at first. Once he got them, it was obvious this was the first time he had looked at them. So he took all of 3 minutes to review/ skim and then launched into a hurried interview. I was still shaken about the lack of proof he had that I have a diagnosis and I feel I didn't answer his questions really well. The actual "examination" felt las routine as a ride operator's schpeel at a theme park. It was standard health stuff like heart rate, b.p., reflexes- but nothing really intensive with the arms. He did not do anything that would be irrefutable in support of a tendon realated injury. Adson's and Tinel's tests are unfakeable. He didn't do anything that I had done at my QME that involved precise, recorded measurement. When he did palpation, it seemed like it was too light and brief for anything to be determined. There were other things he had me do that seemed to be tests to rule out other additional disabilities. And at the end he wanted me to do windmills which I didn't do entirely.

All in all, it was a rotten exam. I feet like my doctor has let me down a bit and its going to affect me on this state disability determination ruling.

My Functional Capacity Evaluation

This week I went to my Functional Capacity Evaluation that was orchestrated by my LTD provider to determine what kind work I might be able to do given my new limitations. I didn't feel bullied but I left feeling beat up for sure. I had to do tasks in spite of the work restrictions made by my doctor. In fact it was like a showcase of all the things I should not be doing. My competitive nature pushed me to prove I can do these things. In the course of the evaluation my pain level started at a 4 and went to a 6 and went to a 7 while home and has stayed at about a 5 since then (its been 7 days now).

For the benefit of any others that may have an arm RSI and have to do a FCE here's a list of the things I did. Almost all of my tasks were administered and monitored by a high tech Occupational Therapy program. First, I verbally gave my work, injury, daily routine, and what-I-do-for-fun histories then this is what I did:
1. strapped a wireless pulse monitor on and took blood pressure
2. Treadmill- power walking! 10 minutes
3-5. Hand Dynamometer for hand strength:

• left then right hand (5 sec each time??), alternating hands 6x for each of all six grip positions
• left to right rapidly 6x for only one position
• left to right (5 sec each time??) 6x, same position

6-9. Pinch Gauge for finger strength:

• key pinch position. alternating right then left hand for 5seconds each 6x
• index finger to thumb pinch position. same as before
• index finger & middle finger to thumb pinch position. same as before

++++++++ these next ones were done on something that looks like a weight gym system but its completely sensored and part of the same computer administered program++++++++++++++

10. Push with all my force one time for 5 seconds
11. Pull ...... one time, 5 seconds.
12. Weighted milk crate (not sure how much it weighed but I would guess 5 lbs) pick it up from a waist level platform and put it on another platform at shoulder height, then back again. 4 times. Repeat after 4x but with a weight added. (couldn't do it myself- if you can, they will keep adding weights til you can't)
13.Weighted milk crate- pick it up from the floor to the waist level platform, then back down. 4 times. Same deal after 4x, with weights. (More added if you can handle it.)
14. Weighted milk crate- pick up from the floor to shoulder level platform 4x. (Then weights added.)
+++++++++ no more exercises using the sensor equipment +++++++++++++
15. Pick weighted crate up from waist level platform and carry it 10 feet away, turn around, out it back down. Repeat 5x.
16. Stand, stoop & kneel + motor skills: moving 6 rows of 2 pegs at a time from a peg board wall starting at the floor- knee height to coordinating slots at knee height to chest height. Repeat 7x. This was timed.
17. 2 step stairs up and down. 24x. timed.
18. Crawl on hands and knees for a minute. (really)
19-22. Fine motor peg board:

• right hand: pick up pegs from dish and put as many in the peg board w/ right hand in 15 seconds (?)
• left hand: same
• both hands: same task at the same time for 15 seconds
• use both hands to assemble as many peg, washer, grommet & washer formations in 15 seconds

23. Writing. Copied an article out of a magazine for 5 minutes.
24. Took blood pressure.
25. DONE!

Looking over your benefits from work while disabled

What does work benefits have to do with being disabled? Isn't that what Workers' Compensation Insurance is for??
Turns out, if you have enrolled in your employer's benefit package prior to your injury, the ins and outs of your work benefits can provide some interesting plot twists in your WC saga. I recommend going through your entire benefit brochure. Don't have one? Request one or go online (- it would be online if you have the option of managing your benefits online). The things that affected me in my time out of work due to injury in terms of my benefits I paid for are:
1. Losing Medical, Prescription Plan, Dental, Vision benefits due to reduction in PAID HOURS.
2. Short term disability and 3. Long term disability which are benefits that most often is paid for through some benefit plan at work.. Part of that automatic deduction from your check every week if you are enrolled in these particular benefits. It helps you out if you become disabled either randomly or from a work related injury.They provide income that you are not receiving normally- however they have limits, and in some cases, won't provide the same dollar amount income as one had before the disability. *IMPORTANT* To receive STD benefits, you — or someone acting on your behalf — must file a claim.

*other points of interest are enrollment, average weekly earnings, paying for these benefits out of pocket while on disability (aka missed payroll deductions) , pre-existing and recurrent disabilities

1. yikes! I didn't know that
2. Short term disability (STD) covered me for the first 26 weeks of my injury. And at which time I had no idea it existed. I am just now understanding that STD and LTD are thing that I have already paid for and I'm figuring out now how they have or have not helped me. With STD, I'm still like HUH?. I'm not sure if I was supposed to receive $ from this plan. I didn't get any... thinking it was because I earned "too much" from WC. There are several sources of potential income while you are out, but they seems to cancel each other out, and the lowest amount is the winner as your main source of income :D
3. Long Term Disability (LTD) has just kicked in although my STD period ended 7 months ago... I guess this normal?? I will admit I was slow to provide them info they needed. My doctors and WC adjustor were slow too. Also. Now that I am PS and WC has ended LTD seems to be my only income now. There are steps I am taking to increase my benefit $ amount right now. It involves lots of forms and reading both fine print AND in between the lines Whereas Another service mine provides is Vocational Retraining $... This week I have a Functional Capacity Evaluation (FCE)- this is the LTD's in house doctor review- to see if I can work at for the same company in any position. I think. HUH? I want to stop here though, because I am still learning about this system.

I will fill in the holes on the questions I have as I get them answered

I have a bandaid on my neck

.... this is not a metaphor. This is actually supposed to help.

Ridiculous? Yes.
I decided to watch Eraserhead after my PT visit in which I got the bandaid put on just to surround myself with something more surreal than this fix. Now I am in in the mindset that ridiculous things are only a big a deal as we make them.

Actual solution? Could be.
The bandaid is there as a booby trap, if you will, for when I am studying or on the computer to NOT strain my neck. When I feel the tension on my skin from the bandaid, I know that I am not using my eyes to look down. ¡With symptoms of TOS, using your neck to do look down a lot agitates the ulnar nerve!

I will give it a try for a few days.

new challenge: Getting PT equipment approved

Getting PT equipment approved is difficult. When your doctor or physical therapist recommends it to you, the prescription also has to go to your WC claims adjustor, he (or she, mine's he, so I'm gonna go with that) has to send it to Utilization Review (UR) to be determined necessary or unnecessary. UR goes by the Occupational Medicine Practice Guidelines as set by the ACOEM (sorry- no website for the guidelines, but the library should have it as a book at the reference desk). The good news is, your WC adjustor isn't telling you what treatment and equipment you can or can't receive. Bad news is, the UR is still working for your employer.
My current status is that I am receiving PT right now that treats Thoracic Outlet Syndrome (TOS) by way of something called the Peter Edgelow Protocol. Sounds funny don't it?? :P I promise to share all of my exercises that comprise the "protocol" later. All it means is a particular way of treating pain due to TOS... The equipment that is needed costs about $300 and the claims adjustor has been avoiding all requests to get it approved, combine that with the need for UR and I could be waiting about another 3 weeks before its ok-ed OR denied.
The problem is there are a chain of events pending>> I need to have this equipment in order for me to get the most out of the PT, otherwise, its just neat knowledge and arms the same as they ever was. I have only 2 visits left of PT for this injury. period. And the biggie= once I am done with this PT then my doctor is closing the case and I will become Permanent & Stationary (PS)/ Maximum Medical Improvement (MMI) [both mean the injured has plateaued and not expected to get any worse or better in the next year]. So you see, I need the PT equipment in order to close the case.
What I can do and what I probably will end up doing is paying for this stuff myself (with all my loads and loads of extra money I'm raking in from WC. HA!!....I can forgo food again this month it looks like). If UR deems this equipment necessary for my recovery they will reimburse me. That is the law- its not like, if they find out you are willing to pay for it, they deny the request and you have to foot the bill... although I don't think I am going to call up my adjustor and ask him if its ok for me to pay now & he can get me back later. I am going to stay mum about it and just cross my fingers that it gets approved and I get $300 back!! Also, it turns out I don't have to buy the whole thing and that might shave off some of the cost.

If you get a chance, go check out the link to Egdelow's site and look at the equipment... I challenge you to define thumbometer.

UPDATE:: I got a call ON the very day that I was going to plunk down my own money for the equipment... It was approved!! That was 4 days ago and now I have the kit! Yay!!

My story- abridged

Back story in a nut shell: Worked at a cafe for 3 years, started to feel acute pain in both arms around xmas 2006, worked despite the pain for about 20 days before going to a doctor, got modified duty & worked one more week, pain was too intense to function in any of the duties at work, was diagnosed with Repetitive Strain Injuries: tendonitis of bilateral upper extremities, have been off-duty/ unable to return to work as per my treating physician ever since. Currently, I am finishing up my last bit of WC-approved PT, following that my case is going to close, I'll be Permanent and Stationary, my temporary disability status will end and I am not sure what comes next....

Day 398

How this is gonna work:
I am not going to backtrack and go chronological with my experience. I would stay injured if I were to type that all out and besides, I am not into reliving all of it and, in turn, wallowing.
Instead I am going to cover things:
I wish I had known ahead of time= Mistakes
I have learned along the way= Hints
I still have questions about= Huh?
(more to come?)

I hope I am writing this blog as a resource. And I wish that people will comment, ask and answer questions here. I will be so happy if this happens. You know, I have a ridiculous amount of experience and knowledge about RSIs and the WC system in California now and it would be silly for me to not share it.