15 July 2011

Assistive Technology and the Cultural Context

I have a patient who broke four of the five metacarpals of his right hand . . . those are the bones in the hand . . . the five longbones that connect the wrist to the fingers.  And while it seems, on the surface, they don't move much, the reality is, without correct positioning of the metacarpals, proper grasp, grip, and general dexterity of the fingers is significantly hindered.

Our surgical team did a good job resetting his bones.  But they can't do anything for him once the cast comes off.  And six weeks of immobility leads to stiffness, pain, and more immobility.  So, they've sent him to me.  After two weeks of an hour a day of (painful) stretching and exercises, he has seen a significant amount of progress.  He can pick up different sized items and can open bottles and pinch clothes pins.

But even if he couldn't, he's got people around who can do that stuff for him.  Who cares about that stuff.  What's important for my patient is that he can go back to the fields and farm his onions and millet.  Without being able to work his crops, his family will not eat . . . there will be no bottles to open.  He cannot afford to stay around the hospital for another two weeks for an hour of hand therapy a day.  He needs to go home and work.

But he can't grip a hoe.

Which means he can't work.

And his family won't eat.
But this is why I LOVE being an Occupational Therapist.  Because it's my job to enable my patient to do his.

So I brought a hoe to work the other day.  When my colleagues saw me walking to my office carrying the platypus-bill of metal jutting from the Fred-Flintstone-style-club they were convinced I was off my rocker.

Using many layers of athletic tape (since I don't have any spare leather lying around) I made a double-fan-shapped strap (wide on the ends, narrow in the middle) and showed my patient how it could be hammered to handle of the hoe to make a secure strap for his right hand so that he could hold the hoe securely.  Science meets art . . . it worked!


Shal said...

Awesome! You are so creative and resourceful!

Deb. said...

I get it from my mom. : )

Melanie Read said...

Love it! Any pics?! I work in the school division now so miss out on the splinting bit. I remember those crazy looks when I'd go running around the therapy department for random things like fishing line, guitar keys & paper-clips for my splints (we are far away from a large city and it took a really long time to get "real" splinting supplies) ! One guy even made his own "improvement" with a used coffee cup!

Wish I could visit and see some of your creations!

Deb. said...

Thanks for stopping by, Melanie! I REALLY need to keep a camera in my office!! Unfortunately he took off with the strap before I could get a shot of it . . . maybe a duplicate is in store . . . I'll see what I can do!

Coat hangers and guitar keys, huh?? I would have loved to see that!! We really do have the best profession, don't we!