February 26, 2024
Content Warning: Some images in this post show stitches, dried blood, etc.
I was really going through it back in November. I was questioning nearly all of my life choices, I was battling mental health demons, and I was having a really hard time staying positive. That is something for a separate blog post in itself, but it all came to a head one blistery afternoon the week before Thanksgiving. I was working the barn alone, and trying to get all the boxes checked in order to go home and prep for my trip north for the holiday.
I was on my last horse of the day. The plan was to lunge him down in the field, and then I would just be finishing afternoon chores and be done for the day.
Lunging went smoothly, the horse was wonderful. I started to wrap up the lunge whip and get the lead organized, and I noticed a very quick change in temperament from the horse at the end of the rope. He must've noticed the ghosts that sometimes wreak havoc in the field, and his entire (very large) body tensed up. I didn't have a second to process how my hands and the rope were organized and he was in the air and ready to book it back to the barn. Unfortunately, I had not remembered a classic Pony Club rule of never wrapping the lead around your fingers in this one instance, and the 1200lb animal yanked that rope and nearly took my right ring finger with him.
Adrenaline was with me immediately, and I was focused a lot more on getting the big guy by my side and walking calmly back to home base than I was about how my finger felt. He was able to be reeled back in fairly quickly, and we discussed how that was all a little silly, followed by several 'good boy' pats on the neck. On our way back up, after we both had calmed down, I noticed that finger was in a lot of pain. I had pretty thick gloves on, so I tried moving my finger around in the glove. I could wiggle it, which made me brush it aside for the time being, as it was at least still attached.
Once we were back in the barn, I busied myself with taking care of the horse and getting him back in his stall with his blanket on. I gave him a cookie and told him how good of a boy he was, and that it wasn't his fault that I wasn't thinking clearly about how I was holding the lunge line. I checked up on the other horses that I had left to take care of, and started cleaning up the barn. The growing pain in my finger was rapidly increasing to a point where I couldn't keep ignoring it. After a few minutes, I decided to bite the bullet and take my glove off to assess the damage.
Upon first glance, I noticed that there was already bruising and swelling. I grabbed an ice boot from the freezer and let it sit on ice for a few minutes to see if that helped. It felt like the pain increased as soon as I started looking at it, and my gut feeling was that it was dislocated. The direction that the lunge line was pulled would correlate well with a dislocation. I thought I confirmed this suspicion when I went to try to bend my finger from the base joint and it began bending in a direction that it was not supposed to go. That's when panic set in.
I put the ice boot away and started manically cleaning tack and throwing hay because I had a feeling I should go to urgent care immediately to get this looked at. I could tell that the finger was not good, but I didn't want to leave the barn a mess.
I made sure all the horses had enough hay and water, and then I took myself over to the closest urgent care facility. Holding my hand like a delicate flower, I went up to that reception desk and they told me that I probably should just head to the ER for X-rays, as they didn't have imagery machines at their facility. I then drove over to the hospital and went into the ER. Time in the car allowed me to dwell on what was going on, and I was starting to feel silly. It was 'just my finger' and it was 'just dislocated'. I didn't want to waste anyone's time. Plus, I had to work the next day.
Eventually I was given a bed, placed into a room, and the X-ray tech came by and took a few images of my then very swollen hand. The bruising was starting to spread, and the pain was really settling in. After a few minutes, the ER nurse came by and very nonchalantly informed me that my finger was broken. I was really surprised - I had fully anticipated that it was dislocated and would simply have to be put back into place. Having it be broken was a lot less convenient.
The original X-ray made it look like the bone between my base and first knuckles was split in half, so everyone in the room seemed optimistic enough that I'd be fully recovered in 4-6 weeks. It looked clean. I was placed in a temporary splint, and sent on my way. I spent that evening FaceTiming family and friends to show off my new look. The next step was an appointment with the orthopedist after the weekend to get it looked at more closely.
I went into that weekend before Thanksgiving feeling so, so stupid for getting myself into this situation. It was entirely avoidable, and I always check how I'm holding lead lines every single time I am on the other end of a horse. Except for this one moment, of course. I then took to my socials and reminded all of my horse friends to watch how they handle lunge lines or leads of any kind in order to avoid this situation. You bet I'll never make this mistake again!!
The Monday before Thanksgiving, I went into the orthopedics office for new X-rays and a cast. They had recommended a hard cast in order to protect the break, especially since I was still planning to go back to work. I remember being in the waiting room seeing a bunch of kids in colorful, signed casts. I thought about where I could buy silver or gold sharpies to have my family sign my cast when I went home later that week. I had never had a cast before, so in the moment it made me feel lighter to romanticize decorating it instead of sulking over having a broken bone. I had to be at least as tough as the kiddos with broken wrists!
I was eventually brought in to the back and they took a good look at my hand. They wanted new images before casting, so they took X-rays at various angles. It suddenly became much more visible to me (and to them):
That bone was SHATTERED.
It was not just split up the middle. It was in several pieces, and had a lot of feathering and cracks. I was blown away at the amount of damage that was caused by such a quick incident.
Upon examining my hand, the doctor determined that my finger also had some malrotation. That is why I had thought it was dislocated, and why it was bending in weird ways. They gave me some numbing fluid, and then - literally - twisted my finger back into place. The noise it made sounded like it was being snapped off. It took me a few minutes to mentally recover from seeing that happen.
They then put the cast on, and informed me that if any of the bones shifted, we would have to pursue surgery. They were optimistic that we wouldn't have to go that route, so I was optimistic with them. I chose black for my cast so that dirt would be less visible once I was back to work, and I planned to stop at Michael's on the way up north for some sharpies.
I enjoyed that holiday weekend with my family, showing off my cast, and not having to help clean the dishes. I planned to return to work as normal the following week, sans riding. When I did get back, I managed to do all of the regular chores, albeit slower than usual. I even got a few bareback rides in on the spotted unicorn. She must have felt some amount of sympathy for me, because she kept her spooking to a bare minimum so I could adequately steer with one hand. It felt like things were looking up.
My next checkup about a week later was great. They took the cast off, took new X-rays, and confirmed that things looked like they were all still in the right places. I left that appointment being told that we were 80% confident we wouldn't need to go for surgery. They put me in another hard cast to continue the added protection, and I returned to work as normal, again with minimal riding.
The next checkup, about a week after the last one, was not as great. They took new X-rays, and found that one of the bones had shifted in a way that would inhibit my use of the finger long term. The doctor discussed surgery with me, and I signed a whole lot of papers.
Surgery was a go.
It was at this point that I pulled away from work altogether.
If you look closely at the X-ray below, you might be able to see the piece of bone that was rotating out of place in that section.
The doctor's office didn't waste any time. Surgery happened later that week, the first week of December, and I was put under general anesthesia just for that finger. They ended up putting 4 screws in that one small section of my finger. That confirmed for me just how damaged it was, if that much hardware was required to fix it. I was stitched up, placed in a big splint, and sent on my way.
What followed was a ton of physical therapy. I was going a few days per week, and working on exercises just to get the finger moving normally at each joint. Once the stitches came out, I felt a little more at ease about completing the exercises, and noticed the swelling was starting to decrease. Around Christmastime, the swelling was decreasing rapidly and the finger was looking a lot straighter. I was being rotated between a few different splints to wear during the day and then at night for protection, and everything seemed to be trending in the right direction. I was feeling really set in recovery. I had also started substitute teaching at my local school district, which gave me something else to focus on besides my wonky finger.
After the holidays, I moved Sophie to a new barn and I started riding again. I was able to do everything as normal; I just switched to holding my right rein in between my middle and ring finger instead of between the ring and pinky fingers. I was struggling to bend the ring finger, but I could still hold it in place against the rein which was enough for me to do what I needed to do.
My hand therapist has been amazing, and every visit she measures the progress of my extension and flexion. At first the progress seemed decent, and my ability to flex was increasing by a few degrees at a time each session. After a few weeks of continued, intense therapy following the holidays, we both started to notice that my flexion was stagnating and my extension was starting to decrease. We did a lot of 'scar massages', which is literally just massaging the skin of the scar to help move the scar tissue around in order for it to not harden too quickly.
We noticed that the scar tissue was pretty thick, and nearly immovable. The doctor had a look at it and told me that, unfortunately, I had tendons that had adhered to the bone post surgery. This was the main reason I was struggling to bend my finger at that one joint.
Our last ditch efforts to avoid a second surgery were this medieval torture device, that was made to slowly force my finger to come down and bend more, and a cortisone shot. I have to say that the cortisone shot was probably the worst part during this whole process. They applied a lot of numbing fluid to that area, which made my hand real fat but also subdued the pain, and then did injections at two sites on top of my hand. The pain from the steroid after the numbing wore off was excruciating. I would describe it as a searing, burning, insistent pain. Throughout the whole process up to this point, I had been dealing with pain that was mostly intense soreness and aching; this was different. It only lasted one evening, but it was brutal.
We let the shot try to work its magic over the course of two weeks, and along with this crazy device, we continued to work at that joint to make some bending happen.
Unfortunately, this device and the steroid couldn't do it. On February 5th, the doctor looked at my progress and decided he needed to go back in. I was in agreement - my finger flexion was only at about 20%. The bones were healing well, but there were tendons that had adhered to the bone, and scar tissue on top of that - all of which was impeding both the flexion and extension so much that the steroid couldn't be effective. I wanted to have full use of my hand again at some point, so I filled out the paperwork and signed up for surgery round 2. The pictures below are from the day before surgery. The original scar had healed so well, but I had such little flexion in that middle joint.
Just last Friday I went under the knife for the second surgery. I was again given general anesthesia for this one freaking finger, and the doctor performed an 'extensor tenolysis' and a 'PIP joint capsulectomy'. In basic terms, they were going to cut some secondary tendons to release pressure, and they were going to peel the adhered tendons off the bone to allow for easier bending at the problem joint.
I had to get a few more stitches, but I took the wrapping off a few times over the weekend to start on my exercises and I can make a fist!! I haven't been able to do that for months. It's not perfect, but it feels like hefty progress. I had my first round of PT this morning and I am feeling really good about where we are at with this now. I will get this round of stitches out next week, and hopefully after the next two weeks of intensive therapy, I will see some major continued progress. I keep slowly working on some basic therapy exercises as I sit here at work, and I am just so relieved to see my fingers all be able to curl into a fist together. It's a motion you probably don't think about that often until you can't do it!
My biggest takeaways from all of this:
DO NOT WRAP LEADS AROUND YOUR HAND. Loop and fold. Loop and fold. Loop and fold!!!!!!
Recovery looks different for everyone. Be patient, listen to the doctors, and take recovery one step at a time.
Whatever I choose as a career, hand model is off the table.
I never want another needle in either of my hands ever again.
I will continue to provide updates on this thing (hopefully all positive) as I head into competition season. I guess it was mildly convenient that this all happened during the off season! Huge thank you's to my doctors, my physical therapist, and family and friends for your support. And a huge thank you to Sophie, who was super for me to lunge with one hand yesterday <3
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