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Focus on hands

August 18, 2012
By Erika Platt-Handru - Staff Writer ( , The Advertiser-Tribune

Becoming a certified hand therapist was like second nature for Christine Boes, who says she fell in love with hands while filling in for a friend at a hand clinic.

Boes, who also is an occupational therapist, had filled that spot 15 years ago, and has been working with hands ever since.

"I absolutely fell in love with the hands," she said.

Article Photos

Christine Boes, a certified hand therapist, places a splint on a patient’s hand at Optima Rehabilitation Center, located inside Mercy Tiffin Hospital.

Boes is at Optima Rehabilitation Services, located inside Mercy Tiffin Hospital, where she sees eight to 12 patients a day.

"Being in such a rural small community, 90 percent of my patients have hand or wrist injuries," she said.

Boes, who has been at Optima for 10 years, also floats over and helps with occupational therapy, such as therapy for stroke injuries, during her three days a week at the office.

"I don't ever completely lose touch with general occupational therapy," she said.

Hand therapists are a bit of a rarity, Boes said, because the practice is so specialized. In fact, there are only five in a 50-mile radius of Tiffin.

"That's why it's so rare to find a hand therapist in a small rural community, most of them are in big cities," she said.

Luckily for Janis Wickham, a patient of Boes', Mercy Tiffin Hospital isn't far from her Upper Sandusky home.

Wickham has been seeing Boes since June, when she injured her left hand while using a meat processor.

"It actually cut all of her fingers," Boes said of Wickham's injury. "To add insult to the injury, she's left-handed."

The most damaging part of the injury was a cut to both flexor tendons and a nerve in Wickham's index finger.

After her surgery and initial therapy in Columbus, Wickham began seeing Boes three times a week. The visits have since decreased.

"Right now we have to wait for soft tissue healing so we can start strengthening," Boes said.

After swelling decreases in Wickham's hand and there is an increase in its range of motion, Boes will bump up the therapy to strengthen Wickham's hand.

Wickham said her healing has progressed quite a bit since June. The swelling is down and the active range of motion is up, she said. However, she still has to wear a splint and is unable to bend her fingers.

"And you have to exercise about every hour," Wickham said. "It totally blows my mind, it's very time consuming and a slow process."

"Anytime you deal with tendon and soft tissue healing, it's tedious," Boes said. "A laceration like she has can just disrupt everything. The hand is so detailed and it's going to be a lot of therapy. That's why there's a specialization in just this kind of therapy."

Wickham said she recently was allowed to actively move her fingers.

"The last three weeks, I've only been allowed to do passive movement," she said.

Wickham said her hand therapy, along with the exercises she must do every hour, is like a full-time job.

"You think when you get a cut, it's just going to heal," she said. "The exercises are overwhelming."

Boes said Wickham will likely need a few more months of therapy before her hand will completely heal.

Along with tendon and nerve damage, other common hand injuries include radius fractures from falls and tendonitis from overuse, Boes said.

"A lot of (tendonitis) is from factories," she said. "We just flat out overuse our bodies."

Workers don't often warm up their hands and wrists, which can lead to tendonitis, Boes said.

Some of the strangest injuries Boes has seen include gunshot wounds to the hands and other mutilating injuries.

"I always ask, 'Where on earth did you stick your hand?'" she said. "They always come back with some rather bizarre answer."

Boes said injuries to a hand or arm are very debilitating, especially if they occur to the dominant hand.

"You use your hands for everything," she said.

Because the hands are such an important part of the body, doctors usually will do anything to leave a patient with a functioning hand following surgery.

Boes said doctors will go into a palm, take out a bone and move a finger over, just so there isn't a gap.

"When removing a finger, you can't have gap in the hand," she said.

While a person can function without an index finger, the rest of the fingers are essential. Boes said the thumb is of utmost importance.

"If you lose a thumb, they will try everything and anything to save it," she said. "They'll even transplant a toe."

"It's not how a hand looks, it's how it functions. That's the bottom line," she said.

Wickham, who is slowly recovering from her accident with the help of Boes, knows all about the importance of having a functioning hand. She said she is blessed to have Boes guiding her along the healing process.

"Chris is very good at her job, I'm blessed to have her," Wickham said. "It's nice to have someone who's knowledgeable. It's totally amazing how our bodies are so uniquely and miraculously made. It takes a long time, but how they heal so well."



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