The Boat Doctor is IN: Update on Aden's Hand
Well we are pretty sure Aden as a broken finger. The base of her 4th proximal phalanx to be exact …or at least as exact as we can tell without an x-ray machine on board.
Having 3 kids (and one sometimes kid-ish husband), we have administered some boat-medicine already including but not limited to (I mean, hey, the day isn’t over) treating the following:
ear infection (minor but painful for Liam; treatment: tough it out kid sorry…got to use our endoscope tho!)
numerous cracked toes (sorry girls, you got this from me, plagued me as a kid too; treatment: clean and tape)
split toe (look where you are going Aden; treatment: clean and bandage)
black eye (watch out for Grace’s right hook Liam; treatment: don’t be an idiot…and ice)
stubborn and painful tonsil stone (sorry Liam, you also got this tendency from me; treatment: salt water rinse and warm tea until it passes)
conjunctivitis (child will remain unnamed; treatment: antibiotic drops and hand-washing lesson)
numerous bumps on heads, arms, legs, torso (some rather big, none of them mine; treatment: don’t be an idiot…and ice…seriously people when are you going to adjust to living on a boat?!?!)
However as our first somewhat significant injury on Matriarch Greg and I had to make some decisions about how to handle Aden’s hand. Or should I say ‘hands’ since technically she also has a sprained finger on the other paw. Given all of those years of jammed fingers playing basketball, Greg and I can attest to the effectiveness of “buddy taping” when you have a finger sprain so that one is a non-issue. We have loads of tape in our med kit. But now that we are pretty sure her finger on her right hand is broken, that is the one that required a bit more attention.
Early bloom of bruise on her middle sprained finger…she’s eager to unwrap it now that it’s been a few days to see what it looks like now :P
After we gave it a day to settle down (and maybe for Aden to be less focused on it) we gently palpated the fingers of that hand, all the way from tip to wrist, feeling each individual bone (it helps that she is pretty scrawny / boney) and each time we touched a very specific spot on that finger she just about passed out. I’ve had sprained fingers and broken ones so I know the difference in terms of pain upon touch…hence, pretty sure it’s broken.
So our questions to each other were as follows:
Will our treatment of it here lead to reduced mobility for her later on?
How does the splinting change (or maybe it doesn’t) given that we think the break is closer to the joint (but not at the joint itself)?
Will an x-ray 2 weeks after the injury be able to confirm if we’ve done a good (or bad) job aligning and splinting? And is that timeframe acceptable for adjustments?
And finally,
Depending on the answers above, do we need to take her to a hospital here in the US and then deal with the travel insurance fallout? OR
Can we wait and have her see a doctor in Canada when we are home in about 10 days and treat her ourselves in the meantime?
Other general questions included:
Can we go sailing / under what conditions are we comfortable sailing with Aden (our clumsiest and most seasick-prone kid) only having one (compromised) hand available for support?
What’s the best way to safely get her on and off the the boat? (We’ve had some crazy high tides here the last few days and the deck is about 4.5 feet above the dock)
How can we impress on the kids (beyond the lengthy lecture they got) about how BLOODY IMPORTANT it is to think a few steps ahead and understand the MASSIVE ripple effect of someone getting hurt while we live on the boat??????
To make it a smidgy more complicated this all happened as Liz and I were / are trying to get all of the materials required for an upcoming event over to our client to make important deadlines. It’s the boat-version of the classic “the sh*t hits the fan on a Friday night shift” scenario.
Immediately after the injury, hoping it wasn’t broken but treating as such, we put a semi-flexible splint under her finger, taped with a buddy and wrapped it up. I opted for one of the old-timely diaper pins that have a lock on them to secure the wrap since after 2 seconds one of the metal tabs was lost. Thanks for those Mom!
Aden inspecting the first splint and wrap job…the tape on the wrist was to cover those metal tabs but they came off anyway…
After the “day of rest” we unwrapped her hand to confirm what we feared (hand was swollen but not shockingly so, bruising was beginning to show at the base between fingers 3 and 4), had her ice her hand again and then Googled splint techniques for precisely where we thought the break was. Turns out our first go wasn’t too bad. We made a slightly larger split and made it a bit more rigid , buddy taped her fingers and then sandwiched them between two splits, taped them together and then wrapped it all up again. The primary question was about the angle. We opted to keep her fingers extended and not bend at a 90 degree angle at the metacarpo-phalangeal joint just in case it put too much stress on the base of her proximal phalanx. We’ve checked her sensation at her fingertips (no numbness or tingling, colour is nice healthy pink) and when her hand is relaxed it’s comfortable. She has an ache at the break spot but that’s to be expected and she’s managed without pain meds throughout…she’s got a cute little self-soothing mantra that helps pluck up her courage…something like “you can do this Aden”, “it has to be done Aden”, “it’s going to be ok Aden”…I effing love it). Revised wrap pics below:
On the upside she is LOVING the attention she is getting. Classic middle child with introvert tendencies, she’s loving the limelight that has fallen on her without her having to say or do anything to get it. She subtly feeds the attention-getting by saying things like “wow, I JUST can’t believe this happened to me” or sigh and say “do you remember when I could use my hand properly? feels like such a long time ago now…”. and the not-so-occasional “Grace you HAVE to help me!!! My finger is BROKEN!”.
In terms of how we’ve dealt with this (as in why didn’t you just go to the hospital?): to be honest here part of me (and Greg too) wanted to treat this as if we were offshore and just had to deal with it…this kind of injury is quite likely on a boat with so many people on it. Soooo…hopefully we aren’t damaging her for life by using her as a test-case (I really don’t think we are). The finger is in a good position to heal properly and minimize stiffness and she’s comfortable and safe. We do have the safety net of medical advice online from our family doctor at home should we feel we need for some, as well as a super awesome doctor we met at our offshore medical course who offered his expertise via WhatsApp on the high seas. We’ll have it looked at when we get home but for now we are pretending we are not actually tied to a dock. Feel free to judge me on this…but I’m comfortable with my choices :P
And now I’m totally vibing on Greg’s blog post the other day about how his Engineering degree is coming in handy. My anatomy and athletic injury courses kicked back in while providing this care for Aden…nice to know I have that knowledge stashed away somewhere in the dusty corners of my brain still! Hopefully it can remain there for at least a few days to give Dr. Mom a break :S
Stay safe out there people!
M
