As I glanced down, I noticed bumps and pieces of my hand jetting out in all different directions. The misplaced fingers poked up, out and sideways…
The greatest snow on earth! That’s what they say.
Utah promotes this slogan and proudly advertises it on its Ski Utah license plates.
Most snow to hit the Utah mountains comes from the west. Rain storms in California follow a path that drags across California to Nevada, and on to Utah. The Nevada and Utah deserts generally dry out the wet California rain clouds and drops the temperature, freezing the rain that then falls in Utah as soft, light, fluffy snowflakes that skiers and snowmobilers find irresistible.
Living in Ohio for a couple years, the state’s different weather patterns introduced me to something entirely different. Freezing rain, and heavy, wet, dense snow, filled with buckets of water. It was definitely different than the Greatest Snow on Earth found in the Utah mountains.
But not every Utah snowstorm contains the air-light snowflakes housing little water and mounds of powdery snow. Yes, Utah does at times, have wetter-than-usual snow storms that gnarl roadways with crashed vehicles, and break the backs of snow shovelers as they lift soppy wet, slushy shovel-filled scoops of snow from their driveways.
For those of us fortunate enough, the use of a snow blower helps alleviate sore backs and arms, during such snow storms. I was grateful for my two-stage blower on a blustery winter day on December 19, 2013. At least I was at first.
I woke up earlier than usual, knowing that the anticipated snow storm dumped about a foot of snow along the Wasatch front. I ate breakfast, and then made my way outside and cranked up my used, but effective, snow blower. It fired right up and lit the air with the aroma of mixed gas and oil.
I quickly ran the machine back and forth up and down our driveway, all while noticing how much the blower struggled to capture and shoot the slushy wet snow. Several times, the chute would clog with the cement-like material and I would stop and free the blower’s long neck from its suffocating sludge.
As I finished another pass down the driveway, I headed into the street for a few feet where the snow was especially soggy. Like before, the five horse power engine struggled and the chute again clogged. My hands were already drenched as the snow had seeped through my tight spandex gloves. Looking down at the chute, I could see it would take some work to clear.
Wanting to be safe, I turned the engine off and I started clearing the snow with my left hand, while bracing myself and my weight with my right hand placed on the snow blower’s handle. Several times I grabed a handful of slush and threw it aside. With three-quarters of the chute now free, I plunged my hand down once again.
The sound was so loud it scared me, and I jerked back, for a second. The loud bang made me think that a rock had crashed into my closed garage door.
I immediately felt both pain and tingling in my left hand. In a moment, I realized what had happened. The snow blower had crushed my hand as the built-up torque in the auger was released as I removed the snow from its jaws.
I was nervous. What had happened exactly? Did I break a finder? Did I get cut? Too afraid to look down, I started moving each finger independently to try and determine the damage.
Wiggling my thumb, I realized that I could still move it normally, but that the tip of my thumb was in horrible pain. Moving to my pointer finger, I tried to move it. This caused excruciating pain and I realized, that finger was broken. I then tried moving my middle finger, with the same result—it was broken. Moving down my hand, I tried wiggling my ring finger—broken for sure.
The realization of what had happened started to sink in. I was in trouble. I then moved to my pinky finger, trying to move it. What pinky finger? I couldn’t feel it at all. Where was it?
With the snow blower still sitting in the middle of the street, snow still pouring down, I mustered up the courage to slowly look down at my hand to survey the damage.
My skin-tight spandex glove was still on my hand. As I glanced down, I noticed bumps and pieces of my hand jetting out in all different directions. The misplaced fingers poked up, out and sideways, but they were still covered by the glove.
I felt sick. My hand throbbed. I became nervous. Maybe I was in shock.
With my hand and arm now pressed up against the trunk of my body, I struggled to grab the snow blower with my right hand and direct it back into the garage. I somehow dragged it up the driveway and made my way to the door.
Kicking off my boots, I went into the house and leaned up against a wall, feeling like I was about to pass out. I hollered for my wife. “Jen!” No response. So I yelled louder. “JEN!” I could hear her upstairs struggling with our children trying to get them ready for school.
“What!” she replied.
“Jen, I need your help!” I mustered.
“What do you need,” she said in a slightly curt manner.
“I’ve had an accident and I need your help, now,” I said.
I could hear her footsteps as she ran down the hallway to the top of the stairs where I stood at the bottom.
“What happened?!,” she exclaimed. Her tone had changes from agitation to frightened.
“I got my hand caught in the snow blower and we need to go to the hospital. Now,” I said emphatically.
The gravity of the moment hit her like a ton of bricks. She burst into tears and seeing their mother cry and their father pale and in pain, the kids also started crying hysterically.
I didn’t want them to panic. “It’s going to be okay. It really is. Everything will be fine, but I need to get to the hospital right now,” I said. “Calm down and call your aunt and have her come over and watch the kids while mommy takes me to the hospital.”
Jen immediately took action. She called my sister and I stumbled out the door and into the car. Within minutes, Jen jumped in the car and we started off to the hospital.
The snow made the roads a mess. We tried to get to the hospital as quickly as possible, but the traffic and weather impeded our progress. As I sat in the car, still holding my hand to my chest, I thought to myself, “Maybe I just have a couple broken bones and nothing too serious. Perhaps it would be better to bypass the hospital and just head to the local clinic,” I said to Jen.
I called my friend who worked at the clinic and told him of the situation. I said we would be there shortly, and he said he’d be ready for us.
It felt like hours before we arrived. When we finally did, my friend was waiting for us at the front door and immediately rushed us back to a room in the Orthopedics area of the hospital. A nurse and orthopedist were waiting for us.
I sat next to a small examination table, and I placed my hand gently upon the top of the table. The nurse took scissors and started cutting the glove from my hand. I was nervous. I remember talking almost uncontrollably, making jokes, trying to reduce the stress I felt and the nervousness that engulfed me. I stared into Jen’s eyes as they pulled the glove off my hand.
Jen looked down at my hand and her optimistic and concerned eyes turned to looks of horror. My heart started beating faster and I said, “No! No! No! Don’t do that!” She looked back at me with terror. “Please don’t look at me like that!” I implored. “Please don’t make that face,” I begged.
She mustered everything within her and said with a very week and soft voice, “It’s…um…it’s…not…um…it’s not that bad.” Her voice quivered. She was lying and I knew it.
By this time, the clinic’s CEO was in the room with us. Surveying the situation, he calmly came over and said to Jen, “Why don’t you run down to the pharmacy and pick up some pain meds for Steve.” Jen exited the room.
The doctor’s face was focused. I saw an intensity in his eyes as he looked at my hand. He then demanded of the nurse, “We need a ring cutter.” My wedding ring! I had forgotten that it was still on my hand.
“We don’t have a ring cutter,” the nurse replied.
“I don’t want to hear what we don’t have. We need a ring cutter and we need it right now,” he said with greater intensity. The nurse again tried to explain that they don’t keep ring cutters on hand. The doctor cut her off and yelled, “Get me a ring cutter right now or he will lose this finger!”
They both scurried out of the room to find a ring cutter. My friend and I were left alone. My heart was racing. I felt sweat form on my forehead.
“Steve,” my friend said. “It is bad.”
I welcomed his honesty. But I was scared.
I tried to make jokes again. I remember talking and talking but about nothing. I then had a thought.
“Kevin,” I said, “Go grab a camera and take some pictures.”
I knew if I had looked directly at my hand right then, I might have passed out. But I knew at some point I would like to see what had happened.
As Kevin went to grab a camera, the doctor and nurse came back in. They had found a ring cutter and started to cut my ring. There was pain. A lot of pain. They had to move quickly because my ring had been completely clamped onto my finger. All blood supply was stopped and had been for nearly an hour. Finally, the ring released.
My wife returned with pills that I choked down. The doctor assessed the situation and determined that it would be best for me to head to the hospital, knowing I would need surgery.
The doctor wrapped my hand in gauze and sent me on my way. The hospital was another 20 miles away and the roads were still a mess. A few minutes into our drive, the pain pills started kicking in and the pain had started to subside. We arrived at the emergency room and they assigned me a room.
It had been only a couple hours since I had eaten my breakfast, so the doctors made me wait in the ER for another six hours, to assure I wouldn’t aspirate my food into my lungs during the surgery. They had me hooked up to an IV and administered medicine to help keep the pain at a minimum. I remember my nose itching uncontrollably. Apparently, my body was allergic to the medicine.
“You’re in luck!” the charge nurse said as she whipped back the curtain and entered my room. “The doctor on call today is a hand specialist.”
The pre-surgery consultation was fairly quick. A brief exam. A quick look at the x-rays.
“Do you have any questions?” the doctor asked.
“Yes, what are the chances I keep my finger?” I inquired.
I knew my pinky was in a bad way. Looking at my bandaged hand, I could see the tip of the pinky lying over the second joint of my pointer finger. But, I could squeeze the tip and see blood circulating and I had total feeling.
“What do you do for a living?” the doctor asked.
“I sit at a computer all day long, typing,” I said with a little worry, thinking about the worst-case scenario.
“Well,” he said, “I’ll see what I can do,” he said as he scooted his chair across the floor and headed to his next appointment.
His response didn’t instill a lot of confidence in me. At least it is my pinky, I thought. If I have to lose a finger, the pinky on my left hand would be my choice.
They wheeled me back to the operating room and I moved from my gurney to the operating table. I could feel my heartbeat pounding in my chest.
. . .
I remember waking up and my hand was immobilized and wrapped up extensively. I could hear Jen’s voice. “How are you doing, sweetheart?”
“Did he take my finger off?” I asked.
“Yes, he had to take it off,” she said with sadness and sympathy.
“Did he keep it in a jar for me to take home?” I responded.
There was a little laughter to lighten the mood. Even though I had lost my finger, there was a small part of me that thought it would be a little cool. You know, to have a little stubin’ rather than a full finger. Yeah, that is weird, I know. But I did worry how I would adapt when using a computer and having to type.
The surgery only took about 30 minutes. My hand was broken in eight places; more specifically, my fingers were broken in eight places. My pinky had taken the most abuse followed by my pointer finger. My middle finger broke in two places—at the base between the first two joints, and at the tip, just below my top joint.
The doctor placed 10-inch stainless steel pins underneath my fingernails, that ran straight through each finger and exited just below my knuckles. He also used a separate wire to wrap around my pointer finger’s base bone. He said that bone was crushed like an egg shell and he hoped the wire would keep the bones close enough to each other that they would eventually heal. Looking at my x-rays, I looked like Wolverine, with steel blades in my fingers.
My hand was completely immobilized in a cast. It made it hard to sleep. My hand hurt, of course, but the immobilization is what really bothered me most—both physically and mentally. It made me feel claustrophobic.
Within days of the accident, I kept telling Jen my hand didn’t feel right. I told her the cast was making me crazy and that the immobilization was having a significant impact on my mental ability to handle the accident and my situation.
We made calls to the doctor. I asked if they could splint my hand, rather than have it in a cast. My requests were denied. Each week, the hospital would take more pictures of my hand and send me with a disc with the scans to the doctor’s office. Each week he would review the progress and send me home.
Three weeks after the surgery, it was time to remove the pins. As I entered the doctor’s office, I noticed some pliers sitting on his table. They were just like pliers you’d buy at Home Depot. They had rubber grip handles and were big and heavy. I asked what the pliers were for and the doctor replied, “We have to use them to pull the pins.”
Jen wanted to video him taking the pins out and I happily agreed. The doctor placed my hand in his lap and then positioned himself with his back to my torso as I laid on the bed. I couldn’t see what he was doing.
He used the pliers to grab hold of the pin in my pointer finger…and then he yanked, and yanked and yanked again. An immense pain shot throw my finger and my hand with each jerk. My heart rate skyrocketed. My eyes felt like they popped out of my head. I yelled! He stopped.
The pin didn’t budge.
I looked at Jen and said, “You cannot video this. Please stop videoing. I don’t want the kids to see this.”
The doctor slightly adjusted his posture and took a firmer grip on my hand and with the pliers on the pin. He pulled harder this time. I thought I would die. The pin didn’t budge and so he started to twist it back and forth, while he continued to yank, over and over.
I had enough. I demanded he stop. He was annoyed.
“We have to get them out!” he demanded.
“Then deaden my hand with a block. I’m not going through this anymore without some sedative,” I insisted.
He was even more annoyed. He got up from the table and asked his nurse to get him a syringe. He loaded the entire syringe with lidocaine. He then took my hand and injected me in the wrist several times on the bottom and the top. Then he moved to the small space at the base between each finger and shoved the needle deep into each crease.
Each time he inserted the hypodermic into my hand, it burned with pain for a few seconds and then it went numb. He injected the lidocaine in 12 different locations on my hand, wrist and fingers. He was overdoing it.
He then got up and left the room and said curtly, “I’ll be back when your hand starts to numb.”
I lay there on the bed looking at Jen and told her how much it hurt when he was trying to pull the pins from my fingers. I had sweat on my brow. It had been a violent 15 minutes.
It felt like the doctor was gone forever. But I didn’t mind. I was worried that the lidocaine might not numb me enough and I dreaded the thought of him trying to remove the pins again. When he did come back in the room he asked if I could feel my hand and if I was ready. I replied by telling him that I thought I was ready, but that I was scared to have him try again.
His patience was spent, and he started again. This time…thankfully…when he pulled on the pins, they each slid out, almost effortlessly. He then again replaced the cast and sent me home.
We walked from the office and I felt like I had just run a marathon. I was spent—physically and mentally. This was so much more intrusive than the actual injury. This felt intentional. This felt unnecessary. This felt vindictive.
Another three weeks went by and I again had x-rays taken at the hospital. They handed me the disc and I was off to the doctor’s office. His nurse escorted me to an exam room and the doctor took the disc and disappeared behind his office door.
A few minutes later, the doctor rushed in the room and said it was time to remove the cast. I was grateful. As he cut the cast, I looked down at my hand. It was pale white and very gaunt. It still had dried blood here and there from the accident and surgery.
I lifted my hand and tried to move my fingers. Nothing. They wouldn’t move; not a single joint. Nothing at all. Not even a little.
“You’re going to want to get into physical therapy as soon as possible,” the doctor said as he saw the look of concern on my face. “But you will want to tell the therapist to be really careful; your one finger isn’t completely healed yet.”
He left the room and his nurse handed me a large manila folder, containing the disc of the latest x-rays, the original x-rays, and the pins that he had removed in the earlier visit. I had so many questions, so many concerns, as I sat there alone.
I gathered up my things and headed to my car. I got in and started driving, still trying to move my fingers, and still no movement at all. I called Jen and told her the latest updates.
“Something is not right,” I said. “My fingers won’t move, and he said I still have a broken finger.”
When I arrived home, I immediately wanted to see what the x-ray’s looked like. I opened them on my computer, not knowing if I’d know what I was looking at, with my layman eyes.
At first, I thought I was seeing things. Maybe I’m not looking at this correctly. Maybe I’m looking at the wrong x-rays. I couldn’t believe my eyes. Jen looked over my shoulder and immediately drew a quick breath and held it in amazement.
Yes, my finger was still broken. So were all three fingers. One break on my middle finger was healing but it was healing incorrectly, shortening it by a quarter inch.
We sat there in amazement. My fingers had not healed and now, from weeks of immobilization, the tendons and pulleys had scared over, and I had no movement in any of them. I was stunned. I was flabbergasted. I was angry.
That day I called several other doctors to get a second and third opinion. I secured appointments with two specialists, one an orthopedic specialist, the other a hand surgeon—both highly recommended by other patients and very well respected in the medical community. I took all the x-rays and pictures taken the day of the accident, the first pictures after I was put in a cast and pins, the third set after the pins were pulled, and the last set taken right before my last visit to my doctor. I walked both doctors through all the events that had taken place from the time of the accident to my meeting with them. Each doctor’s assessment was the same, and both were chilling.
First Doctor’s Findings
After looking at the x-rays and hearing the treatment provided, this doctor responded with great distain and disgust by stating, “The first rule you learn as a doctor is that you don’t bad mouth other doctors. But I can’t help myself…this doctor totally screwed you up!” He asked who performed my surgery and I told him. His responded “You should have seen a hand specialist from the start.”
“He is a hand specialist,” I replied.
“No he isn’t,” He quickly replied. “I know all the hand specialists in this state, and he isn’t one!”
I told him the doctor had a certificate hanging on his wall stating he performed a hand fellowship.
“Well, he’s not viewed as a hand specialist in this medical community,” he said gruffly.
He went on to tell me that immobilizing the fingers with pins was a practice of doctors 20-30 years ago but that for the last many years doctors utilize plates and screws to immobilize bone breaks and then start physical therapy a very short time after the surgery in order to assure scar tissue doesn’t build up on the tendons and pulleys resulting in complete lack of mobility in the fingers and joints.
This assessment was also confirmed when I went into the physical therapists for the first time. The therapist said, “Every doctor that sends patients to us would have you in therapy within a week or so after the accident.” He clearly assumed that plates and screws were used in my surgery, not long immobilizing pins.
The doctor, while looking at new x-rays taken in his office, verified that all three fingers were still broken. He also noticed that the break on the middle finger distal phalanx had bone unionization, however because it was not addressed in the first surgery, the bone had healed incorrectly, resulting in a shortening of my finger, creating a slack in the tendon. The tendon slack would ultimately result in no range of movement in the finger’s joint, aside from the scaring of the tendons and pulleys, which ultimately resulted in no range of motion.
The doctor’s final assessment and recommendation was to have a surgery where he would place plates and 12 screws on each proximal phalanx bone (all three), re-break the middle finger’s distal phalanx and re-attach it in the correct position using three screws, and perform extensor tenolysis—a freeing up of the tendons and pulleys by removing scar tissue—on the tops of the fingers and hand to free up the finger tendons and pulleys from scaring caused by the eight weeks of immobilization. After the surgery I would engage in a rigorous schedule of physical therapy to gain passive motion in my fingers and joints. After the passive motion was gained, I would have another surgery, flexor tenolysis, to regain active movement in my fingers and hand. Following that surgery, I would engage in physical therapy twice a day for three weeks straight, to assure the best possible results from the surgeries, followed up with therapy daily for a month, and then therapy three times a week for a month.
Second Doctor’s Findings
I was overwhelmed with the information the doctor gave to me. To be sure I was getting the correct diagnosis from this hand specialist, I scheduled another meeting with a different doctor, an orthopedic surgeon, as well. I was surprised that he gave me the same diagnosis. Not only regarding my hand, but the treatment I received from you. He said he didn’t know of a doctor that would have prescribed mobilization as my doctor did. His recommendation was three new surgeries; the first to put plates and screws in my broken fingers to finally reach unionization. The second surgery would be an extensor tenolysis. The third surgery would then be needed for flexor tenolysis. He also then would prescribe extensive physical therapy following each surgery.
The part that was also very alarming was the diagnosis that both doctors gave me regarding my pinky finger. After looking at all the x-rays and knowing that I had both feeling and circulation in the tip of my finger before the surgery, both doctors thought there was probably a very good chance I didn’t need to have it amputated. One doctor was extremely sure it shouldn’t have come off, the other reserved his judgment a bit by stating that without being in the surgery and seeing the actual damage in person, he couldn’t be for sure, but from all the x-rays and information I showed him, he said he thought there should have been an attempt to save it…especially since my career is based on my ability to type on a computer all day long, something I had notified the doctor of before my surgery.
I ultimately had three more surgeries. The three surgeries were necessary to 1. Get my bones to heal, 2. Regain passive movement in my fingers caused by the immobilization, and 3. Regain active movement in my fingers caused by the immobilization. And finally, my last, was to release a trigger finger and carpel tunnel syndrome created from the extensive 10 months—yes 10 months—of physical therapy.
In life, we often pay a stupid tax. We do stupid things and have to pay for it. Sometimes we lose money. Sometimes we lose a limb or an appendage. Sometimes we lose a friend. We learn lessons and receive a paid education from these types of experiences. The goal is to learn as much as possible, by paying as little as possible.
Today, my hand has regained 90% functionality. I have learned to adapt when working on the computer. The pain has finally subsided. I used to have phantom pain and feeling in my finger, but that has disappeared as well.
The biggest lesson I learned was I worked through my physical therapy. One night I sat at home after completing my exercises. I was tired, and tired of all of it. I was frustrated. I cursed the doctor who I believed to be the cause of my problems. If he had only done xyz. If he had not done abc. Why did he… Why didn’t he…I went on and on.
Jen sat with me sympathetically listening and then said, “Well, you can look at your circumstances in two ways. First, you can be frustrated and angry. You can blame the doctor. You can worry about paying all the doctor’s and hospital’s bills. You can do all of this and you are completely justified in doing so.”
She continued, “Or, you can be grateful.”
“Grateful!” I nearly screamed. “Grateful for what? What is there to be grateful for?
I wanted to have a pity party and she was ruining it for me.
“You can be grateful you have use of your hand. You can be grateful we have health insurance to cover a lot of the cots. You can be grateful the accident didn’t take your hand, or arm, or worse. You could be grateful you have a family who loves you and supports you. You could be grateful we have enough money to cover the expenses.”
She was right and I knew it. That didn’t make it easier in the moment. But she was absolutely correct. Even while in the middle of the difficulties, I still had so much—have so much—to be thankful for.