Question
Hi,
My hand got smashed while unloading several months ago.
It seems like I have good days, and some real bad days. I’ve been on and off the pain pills. The pain was tolerable until a couple of weeks ago, now I am back on the pills.
The healing is taking a long time. Their were no broken bones, just some tearing, inflammation and contusions. Two doctors have evaluated me for surgery and both said it would not help me. Although there is damage, it is not enough where surgery would do me any good.
I’ve been told that healing may take up to a year, or more. I’ve also been told that I may never be pain free.
I still want to drive. I realize that I could not drive while I am taking the pain pills. But once I am off the pain pills, would I be able to drive with a bad hand? Or is that a bad idea? Also are there companies that have 100% no touch freight? I think I could drive with one good hand, but I am not sure if I would be able to load or unload a trailer.
I talked to my doctor about “Pain Management” but he blew me off. Is that something that would be worth doing?
Thanks.
Answer
How bad is your hand? Will you be able to operate a truck IF the pain stops? I belive the dot has guidelines on this, but I may be wrong, Nurse Red would know for sure. Good luck.
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Answer
I do not have a very good grip. The tendons used to close my hand to grip things are torn. It is difficult to hang onto things. Twisting a door knob and pulling is difficult. But I can pull a door open, as long as I do not have to twist a door knob in the process. Part of my physical therapy is turning a simulated steering wheel, which does not seem to bother me.
I took a road trip in a rented car a couple of weeks ago. 2 hours into the trip my hand started bothering me. About half an hour into the return trip, my hand became unbearable. I was not able to use my left hand at all.
Even if the pain stops, I am not sure if I will have 100% use of my hand. The Dr’s have said different things about it. I don’t think they really know for sure!
I have been told that 100% recovery is possible and I have been told that I will not get 100% recovery and that I may never be pain free. My current doctor is optimistic that I can return to driving, but he also said that I may never be 100% pain free. He does not have a time line.
Thanks
Sign me, confused at best.
Answer
I injured my right hand 3 years ago, same as your injury, crushed with one broken bone in the ring finger. I did extensive therapy for 5 weeks, even to this day I still have too do daily flexing and massaging of my hand to keep it from "freezing". I was back to work in 6 weeks, just very cautious of the very little daily tasks. It took a year before I was able to lift a gallon of milk without my hand shaking. All I take is Naproxen (over the counter) for the inflamation and that works well for me and does not inhibit my ability to drive. The DR told me with this type of injury I can expect to develope arthritis as I get older , like this is news to me since arthritis runs on both sides of the family and I have it in my knees already.
Answer
I didn’t break any bones. I am taking Codeine, which means I cannot drive, I think, for 24 hours after taking. Plus I am waking up about 3 times a night from the pain. Even when I take the pain pills, I still wake up, and I am groggy for most of the day, after taking the pills.
A lot of the time my hand is numb in the wrist and fingers.
I picked up a pitcher of water this morning, it hurt like hell!
I don’t tolerate anti-inflammatory medication. It tears up my gut and I can’t stay more then five minutes from a restroom, a difficult task when driving a truck.
I will have to check and see if arthritis runs in my family.
Answer
Hi There
Just my 2 cents worth
"I don’t tolerate anti-inflammatory medication. It tears up my gut and I can’t stay more then five minutes from a restroom, a difficult task when driving a truck."
Have your tried Vioxx, this is an anti-inflammatory medication that does not affect the stomach lining. its maximum dose per 24 hours is 50mg, which gives good cover (slow release).
In addition, if you feel the advice you have received is "not working" for you, seek further medical intervention. Pain should always be addressed and not discounted.
Pharmacokinetics:
Codeine: Codeine is readily absorbed from the gastrointestinal tract. It is rapidly distributed from the intravascular spaces to the various body tissues, with preferential uptake by parenchymatous organs such as the liver, spleen and kidney. Codeine crosses the blood-brain barrier, and is found in fetal tissue and breast milk. The plasma concentration does not correlate with brain concentration or relief of pain; however, codeine is not bound to plasma proteins and does not accumulate in body tissues.
The plasma half-life is about 2.9 hours. The elimination of codeine is primarily via the kidneys, and about 90% of an oral dose is excreted by the kidneys within 24 hours of dosing. The urinary secretion products consist of free and glucuronide conjugated codeine (about 70%), free and conjugated norcodeine (about 10%), free and conjugated morphine (about 10%), normorphine (4%), and hydrocodone (1%). The remainder of the dose is excreted in the feces.
At therapeutic doses, the analgesic effect reaches a peak within 2 hours and persists between 4 and 6 hours. Hence why a slow realase anti inflam may provide more effective pain control.
Codeine may impair mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. Such tasks should be avoided while taking this product.
Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and should be avoided.
Codeine may be habit-forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed.
Laboratory Tests: in patients with severe hepatic or renal disease, effects of therapy should be monitored with serial liver and/or renal function tests.
My feeling is that you should hold on to your dream of driving the big rig again. However, presently you need to address the pain, and discover the cause of the pain. ? infection, ? arthritic, ? RSI.
Moreover, codeine can cause constipation...(keep up the bran and fruit and increase your water intake)
Take care and good luck
Skye (RCpN, BN, PostGradDipRehab, PostGradDipEthics, Post GradDipwomans health, MasterHealthScience)
Answer
Hi skye,
Just two cents?
Cannot take Vioxx due to asthma and ulcer.
Company policy is no driving for 24 hours after taking codeine, but since I cannot drive do to the injury, right now I am not too worried. I just want to get my hand healed.
I have found that 1 pain pill will get me through some spurts of heavy pain. I usually have to take two to sleep. I usually don’t sleep at night due to pain, but on the third night it catches up with me and I sleep. If not, I will take two of the pain pills. I am also sleeping a lot during the day.
Having done the Al-Anon (both parents, both grandfathers) / AA waltz, I am all too aware of addiction, which is why I usually avoid the pain pills if I can.
I am drinking lots of water.
I did find that arthritis does run in my family.
What is RIS?
And where is Nurse Red?
Thanks for the 20 cents.
Answer
But here is my response.
Crush injuries DO take longer to heal that actual breaks. The injury usually involves much more anatomy than just a broken bone. The tendons and ligaments take much longer to heal and it is easier to re-injure and aggravate the existing injury.
The DOT medical examiner will more than likely fail you due to the lack of grip in your hand.
Are you using any type of protective splint/immobilizer? You may find this helpful during times when the injury can be aggravated. During rest times it is best to use heat and moderate exercise to the hand.
When sleeping, try elevating the hand above the level of your heart. This may reduce throbbing and pain while you sleep.
Tendons and ligaments can heal themselves without surgical intervention, however it takes a much longer time than bone regeneration, as in a fracture. AND, the healing may not be complete. This may mean the hand will NOT ever be as good as new. Hopefully your Dr. has recommended some physical therapy.
Has your physician tried Relafin for an antiinflammatory?Visit us at
Answer
Hi Nurse Red,
I’ve had pneumonia, complete with a temp of 106, I understand.
My last eval the grip in my left is about 80% of my right. Things are improving. I still struggle with turning a door knob and pulling on the door at the same time. Sometimes I can pull it off, other times the door knob just falls out of my hand. I just tried to open a Pepsi bottle, had to pinch it between my arm and chest to get it open. They did a PCE and I just about blew out my left shoulder.
They did discover that I was having problem with my shoulder several months ago, but I’ve been so worried about my hand that I have not been getting anything done with my shoulder. A couple of weeks ago the shoulder got so painful I had to have the doctor look at it. Turns out that the way my hand got caught, I may have caused some damage to my shoulder. Great!
During the PCE my lift limit was about 30 to 35 pounds. Less weight and more painful when lifting over my head. Company requires ability to lift 75# from floor to overhead.
I did ask my company if I could drive without being required to load/unload, they said no.
I have used a protective splint when I carry heavy items.
Currently my struggle is not being able to sleep due to pain. I can take two pain pills (Hydroco/APAP) and still I waking up due to pain. They did try Amitriptyline, got rid of the pain but it knocked me out for about 18 hours and left me groggy the remaining 6 hours. .
Will DOT let me drive with the ability to lift only 35#? My ability to grip is better then the last time I posted, but it is not at 100%.
Personally I think for the most part if I get going again, I will be okay. I would not want to carry out 75# crates on my first trip, but I think I would be able to work my way back up to it. I just can’t seem to get this pain under control.
Any ideas for coping with sleep disturbing pain?
Thanks.
Answer
Had an MRI on my shoulder the other day and got to see my doctor with the results this morning. Not good at all. Looks like a shredded truck tire in there, lot of tearing. I am going to get second opinion, but from the looks of things there is a lot of damage in there.
The MRI from my hand showed minimal damage. My last had eval shows that I went backwards.
He also going to have me tested for Carpel Tunnel Syndrome.
After looking at the MRI my doctor asked me if I wanted to return to trucking. I really hesitated. I finally said yes. But even now I am not sure. I am not sleeping due to pain, the Dr. suggested taking aspirin with my Hydroco/APAP and see if I can get relieve that way. He did not want to increase my dose. But wants me to check back in a couple of weeks if I am still in pain.
Do shoulder operations heal pretty good? Is there still I chance that I can return to driving?
Answer
My brother had shoulder surgery, said it took about six months to heal. His doctor said he is about 95% and will probably stay there. He is a lineman, climbs pole and such, says he dosen't notice a big differance, and is almost pain free except in cold weather it will nag him a little. Hope this helps. Good luckMarines stay and fight, Bush makes sure of that.
Fox News, just a bowel movment away
Blind faith in a bad leader, is not patriotism
Answer
This is all going to be a very personal choice for you.
No surgeon can accurately predict how well surgery is going to turn out. They may be able to promise improvement, but no one can tell you that you will be better than new. No one can tell you that the surgery will restore the strength to 100% or that you will be pain free after surgery.
You may be able to find 'no touch' companies that will allow you to drive without having to load/unload. But it sounds to me like you have more treatment to undergo before you even think about getting back on the road.
You talk about pain during sleep.....are you in pain during your waking hours as well? What releives the pain when awake? Is it positioning? If so, maybe propping yourself to remain in one position can help.
At some point, you may want to address the subject of nerve blocks with your Dr. However, that is usually a last resort.
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Answer
Hi Nurse Red,
Saw doctor today. He said that I am making great progress. He wants to see how the progress continues. He also is going to postpone the surgery and if the progress continues, then I can skip the surgery. I am okay with it.
I am taking Nortriptyline 10mg for pain at night. I am doing better sleeping; I do wake up on occasion from sleeping on my left (injured) side with a dull ache. Not the screaming in pain ache of a month ago.
I think I have taken one or two vicadan in the last couple of weeks to help with evening pain.
I do get a sudden onset of excruciating pain about once or twice a week, it lasts a couple of minutes and then everything returns to normal.
I am doing more with my left hand, caught myself using it to write. I twisted my door knob and it hurt like all get out. I think I am having more good things then bad things.
I am thinking that once I get back to holding a steering wheel, there maybe pain in the beginning, but I am hoping that the pain will subside as I start using my hand more.
I do have another question: How hard is the scrutiny of someone taking medication daily that makes them drowsy? The Nortriptyline does make me drowsy but I go to bed a couple of hours of taking it. If it is going to interfere with my going back to driving, then I want to take a hard look at getting off of it before I return.
Thanks for you support.