Very Long Term Health Mistakes
For my 24th birthday in 1998, a dear friend gave me a fancy bottle of Bushmills Irish Whiskey. Sadly, that was a Thursday and I had an early start on Friday, so I put it aside for the evening. But on Friday afternoon my girlfriend Kellie came over, and I couldn't wait to give it a try.
I grabbed the bottle and a glass and decided to have it on the rocks. I had drunk a lot by age 23, even among my military peers, but I wasn't that into whiskey yet, and I thought some ice might take the edge off things. Because I was a bachelor, all of my ice came in 10-16lb bags for parties, was left out and then stored in the freezer half-melted together. I grabbed the smallest chunk of ice and tried to put it in the glass, but it didn't fit. So I opened the freezer, smacked it into the larger lump still in the bag, and tried again. And again. And again.
At some point, after much consternation, I guess I got frustrated. I ended up squeezing the glass in frustration and crushing it with my left hand while attempting to shove the ice in my right hand into the glass. I ended up getting a ring of wounds around my palm where bits of ice inserted themselves into my skin. Oh, and I was bleeding. A lot.
Kellie, who would I would marry in 6 months, was not good around blood and immediately fled the kitchen to avoid passing out. I threw out the broken glass and ice, and tried to alternate quickly between three tasks at once: pick out all the pieces of glass, apply pressure to the wounds, and hold my hand over my head. After 5 minutes of this, I resolved that I wasn't going to find any more glass before I bled out, and asked Kellie to get me a big hand towel from the bathroom. I wrapped my hand in paper towels, then a kitchen towel, then a plastic grocery bag, and finally the hand towel.
My next problem was getting to the hospital. I was in the Air Force and living a few miles from Fort Meade, where I needed to go to get to Kimbrough Army Medical Center. My car, a 1981 BWI 318i, presented two challenges.
The first was that it had a manual transmission with a broken clutch. A friend had given it to me in exchange for paying the cost of a radiator repair that had gotten just large enough that it was more than the value of the car. Kellie couldn't drive stick. She certainly couldn't slam-shift a manual transmission by adjusting the RPMs of the motor to ease the car into gear as you shift, and I had only learned out of necessity.
The second was that the driver's door didn't work from the outside. To open it you had to have somebody inside to do it for you. On nice days you could leave the windows rolled down, but I was in a hurry and one-handed at the moment, so I needed Kellie to come with me. Also, I was a little worried that I would pass out.
We rushed off to Fort Meade. I was mostly steering with my left knee, since I didn't need my left foot for the clutch, while shifting with my left hand. My right hand was pressed against the dome light above to apply pressure and keep it elevated. This wasn't very efficient, but it worked. It also let me know that there was still glass in my palm, the hard way.
We got to the base and discovered that Kellie had forgotten her wallet. Fort Meade was a mostly open base, but by not having her ID, I needed to sign her in, which meant getting out of the car, presenting my military ID, and then signing a form with my left hand promising that I would keep her from causing trouble. Friends, I am not left-handed.
Once we arrived at the hospital, we were delighted to see that we had beaten the rush. Everyone else who was going to inevitably end up in the emergency room was waiting until after they'd been drinking to hurt themselves. I got seen quickly by an army captain who seemed to be ignoring my small-talk.
But I would not be deterred because I had important information. I told him about a recent study published in the New England Journal of Medicine which found that those with red hair needed 25% more local anesthetic to get the same relief as other people. He nodded and said something like, "that's interesting," and went back to picking bits of glass out of my hand. He injected me with some local anesthetic and told me he'd be back in 5 minutes.
He came back to sew me up, and as he inserted the suture hook I cried out in pain. "You can feel that?" Through gritted teeth I said, "We. Just. Talked. About. That." He sheepishly gave me a little more anesthetic, left, came back, and sewed my palm back into shape.
In a normal story, this would be the end. I'd try to come up with a fun conclusion, maybe some words of wisdom, hopefully a mildly amusing sign-off. But this story goes on for another 25 years.
About 6 months after my birthday, I was working on the sixth floor of a tall office building, and any time my friends and I left the office we would take the stairs. It wasn't exactly a race, but we were fit military 20-somethings, so it wasn't not a race. On the way back from lunch one day, as I dashed up the stairs, I grabbed the handrail firmly with my right hand to pull myself up, and immediately dropped to my knees. A flaming, shooting pain in my palm had me tearing up and stifling screams. I thought back to my birthday, but I had people to catch up with, so I ran up the stairs as best I could.
This continued to happen every few months during different activities until I started getting a sharp persistent pain in my palm. Eventually the skin started poking out like a miniature chest-burster from Alien, and one day a tiny piece of glass started poking through. By this point I knew what it was, and, with the foolish bravado of youth, didn't worry about it at all. It continued to slowly work its way out over the course of a couple weeks, and eventually there was enough glass for me to try to remove it.
I went to the bathroom, got a pair of tweezers, and carefully pulled it out. But once the glass was out, I discovered that there was a little knot of scar tissue around the middle of the shard and a string of something leading back to my hand. I grabbed a pair of cuticle scissors and snipped the little string.
Sorry, I should have said that I snipped the nerve.
If I thought that the glass banging around in my hand hurt, this was far worse. I cried for a while. Eventually I was able to poke the little bit that was still protruding from my palm back in, which hurt even more. I wiped the hole down with alcohol and put a band-aid on my palm to keep it from getting dirty.
This would also be a great place for this story to end.
Over the next few years, that pain from grabbing something hard would reoccur, and each time it did, I chalked it up to nerve damage. I mean, I had gotten the last piece of glass out, right? What was left was just the consequences of an ill-considered home surgery, obviously.
I got out of the military in 1999 and worked a series of tech jobs as a programmer. That meant a lot of typing. And a lot of typing meant a lot of wrist pain. I first switched to a Microsoft Natural Ergonomic Keyboard 4000, which helped a little. I progressed through the world of ergonomic keyboards spending a long time with a Kinesis Freestyle2 Blue for Mac, a split keyboard that you could buy risers for to angle it up to be basically vertical. This allowed me to position the keyboard such that my hands were almost straight out like I was going in for a handshake, and my wrists weren't bent. That meant that the tendons that attach my forearm muscles to my fingers met the least resistance on their way through the tunnels of my wrist.
Eventually that wasn't enough. By 2023 I had taken the risers from the Kinesis and used them to attach am Ergodox-EZ ortholinear split programmable mechanical keyboard to them. And I had a separate keyboard and set of risers for home and the office. Yes, that's over a grand in keyboards.
But it wasn't helping.
I tried seeing a series of doctors starting with an orthopedic surgeon. He took some x-rays of my wrists, and then manually moved my hands around in different ways to see what did and didn't hurt. After he finished, he sat across from me looking at the floor. I asked what he thought was the problem and he shrugged and told me that if it started hurting a lot more, I should come back.
So I saw a rheumatologist. She did blood tests that were too weakly positive to mean anything and took x-rays of my whole hands looking for signs of pitting in the joints, which she didn't find. She gave me some topical creams for pain and told me that if it started hurting a lot more, I should come back.
After a year, I was scheduled for a follow-up and I finally got around to looking at the x-rays she took. Here's the important part of the x-ray of my right hand:
I asked a friend who had been a trauma surgeon what the little items labeled 1 and 2 were and he said that they were glass. So when I went in for my follow-up I had something to talk about!
She encouraged me to get surgery to have them removed. Here in Baltimore we're lucky to have access to the Curtis Hand Center which is very well-regarded, but I was unlucky because it was the fall of 2019, and by the time I had a referral, there was a global pandemic going on.
I did what any 46-year-old with glass in hands would do in such a situation: I just forgot about it. I mean, the bit in the circled labeled 1 would hurt me a few times a year, but I was a) used to it, and b) nervous about surgery. So I didn't think about it again until the next time I saw my rheumatologist for another follow-up in 2023 where she yelled at me for not getting surgery.
This time I listened, both because I was getting tired of the nightmarish pain, and because I had started riding my bike a lot. That meant that I was putting a lot of pressure on my hand, which meant the frequency of the pain was increasing.
I eventually got in to see the fine folks at the Curtis Hand Center and the doctor asked me if I wanted to have both pieces taken out. I told him that the piece labeled 2 had never bothered me, so we agreed to just take out the one that's a problem. The surgery went well, though I couldn't really bring my middle and ring fingers together afterward, meaning I was always giving the Vulcan salute, but that wasn't much of a problem for a Star Trek nerd and it went away over time.
After another few moths of riding my bike too much, you'll never guess what happened: that other piece started hurting terribly. In fact, it started to move around to the point that it felt like it was going to poke its way out of my hand. Luckily, I had exhausted our deductible for the year, so I got the second surgery basically for free, after only 25 years. Here's a picture of my hand today:
What you see labeled above:
- The scar from the largest of the original holes that got stitched up by the doctor
- The hole where the first piece of glass worked its way out
- The new scar in my palm from taking out the chunk labeled 1 above
- The combined hole from where the piece labeled 2 tried coming out and the scar from the surgery to remove it
And as of today, almost 27 years since the original injury, my hand is glass-free, and I'm only very occasionally in searing pain that runs from #4 above down to the end of my pinky. That's pretty good!
It's unlikely that this will come up for any of you reading this, but I have some advice:
- Don't get medical care from a bored army doctor if you can avoid it.
- When you realize that you have some glass in your hand, don't perform home surgery.
- When you realize that you still have some glass in your hand even after the ill-advised home surgery, have a professional take it out right away.
- Your hand is not a safe place to store tiny pieces of glass for a quarter century.
