Diana Shafer

In June 2006, Diana Shafer almost lost her right arm while cleaning a running machine at a local food production plant. Diana said a chain and sprocket caught hold of her shirtsleeve. She remembers being medevaced to Baltimore—most of all, she recalls the EMT saying her forearm was three-quarters amputated. At Union Memorial Hospital, Diana underwent immediate trauma surgery, followed by plastic reconstructive surgery in December 2006. Doctors told Diana that they would need to take parts of other areas of her body to save her arm. “It took six months before what had happened really sank in,” said Shafer. “It hit me that I could really lose my arm.” Doctors saved Diana’s arm, and with nearly two years in rehabilitation, she was able to gain limb functionality. “Without my doctors and therapists, I wouldn’t be where I am today,” said Shafer.

Your hands are valuable. With them, you can precisely thread a needle, grip and swing a heavy ax, feel a hot surface, wave hello, or caress a hand. At the same time, your hands are complex, with twenty-seven bones including the wrist. Yet this intricacy does not end at the wrist. The wrist works with your forearm, forearm with elbow, and elbow with shoulder—all allowing you to use your hands.

Meredith Cirtwell

When you consider the importance and complexity of your hands, arms, and shoulders, it only makes sense to seek advice from someone who is specially trained to treat them. A certified hand therapist (CHT) is an occupational or physical therapist with a minimum of five years of clinical experience and 4,000 hours of direct practice in hand therapy. They must also pass a rigid exam of advanced testing and assessment in upper limb rehabilitation.

Certified hand therapist Meredith Cirtwell, OTR/L, CHT, CEES, was present at Diana’s reconstructive surgery and for a third surgery in 2007. Hand therapy treatment was started shortly after surgery. “The primary objective was a full recovery and return to independence at home and her work activities,” said Cirtwell. Because of the hand therapy program at Total Rehab Care, Diana was able to undergo occupational therapy treatment three times a week in her hometown. Her eighteen-month rehabilitation sessions included a complex therapy program including splinting, swelling and scar management, muscle reeducation, strengthening, coordination exercises, and work simulation activities. Diana’s can-do attitude contributed to her positive experience, but so did certified hand therapists Meredith Cirtwell and Tobi Smith. “They made it fun—not strictly business,” said Shafer.

Shafer returned to her original job position and operates the same machine where the accident occurred. She has limited sensation in her right hand and relies on her left hand as her dominant side. “If you have to adapt, you will,” commented Shafer. Occasionally, she visits her former therapists and brings them coffee. After all, she misses talking sports with Tobi, and Meredith’s famous hand massages.

The certified hand therapists at Total Rehab Care provide treatment for patients with injuries like Shafer’s, and for arthritis, carpal tunnel, broken bones, and tendonitis. They also treat patients after surgeries for tendon and nerve repairs, rotator cuff repair, total shoulder replacements and trigger finger release. These therapists receive referrals from as far as State College, Pennsylvania and Union Memorial Hospital in Baltimore. “Doctors view this specialized training very highly,” said Meredith.

How it works
A referral to the Hand Center starts with a thorough patient evaluation, including the patient’s medical background and history of the injury. The therapist also assesses the patient’s movement, coordination, strength, swelling, sensation, and ability to perform everyday activities. During the evaluation, the therapist works with the patient to determine goals. This helps the therapist gauge the length of treatment and encourages patient involvement.

The duration of treatment varies for each condition and person. An elbow tendonitis can take four to six weeks of therapy occurring two to three times a week—more serious traumatic injuries, like Diana Shafer’s, can take far longer. While in therapy, patients experience a range of treatments including paraffin, ultrasound, and electrical stimulation—and they are given homework. Home exercise enables patients to speed up their recovery by doing things at home to complement the therapy sessions.

For more information
Our hands are priceless, although we never give them a thought until something goes wrong. When an injury or disease comes between you and your hands, a certified hand therapist can assist in returning you to your normal everyday life. For more information, contact Total Rehab Care’s Hand Center at 240-313-9950.