(Living Beyond Disabilities / February 2015) - When Tariq Farr first came into MossRehab seeking therapy for a wrist that was shattered in a motorcycle accident, it wasn’t clear if he would ever regain full use of his left hand.
He had almost no motion in his fingers or his wrist, which was still in a cast. Three of his fingers—index, ring and smallest—were frozen in a bent position.
“He was badly hurt,” says MossRehab Occupational Therapist Diane Pauloski-Hunt, OT, CHT, a certified hand therapist. “His fingers were swollen—almost like a glove that has been blown up. Where he was supposed to be and where he was, were just very, very far apart.”
In addition to the cast on his hand, Farr was wearing a neck and back brace and was undergoing physical therapy as he healed from 11 fractures in his spine and neck sustained during the accident.
Active and Fit
Before the accident, which took place on Father’s Day in 2012, Farr was active and fit, hitting the gym three or four times per week, holding down positions as a family therapist and in real estate, playing with his son and daughter.
In addition to surgery on his spine, he also had faced two surgeries on his wrist. The surgeon, James S. Raphael, MD, chairman of the Department of Orthopedics and director of the Hand and Upper Extremity Surgery Program at Einstein Medical Center Philadelphia, had to use two pins, a plate and four screws to repair the fractures and dislocations among the bones in Farr’s wrist.
Dr. Raphael emphasized with Farr the importance of moving toward hand therapy quickly after the surgery.
“We’re very focused on talking to the patients about regaining hand function as fast as possible,” he says. “If patients remain immobilized for a prolonged period of time they can end up with significant stiffness.”
When Pauloski-Hunt began working with Farr about six weeks after the accident, the cast severely limited his hand use since it came up to the large knuckles of his fingers and thumb.
“It was a challenge getting the hand to move let alone be functional,” she says.
Wide Range of Conditions
Pauloski-Hunt is one of 10 certified hand therapists working at MossRehab. The therapists treat patients with conditions such as carpal tunnel syndrome, fractures, tendonitis, tendon lacerations, nerve injuries, amputations, replantations and congenital deformities.
“The dominant diagnostic group that we see is orthopedic trauma in the arm,” Pauloski-Hunt says. “Then you have the gambit of cumulative trauma—things like carpal tunnel and trigger fingers and tendonitis. Then you have nerve compressions and tendon lacerations."
The therapists work closely with the physicians and other clinicians as part of MossRehab’s team approach to care. They discuss goals with the patient then—together with the team— devise a treatment plan.
“We review with the patients what their goals are, what is important to them, what activities they really want to be able to return to,” says Pauloski-Hunt, who has been a therapist for 38 years. “You have to find out what things they can’t do and what things are important to them and gear the program specifically to their needs and wants.”
MossRehab offers hand therapy at its Main Campus in Elkins Park, Pa. and at five other locations—Tabor Road, Plymouth Meeting, Einstein Center One (in Northeast Philadelphia),Center City, Collegeville and Norristown.
Finding Motivation
At night, Farr wore splints that forced his fingers to straighten. During the day, he wore comprehension garments and focused on splint exercises that helped restore motion. Pauloski-Hunt provided the exercises. Farr provided hard work.
“It was a lot of pain,” he says. “A lot of work. I don’t mind going through the pain as long as I know it is for something that will make a difference. I was determined to get as [close to] normal as I could. Whatever the therapists told me to do, I did it and I did more of it. I would do it all day long. I had nothing else to do, so I would just do therapy all day long.”
At the beginning, when the obstacles seemed insurmountable, Pauloski-Hunt focused on offering motivation.
“He worked really, really hard,” she says. “People have to realize that windows of opportunity have to be seized, or the outcomes will not be as desirable as the therapists or the physicians or the patient would like. He understood that. He did everything he was supposed to do.”
After 14 sessions of hand therapy, Farr had met his goals—personal care, opening containers, turning doorknobs, hanging clothes in the closet, light cooking. He was driving again and was back to work. He had gained nearly all of the function in his damaged left hand.
His doctors and therapists kept using the word “miracle,” but Farr was not surprised.
“I always knew that I was going to get better,” he says. “The encouragement from the doctors and the therapists—them telling me that I’m doing better, each time I go back I’m doing better—that helped me a lot. I never doubted that I was going to get back to my normal self.”
He also benefited from the love and support of his family and his experience as a family therapist.
“It helped me to calm my emotions,” he says. “I teach that to people every day about calming their emotions, thinking about the future, working now and trying to help yourself in the future. If there are setbacks, then you learn from that setback and you try to improve in the future. I think that has helped me.”
He learned some other lessons as well.
Listen to the therapists and doctors.
Share your story with others in a similar position. It will provide them with hope.
“All you need is hope,” he says. “If you have hope, you’ll have determination. The two go hand in hand.”
And, most importantly, believe.
“Believe in yourself—that you can do better,” Farr says. “Because you can always do better.”
