Pinkies Up!
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| What would you bet to win this car? |
Even though our little finger may seem small and insignificant it actually has a big job. While reading "Man from the South" I noticed that the young naval trainee from America did not realize the importance of his pinky finger. He was very willing to give up this vital piece of himself for a new car. Little did he know, his little finger plays a huge role in his daily occupations. The young soldier would no longer have been able to grasp his lighter to win a bet or even would have found it pretty difficult to drive his brand new 1947 Cadillac. With the shifter of the car needing a firm grasp to operate, he would have quickly learned the strength his pinky held.
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| As you can see from the picture above, the shifter is a small knob next to the steering wheel. A firm grasp is needed to pull it up and down to shift gears and operate the vehicle. Also shown is the slimness of the door handles. He would find it difficult to even get in or out of the Cadillac. |
As stated before of one of the most important roles for our 5th metacarpal is providing a stable grasp. In order to have this firm grasp, you need the strength of all 5 of your fingers. The digits work as a team. However, the pinky finger holds about 50% of the grasp strength within itself. Another problem that would have occurred with losing his last digit would be ulnar nerve severation. Since the ulnar nerve runs from your pinky to your shoulder, having it be severed would result in ulnar neuropathy. This can cause tingling and loss of sensation in places of his hand and elbow area.
As an occupational therapist to be, it is important to realize the help that we would certainly be able to provide for the young man. One intervention type that is listed in the OTPF that may help the young man would be the use of orthotics and prostetics. Using a prostetic would help enhance his participation in occupations dramatically. He would more easily be able to grasp a stick shift or even have a better hold on his lighter. Having this modification would help improve many of the young man's outcomes in the OTPF. Some of those that would be positively impacted from the OTPF are his occupational performance, participation, role competence, and maybe even his occupational justice. I listed occupational justice because with his new prostetic, he now could participate in occupations needed while working as a naval soldier. Without this modification, it would be more difficult for do this job and he might would even be labeled as "disabled" unjustly. With the new modification, he now has the confidence and capability of working as he was.
On the other hand, pun intended, the older man's wife only had one finger and a thumb. In this situation, her daily life is significantly affected. As it is not impossible to live with such a limited number of digits, it is very, very difficult. One of her occupations were even described in the story. She stated that she just returned from getting her hair washed. The simple ADL of washing her own hair was no longer a viable task for her. She needed the help of others because it is very difficult to scrub your head with shampoo without the use of your fingers. A modification that I would recommend to the wife would be the orthotics and prostetics
intervention from the OTPF. Below is an example of the prostetics I would recommend. It can be customized to the number of digits that are missing. This would greatly improve her occupational performance in washing her hair, as well as result in outcomes listed in the OTPF such as improved enhancement and quality of life. The wife would be more confident being able to do things on her own without the help of others. 
Bet ON yourself, don't bet YOURself
I love the observations you made regarding the short story. Mentioning the use of the shifter is very important and would be a difficult task if he had lost the bet. Imagine winning a brand new car but having difficulty operating it! To me it would not even be worth it. This makes me think of the difficulty he would have if the car would end up to be a manual. It was interesting how you mentioned the extent of the ulnar nerve damage not only affecting his hand but his entire arm as well. The choice of a prosthetic intervention is ingenious. This is a great way to implement the use of assistive technology. I really appreciated how you brought up occupational justice. I feel like that is not something that is talked about a lot and as a future OT we should keep occupational justice at the forefront. In regard to the wife I think the prosthetic you chose would help out tremendously. It may even be able to help her better keep an eye on her husband so that no others fall victim to his shenanigans!
ReplyDeleteThe ulnar nerve damage you mentioned was a really interesting point. I had not considered that aspect of losing a finger. I briefly thought about the possibility of phantom pain but disregarded the fact that it might affect more than just the area where the pinky was.
ReplyDeleteFor the wife, I think that strategies could also be taught to help her wash her hair. It would probably more difficult initially, but with help she could learn how to do it herself. I would think she could do something along the lines of putting shampoo directly into her hair instead of in her hand first. She could even use smaller bottles that would allow her to pick them up with just a finger and thumb.
Overall, I agree that both people could definitely benefit from the prosthetics! Even if they were not functional physically, they could create a more normal look for the individual which could help their sense of normalcy and social interactions (should they feel self-conscious about their lack of digits).