how to audiobook with severe hand injuries

Oh covid!  You scamp!  You came for my hands – you didn’t realize that I’ve had hand injuries since my 20s and I HAVE KNOWLEDGES.

That doesn’t mean, dear readers, that things are resolving quickly….this looks like it will be a long haul.  And thus I have created even more hands-free editing tools for myself.

[how am i typing right now?  lots of ice breaks, lots of effort breaks, that’s how.  i just wanted to write this, because hand injuries are very common among those of us who need to do a ton of keyboard shortcuts and little fussy precise mouse movements as we edit our audio.  I hope this helps some peeps :)]

What happened?  A known, if uncommon, covid effect is inflammation of all synovial joints in the hand.  

This happened to my youngest.  He lost about 75%  of the use of his hands for about 6 months.  I pulled out all the stops on PT for hand injuries, and it did work – but so so slowly. The inflammatory process seemed to be ongoing, which seems to be another covid thing.  He has most of his hand usage back, but still needs to ice his fingers twice a day and will for at least the next year.  I did years of traumatic injury recovery body work on clients – and for myself, for hand injuries that turned into a massive clusterfuck of ‘why is my physiology doing this??’

The poor PT who worked on me when every single flexor tendon in both hands became inflamed and absolutely would not heal no matter what he did…he’d never seen anything like it.  We worried i would never get the use of my hands back.  I went to the wall and used all the sports medicine injury treatment I’d learned just, yk, THREE TIMES as hard and long as normal body would need.  I got my hands back, but they have been vulnerable to recurrence ever since and i am very careful not to overstress them, whether with strenuous activity (carrying heavy things, any rebound energy etc) or repetitive activity (keyboarding, mousing, writing).  The discovery that I have EDS has cleared up a lot of questions – no wonder the tendons reacted so badly, no wonder they have never healed properly, etc.  With much care i had a decade long career in massage therapy, so the hands did remarkably well all things considered.

Okay, I’ve been careful of my hands for years and know their limits. Yay!  Then?  Cancer.  When you have a mastectomy, they check to see if any cancer cells have escaped into the lymph system – because that’s how you get metastasis.  If any cells have escaped, they remove all the lymph nodes in the nearest pathway – which happens to be the arm pit.  Ever so thankfully they did not find any further cancer cells in my arm pit nodes.  But the surgery did leave me without any lymph nodes in that arm pit – and those nodes have a JOB.  Their job is to be a huge train-station interchange for lymph draining out of the arm back into the rest of the body (the lymph system is fascinating, really). 

So what we’ve done is removed the train station – and there’s no way to surgically re-route the lymph train tracks to a new option.  They’re just terminated.  If you are fortunate, those major train track pathways find a way to continue to drain lymph a bit, but it’s never as efficient as the original system.  Mostly, the lymph now has to leave the arm through little woodsy dirt tracks toward their objective of the torso.  No matter what, lymph simply cannot drain out of that arm as well as it could before.  Anything that causes a lot of blood to rush into that arm – a sunburn, a big bug bite, an injury – will bring a ton of fluid in the form of blood into the arm, some of which has to exit via the lymph system.  Even if that arm has healed enough that lymph back-up in the arm isn’t usual, any inflammation source can easily overload the arm’s carrying capacity and lymph will start to back up into the arm causing it to swell (and then a bunch of self-reinforcing processes kick in – insert biochemistry here).  You must get the lymph back out of that arm and get things back to equilibrium, it is medically crucial.  The medical term for this condition is lymphedema.

After all the earlier hand injuries, my dominant right hand suffers the most long term damage and i’m careful with it.  The left hand is much stronger.  The cancer surgery was on the left side.

Okay, so you can see were this is going, right?

So 3 weeks ago the covid inflammation hits every synovial joint in both hands.  In a matter of hours both hands feel like an acute onset of rheumatoid arthritis.  I can’t pick up a pen.  I can’t fill a coffee cup.  I can’t type.  I can’t use a mouse.  I watched my youngest son deal with this – I know this could last six months…and with my body’s affinity for inflammation, even if i’m aggressive with therapy it could last much longer.  Within days the old flexor tendonitis latched on to the inflammation and flared up, doubling the injury.  Within days, the lymphedema started in my left arm, tripling the injury.  My stronger left hand is now severely effected – the more I use it, the longer I keep it lower than heart-level, the worse the lymphedema becomes.

I cried a lot.  I raged a lot.  I was close to finishing the current audiobook….but I need to use a mouse and a lot of keyboard short cuts in order to edit. I just didn’t see how i was going to get there.  And what about the long view of the work that I love?

So I went at the PT techniques I know so well (‘hydro-therapy’ – hot and cold water treatments, ice massages, and more) with my usual necessary excessive treatment schedule.  it took a couple of weeks, but my hands got to the point that I can use them if I do not do anything strenuous (this means ‘pick up a coffee cup with 2 hands’ this means ‘use a mouse with my arm elevated above my heart’ this means ‘ice hands before and after showering because washing hair puts a lot of pressure on joints’ this means ‘dictate anything needing typing’).  I was up to the point that i could edit for a few minutes a time if i iced my hands before and after, so i pushed on slowly.

What was killing me was 1) because of the longer term injuries in the right hand, i had to mouse with my left hand – but mousing causes rapid lymphedema build up, and mousing with my hand on a pillow higher than my heart is hard on my entire body; and 2) I use a lot of keyboard short-cuts I’ve built into my software.  The short-cuts are there so that i can use the mouse LESS – but keyboarding was out of the question for more than a few minutes.

Now, my editing set-up is already REALLY well designed for hand injury prevention.  my ergo keyboard is wild and awesome, i have both a left and a right handed vertical mouse, and i have a 3 button foot pedal that’s programmed with the most common keyboard short-cuts.  I realized right away that what i needed was A LOT MORE FOOT SWITCHES.  I was going to end up looking like i was playing a pipe organ by the time i had all the switches i needed 😀

So I researched the heck out of the options, and purchased a 6 switch foot pedal, bringing me up to a total of 9 key macros i could program for my feet – suddenly i need to do ZERO keyboarding.  The mousing can be carefully distributed between the two hands as they are able (often mousing with both hands on one mouse…) – and now i can edit audio.

I have about 0.5 hands between my two hands – 75% of that in my left hand, 25% in my right.  Neither of them can do anything weight-bearing, neither of them can rotate for very long, neither of them can grip strongly, neither of them can do excessive repetitive motion.  But I’ve lived like this before, and I have more strategies for how to do things hand-less than you could probably imagine 😀

Can I work quickly?  No.  Can I work to my usual standard of quality?  Absolutely.  Can I do the work without increasing the injuries?  Yes, but i have to be aware, i have to be careful.

I have chronic fatigue syndrome.  I have EDS.  I have so many food allergies that since covid I’ve been living on protein shakes, green powder, supplements.  I have mental health issues (though those, thank god, are well controlled).  The activities I can do in my life are so limited…if I walked up to the average person and yanked their health to this level they would have a crushing crisis of despair, grief, and years of building coping mechanisms, support systems, and adjusting their world view radically.  This past year that exact thing has happened to hundreds of thousands of people around the world for whom covid kicked off a similar suite of chronic health symptoms, and my heart goes out to them.  If you read their personal accounts, they are grieving their health to the same degree that someone who lost a limb or has early onset dementia experiences.  And with complete justification.

Add these hand injuries to my limitations and I feel so helpless and robbed – and angry, because I’ve been through this level of loss and despair and rage so many times and now i have to do it again.  The idea that making art – audiobooks, music, podcasts – could be taken from me was terrifying.

I now have 9 foot switches.  I am learning where they are on the floor without looking (touch typing!  with feet!).  I’m re-re-programming them for better macro arrangement.  I have a tight compression sleeve on my left arm. It’s propped up at chest level.  I mouse with both hands.

I finished editing the audiobook and it’s promo material by the due date.  I am looking forward to the next one.  And the one after that.  And Sekrit Projects.

And now if you’ll excuse me – I have to go ice my hands again.  Thanks for reading 🙂

 

my long-time 3 switch foot pedal.
astonishingly with these wrists, i used to do medical transcription – 
i adapted the pedal for audio editing software key combinations about 5 years ago.
the only software that will run it is controller-mate, but it does
anything.

 

the 6 switch floor pedal I just got.
spent hours programming this thing via the android app on my phone – works great though!

 

 

ETA:  In the end, my feet just weren’t able to do the 6 switch pedal, so I ordered 2 more of the 3 switch pedals, and now have 9 ‘key strokes/key combos’ on the floor right at my toe-tips 🙂  The kinesthetics of these foot pedals just works better for my spatial perception: translation, my feet know where everything is 😀

We use ControllerMate to get them to talk to MacOS politely – works great!  Even has the option of different configurations for different activities, just by switching a ticky-box.

 

 

 

 

 

 

Liked it? Take a second to support Jewelwing Audio on Patreon!

Leave a Reply

Your email address will not be published. Required fields are marked *