Wrapped around my right hand and wrist was a neoprene glove. A Velcro strap extended around my thumb providing an extra layer of protection for that arthritic joint. Every time I squeezed the too-small pruning shears a flare of achy pain zinged my wrist, thumb, and fingers. Cutting last year’s bluestem grasses caused throbbing discomfort. I took the black glove off and rubbed a pain relief ointment onto my skin. As I rubbed the cream into my joints, I thought about Dad’s hands.
We’d sat at the farmhouse dining room table. I must’ve been in my 40s, Dad in his mid-70s, about the same age that I am now. His work-worn hands rested on either side of his plate. The joints looked swollen, the knuckles enlarged, bent, and gnarled. They weren’t the same hands that he had had when I was a child. Back then they had been strong and straight, capable of fixing tractors, building barns, cleaning the cows, and hooking up the milking machine hoses. Sitting next to him that day, I assumed that the changes in his hands had come from hard labor in a frigid Minnesota climate. Surely his deformities came from hours in the barn, repeatedly plunging his hands into pails of water to wash manure off the cow’s udders so it wouldn’t contaminate the milking machine. I didn’t touch his hands or comment on them. I didn’t ask, “Dad, are your hands sore? Do they hurt?”
None wants the deformed knuckles, the disabling pain, the disfigurement of old age. In childhood, I noted, but didn’t yet understand, the passages through aging. I got more glimmers in my 40s while observing Dad, but I didn’t think it would happen to me. “Not me,” I thought, “I won’t have gnarled hands because I’m not a farmer like Dad.”
Dad and I belong to a large subset of the American people. According to the Centers for Disease Control and Prevention, nearly 1 in 4 US adults (23.7%) have some form of doctor diagnosed arthritis. A slightly larger number of women than men are subject to the condition. Yet Mom’s hands stayed strong even into her 90s. I assumed that, as a female, my hands would be more like Mom’s. As it turns out, that assumption wasn’t true.
I was first diagnosed with osteoarthritis in my early 60s when a large, red, fluid-filled blister developed on the first knuckle of my pinky finger. The doctor I consulted recommended out-patient surgery to remove the blister. I made the appointment, but canceled it a day or two ahead. He hadn’t convinced me that surgery would improve the finger nor that it would stop the deterioration of my knuckle. Surgery is an option for arthritis relief, but often, doctors suggest other options first. These include exercise, weight loss, prescription medications, and over-the-counter pain relief such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Dad’s favorite form of pain relief lived in the kitchen cupboard. He unscrewed the aspirin bottle, poured three to four tablets into his hand, tossed them into his mouth and swallowed. Maybe sips of water were involved. I watched as his Adam’s apple bobbed up and down. He repeated this a few times a day. I couldn’t imagine how his stomach tolerated so much aspirin.
As the years progressed, more of my finger joints began to develop those blisters. Each large blister would burst or slowly disappear after months of painful irritation. At that point, the knuckles would calcify into twisted, disfigured, witchy-looking digits. The pride I once had in my dainty fingers was injured. I couldn’t slide rings past the swollen, abnormally large joints.
Osteoarthritis (OA) has more consequences than affecting how Dad’s or my hands looked. One morning, as I got dressed, shooting twinges of pain radiated through my hands just from inserting my thumbs into the elastic waistband of my leggings to pull them up.
As I described to my sister and later to a friend how painful my thumbs were when pulling on leggings, they both asked, “Have you eaten tomatoes lately? They’re very inflammatory, especially for arthritis.”
“Yes,” I replied, “I’ve eaten them twice a day for the past few days.” It was summer. Fresh tomatoes were in abundance.
There’s conflicting evidence about the inflammatory nature of tomatoes and other foods. Although the cause of OA is often linked to wear and tear on the cartilage and joints, inflammatory foods are mentioned, especially sugar, alcohol, trans fats, white rice, foods containing gluten, and dairy. Eating an anti-inflammatory diet can minimize symptoms.
When two people warned me about tomatoes within a 24-hour time span, I sat up and took notice. I didn’t need a third warning. My county didn’t yet have a compost recycling drop-off spot. I could have put them in the garbage. Instead, later that same afternoon I carried the vibrant organic tomatoes out to the wooded ravine behind my townhouse. I dumped them onto the decaying leaves littering the forest floor. Perhaps birds, mice, voles, and other creatures would find them a delectable treat.
Osteoarthric changes in the tissue can occur for reasons other than inflammatory foods. The likelihood of developing OA is increased by: Aging, being overweight, a history of injury or surgery to a joint, as well as overuse from repetitive movements. As OA progresses, getting dressed, and other daily activities start to get affected. People struggle to grasp small objects, open jars, and hold a pen. Reaching over one’s head, sitting, standing and lifting as little as 10 pounds can all become difficult. Stooping, bending, kneeling, and using tools like gardening shears, can all be affected. These activities are basic to living a normal life.
I sought out a new doctor. He recommended seeing an occupational therapist (OT) to learn exercises that would strengthen the muscles surrounding the joints. The exercises prescribed by the OT don’t change the downward trajectory of cartilage decay. They’re designed to strengthen the muscles to avoid further loss of mobility and function. I’ve done some of these exercises in the bath or under warm water to help soften tense muscles.
The doctor also recommended an acetaminophen-based lotion available over-the-counter. By using a lotion instead of taking capsules by mouth, I could avoid upsetting my already sensitive digestive track. I wouldn’t have to toss back multiple aspirin a day like Dad. I could rub the soothing balm on my aching hands 4 to 5 times a day and take ibuprofen occasionally for the pain. When I used an alternate lotion , such as a CBD oil that contains menthol, I’m reminded of Dad’s use of Bengay®, a menthol-infused pain relief cream. The aroma of menthol rubbed on sore muscles often permeated my childhood home.
I researched the impact of of labor on osteoarthritis. Could Dad’s condition have been exacerbated by his farming duties? If so, how much of the degeneration in my hands could have started with my own labor-intensive jobs? I worked as a seamstress in an upholstery studio for two years, wielding foot-long scissors through heavy, tightly woven fabrics. My homemaking duties, such as doing laundry, scrubbing floors, washing dishes, and tending flower gardens also could have taken their toll. As a writer, I’ve held my hands in an awkward position over typewriter and computer keyboards. Texting, scrolling, and holding a cell phone also require cramped hand positions. Dad was proud of having taught me and my siblings how to work hard. Since OA is most often linked to wear and tear on the joints, all our hard labor could certainly have contributed to mine and Dad’s progressive joint problems.
At a seminar hosted by the YMCA, I learned more about easing the disabling impacts of osteoarthritis. Numerous inventions designed to help people were displayed: Grippers, gloves, joint stabilizers, writing aids, grabber tools, gel packs, paraffin wax baths, and compression sleeves, to name a few. I’ve found bottle openers, gripper pads, and reach extenders especially helpful in the kitchen. Pens that come with larger grip surfaces and colorful foam grips to slip over pencils have made it easier for me to grasp a pen while writing longhand in my journal – a place where stories start to form.
As I’ve managed this disease, I’ve continued to wonder about the genetic link to osteoarthritis. Mine and my sisters’ hands look like Dad’s. Our brothers’ hands all look like Mom’s. When other members of a family have OA, the risk of developing it increases. OA of the hand, especially, has been found to run in families. My sisters and I compare our swollen knuckles, deformed joints, and which types of pain-relieving ointments provide relief.
On the day when I cut down the prairie grasses, I was tending to the spring clean-up of the flowerbeds outside my townhome. As I squeezed the pruning scissors to bite into the decayed stems, a musty odor reminiscent of straw bales pushed into my nostrils. My garden held both last year’s grasses as well as the pale green growth pushing up from the earth. The conflicting odors reminded me of the aromas of a childhood on the farm: The contrast between freshly mown hay to the dry, dead, musty smell of straw.
It hasn’t been that long since my hands were the strong ones, like the green shoots pushing out of the earth. Like Dad’s in my youth. Gripping the pruning shears, my hands felt more like the old prairie grass and musty dried straw. Not useful. Not needed. Only good enough for the scrapheap back in the woods where I threw out the tomatoes. I felt forlorn. My former ability to work, to be productive like Dad urged us to be, has been minimized. I manage my symptoms, exercise, eat healthy food in moderation, and stay productively busy. I cook, clean, read, sew, go for long walks, call family and friends, and continue to write, both longhand and on my computer. I’m still able to cut the clumps of big bluestem in my garden, especially now that I purchased larger pruning shears. Perhaps the dried stalks of last year’s prairie grass aren’t my metaphor for today.
Lots has been learned about how to manage OA, minimize the downward trajectory, and aid daily activities since I observed Dad’s osteoarthritis. I can apply these new learnings to benefit my hard-working, essential, and life-enhancing hands. I can also continue to explore the genetic connection to the disease.
I wish I would have asked Dad about his hands. Perhaps his spirit is speaking to me now. “Don’t give up. Take care of yourself. Your hands are tools, you need them to work hard. Treat them well. They might become gnarled and deformed like mine, but do what you can to prevent that.”
As I compare my hands to Dad’s, I can remember that my genetic code lives within me. Although that code has given me osteoarthritis, my genotype has also given me creativity and love. I can let my hands be hands of love.
References
- Centers for Disease Control and Prevention, Arthritis, accessed from: cdc.gov/arthritis
- Osteoarthritis Research Society International, accessed from: oarsi.org
- National Institute of Arthritis and Musculosketal and Skin Diseases, Arthritis, accessed from: niams.nih.gov/health-topics/arthritis
Mary Berg is a retired associate professor of clinical education, a resume writer, published author, and poet. Her first poetry collection, A Mystic in the Mystery: Poems of Spirit, Seasons, and Self will be released in 2024. Her website is: marybergresumewriter.com.