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RSInetwork#8/October 92
=======================
For People Concerned About Tendinitis, Carpal Tunnel Syndrome, and
Other Repetitive Strain Injuries
Produced by:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
(crose@applelink.apple.com)
Apple Computer is in no way affiliated with this newsletter.
This document is in setext (structure-enhanced text) format.
To index, browse, and copy from collected setext documents,
use Easy View, written by M. Akif Eyler, Bilkent University,
06533 Ankara, Turkey
(eyler@trbilun.bitnet).
Setext formatting by:
Craig O'Donnell, Assistant Sysop, MacWEEK Forum on ZiffNet
(72511.240@compuserve.com).
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH. Easy View is in the "Applications" library at
the same location under filename EASYVW.SEA.
Input Devices
-------------
TONY! Keyboard: Update
The TONY! is expected to be shipping late this year.
Many of you have already tried it out and are wondering
how to order one, and how much it costs. The answer is
to send him a letter expressing your desire to purchase the
keyboard; you can write to him at 2332 Thompson Court, Mountain
View CA 94043. The cost will be $625, including shipping and
handling. The version that will be shipping will have several
improvements over the prototype Tony has been hauling around all
these years (no details are available). The TONY! will work with
Macintosh and IBM computers as well as Sun and DEC computers and
possibly others (in some cases with a plug change). For more
information, you can call Tony at (415)969-8669 - but be warned:
He is getting a lot of calls these days and so it may be a while
before he can return yours.
Laurie Ochsner of San Francisco has a "second-generation" TONY!
keyboard that she'd be happy to talk to you about. You can reach
her at (415)664-4035.
The Twiddler
The Twiddler is a combination pointer and chording keyboard that
can be used with either the right or the left hand. The pointing
function is based on some kind of inertial sensor that tracks hand
rotations in space and the keyboard is a keypad with 12 finger
keys and 6 thumb keys. The Twiddler is an MS-DOS/Windows device
that doesn't "talk" to a Macintosh, though an Apple engineer tells
me "a reasonably competent hacker could interface it to a
Macintosh." The Twiddler is made by Handykey Corporation of Mt.
Sinai NY, (516)474-4405.
The BAT
The BAT is a chording keyboard that's available in either left- or
right-handed models, for the Macintosh or IBM PCs and compatibles.
It has seven keys - one for each finger and three for the thumb.
Its ergonomic advantages are that it includes a rest for the heel
of the hand, it can be positioned at any angle, and there's no
need to move your hands around rows of keys. For more information,
contact Infogrip Inc. in Baton Rouge LA, 1-800-397-0921.
DragonDictate: Price Drop
--------------------------
As of September 1, the price of DragonDictate, the state-of-the-
art voice-recognition program for IBM-type computers, was reduced
from $9,000 to $4,995. Since the price of computers has dropped as
well, a $14K system purchased 9 months ago can be purchased today
for half that. For more information in the SF Bay Area, contact
Glenn Davis at DCR, Inc., (415)499-9009. Others should contact
William Flynn at Dragon Systems, (617)965-5200.
Associations
------------
More on ACTSA
Some of you have asked just what the American Carpal Tunnel
Syndrome Association (ACTSA) has to offer. I'll tell you what I as
a member have received from them so far: a "Carpal Tunnel Syndrome
Information Kit" consisting of a 16-page color pamphlet from
Krames Communications, "Carpal Tunnel Syndrome: Relieving the
Pressure in Your Wrist" (I've seen this in physical therapy
offices); a 2-page reprint of an article on CTS from People
magazine; 4 more pages of reprinted articles on CTS; and a
quarterly "informational update," in the form of a newsletter
called the Carpal Tunnel Light, which contains about 2 1/2 pages
of articles, a membership form, and 2/3 page of advertising. They
also offer members "access to an expansive library of
information," but I don't know if that means you'd have to go to
Michigan to access it.
An RSI Network member has expressed disappointment over the extent
of the materials ACTSA provides. Personally, I joined this
nonprofit corporation because I support their cause. You may not
learn a lot about CTS beyond what you already know, but it's
another source of information you possibly might not already have,
and it helps support ACTSA's effort to educate people about CTS. I
only wish it weren't restricted to just that one form of RSI!
ACTSA is holding their first Annual National Conference in
Atlantic City on November 20-22. There will be interactive group
workshops on CTS. The registration fee is $99 per person ($49 for
spouses). For more information, call ACTSA at (517)790-7846.
Center for Rehabilitation Technology at Georgia Tech, 1-800-726-
9119: Contact for details about computer products or services for
people with injuries or disabilities.
American Physical Therapy Association: Send a business-size,
stamped self-addressed envelope to them for a free brochure
including exercises and tips for beating CTS and other RSIs (1111
No. Fairfax St., Alexandria VA 22314).
CTDNEWS
-------
The monthly newsletter CTDNEWS, based in Philadelphia PA, provides
news and information about how to cut the high cost of "the
booming cumulative trauma disorder crisis." In particular, it
covers prevention, legalities, changing claims guidelines, and
treatment and diagnosis. But don't get too excited; the cost is a
whopping $125 for an annual subscription (it's geared toward
businesses; rumor has it they may set up a cheaper, "individual"
subscription). Call 1-800-554-4CTD for more information.
Hypercard Stack On Preventing RSI
---------------------------------
For Macintosh users, A HyperCard stack on preventing RSI is
available from Laurie Ochsner of San Francisco. She asks that you
send a stamped, self-addressed envelope with $5 to cover expenses,
and she'll send you a disk containing the stack. Laurie's address
is 1294B 42 Ave., San Francisco, CA 94122
UC Extension
------------
The University of California Extension is offering a one-day,
for-credit course called Preventing and Coping with RSI in the
Workplace: A Comprehensive Guide, on 11/7, 9 AM to 5 PM, in Santa
Clara. Cost is $185. For more information, call (408)427-6600; to
enroll, call 1-800-660-UNEX.
Yari's Story
------------
(This story comes to us from Yari Leski, one of the founders of
the new San Francisco RSI Support Group. You can contact Yari at
(415)759-0140.)
I worked as a software product designer when I began suffering
from an RSI I believe was acquired mostly from the using a mouse
and from a badly designed workstation. The pain in my arm is
primarily located at the top of the forearm close to the elbow,
secondarily on the lower side of the elbow. The intensity of the
arm pain seems to correspond to pain in my scapula area as well as
the shoulder joint and the right side of the neck.
I continued to work for a year and a half after I first had
symptoms. Nine months after I noticed symptoms, I took a month off
from work. The pain was gone after a month, but returned almost as
soon as I started working again. The pain intensified the longer I
worked until I was in too much pain to be productive at my job. I
had difficulty sleeping and performing household duties. Along
with the arm pain, my elbow felt like it was packed in dry ice and
my hand became stiff and cold. I tried other types of input
devices including finger pad, tablet, and trackball. The trackball
was less stressful than a mouse, but once I was injured it was
painful to use any input device. I switched to primarily using my
left hand and developed similar pain in my left hand within a few
months.
I stopped work in January 1991 and haven't worked since. (My
employer laid me off and though they said it was not because of my
injury, the only other technical people laid off were another
woman with a similar strain injury and her husband.) The pain has
subsided almost completely in my left arm and somewhat in my right
arm, although daily activities keep me from being pain-free and in
fact the pain has spread to other parts of my elbow that were not
previously affected.
Worker's Comp
My Worker's Compensation carrier put me on rehabilitation payments
almost immediately. My payments were based on the rates set when
it was determined I first had pain in my arm instead of the rate
set at the time I stopped work. I was told later by two attorneys
that the last day of work should determine the rate.
The Workers' Compensation insurance carrier should not start your
rehabilitation program until a doctor has certified your condition
as "permanent and stationary," meaning that your condition has
stabilized. No doctor determined my condition as such until close
to a year later. Before that I should have received "Temporary
Disability" benefits, which are higher than rehabilitation
benefits and have no cap on total benefits received.
The insurance carrier assigned me to a rehabilitation counselor
and never bothered to tell me that I had a choice as to who the
counselor was. I was given aptitude and career tests. I hired an
attorney who demanded that the insurance carrier change the
counselor to one my attorney was familiar with. The second
counselor had few if any ideas for me and eventually hired a
career developer. Finally a report was written stating that my
rehabilitation plan should be an MBA program, which is what I
wanted to do all along. The insurance carrier didn't approve the
plan. In October '91 they cut my rehabilitation benefits and paid
only "Permanent Disability" payments. They neglected to tell me
that permanent disability payments come out of the final
settlement. After five months of PD payments they stopped those,
stating that they had probably paid off whatever my final
settlement would be.
I had no lawyer in February '92 when my PD payments were cut. I
had dismissed my first lawyer, because I couldn't get her to
return my calls or give me copies of medical evaluations. I
couldn't find another lawyer who would take my case because my
first lawyer would get a significant portion of the 12% the
claimant's attorneys are allowed from the final settlement. I've
heard that most settlements for arm injuries run about $5000 for
the PD part of the settlement. This means our lawyers get about
$600. This cap on what we can spend for attorney fees is stated to
be a law that protects us, but it should be noted that the
insurance carriers have no cap on what they can spend on their
attorneys and will likely pay 20 times more then our attorneys
will ever see. I won't go into the manipulations and harassments I
received in the hands of the insurance carrier's attorney while I
was trying to represent myself. I finally found another lawyer to
represent me; Steven Birnbaum took my case and so far I am happy
with his office.
I filed a complaint with the Rehabilitation Board during the time
I was representing myself. The board wrote an order for the
Worker's Compensation carrier to reinstate my rehabilitation
program last March. So far I haven't heard anything and they're in
contempt of court. I started the MBA program anyway last spring
and hope to be reimbursed later.
For every medical evaluation the Workers' Compensation carrier
sends you for, you have the right to another from a physician of
your choice. Lawyers have certain physicians that they send their
clients to. So far I've had seven medical evaluations. I heard
from a doctor I know that the insurance carriers pay their
evaluators up to 10 times more than the claimant's evaluators can
charge. The doctor who told me this was solicited by several
insurance carriers with promises that she felt were unethical. She
attended a Worker's Compensation evaluators seminar to learn the
scoop. She heard from one lecturer that the point was not to tell
the truth, but to "refine" the truth in ways the insurance
carrier will appreciate.
Treatments
I haven't had much medical treatment since I left work. The
insurance carrier has refused to pay for more than a total of four
weeks of physical therapy. Dr. Markison gave me a steroid
injection in March and ordered a TENS unit rental for four months.
The insurance carrier refused to pay for more than two months
rental. Dr. Markison has prescribed trigger point therapy that the
carrier also has refused to pay for. I'm discussing the
possibility of an operation with Dr. Markison. Needless to say
they refused to pay for that also and are not even paying
Markison's bills now even though they first sent me to that office
to be evaluated by Markison's partner Dr. Newmeyer (whom I and
other injured workers suggest avoiding).
I find alternate warm and cool water baths and massage therapy
helpful. The TENS Unit seemed to relieve pain for several hours,
or at least it distracts me enough not to notice if I'm in pain.
Acupuncture seemed to keep the pain level down as long as I didn't
work too hard. My hands are usually cold and Dr. Markison claims
that people with cold hands heal at a much slower rate. He
suggests wearing fingerless gloves. I had ultrasound treatment
during the year I was working and tried an elbow strap; both these
increased the pain. Another doctor said I was wearing the elbow
strap wrong; he suggests getting a man's wrist support band and
pulling it up only to mid-arm level. A rheumatologist prescribes a
mild dosage of the anti-depressant Norpramin, which induces level
4 sleep and thus relieves muscle tension and anxiety. I find this
drug takes the edge off the pain.
Letters From Members
--------------------
Please send in your letters, questions, or personal story. Other
members can reply to you via this newsletter or directly (indicate
which you prefer in your letter). Please take the time to reply if
you can help someone out!
Help for Lefties
From Bruce Brown: I have myofascial pain dysfunction (on the right
side) in my arm, hand, shoulder, and neck. Do you know of products
to assist lefties? (See above for one-handed "chording" keyboards.
Do any readers know of catalogs with products for lefties? -
Caroline)
Light-Steering Cars
From Wayne Vucenic: My wife has shoulder and forearm tendonitis.
Driving is a big problem since steering aggravates the condition.
We'd like to know what kinds of cars you and your readers have
found to drive. We've found that Cadillac has sufficiently good
power steering, but its various other problems make it
unsatisfactory for everyday driving. Does anyone know of a good
small or medium-sized car with light steering? (I was loathe to
part with my hard-steering 2002 BMW, but finally got a 1984 318i
BMW, which has power-assisted steering. Even lighter would be
better, though. Since getting tendinitis in my shoulders, I really
should have power-everything (sigh). Readers? - Caroline)
Swimmers Beware
Here's a reply (from a "hardcore distance swimmer") to my letter
in Issue 7 that noted I now have tendinitis in my shoulder (now
both shoulders), supposedly due to swimming:
As far as tendinitis and swimming, it's very common. People argue
about cause a lot, but my opinion is that the root cause is in
your statement that you've swum freestyle 3 times a week for about
15 years. Anyone who swims only freestyle is pretty much doomed.
Bad stroke mechanics will get you every time as well. (Just like
in running; if you have some quirk about your stride, you probably
pay for it sooner or later.) As far as swimming advice, here's my
list:
* Never ever use paddles. They are very likely to rip shoulders.
* Watch out for unbalanced breathing patterns. Some 95% of such
injuries are from swimmers who always breathe to the same side -
it's usually the opposite shoulder that goes.
* Swim more breaststroke, which balances out the muscle
development.
* Swimming magazines and stores carry a shoulder band, which is
basically a support that goes near the bicep. I've never worn one
myself, but some people swear by them.
RSI Support Groups (California)
-------------------------------
San Francisco:
Judy Doane, (415)931-8780, or Yari Leski, (415)759-0140.
Alternate Mondays, 7:30 PM, at the California Pacific Medical
Center (3773 Sacramento St., at Maple, SF), rooms G and H.
1/18: Ilana Parker, physical therapist specializing in the
Feldenkrais method
1/4/93 and 2/1/93: no speaker, general support meeting.
East Bay:
Joan Lichterman, (510)653-1802.
Meets monthly, 7 to 9 PM, usually on the second Wednesday, at
CalARM 400 29th Street, #105 (at summit), Oakland.
1/8/93: Glen Kohler, Using Tai Chi to Prevent RSIs
North Bay:
Stephanie Barnes, (707)571-0397.
Tuesday evenings in Santa Rosa, 7 to 9 PM, Round Table Pizza 550
Montecito Blvd., between Middle Rincon and Mission Blvd.
South Bay:
Pat Roggy, (408)297-8725, or Petzoldt Hand Center, (408)261-
7660.
Los Angeles area:
Samantha Greenberg, (213)207-1653.
A "computer injury network".
Contributions & Subscriptions
-----------------------------
This newsletter relies on contributions from its readers: please
contribute your questions, stories, and any information that may
be of interest to people with RSI.
Where possible please submit contributions on diskette or via
Email. Xeroxes of interesting articles from anywhere are always
welcome. Mail disks or xeroxes to:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
Electronic subscriptions are free.
Formatted setexts are found on ZiffNet/Mac via Compuserve.
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH.
For Internet mailing list distribution, send your Internet
address to:
crose@applelink.apple.com
and you'll receive the newsletter (plain ASCII).
..