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RSI Network Newsletter #11/April 93
===================================
The RSI Network Electronic Newsletter
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>
Copyright 1993 Caroline Rose. All rights reserved.
Apple Computer is in no way affiliated with this newsletter.
Setext formatting and electronic version editing by:
Craig O'Donnell, Assistant Sysop, MacWEEK Forum on ZiffNet
<dadadata@world.std.com> or <72511,240> on CIS
About this document:
This document is in setext (structure-enhanced text) format.
Mac users: 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>.
"RSINET.SEA" and RSInn.SIT files are available on ZiffNet/Mac
in the "Reference" file library at location ZMC:DOWNTECH.
Easy View is in the "Applications" library under filename
EASYVW.SEA.
To subscribe, see "Electronic Subscription Information", below.
Comfort Keyboard: First Impressions
-----------------------------------
This is from Ed Cullen, who can be reached during working hours
(PST) at (510)287-4211. The keyboard is from Health Care Keyboard
Company, Inc., (414)253-4131, and is compatible with various IBM
models, Macintosh, and Sun, among others.
Recently I received a second-generation Comfort Keyboard. It's the
traditional QWERTY arrangement with a numeric keypad, split into
three sections. This allows you to rotate the sections so the
keyboard can be used in a neutral posture (palms facing each
other, as if you're shaking hands with the keyboard). Adjusting
the sections was not easy, but once set up, keying was pain-free
for me. However, the impact required to register each keystroke
both reduces speed and creates hand tension. The combination of
keying ease and high impact can lead to "overdoing it" for those
of us who already have a cumulative trauma disorder.
Some of the keyboard enhancements of the Comfort Keyboard system
include: the ability to assign the backspace to one half of the
space bar or the other; a rest-break indicator to alert you to
take micropauses; macros of up to 1,378 keystrokes per macro with
the number of macros limited only by your hard disk space; and two
extra keys for retrieving macros, deactivating the keyboard for
adjustments, and setting pauses in the macros. These enhancements
allow you to perform many functions within your individual comfort
zone with fewer and less difficult keystrokes.
My setup includes arm supports and a two-level table with the
monitor elevated and the keyboard lowered, which, together with a
good chair, complement the keyboard system. Probably no keyboard
would be perfect, but this one is as good an input device as I've
seen or heard of for sale at present.
Kurzweil Voice Input Software for the PC
----------------------------------------
A new voice-recognition system for PC users is available from
Kurzweil AI, Inc. Called Kurzweil VOICE, the product has an
intriguingly long list of features. It comes with a 40,000-word
dictionary with room for 10,000 more unique words. The system is
context-sensitive to words such as "to, too, and two" and can
differentiate between spoken commands and actual voice input to a
database, spreadsheet, or word processor. It supports command and
text macros (such as a dictated address, followed by a complete
form letter created with one voice command, followed by "Sign it
John Q. Public," followed by "Print two copies").
One interesting claim is that the system requires no explicit
training, works right out of the box, and becomes smarter about a
speaker's style as time goes on.
According to the press release, Kurzweil worked with Tufts
University Assistant Professor of Rehabilitation Medicine David M.
Horowitz in tailoring the system for disabled people who cannot
type, and for those who suffer from RSIs. The research was
supported by a Federal grant.
The system consists of an ISA/EISA-bus board, a headset or handset
microphone, and software. This general-purpose system is based on
a dedicated medical-dictation system developed for hospitals. We
suspect it is an expensive solution. For pricing information, call
Kurzweil AI at (617)893-5151.
RSI Video Price Drop to $19.95!
-------------------------------
The price of the half-hour video called "Working Until It Hurts"
(from the "We Do the Work" public TV series) mentioned in RSI
Network Newsletter #9 (December 92 ) has dropped from $40 to
$19.95 for individuals, due to the heart-wrenching calls the
producers are getting from all over the country. For more
information, call (510)549-0775.
Products
--------
TRIM "Easy Hold" Nail Clippers
A "product report" from Craig O'Donnell: Nail clippers, tweezers,
and the like can be very hard to manipulate. This TRIM set (made
by W. E. Bassett Company, Shelton CT, 06484) consists of a large
toenail clipper, a smaller fingernail clipper, and tweezers. The
tweezers have large gray plastic, oval finger grip pads on the
sides to make them easier to use. The clippers have a fat,
contoured bottom and long, rectangular "levers" with a contoured
plastic grip at the end. These look like something that a
recovering RSI patient might want instead of the usual,
impossbile-to-use nail clippers. Look for them in drugstores.
Shepherd Heavy Duty Appliance Rollers
This from Robin Coutellier: I needed to move a file cabinet around
and wasn't sure where I wanted to put it yet, but I didn't want to
waste effort and hurt myself seeing how it looked/fit in different
places. I went to the hardware store to look for some kind of cart
and found, instead, appliance rollers. They are two rust-resistant
aluminum rods with a 3-4" square platform on each end. I think it
has 16 wheels attached. It's meant to move things like
refrigerators, etc., but it worked well for me for lighter things
that weren't too difficult to "tip" onto the rollers. The rollers
can be adjusted from 18 1/4" to 28", and they add only 1 1/4" to
the height of whatever is riding on them. The ones I bought come
in a 19" x 1 1/2" box (easy to store and very lightweight).
They're called Shepherd Heavy Duty Appliance Rollers, model #9603,
and cost $14.49 at Orchard Supply Hardware.
Open Up Power Twist Jar Opener
This battery-powered product screws the top off anything in
seconds. It has a motor that generates up to 17 ft-lb. of torque
at 10,000 revolutions/minute. It can be mounted under your wall
cabinets and works on lids with 1/2- to 4-inch diameter. Available
at Macy's, Williams-Sonoma, hardware stores, etc., for about $40.
Rests for the Weary
This from Sharon Mello of Fremont CA, (510)794-7521: I ordered an
item that, for mouse users, really takes the stress out of the
neck, back, and arm muscles. It's from Arm/Wrist Technologies of
Tucson AZ, (602)886-3701. It attaches to the table in front of the
keyboard and has a padded wrist rest with two arm rests that
adjust horizontally and are padded as well. It sells for about
$125; if you buy more than one, they'll come down in price.
They're made out of oak and a good grade vinyl, and they're made
to order according to the thickness of the table.
Resources
---------
Vocational Counseling in NY
There's a NY state agency (VESID) that offers vocational
counseling to disabled people. They can arrange to pay partial
tuition for re-education. Contact the Office of Vocational and
Educational Services for Individuals with Disabilities, 116 West
23 Street, NY NY 10001, (212)630-2306.
Reading
-------
Magazine and Journal Articles
"Symptoms May Return After Carpal Tunnel Surgery," by Paul Cotton,
The Journal of the American Medical Association, April 17, 1991.
CTS surgery statistics; the high incidence of recurring symptoms.
There's an article on RSI in the February '93 issue of Working
Woman magazine.
Health Library
Bay Area and Mid-Peninsula readers in California can check out the
Health Library at Stanford Shopping Center. A community service of
Stanford University Hospital, the Library is free and open to the
public. Its extensive resources include books, medical texts,
health newsletters, medical journals, and much more. For more
information, call (415)725-8400.
TidBITS Wrist Care
Valuable electronic reading: Adam Engst of the Internet newsletter
TidBITS has been circulating a PageMaker 4.x file called
TidBITS/Caring For Your Wrists. This is a two-sided document
summarizing things you can do to cut down on wrist pain and the
possibility of developing carpal tunnel syndrome or any other less
crippling but equally painful arm and shoulder disorders. It's a
large download, about 400K uncompressed, but well worth the time.
Print it and hang it over your desk. It's found on a variety of
online services, including ZiffNet/Mac and CompuServe's MAUG
Forums.
Tips For Knitters & Others
In their Spring '92 issue, Knitter's magazine published tips for
knitters who are experiencing symptoms of carpal tunnel syndrome
or similar problems. Many of these tips are applicable to anyone
performing repetitive motions. Here's a sample; for a copy of the
complete article, send me a stamped, self-addressed envelope with
your request.
* Submerge hands in warm water while squeezing a sponge, for
15 minutes, 3 times a day.
* Keep your elbows at your side when you knit; don't use an
arm rest.
* Sit on a sofa; when arms ache, prop them with pillows.
* Arrange your hands in a neutral position when you're preparing
to sleep.
* Don't wear a wristwatch, or anything tight around your wrist.
* Keep dressmaking shears, gardening shears, and other tools
very sharp.
Hardcopy Subscriptions Update & Newsletter News
-----------------------------------------------
You can receive the RSI Network Newsletter electronically, and
it's available on many public electronic sites. Our new
"Electronic Editor" Craig O'Donnell at the Internet address
<dadadata@world.std.com> can put you on his Internet mailing list.
See "Electronic Subscription Information" for system-by-system
specifics on where our Newsletter is found.
No More Print Subscriptions For Now!
*Caroline writes: If you want to subscribe to this newsletter in
print, please hold off for at least three months; I'm in the
process of trying to find someone to handle subscriptions and
distribution, and meanwhile can't handle the load myself.
Feel free to print this issue and pass it on to others. Anyone
interested in taking over the hardcopy distribution (printing,
collating, mailing, and asking nicely for donations to cover
costs), please send Email to Ric Ford <ricford@world.std.com>. Ric
has volunteered to act as the contact for this.
Donations to help cover expenses are always welcome; please send a
check made out to "Caroline Rose" (not "RSI Network"!) and mail to
me (the address is in the header above).
Newsletter News
*Craig says: Since Issue #10 appeared, our Internet mailing list
has just about doubled in size! Publications like VDT News and the
San Francisco Examiner have called to get information for
articles. Things are looking good now that CTS and RSI have
become, if not household words, at least popular topics.
I saw a TV report on Boston's Channel 4 about anti-RSI efforts at
one Boston-area hospital. Employees were attending classes for RSI
education and tips on better workspace ergonomics. The report was
several minutes long, a sign that the news producer considered RSI
an important topic. Although the commentator seemed a little
unclear as the report closed, he seemed to say either that
Massachusetts' latest statistics showed 45,000 cases per year, or
that the Bureau of Labor Statistics' latest info showed 45,000
cases per year nationally (it seems the statistical confusion
discussed in past issues rears its head again).
Letters From Members
--------------------
Please send in your letters or questions; other readers can reply
to you via this newsletter or directly (don't forget to indicate
which you prefer). Please take the time to reply if you can help
someone out.
Boston Area Practitioner
*From Craig O'Donnell of Boston <dadadata@world.std.com>:
I've been plagued by severe tendinitis for over eight months. I
went to my general practitioner, who referred me to a wrist
specialist. After several months' rest the specialist felt that
carpal tunnel syndrome was unlikely (he is a surgeon and wanted to
operate), and I was referred to a physiatrist. X-rays and nerve
conduction tests (uncomfortable but not painful) revealed that CTS
could be ruled out and that the problems lay elsewhere in the
forearm and shoulder. The physiatrist, who impressed me as a
competent and caring doctor, is Dr. James Sarni at Spaulding
Rehabilitation Hospital in Boston (he also has hours at Beth
Israel Hospital in Boston). He can be reached at (617)278-7154 or
(617)720-6544. By the time you read this, I will have started
occupational therapy, and with a little luck, will be able to
function better. I'll keep everyone updated.
What about Philadelphia?
*Robert Carey, a UNIX system adminstrator at the University of PA,
wonders if there are any good practitioners in the Philadelphia
area. Contact <carey%deadlock@uunet.uu.net>
Hormones, Women and RSI
*Physical therapist Lisa Voge sent this in answer to a question in
a previous issue: There is definitely a link between hormones and
CTDs ("cumulative trauma disorders," another term for RSIs). Women
who are in their third trimester of pregnancy or who have had
hysterectomies with ovaries removed are considered to be at higher
risk for developing CTDs. This is due to increased fluid retention
for pregnant women, and, for women with hysterectomies, to
decreased estrogen causing decreased lubrication of tendons in
their tendon sheaths.
Clinically I have noticed women complain of increased symptoms at
the time of their period, related to fluid retention and thus
pressure on nerves and tendons. I don't know of any research on
this topic but it would be an interesting project.
*On the other hand, Sharon Mello says:
At the time of my injury, I was already on estrogen therapy 23
days a month. If it's true what Dr. Dean Edell says about there
being "a relationship between hormones and how swelling and
similar functions are handled in the body," I should be in pretty
good shape. NOT! The only thing that helps my hands, arms, and
elbows is Disalcid, 3000 mg a day.
DeQuervain's Tenosynovitis
*From Susan Maller, 4225 N. First Ave., #816, Tucson AZ 85719,
(602)887-4616, <maller@ccit.arizona.edu>:
I recently had surgery for DeQuervain's Tenosynovitis. (I've also
been told that I have extensor carpi radialis tendinitis.) I've
had every treatment in the book: splints (in every shape and
color), a cast, injections, and surgery. This has been going on
for a long time. I would really like to talk with someone else who
has had this condition.
Sharon's Story: Vocational Rehabilitation
-----------------------------------------
This story comes to us from Sharon Mello. You can reach Sharon at
(510)794-7521. Please send in your own story or helpful tips for
other RSI sufferers.
I completed vocational rehabilitation in December 1992. I have 11
years of computer knowledge and experience (mostly software, and
I'm very DOS-literate) and I wanted to switch to teaching
software. I did a lot of legwork researching which companies in
the CA Bay Area (South Bay, San Francisco, and East Bay) and which
colleges taught software and who taught "Train the Trainer"
courses. When I gave Voc Rehab all this information, they decided
I didn't have the education to do this and told me the insurance
company wouldn't pay for the courses I needed to switch vocations
(which didn't amount to half as much as it really cost to retrain
me). The insurance company, they said, wouldn't pay because that
particular industry is not growing fast enough.
So they talked me into going to school for the "hospitality"
industry, which means you work in a hotel, motel, or restaurant.
The particular school I went to was the Hospitality Institute in
San Francisco. The owner and Director of Admissions assured me
before I even signed up that I wouldn't have to get a job as entry
level because of my business background (I've been working for 25
years). So, I figured, what could I lose. I went to school for
five months, four days a week, four hours a day, did my homework,
did my extra credits, graduated with a 4.0 GPA and what did I
learn? That I have to go in as entry level ($5-8/hour) because
they realized quite a while ago that I didn't have the background
they thought I did and never bothered to let me in on it.
What they teach you is all from books. I have not learned a new
vocation (as one would think from the name Vocational
Rehabilitation). The only thing I've learned is that no one cares
about you as a person - you're just a dollar sign to them. Voc
Rehab counselors aren't in it to help disabled people turn their
lives around. They're not in it for the satisfaction of seeing
someone pull their life together and keep going.
I have another story about a Voc Rehab counselor. The first one
that was assigned to me by the insurance carrier (On Track in
Berkeley) was trying to place me back into a keyboarding position
without any Voc Rehab training at all. They wouldn't listen to me
that I could only keyboard a maximum of two hours a day, but
instead told me the doctor said I could keyboard six hours a day.
Needless to say, I told them they were incompetent, "fired" them
(after having an informal hearing) and picked someone else to work
with. The insurance carrier won't let you pick a Voc Rehab
counselor if they're not on the approved list of providers. So
much for democracy.
To sum up my story, all the tests they've done show negative
results. I've been to numerous doctors, had physical therapy,
topical steroid therapy, and massage therapy, used a TENS unit,
put on ice when it gets really bad, had Voc Rehab, and gone to
school again at age 48. I had an insurance company person ignore
me the first year, got someone good the second year, and now have
someone who seems to really care. I don't have an attorney because
a worker's comp attorney said I was getting everything coming to
me on time and that the settlement she thought I'd get wouldn't
compensate her for the time she'd spend on my case. I've just been
offered a fair settlement by the insurance company (even though I
still don't have a job and have been looking for two months
actively and have sent out almost 200 resumes and letters).
Let me say that the state's rating of your disability is about the
only criteria the insurance company uses as a guideline for
settlement. If you settle for just the state's permanent
disability schedule, you get weekly disbursements until the
settlement is used up. Your medical remains open as far as the
insurance company paying for prescriptions and visits to the
doctor, surgery, etc. You can also sign a compromise and release
which will give you one lump sum which includes the dollar amount
suggested by the state plus what the insurance company thinks your
future medical will be. The state rated me at 32% permanent
disability and my settlement is in excess of $20,000. That should
give hope to some of you.
New RSI Support Groups: Marin, NYC, Texas
-----------------------------------------
NEW! Forming in Marin CA
Liza, San Anselmo, (415)459-0510 after 11 AM to discuss
forming this group.
NEW! New York NY
Susan Nobel, (212)241-1527. Meets monthly.
Susan is a social worker at Mount Sinai Hospital who
offers free counseling to RSI sufferers.
WANTED! Texas
Lynne Johnson in Austin is interested in finding an RSI support
group in Austin, Dallas, or Houston. She can be reached at home
at (512)345-7125.
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.
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.
North Bay:
Stephanie Barnes, (707)571-0397.
Tuesday evenings, 6:30 to 9 PM, at Santa Rosa Plaza, in the
Community Room.
South Bay:
Pat Roggy, (408)297-8725, or Petzoldt Hand Center, (408)261-
7660.
Los Angeles:
Samantha Greenberg, (213)207-1653.
A "computer injury network".
Submissions
-----------
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
To submit material to Caroline Rose via Internet, send mail to:
<crose@applelink.apple.com>
Caroline will not be able to Email personal responses back to
people for the indefinite future. Please do not let that inhibit
any of you from sending her your material for the Newsletter
--COD.
Electronic Subscription Information
-----------------------------------
The following is current as of 4/93. Craig says:
Anyone who would like to subscribe to Issues 11 and later via
Internet, please send Email to: <dadadata@world.std.com>.
Put "RSI Subscription" (without quotes) in the SUBJECT: line
and my mailer adds you to the distribution list. [I will not
answer personally --- COD.]
Sysops Information
Anyone who wants to redistribute the RSI Newsletter on a BBS,
online service, or corporate network, please let Craig know by
specifying in the message you'd like to be on the Sysops' Mailing
List. Sysops receive the latest issue plus Macintosh archive
files.
He has adopted naming conventions. For Macintoshes:
"RSInetwork.SEA" or "RSINET.SEA" for the full all-issues archive
file; "RSI10.SIT" for individual issues, "RSI10.ETX" for issues
in uncompressed setext format ASCII.
For all platforms:
"RSI10.ETX" for individual issues in setext format
(uncompressed ASCII text). If you compress a file - use
RSINET.ZIP for a collection and for individual issues,
RSI11.ZIP, etc.
Craig asks BBS sysops to please use the same scheme, where
possible, for searching consistency throughout the "universe",
and please always include "RSI" as a keyword.
Online Distribution
-------------------
Our goal is to have the RSI Network Newsletter available on as
many sites as possible, both free sites and commercial services,
on user group BBSes and on private BBSes. Again, feel free to
download and print out the Newsletter to give to others.
Newsletter on ZiffNet
The newsletter is available first through ZiffNet. It is posted
for Mac, DOS and Windows users in different ZiffNet libraries.
For Mac users:
Back issues are gathered in one archive, RSINET.SEA,
in the "Reference" library (GO ZMC:DOWNTECH).
The latest Newsletter is in the same library (for
example, Issue 10 is "RSI10.SIT"). Use the keyword
"RSI" to locate archives and single issues.
Message Sysop for assistance.
To index, browse, and copy from collected setext
documents, use Easy View, in the "Applications" library
(GO ZMC:DOWNTECH) under filename EASYVW.SEA.
For DOS and Windows users:
Issues 1-10 have been gathered in one summary,
RSI.ZIP, (GO PBSARCADE, Library 7).
Later Newsletters as text are in the same library
(for example, Issue 11 is "RSI11.TXT"). Use the
keyword "RSI" to locate archives and single issues.
Message Sysop for assistance.
Planet BMUG BBS & BMUG Boston BBS
These Mac-oriented bulletin boards run on the Macintosh First
Class graphic host, but you can log in with any simple terminal
program.
BMUG Boston is 617-721-5840 (2400 to 14,400).
RSINetwork.SEA is in the Public Files folder. BMUG Boston has a
conference area, AccessABLE, devoted to disabled users of all
types.
Planet BMUG is: 510-849-2684 (2400 to 14,400).
Ask Sysop to locate RSINetwork.SEA.
Both boards have 16 high-speed lines.
America On Line (Macintosh)
Use Keyword BMUG and look in the file library for the up-to-date
archive of all issues. Thanks to David Schwartz!
GEnie
Newsletter #10 and later are available as a plain text file in
GEnie's disABILITIES roundtable thanks to Richard Brosnahan. To
get there:
Log in, type "ABLE" at any "<H>elp ?" prompt.
Once in the roundtable, type 3 for the libraries.
Type 8 to set the software library, type 7 for Newsletters
and Articles.
The RSI Network Newsletter #10 is file number 649, titled
"RSINETWORK.TXT". Later issues are in the same location.
AppleLink
More thanks to Richard Brosnahan. Path:
Community Connection:Disability Solutions:Empower BB:The Reference
Desk
FTP & Internet Archive Sites
----------------------------
Info-Mac Archive
A full back issues archive is on the Info-Mac internet site. To
get the file, gopher or ftp <sumex-aim.stanford.edu> and look in
the directory
<info-mac/digest>. Filename: < rsi-network-news.hqx >
ftp for Macintosh
Anonymous ftp for is being prepared for May. All subscribers will
receive a short news mailing when these go online. Filenames will
be:
< rsinetwork.sea.hqx > (all issues to date, archived).
< rsinetwork.10.sit.hqx > (out 2/93)
< rsinetwork.11.sit.hqx > (out now)
< (etc). No caps due to UNIX conventions.
ftp for Others
ASCII, setext formatted archive files will appear on several ftp
sites for those using computers other than the Macintosh. Of
course, anyone can simply subscribe to the Internet mailing list
to receive future Newsletter issues by Internet mail.
For now, ftp to Dan Wallach's archive:
<soda.berkeley.edu>
The directory is: <pub/typing-injury/rsi-network> and individual
issues have file names "issue1", "issue2", ..., etc. These copies
are plain ASCII text.
Prior Contents
--------------
The RSI Network Newsletter has covered:
Issue 1, 6/91:
Hardware and software of interest; books of interest (2 pp)
Issue 2, 8/91:
The TONY! keyboard; Stanford Pain Clinic's psychologist;
long-term disability (2 pp)
Issue 3, 10/91:
SF Bay Area doctors; Special Technology Center; ergonomic/
employment resources (4 pp)
Issue 4, 12/91:
Software; ergonomic resources; publications; more on long-
term disability (4 pp)
Issue 5, 4/92:
Voice-activated text input; practitioners; forearm supports;
hints and tips (4 pp)
Issue 6, 6/92:
Statistics; voice recognition and word prediction;
legislation;
publications; organizations (6 pp)
Issue 7, 8/92:
CTS survey; iontophoresis; SF Bay Area ergonomics showroom;
pain relief; reading hands-free; mouse relief;
publications; legislation (6 pp)
Issue 8, 10/92:
TONY! keyboard update; other alternative input devices;
ACTSA and other associations; CTDNEWS newsletter; advice
for swimmers (6 pp)
Issue 9, 12/92:
Video of RSI TV special; input devices (esp. DataHand);
software; practitioners; job accommodation (6 pp).
Issue 10, 2/93:
Rolling scissors; Apple adjustable keyboard; keystroke-saving
software; reading (6 pp)
..
This text is wrapped as a setext. For more information about
The RSI Network, contact <dadadata@world.std.com>.