Info-Mac 3/Info_Mac_1994-01.iso/Periodical/General/RSI Network Newsletters/RSI.Network6.etx

Text File | 1993-01-02 | 19KB | 433 lines

RSInetwork#6/June 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
  ([e-mail])
  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
  ([e-mail]).

  Setext formatting by:
  Craig O'Donnell, Assistant Sysop, MacWEEK Forum on ZiffNet
  ([e-mail]).

  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.


Thanks!
-------
  These past two months I've gotten lots of materials from
  subscribers, as well as a lot of new subscribers. (We're
  especially gaining momentum on the East coast.) Many thanks to all
  of you who have contributed! Please don't be surprised if your
  letters or information didn't make it into this issue; I'm limited
  by how much I can type. I hope to publish everything in time.


Requests From Readers
---------------------
Alternative Employment?
  More than one member of the RSI Network has asked me what careers
  people have changed to who have come down with RSI. Please send in
  your stories.

Workers' Comp Complaints
  A reader who is gathering complaints against California Workers'
  Comp medical evaluators asks that if you have any such complaints,
  please send them to Workers' Comp Complaints, 2130 Fillmore #222,
  San Francisco CA 94115.


Statistics
----------
  People often ask me about RSI-related statistics. I'm jotting down
  what I learn, but often find discrepancies in figures from
  different sources, even though they all claim to be based on data
  from the U.S. Bureau of Labor Statistics. Here's what I've come up
  with so far ("percentage" means the percentage of workplace
  illnesses reported by private industry that are RSI). Please let
  me know if you can verify or fill in any numbers.


Year     Percentage Total RSI cases
1980?       18%          ?
1985        ?            29,000 ?
1989        52%          73,000
1990        60%          87,000 ?


  Regarding the cost: Aetna Insurance estimates a cost to U.S.
  industry of $20 billion/year. The American Academy of Orthopedic
  Surgeons estimates a cost of $27 billion in lost wages and medical
  care for the year 1984 (obviously quite larger now).


Voice Recognition And Word Prediction
-------------------------------------
  Madenta Communications has announced three Voice Recognition
  Technology-based products for physically challenged users of
  Macintosh computers: Pre-Dict-ate, VT (Virtual Telephone), and
  Telepathic. These products, which use Articulate Systems' Voice
  User Interface technology, allow people who are unable to use
  their hands to control the computer and a telephone by voice.

  Pre-Dict-ate is a word-prediction program that combines the
  hardware and software of Voice Navigator II with Madenta's
  Telepathic software. You enter letters by saying the military
  alphabet and the computer predicts what word you're spelling.
  Pre-Dict-ate retails for $1095. Voice Navigator II owners can
  purchase Telepathic software, which comes complete with language
  files, for $395.

  Telepathic, the prediction module in Pre-Dict-ate, also ships
  separately for $295. Words are predicted just as with Pre-Dict-
  ate, but with the keyboard as the input device.

  VT is a voice-controlled on-screen telephone that retails for
  $1295.

  Madenta is located in Edmonton, Alberta, Canada, and can be
  reached at 1-800-661-8406, [phone], [phone] fax, or
  AppleLink MADENTA.

  Another word prediction program that's supposed to be very good is
  Co:Writer from Don Johnston's Developmental Equipment, 1-800-999-
  4660.


Other Resources For Macintosh Users
-----------------------------------
  For Macintosh computer users who have HyperCard 2.0 or later,
  Apple Computer offers the Macintosh Disability Resources (MDR)
  stack for finding accessibility solutions for the Macintosh. It's
  a collection of answers developed in response to the hundreds of
  questions the Worldwide Disability Solutions Group at Apple
  receives every week from individuals with disability and from
  special education and rehabilitation professionals. Contact
  Marianne Wydeven at [phone] or AppleLink WYDEVEN.M.


Legislation
-----------
  California Legislative Alert Two bills that would limit vocational
  rehabilitation to $25,000 are ready for a vote in both the
  Assembly and the Senate: AB 2570 (Burt Margolin) and its
  companion, SB 1539 (Bill Lockyer). These Workers' Comp reform
  bills also cover fraud, stress claims, medical-legal evaluations,
  arbitration, disability rates, etc., but the voc rehab cap will
  have the most serious negative effect on RSI victims, especially
  if injuries are permanent. Write to your representatives
  immediately!

  Pending National Legislation A "Comprehensive Occupational Safety
  and Health Reform Act" has been introduced by Senators Kennedy and
  Metzenbaum (S.1622). Look for details in the next issue, or write
  to the Senate Labor & Human Resources Committee for a copy.


Publications
  Basic Stuff: A Survival Guide to Workers' Compensation
  by Dorsey Hamilton.

  This book is available through a non-profit organization
  named Compensation Alert in Novato CA. To get the book, send a
  check for $12.67 ($9.95 for the book, plus shipping and handling)
  to Compensation Alert, P.O. Box 1907, Novato CA, 94948. Their
  phone number is [phone].

Workers' Compensation Claims
  by Gwen Hampton.

  I'm told this is the "bible" used by California WC caseworkers
  themselves. To get this (big) book, send a check or money order
  for $50.81 to Workers' Compensation Company, P.O. Box 11448,
  Glendale CA 91226. For more info, call [phone].

Healthy Computing: Risks and Remedies Every Computer User Needs to
  Know
  by Dr. Ronald Harwin and Colin Haynes, 1992.
  Published by Amacom (division of American Management Association),
  135 West 50th Street, New York NY 10020.

Sitting on the Job (How to Survive the Stresses of Sitting Down to
  Work - A Practical Handbook)
  by Scott Donkin, 1986, 1989. (Houghton Mifflin)

Computers and Visual Stress - How to Enhance Visual Comfort While
  Using Computers
  by Edward Godnig, OD, and John Hacunda, 1990.
  Seacoast Information Services, 4446 South County Trail,
  Charlestown RI 02813.

VDT NEWS (The VDT Health and Safety Report)
  published bimonthly

  Carries articles, stories, and news about health issues related to
  VDTs, including repetitive strain injury, ergonomics, and
  electromagnetic fields. It's a good source for manufacturers'
  information through the advertisements for various products, and
  it lists meetings and other publications related to VDT use. Cost
  is $87 a year. Write VDT NEWS, P.O. Box 1799, Grand Central
  Station, New York NY 10163; phone [phone] or fax (212)734-
  0316.

Recording for the Blind recorded books
  People with physical disabilities, including repetitive strain
  injuries, can apply to Recording for the Blind for recorded books
  and electronic (computer) versions of textbooks and computer
  manuals. Verification by a doctor or physical therapist is
  required. Contact Recording for the Blind, 20 Roszel Road,
  Princeton NJ 08540, 1-800-221-4792, [phone], [phone]
  fax.


Organizations
-------------
  The American Carpal Tunnel Syndrome Association is a nonprofit
  organization, based in Michigan, that has a technical Advisory
  Board consisting of six physicians. The basic annual membership
  fee of $30 gets you a Carpal Tunnel Syndrome Information Kit and a
  quarterly newsletter. Send your name, address, phone number, and a
  check or money  order made out to ACTSA, or just a request for
  more information, to P.O. Box 6730, Saginaw MI 48608.

  Compensation Alert, whose founder wrote the first book listed
  above under "Publications," is a nonprofit organization dedicated
  to teaching injured workers and employers about workers'
  compensation in California. Call [phone] to request an
  information packet. They offer a workers' compensation lawyer
  referral service; the number for using that service is 1-800-800-
  0391.


Jennifer's Story
----------------
  (Jennifer Ovink, who lives in Corvallis OR, took a lot of time to
  write down her story so the rest of us can learn from it. Please
  consider doing the same with your own story. - Caroline)

  I'd like to provide some information that I've learned the hard
  way. If anyone thinks this is a trivial problem, let them read on
  and take a few words from one who is wiser.

The GP, PT, and OT
  I started having symptoms in my right wrist in October 1990. I
  went to my GP in November and received advice to take 4 Advil 4X a
  day and wear a wrist brace that he provided. He also told me to
  start using the Macintosh mouse and my Sun workstation mouse with
  my left hand. Within two months I had symptoms in my left arm and
  the pain in my right had not subsided. I went back to the GP and
  received a brace for my left wrist. I bought a foot rest and moved
  the keyboard around so my arms were better supported. However, in
  January, 1991, a short deadline caused me to work two late nights,
  past my usual 6 hours at the mouse/keyboard.

  With the problems continuing to worsen, in late June I was sent to
  physical/occupational therapy locally by my GP and I filed a
  workers' compensation claim in Oregon. My injury was accepted as
  non-disabling. Hindsight has shown me that PT and OT were shooting
  in the dark and I knew more than they did about the problem due to
  my own research. PT did two sessions of ultrasound and showed me
  how to ice and wrap my forearm above the wrist brace. OT explored
  the usual advice about workstation ergonomics that's generally
  available to the public. After 5 weeks of this nonsense, I quit
  the physical therapy and went back to my GP. I had heard of people
  receiving relief by taking a break from the job for a month; he
  agreed. At that time I refiled my workers' compensation claim as a
  disabling injury.

The Rheumatologist
  On August 1, I left work and was told by my GP that I had tested
  positive for the rheumatoid arthritis factor. This meant that I
  had to see a rheumatologist and that workers' compensation might
  rebill me for past expenses if it turned out that I had an illness
  and not an injury. After waiting 7 weeks (off work) I saw a
  rheumatologist; three weeks later all tests turned up negative.
  However, the rheumatologist said he could help me. I got a
  cortisone shot in each forearm (extensor muscles) and he
  prescribed 8 weeks of physical therapy 3X a week at a sports
  injury clinic, plus 4-6 weeks of massage 2X a week. Two days after
  the shot, I received my first PT at the sports injury clinic. My
  therapist was a certified athletic trainer as well as a physical
  therapist. I felt amazing relief from the cortisone within two
  days. My pain went from a 10 to a 4.

The Consultants from Workers' Comp
  The workers' compensation insurance carrier hired two consultants
  to work on my case. The first, a vocational rehabilitation
  company, assigned a case worker to oversee my medical care and all
  PT and learn in-depth about my job history and possible employment
  options. The second consultant was a medical consultation group
  that scheduled an appointment for an exam with an insurance-
  approved physician to determine whether or not I was medically
  stable. Once a worker is declared medically stable (no chance of
  improvement), the Oregon insurance carrier is not required to pay
  time loss from employment. Of course the insurance doctor found
  that I was medically stable.

The Orthopedist
  After two months of this nonsense, on my own I sought the advice
  of an orthopedist who specializes in hands and upper extremities.
  Dr. Walter Hales, who had already seen a great number of RSI
  cases, diagnosed me as having tennis elbow (lateral epicondylitis)
  from a long-term overuse. As he described it, this condition is a
  degenerative one, not a true inflammation; the tendon may actually
  be full of holes or tears, or have dying tissue on it. Dr. Hales
  administered another cortisone shot, this time in the right
  lateral epicondyle. OUCH. After a month, my recheck found no
  improvement. Dr. Hales recommended surgery in my case but he
  admitted that it has, at best, only a 40% success rate. Mentally,
  I'm not prepared for a 12-week recovery period with only 20%
  chance of improvement, 20% chance of "complete" recovery; I
  declined the surgery. Dr. Hales did prescribe an anti-inflammatory
  medication, Lodine, which I've found to be far superior to
  Naprosyn. I continue with stretching and ice, and massage when I
  can afford it (insurance won't pay for this any longer).

Where I Am Today
  I am now back to work part-time. I am somewhat resigned to the
  fact that my elbows/forearms will never be the same. I have cut
  back on all activities that use the extensor muscles: sports,
  housework, any writing with a pen or pencil. I got an electric can
  opener (yecch) and a food processor (no more hand cutting) for
  cooking. I keyboard only 2 hours a day for work.

Mistakes and Regrets
  1. I did not take this problem seriously sooner.

  2. I believed that the insurance company and their agents were
  working in my best interests, for the first two months I was off
  work.

  3. I let my GP treat me for over a year even though he admitted
  that he did not know much about the cause of my problem. He felt I
  had "routine" tendinitis that he could treat with conservative
  care.

  4. I did not seek the advice of a specialist sooner.

Changes to My Workstation
  1. ErgoArms by ErgoFlex, 1-800-788-2810. These are marvelous! They
  take the strain off shoulders and neck. Neck and shoulder problems
  and pain are common after the original injury has caused stress
  and tension in the forearms. Hands floating over the keyboard
  helps since in my condition, using the extensor muscles to hold up
  my hands continues the injury.

2. Trackball and foot pedal.
  I have the Curtis trackball and foot pedal on my Macintosh and an
  Evergreen trackball for my Sun. To the Evergreen trackball, my
  employer wired four foot pedals (cassette recorder foot pedals
  purchased at Radio Shack) to the four buttons on the trackball. I
  use only two of the foot pedals.

3. Footrest.
  I angle the foot pedals so that I rest my foot on the foot rest
  and use my heel to push the foot pedal down. This relieves stress
  on the muscles attached to the shin area of the leg.

Insurance and Workers' Compensation in Oregon
  This is a whole 'nother story. Even though my two doctors have
  said I'm not medically stable, the insurance company's doctor says
  I am. The state of Oregon just issued a Determination order of
  Closure in my case and the insurance company was ordered to pay me
  permanent disability, MINUS all the time- loss payments from
  October 1991. To make a long story short, even though I was not
  conditionally released for work by my doctor until January 24,
  1992 and my employer had not made any work site modifications
  until March 1992 (the conditions for my release), since I
  continued to receive time-loss benefits all during this time, the
  insurance company may subtract all the time-loss benefits from the
  final disability payment. Result: they owe me nil. Under Oregon
  law I have 180 days to consult a lawyer and contest the findings.
  It has been an education in incompetence and mental stress.


Quote Of The Month
------------------
  "Our evaluation of more than 1,100 workers...indicates that
  individual characteristics, such as body mass (a measure of
  obesity), age, wrist dimensions, and lack of exercise, are major
  determinants of median nerve entrapment neuropathy, which causes
  carpal tunnel syndrome. Poor health habits, such as cigarette
  smoking, alcohol abuse, and excessive caffeinated beverages, also
  appear to affect condition of the median nerve. . . . Job-related
  factors, such as specific occupation, duration of employment, and
  occupational hand use, have contributed very little to abnormal
  median nerve conduction."  - Peter A. Nathan, MD, Portland OR,
  letter to the editor of the NY Times, in response to their article
  on RSI. Joan Lichterman of the CA East Bay support group sent an
  excellent letter refuting Dr. Nathan's, but it wasn't printed.


RSI Support Groups (California)
-------------------------------
  San Francisco:
  Judy Doane, [phone], or Yari Leski, [phone].
  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, [phone].
  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, [phone].
  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, [phone], or Petzoldt Hand Center, (408)261-
  7660.

  Los Angeles area:
  Samantha Greenberg, [phone].
  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.
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    and Compuserve, in the "Reference" file library at location
    ZMC:DOWNTECH.

    For Internet mailing list distribution, send your Internet
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      [e-mail]

    and you'll receive the newsletter (plain ASCII).

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