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You can earn .2 CEUs by passing the exam for this article, which has been approved for publication by NCRA’s Council of the Academy ofProfessional Reporters. The exam is available on the NCRA Web site,or a hard copy is available by calling 800-272-6272. The questions arebased on the material in the article, but some may require additionalresearch. Hands. Not an expendable tool of our trade, are they? Just as we should know our trade, medicalterminology, legal terminology, news, and CATsoftware in and out, so should we be as knowl- edgeable about our hands, the diseases that affect our hands, You can buy a second laptop if yours and how to prevent some problems that we could cause to our crashes, and you can buy new software, but you cannot do your job if your hands I am not a doctor, so I cannot teach you everything you may want to know about your hands. If you feel you may be suffer- ing from some of the symptoms I mention in this article, foryour own sake — and our profession’s sake — please seek med- fine-hand functions, such as playing a musical instrument or, in ical advice. You can buy a second laptop if yours crashes, and our case, writing on a steno machine. The hand and finger you can buy new software, but you cannot do your job if your muscles contract or extend, which stops or causes the exagger- hands are not well. Information is power. You will have more ated posture to continue. Some people explain their symptoms as “their hand having a mind of its own.” Maybe we can say this I will cover the following topics in this article: writer’s problem is the cause of some of our “bad writing days” — our cramp and dystonia, carpal tunnel syndrome, and fibromyalgia.
hands just “decided” not to write well that day! Often, as soon This list is not an exhaustive one of diseases involving the hands.
as the writing instrument is removed from the hand, the mus- Further information is out there by the truckload on the Web. cles relax. (I have “selective writer’s cramp” every quarter whenI write out my quarterly tax payment checks.) Writer’s cramp was first reported in the 1830s. Its cause is The official definition of writer’s cramp that I am using unknown. It is often believed that the condition goes undiag- comes from the Dystonia Medical Research Foundation. First I nosed and unreported. Unfortunately, it is sometimes misdiag- must define dystonia. Dystonia is a neurological movement dis- nosed as carpal tunnel syndrome, tennis elbow, strain, stress, or order that causes muscles in the body, such as the neck and shoulders (cervical dystonia or spasmodic torticollis, which Writer’s cramp is diagnosed simply on clinical observation.
turns the neck to the side or pulls it back or forward), vocal Sometimes an electromyogram (EMG) detects which muscles cords (spasmodic dysphonia, which makes it difficult to speak), are overactive and to what degree. Symptoms usually begin eyelids (blepharospasm, which causes the eyelids to close), face between the ages of 30 and 50 and affect both men and women. (oromandibular dystonia, which causes the lower face muscles The two types of writer’s cramp are simple and dystonic.
to pull or contract), or limbs (discussed in the paragraphs Dystonia symptoms appear with other tasks, such as eating with below) to pull or involuntarily spasm, sometimes painfully. It is utensils, applying makeup, shaving, or using scissors or screw- the third most common movement disorder after Parkinson’s drivers and other tools. In other words, simple activities of dai- ly living (ADLs). Cramping or aching hands are not common, Inherited forms of dystonia include early-onset childhood, although mild discomfort may occasionally be observed. Typists dopa-responsive dystonia, paroxysmal dystonia, X-linked dys- tonia-parkinsonism, myoclonic dystonia, and rapid-onset dys- It is difficult to predict the prognosis of dystonia. Writer’s cramp can progress further or remain unchanged. Spontaneous Writer’s cramp, the best known occupational dystonia, is improvement, although rare, has also occurred. triggered when a person attempts to write or perform other There is no cure for dystonia. Treatment helps the symptoms J O U R N A L F O R T H E R E P O RT I N G A N D C A P T I O N I N G P R O F E SS I O N S / M A Y 2 0 0 6 thicker pens or to write with a different fist, transferring the pen from the thumb and first finger to between the first and ment we don’t like to hear, “It’s all in mendation if you feel you have writer’s the pen in a prolonged static position.
Write for short periods and take frequent toxin injections to treat dystonic spasms.
breaks. This advice is also good for steno cation, such as typing, dictating, or using writers. Use it once in a while for those cause paralysis. It is a nerve blocker thatbinds to nerve endings, which then pre-vent the release of chemical transmittersthat send messages from the brain to ASK ABOUT OUR TOP CAT TUNE-UPS
contract muscles. You could call themspies: They block or intercept messagesfrom “headquarters.” small needle, sometimes with the aid ofan EMG. There is usually only tempo-rary discomfort at the site of injections.
Effects usually are not noticed for five to10 days. Not good for the impatientpatient! But benefits last three to fourmonths with minimal side effects, whichgives you enough time to save up for reduction of pain. Remember, results arenever guaranteed. For those people who ANNUAL MAINTENANCE CONTRACTS
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worse when they are more stressed. Mypersonal recommendation is yoga. group is usually beneficial. The Dysto-nia Medical Research Foundation is a Web site is Available for most writers
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J O U R N A L F O R T H E R E P O RT I N G A N D C A P T I O N I N G P R O F E SS I O N S / M A Y 2 0 0 6 ward joint posture; four, direct pressure; strained posture. I believe reporters can those that are “heavy hitters” on the mentioned earlier are loss of the sense of hose so there is steady flow. Now step on heat and cold, feeling as if the hands are this list intense deadlines, interpersonal swollen with no visible evidence thereof, your water hose — just as it can happen actually be one of the first symptoms in a nel syndrome, tenosynovitis, trigger fin- feel are tingling in the wrist, hand, and ger, de Quervain’s disease, tendonitis, arthritis, and Raynaud’s phenomenon.
As you can see, a doctor’s diagnosis is thritis, rheumatoid arthritis, and repeti- tive and forceful use of the hands. Do we repetitively use our hands? So let’s dis- believe lead to the development of CTS.
interesting fact to me was that the fingers What It Has Meant to Me to Complete most challenging undertaking of my life, and there have been many times when I wanted to quit. Yet for some reason, I haven’t.
The belief that this career is exactly what I am meant to be doing keeps me going, and I strive harder and harder every day. Each Four essays were chosen to receive the National Court time I think to myself, “I’ll never be able to do this,” I remember Reporters Foundation’s new scholarship. Each student received when I was struggling to squeak out 30 words per minute. I am $1,400 toward tuition and books. Following is the first of the four now at 150 words per minute, and I know I’ll reach my goals. What has it meant to me to finish the first year of the pro- gram? Well, to be honest, it has meant dealing with some smaller negative issues. Because of my school and practice schedules, I cannot even take a part-time job, which means living on one pay- Some time ago, I felt like a lost cause. At 32 years old, I had no check. It has meant having to get up at 4:30 a.m. every day to idea what I was going to do for the rest of my life. Tired of the work out before school. It has meant having to pay for school by endless politics of the entertainment industry and longing for a myself (somehow) because I am not eligible for financial aid. Of “respectable” profession, I decided a change of employment was course, these are small burdens, because I have gotten much more in order. I soon found, however, that my hard-earned degree in theater entitled me to work minimum wage jobs for the rest of my After finishing the first year of the program, I have a much life. In addition, I had gained a huge amount of weight over a few more positive outlook — not just concerning my career — but also years, which made me want to stay home and hide from the toward life in general. For once in my life, I can look back over my world. As more and more doors to employment were slammed in progress and be proud to have accomplished so much in such a my face, my sense of self-worth hit rock bottom.
short period of time. For once in my life, I can look ahead to the Because “Do you want fries with that?” is a question that future and see how valuable my contributions to society will be.
seems to stick in my throat, I decided to go back to school. After Because I have finished the first year of the program, I am confi- quite a bit of research, the field of court reporting and broadcast dent that I will finish the entire program. I now know that I can be captioning appealed to me, so I started school.
a strong, healthy, productive, professional woman. That knowl- In the last year or so, I have noticed many, many positive things edge makes all the difference in the world. happening for me. Learning to use the steno machine has been the J O U R N A L F O R T H E R E P O RT I N G A N D C A P T I O N I N G P R O F E SS I O N S / M A Y 2 0 0 6 it or you will regret it one day. You will you’re writhing in pain. Exercise is free; puter keyboard. Let’s overlook that dif- your doctor lately, see him or her before “type” 240 words per minute. We would tive solutions and progresses to surgery.
lem is the first step. Resting the hands as much as possible is also suggested. Alter- sues and relieve pressure on the nerve.
wrist splint off the shelf. Take the time to see a hand specialist. Buy and use the nutrition, previous injuries, and stress.
irritated tone of voice, too, I might add) be done to assess risks and benefits ver- four different types of surgery for carpal after the diagnosis. I think this absence There is no test, however, that can deter- study of our industry to ask, “How many government entity) lost to CTS”? We, as experienced set of hands we can get.
office. He said that the angle that it was consider before jumping into surgery.
tions that could irritate your problem.
Sure, they’re not natural, but compared your chances of getting it. I can person- to the alternative, I’ll sleep with them. high levels of vitamin B6 were associated ally testify to the helpfulness of stretch- ing exercises, not just for the wrists and ments is physical therapy. Frankly, I have and back. (I’ll reiterate my earlier sug- gestion of yoga.) I am told that it is best to do these stretches for four to five min- excellent books on carpal tunnel exercis- is currently no cure. Yet those afflicted apy. A low-energy laser light penetrates, but does not cut the skin to stimulate cell activity in the injured areas. I have heard condition experience constant fatigue.
bic and resistance training. Make time for J O U R N A L F O R T H E R E P O RT I N G A N D C A P T I O N I N G P R O F E SS I O N S / M A Y 2 0 0 6 throat; diarrhea or constipation; irritable which is a greater sensitivity to changes il); or a combination of Elavil at night to told that “it’s all in their head,” which often leads to depression. It was official- in the Department of Labor’s Solicitor’s than is known. It is estimated to affect (Zanaflex), and ondansetron (Zofran).
policy initiatives as well as enforcement other DOL agencies. As a result, I devel- es such as yoga, as well as aerobics, such chronic pain is the presence of “tender points” or “trigger points” located at the back of the head, base of the neck, upper with the professional staff and the Secre- can help alleviate stress. Too little sleep tary to set priorities for the agency, man- can intensify pain, too, as any new moth- er can testify. Keep regular hours. Get up and go to bed at the same time each day.
illnesses, and deaths on the job in Amer- descriptions, please do not self-treat.
be a priority for the Secretary. I look for- ber, depression is not the cause of any of worthy of an entire article itself. Briefly, it is similar to yoga. It consists of 10 one- help relieve the stressors in their lives.
create complete integration and a feeling of overall balance at the end of each ses- patient’s body is more focused as differ- Kathy Cortopassi, RMR, CRR, CCP, is a captioner ent areas of the body are manipulated.
certified rolfer, “Rolfing is not about listening tactilely to what is going on in el for success in the agency’s balanced ment so that the body can regain its nat- J O U R N A L F O R T H E R E P O RT I N G A N D C A P T I O N I N G P R O F E SS I O N S / M A Y 2 0 0 6


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