- Medical Questions
- Questions About Surgery
- Questions About Splints, Casts and Bandages
- Insurance, Billing and Financial Questions
- Questions About Hand Therapy
- What is a Hand Surgeon?
- What does it take to obtain the Subspecialty Certification in Hand and Upper Extremity Surgery?
- What is an Occupational Therapist?
- What is a Hand Therapist?
- What does it take to become a Certified Hand Therapist (CHT?)
- Alphabet Soup
- Other Questions
Q: I had an injection today. It is hurting more than I thought, or I think I'm having a bad reaction to it. What should I do?
A: It is common to have pain or "achy-ness" in the region of your injection. In addition to the primary medication, our injections contain Lidocaine that has a temporary numbing action. When this wears off, one often feels some pain. Depending on the location, the tenderness can last for a day or even two.
To help relieve the pain, use ice on the affected area for fifteen minutes or so and then a fifteen minute break. Use an anti-inflamatory such as Advil or Aleve or if you have been given a prescription you can use that as instructed. If you have a spint, wear it. If you still have discomfort, please call our office.
If you think you are having a bad reaction to this or any treatment, call our office.
Q: I have heard about new treatments for Dupuytren's Disease. Do you offer these treatments?
A: Our Center offers all available treatments for Dupuytren's Disease, including the Needle Aponeurotomy procedure and Xiaflex injections. Click here for detailed information.
Q: I'm uncertain if I'm having an allergic reaction to a medicine you prescribed for me. What should I do?
A: A true allergic reaction comes in the most common form as a rash and this typically occurs within a few hours of taking the medicine. Extreme allergies cause shortness of breath and can be a medical emergency, if this is occurring to you, proceed immediately to the Emergency Room.
Allergies are not nausea or stomach aches. Often this occurs because you are taking the medication on an empty stomach; try eating a snack when you take the medicine.
Q: I have heard that there is a laser treatment for carpal tunnel syndrome. Do you offer this treatment?
A: Our Center offers comprehensive care for carpal tunnel syndrome. Click here for detailed information about this commonly misunderstood condition.
Q: When can I return to the exercise or strength training program?
A: The therapists will assess your strength and ability to return to these activities as soon as the doctor states that strengthening is appropriate and there is no danger of re-injury.
Questions About Surgery:
Q: Where do you do your surgery?
A: Our surgeons operate at the Naugatuck Valley Surgical Center, St. Mary's Hospital, and Waterbury Hospital.
Q: What is the recovery time for surgery?
A: All surgery recovery times are dependant on the type of surgery and on the individual. Please speak with your doctor or hand therapist for more information about your particular situation or concerns.
Q: I just had surgery, when can I shower?
A: Patients should not get their bandages, wounds or stitches wet, this can lead to a moist wound and infections. Showering should be done with a plastic bag over the area to keep it dry. If the area gets wet accidentally, you should contact the office immediately and you will be instructed on what to do. Most patients are usually allowed to begin showering without a cover over the bandage after the stitches are removed.
You may use any of a number of items to cover your hand or arm. Simple plastic bags do just fine. Drug stores and orthopedic stores offer specialized covers between the $15 to $30 price range.
If just a little water gets on the bandage you may use a hair dryer to dry it. If there is any question the water traveled as deep as the skin and wound, call the office for further advice.
Q: I just had surgery, when can I start driving?
A: We recommend that patients avoid driving until they have regained normal use of their hand. We understand that it can be very difficult and inconvenient to depend on others for transportation, however, limitations in motion, weakness, pain or medications can create significant safety issues and endanger the patient or others.
Questions About Splints, Casts and Bandages:
Q: Can I shower with my splint, cast or bandage on?
A: This depends on the type of injury and the type of splint you have. If you were given a removable splint and your Therapist or Doctor stated you may remove the splint, then you may do so for showering. If you have a non-removable splint placed by the Emergency Room or your Doctor, then this splint must remain in place and covered for showering. Fresh trauma wounds or surgical wounds may not get wet and require covering. You may use any of a number of items to cover your hand or arm. Simple plastic bags do just fine. Drug stores and orthopedic stores offer specialized covers between the $15 to $30 price range. (Sometimes our patients are provided with removable splints. You should discuss this with your doctor or hand therapist to be sure you are using your splint correctly.)
Q: What do I do if I get my cast or bandage wet?
A: That depends on what kind of cast or bandage you have, and how wet it has gotten. If just a little water gets on the bandage you may use a hair dryer to dry it. If there is any question the water traveled as deep as the skin and wound, call the office for further advice. Please call our office and speak with one of our medical assistants or hand therapists who can help you. If it is after hours, and you are concerned, please call our office where you will be routed to our answering service and our physician on call.
Q: What do I do if my cast or bandage feels too tight?
A: Make sure you are elevating the surgical area above your heart-preferably as high as your chin or nose. Think of creating a waterfall where the surgical area is on top, up high, to drain the swelling fluid back into the body. The heart is a powerful pump; make it hard to pump swelling fluid up to the surgical area. You may also use ice on the area for about fifteen minutes on and then a rest for fifteen minutes. If after you have made this adjustment and feel no better after an hour, call our office to discuss further with our medical assistants. There are occasions where a bandage change is needed.
Q: My splint feels too tight or it's rubbing me, what should I do?
A: You should call the office immediately and speak to one of the therapists who will give you personalized instructions depending on the type of splint you have. You may be asked to return to the office to have an adjustment made to the splint or be given instructions you can do at home. Please do not modify the splint without speaking to one of our staff first. If it is after hours and the office is closed, you can try to pad the splint with cotton or tissues to alleviate the pressure.
Insurance, Billing and Financial Questions:
Q: Do I need a referral to come to your facility?
A: Each insurance company and plan is different. Please check on your insurance card or call your insurance carrier to determine whether you need a referral to come to this "specialist" practice. It is your responsibility to obtain any referrals required by your insurance plan.
Q: Does my insurance cover splints?
A: Each carrier and insurance plan is different. Please call your insurance carrier to discuss the coverage limits of your plan for splints or other Durable Medical Equipment (DME). Generally speaking,
- Some insurance plans pay 100% of the billed amount.
- If you are responsible for co-insurance, insurance will pay a percentage of the DME costs.
- Some insurance plans apply DME costs to your annual deductible.
Q: If I am a Worker's Comp patient, how long will it take for services such as therapy, splints, injections, x-rays, EMG or nerve studies, MRI, CT scans, or surgery to be approved by my Worker's Comp Insurance Carrier?
A: Generally the process takes no longer than 3-5 business days, although surgery approvals may take 1-2 weeks depending on the severity of your injury, and your Worker's Comp Carrier.
Q: Is there a co-pay with my visit?
A: Most insurance plans have a co-pay each time you see the doctor or attend hand therapy. Please refer to your insurance card and/or contact your insurance carrier to discuss the coverage limits of your plan. If you are unable to pay your co-pay at the time of your visit, we will need to reschedule your visit.
Q: Will you submit all claims directly to my Insurance carrier?
A: Yes. We have our own billing team in-house and process claims for our patients daily. We submit directly both to primary, secondary and tertiary general health insurance carriers as well as Worker's Compensation carriers.
Questions About Hand Therapy:
Q: I had therapy today and now I am more sore than before my treatment. What should I do?
A: If it is during office hours, you should call and speak to the therapist who treated you. They can discuss your symptoms and will know what the best course of action is. If your therapist is not available, one of the other therapists will gladly assist you. If it is after hours and the pain is mild to moderate, you can try to elevate the body part, and apply either heat or ice to alleviate muscle or joint pain. If is after hours and the pain is moderate to severe, call our office, our answering service will contact the physician on call.
Q: The therapist gave me some new exercises, but when I got home and tried them, they caused me pain.
A: Stop doing the exercise. You may review your home plan at your next visit with the therapist or you can call the office to notify the therapist. The therapy staff will follow-up with you and instruct you on whether to re-start the exercises or to discontinue them temporarily. Do not restart any exercises that are causing pain at an unreasonable level until they are reviewed by our staff.
Q: The splint is rubbing, what should I do?
A: For each splint an instruction form is provided. Contact the therapists and schedule an appointment for an adjustment.
What is a Hand Surgeon?
Hand Surgeons are trained to diagnose and treat injuries and diseases of the bones, joints, ligaments, tendons, muscles, nerves, skin, and blood vessels of the hand and upper extremity including the shoulder. Hand and upper extremity surgeons have received specialized additional training in the treatment of hand and upper extremity problems in addition to their board certified specialty training in orthopaedic surgery, plastic surgery, or general surgery. Hand and upper extremity surgeons are eligible to become members of the American Society for Surgery of the Hand, after they have completed a full year of Hand Surgery fellowship training and must pass a rigorous certifying examination. About 70% of Hand Surgeons are Orthopedic Surgeons first and about 30% are Plastic Surgeons first.
Not all problems treated by a hand or orthopaedic surgeon need surgery. Our surgeons follow a "ladder of treatment" approach with each patient and all diagnoses. This step-wise approach may include such non-surgical treatments as rest, medication, splints, occupational or physical therapy, and injections. Our combined goal is to get our patients back to their optimal functioning using surgical options only when necessary.
What does it take to obtain the Subspecialty Certification in Hand and Upper Extremity Surgery?
- You must complete a Medical or Osteopathic Doctoral Degree at an accredited college or university.
- You must be a diplomat of the American Board of Orthopaedic Surgery or similar Board for Plastics or General Surgery.
- You must have satisfactorily completed an accredited, one-year fellowship in Surgery of the Hand.
- You must have been in the active practice of surgery of the hand for at least two years and currently have privileges in Hand Surgery at an accredited hospital or surgical facility.
- You must be currently licensed to practice medicine in the United States or Canada.
- You must demonstrate professional competence and adherence to acceptable ethical and professional standards.
- You must submit a list of at least 125 surgical cases of Surgery of the Hand from a recent one year period.
- You must take and pass a specialty board exam that is offered only once a year by a specialty board such as the American Board of Orthopaedic Surgery.
- Once you are certified, you must re-certify every ten years, showing you are still practicing in good standing and have maintained advanced continuing education in the area of hand and upper extremity surgery.
What is an Occupational Therapist?
Occupational therapy practitioners are skilled professionals whose education includes the study of human growth and development with specific emphasis on the social, emotional, and physiological effects of illness and injury. Therapists provide skilled treatment that helps individuals regain function with the daily activities that are necessary for independent and satisfying lives.
Occupational therapists currently enter the field with a masters, or doctoral degree. An occupational therapy assistant earns an associate degree and works under the direction and supervision of an occupational therapist.
Practitioners must complete supervised clinical internships in a variety of health care settings, and pass a national examination to earn certification to practice. To maintain this certification, practitioners must complete 36 hours of approved continuing education hours every 3 years.
Most states also regulate occupational therapy practice through licensure. Connecticut licensure requires therapists to complete a minimum of 12 hours of approved continuing education each 2 year recertification cycle.
What is a Hand Therapist?
A hand therapist is an occupational or physical therapist who, through advanced study, specializes in rehabilitating patients with conditions affecting the hands and upper extremity. Approximately 80% of hand therapists are occupational therapists.
The therapist's high degree of specialization requires continuing education and, often, advanced certification. This enables the hand therapist to work with patients to hasten their return to a productive lifestyle.
What does it take to become a Certified Hand Therapist (CHT?)
- You must complete a Master's Degree in either Occupational or Physical Therapy at an accredited college or university.
- You must complete a minimum of five years in practice as an occupational therapist or physical therapist.
- You must complete a minimum of 4,000 hours of direct patient experience treating hand injuries or diagnoses, in the five years prior to taking a specialty board examination.
- You must be currently licensed to practice in your field.
- You must take and pass a specialty board exam that is offered by the Hand Therapy Certification Commission.
- Once you are certified, you must re-certify every five years, showing you are still practicing in good standing and have accumulated a minimum of 80 hours of advanced continuing education in the area of hand rehabilitation.
|BA||Bachelor of Arts degree|
|BS||Bachelor of Science degree|
|CHT||Certified Hand Therapist.|
|COTA||Certified Occupational Therapy Assistant|
|FAAOS||Fellow of the American Academy of Orthopaedic Surgeons|
|MOT||Master of Occupational Therapy degree|
|MS||Master of Science degree|
|OTR/L||Occupational Therapist Registered / Licensed|
Q: Do you have any late appointments?
A: Yes, we are open until 7 p.m. on Mondays for both physician and therapy appointments.
Q: How long will it take for my disability or other paperwork to be filled out?
A: Non-Surgical patients paperwork takes 7-10 days; Surgical patients paperwork will be filled out after surgery.