Education

Helping Hands: Expert Care can Help with Hand Conditions

Sketch pencil in her right hand, Laida Arcia Carro (pictured above) adds tiny details to complete her portrait of a strong Haitian woman. Ms. Carro can’t imagine a day without drawing, yet at age 71 the osteoarthritis in her hands often forces her to end her sketch sessions sooner than she’d like.

“Four or five years ago I noticed that my graspwasn’t as good as it had been, and I had pain with certain motions, likeopening a jar,” said Ms. Carro, a retired elementary school art teacher. “Itgot progressively worse and now the bone on the inner side of my wristprotrudes. It’s in both hands, but my right is worse than my left.”

Unfortunately, just being female places Ms. Carro at a higher risk for a hand or wrist problem. According to the National Institutes of Health, women are about three times more likely than men to suffer from rheumatoid arthritis and carpal tunnel syndrome, and twice as likely to fracture a wrist or have osteoarthritis in their hands. The gender gap is true across all age groups, yet it widens as we age.

“Genetics, hormones, anatomy and metabolism all play arole,” said Elizabeth Anne Ouellette, M.D., chief of hand surgery at Miami Orthopedics & Sports MedicineInstitute. Inaddition, women often lack adequate levels of calcium and vitamin D, importantin forming and maintaining strong bones.

Although Dr. Ouellette is an orthopedic surgeon, sheisn’t quick to take a patient to the operating room. “I’m going to talk you outof surgery if I can,” she said. “If you aren’t sleeping because of the pain oryour life is severely disrupted — for example, you can’t turn the key in yourfront door — then we have a conversation about surgery.”

Dr. Ouellette understands what her patients areexperiencing because early in her career, just after having her second child,she underwent carpal tunnel surgery on both wrists at the same time. “I wasbeginning to lose finger sensation and I was not sleeping. This could havebrought an end to my career.”

Because of the impact a hand problem may have on dailylife, it’s important to see a specialist if you have symptoms. The hand andwrist are delicate and complex, with 27 bones and many muscles, tendons,ligaments, arteries, veins and nerves. Many conditions can be addressed, andtechnology is constantly evolving to improve and expand treatment. Dr.Ouellette is involved in a wide range of research on everything from nerveinjuries to the use of tiny anchors in the wrist for tendon repairs. Inaddition to her role at Baptist Health, she is chief of hand surgery and aclinical professor of orthopedics at Florida International University’s HerbertWertheim College of Medicine.

Although Ms. Carro is a candidate for surgery, she andDr. Ouellette discussed the options, and together, they decided to watch and wait.“Her symptoms could improve with conservative treatment,” Dr. Ouellette said.“And sometimes patients have no pain after the cartilage has worn down and thejoint is bone on bone. Then we do nothing.” Waiting could also mean thatmedical developments, such as tissue re-engineering, could move from theresearch setting to everyday use.

Occasionally, Ms. Carro wears asplint on her hand, takes anti-inflammatory medicines and rubs on a topicalnumbing cream. She hopes to avoid the disruption surgery would require. Whenshe can, she still teaches private art lessons and attends regular drawingclasses, and hopes those resume soon. Careful to maintain social distancingduring the pandemic, Ms. Carro has filled her days by continuing her sketching,except without live models.

“My art is so important,” she said.“I don’t want to stop. It keeps me alive.”

Tips for “handling” the future:

Dr. Ouellette has 30 years of experience in researchand in treating athletes and people of all ages who need small jointreplacement or surgery for hand, wrist and joint injuries. She offers patientsplenty of advice when it comes to preventing — or slowing — problems that canbecome debilitating.

Some suggestions:

• MAINTAIN A HEALTHY WEIGHT. Fat contributes to a higher level of the hormoneleptin, which leads to inflammation. “It’s not the extra weight on joints thatcauses problems,” she explained. “Inflammation can cause swelling, cartilageand bone damage, and pain.” Leptin has been linked to arthritis, lupus,multiple sclerosis and even heart disease.

• EXERCISE. It keeps bones strong, improves balance, buildsmuscle and has long-lasting health benefits for the whole body.

• FEED YOUR BONES. Take a vitamin D supplement and eat plenty ofdark green, leafy vegetables to increase your calcium level.

• CHOOSE ORGANIC. The fewer chemicals youabsorb from skin care products, makeup and food, the better. Apps such as EWGHealthy Living, Think Dirty and Detox Me can help you determine your toxicityexposure.

Healthcare that Cares

With internationally renowned centers of excellence, 13 hospitals, more than 23,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.