Old 09-18-2008, 11:33 AM #16 (permalink)
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Hello~I think we 'do' have many muscles in our fingers....If I am 'wrong' Wright will be coming to correct me for sure!
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Old 09-18-2008, 11:43 AM #17 (permalink)
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Fmarino is correct: we do not have muscles in our fingers. The bones of our fingers have tendons attached to them . . . and these tendons are in turn attached to muscles of the hands and forearm . . . and it's the contraction of those muscles that allows our fingers to move.

You almost make it sound like if I corrected you, I was scolding you. Nothing could be further from the truth. I'm just here to help and I hope that helped.


P.S. Robert, you were dead-on about the Rowdy Raider. You're a very observant person. You would have made a great scientist.
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Old 09-18-2008, 05:59 PM #18 (permalink)
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Hi Wright....thanks for the correction! We do have muscles in the hands~don't we? Other wise there could be no atrophy...Just checking.
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Old 09-18-2008, 06:02 PM #19 (permalink)
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Sorry, Wright.....Daaa! You already answered that question!
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Old 09-18-2008, 10:55 PM #20 (permalink)
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Thank you for the replies. I should have been more clear. I was referring to the knuckles in my hand at the base of my fingers, not the knuckles mid-finger. So with that in mind...

Yes, April, its king of like the skin is baggy (or in my case more like puffy). It's almost like if my hands were made of dough, and someone pushed down on my knuckles. The skin feels loose, though, not swollen. Can that happen with Rheum. Athritis? My impression was that in that case the joints were swollen, and enlarged.

I also wanted to update on the vibration sensation. I had my wife hold my foot while it was happening, and she said she could feel the vibration. Is this a type of of tremor?

Again thank you for your responses

Robert
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Old 09-19-2008, 08:53 AM #21 (permalink)
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Hello Robert~I have a vibration in my foot, and now in other areas. The neuro refers to them as purring. For me, not a tremor.

Hope that helps!
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Old 09-19-2008, 10:29 AM #22 (permalink)
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Sorry, couldn't resist replying, its all in GOOD FUN and you KNOW despite all the crap I am experiencing in undiagnosed limboland that this reply is a SURE indication that I am still me! LOL and as a post script this was actually FUN for me to write. LOL
Wright is RIGHT about the Anatomy. I just wanted to help explain some of the " WHY's" to this. Why if there are no muscles in my fingers do they look funny?


Okay. I do have a bit of knowledge about anatomy/physiology and kinesiology and have worked on MANY hands in the past 10 years as a part of my job, but am NOT a certified hand therapist. I do not have a masters degree, but an associate of applied science in Occupational Therapy and am nationally certified and liscensed to practice OT. I am telling you this because the things I share with you regarding hands aren't (usually )) just a guess. I consult books and other therapists frequently when I feel like I am guessing. I am not a huge anatomy GURU and am much more interested in helping people to regain or maintain function as it applies to their daily lives.
Wow, I am really blabbing. Sorry. I am a huge advocate for OT.

I help people strengthen them, stretch them, find ways to compensate for loss of them, massage them, stimulate them, order splints for them and educate them and caregivers on how to protect them.....

I think we need to get a video conference going "ALL ABOUT HANDS!"

There are MANY muscles in your hand and forearm that control your hand/fingers.wrist. This is where the majority of muscles are located that control hand function- I encourage all of you to google hand anatomy illustrations. The hand is VERY complex! There are some muscles that insert (end) just past your first knuckle, though the area I believe Robert is referring to where they look sort of puffy are his MCP's- (on the back side of his hand)
A lot of times there is more than one muscle needed to move a joint, rather a whole team effort.

Nerve problems can also cause hand problems. Oftentimes in MANY neurological conditions nerves AND muscles are affected.

A number of problems can cause your fingers to "waste" or appear different.
- spastic tone and its opposite- flacid tone can literally deform fingers and cause them to take on all sorts of bizarre appearances. Inactvity due to paralysis and weakness causes tendons and ligaments to shrink which causes the "curling" so it is imoprtant to stretch and massage those things even if you can't or it wouldn't be beneficial to actually exercise them.

When the myelin sheath becomes damaged- as in Guillan Barre'- it is literally like if you take a straw out of its wrapper and then try putting that straw back in a crumpled wrapper. Tough, eh?

So I guess what I meant to say is that YES! Your fingers can look different from neuro problems. Your fingers CAN weaken even though there aren't actual muscles attached to the top of them. Muscles are needed to straighten, bend, spread, pull apart your fingers.

Hope this helped.
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Old 09-19-2008, 11:09 AM #23 (permalink)
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That's is what RA looks like. My husband, in addition to ALS, has been suffering with RA for several years. Not much fun!
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Old 09-19-2008, 01:17 PM #24 (permalink)
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Lovelily - thank you for the information. Is "purring" indicative of anything? Has your neuro mentioned what causes it?

Linray - When you say RA looks like that, you mean it looks like I described?

Robert
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Old 09-19-2008, 01:45 PM #25 (permalink)
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Hi Robert, I wanted to share that my knuckles (mostly on left side) also appear "sunken" even though that is not how I would have described it. The skin is so loose and baggy on the back of my hands that the knuckles are sort of buried under the folds, hence looking sunken. Is that what you mean? Also, I can easily pinch a good inch of skin on the back of my hands. Depending on level of hydration/dehydration, that bunch of pinched skin can take a long moment to settle back down. I don't know if everyone's hands do this, but I was using an electric hand dryer in a public bathroom recently and was quite amused to see what it did when blowing on the back of my hands...try it, it's good for a laugh

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Old 09-19-2008, 05:23 PM #26 (permalink)
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I'm having a good day off with the kids today. It's teacher inservice day, and Daddy has more vacation days than Mommy

Lydia, to answer your question, not quite. I geuss I used the term "loose" to describe it because I didn't want to give the impression that the skin is swollen. I can't pull up what I would call an excess of loose skin. No pushing your fingers into dough is about the best I can describe it.

Robert
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Old 09-19-2008, 07:41 PM #27 (permalink)
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OK, this is not exactly about knuckles, but I had to "share" LOL. Since I've been on disability, I've obviously not been going to work and have had loads of time to lay out in the sun. So.... I went in for routine blood work because I'm in the Rilutek. I have always had just awful veins, they're a nightmare for anyone wanting to draw blood.... There I am today at the lab, and the girl has checked both arms, and not settled on trying either. She looks at my hands and says "hmmmm you've got really good... ~ and my mind fills in the word "TAN!" ... but she says:
"veins" ... do you mind if I just put a little line in there instead? ! For whatever reason I just thought this was so funny, instead of sitting there in the lab, dwelling on my dubious future, I'm basking in my awesome tan, but got brought back into reality

Anyway, as one gets older (I know this because I'm going down that path) one's veins get more prominent, as well as the knuckles, because the skin gets thinner and just falls in around structures within the hand ~ probably due to decreasing collagen. It makes me wonder if your knuckles are less prominent if maybe you have swelling? perhaps due to vasculitis and an autoimmune process going on? just a thought.... take care,

Oh, and I just love the photo of your daughter in her tutu, its quite precious!

Last edited by rose : 09-19-2008 at 08:11 PM Reason: spelling...... of course!
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Old 09-19-2008, 08:28 PM #28 (permalink)
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Hi Robert...I had just had my second muscle biopsy and went to see the neurologist about the results. I was speaking to him about muscle movement, but he specifically wanted to know how some symptoms were coming about. I told him I felt a deep ache or pain in both legs, and a buzz in one foot in particular.

He said that the feeling I had was called purring~as I said. He never indicated what exactly it meant. I went for an EMG after that, for the opposing side of the body. I cannot remember if he said that the buzzing would show or not.
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Old 09-19-2008, 10:33 PM #29 (permalink)
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Rose - I loved the tan story, its funny how medical folks can be so in the zone that they miss the little things (or the obvious). One of the rooms in the lab at our hospital has a large photo of a bee on a flower. I pointed out how ironic it was to the phlebotomist, and after being puzzled for a second she chuckled. She had never noticed it before even though she's there almost every day. What's funny is the decorator may have even put it in the lab intentionally.

Back to the knuckles, that's what I was wondering, whether or not it was indicative of something up with the tissue, and running with the auto-immune hypothesis. I see the rheum on the 7th. I was reassured because one of my nurse acquaintances from back east (Philly to be precise) said that the particular rheum is excellent. She likes my local neuro too, as do I. It's funny because I set up the appt in June. I hope follow-ups don't have to be set up that far in advance (Actually I hope the rheum figures out what it is in one shot, and the next time I go to the doc besides the annual physical is to see my first grandkid ).

Lovelily - Hmm... maybe I'll have to ask my neuro more about it next time I see him. Although I still don't have my chart from the U of U yet, my EMG didn't have any abnormalities. I have a biopsy coming up as soon as the chart gets here. Does anyone else know anything about the "purring?" I'm not so much of a cat person, so for the purposes of my matrix I'm going to refer to mine as a low "growl".

Robert
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Old 09-20-2008, 12:17 PM #30 (permalink)
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Lydia~ oh, yes I can pull up my skin on the back of my hands. THe skin also has bigger pore texture. I would *think* if I lost muscle then it was stretched across more and that is why now it looks baggy and bigger pores?

CINDY~

If you can do PT/OT on your hands that are weak, can they get stronger? when I had PT and she my grip stength was weak (and alot of other things) it scared me into never going back. I Just felt like if my hands are weak and I use them all the time, how could I improve this? If you have read about my PT expierence or symptoms, do you think I should go back? I just felt that I could use cleaning, errands, carrying baby etc as PT? WOuld like your opinion.

thanks

april
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