Hand/fingers skin question

[jen729]

My sister, 42, has ALS. She is a quadrapalegic (I can never spell that word right!) and on a home vent. She has nursing care every weekday morning, friends and family the rest of the time (the majority her husband when he is not at work). We all try to do ROM exercises and I do believe her hands and fingers are at least moved around and lotioned everyday. We (our mom and I) have begun, however, to notice the skin between her fingers is getting almost calloused. With some scrubbing, the extra skin comes off easily, but we can't figure out what's going on. She has no use of either hand. They are not curled, but are pretty stiff. We thought maybe her hands were just not getting cleaned with her sponge baths, but it seems to be more than that (though maybe not). I've searched many places on the internet and through these forums and on PatientsLikeMe but haven't seen anything. I did find a "cone and finger separator" on the Patterson medical site to prevent "skin breakdown." I can't find any further information, though. Is this common? Any thoughts and comments would be greatly appreciated? Also, have any of you had luck with getting your wedding rings back on after some (unwanted) weight loss? She can't wait to get her rings back on. Should we just get them resized instead? Any thoughts and comments much appreciated. Thanks!

You guys are a great community.

 

[Toto's Dorothy]

Jen
I am a new quad as of november 2011 my hands are clenched tight and have noticed two fingers pointer and middle finges have gotten like a callous on them left hand only will ask neurologist when I go next week

 

[lgelb]

Rings: one of those plastic inner rings that fit inside the ring? Don't know how well they hold. Maybe resizing is an option if she has a PEG and her appetite is stable, but be aware that later on her hand/fingers may swell.
Fingers: yes, the fingers rub each other and the nails may dig into her palm. You can keep them apart with a soft separator -- the one you found is one type and there are others. You may need to gradually increase the wearing time since they can be hard to get used to. A less elaborate solution is a fleece hand protector, but something that covers the knuckles is better since that is where a lot of rubbing occurs.

 

[penny1]

It maybe a build up of dead skin. The hands and feet seem to build up because of lack of friction, and no long showers. Try soaking the hands and feet in warm water with mild soap or bath salts. Dry them and gently rub to see if the dead skin rolls up, work over a towel. Rinse with water again and aply lotion. We did this about once a mth. It also seemed to help his feet dry faster without of the dead skin holding water between his toes. Who doesn't like a nice foot soak. Penny

 

[kmendsley]

There are little plastic inserts or metal ones that can clip onto the ring so you don't have to actually resize the actual ring. My grandmother got them in all of her rings when she lost a bunch of weight. Any jewler should have some.

 

[marypat]

The buildup of dry skin between the fingers might be caused by tube feedings if she is on those or protein drinks. When this is the cause it has to do with the body not metabolizeing some nutrients correctly. You might also notice a build up on her forehead, around her eyebrows and also ears. This is all the same thing. Rub it off gently with a washcloth and a light lotion helps.

 

[jen729]

Thanks guys! She does have a Peg and gets those protein drinks, though the skin on her forehead, etc., is normal. Will try soaking and will check her feet, too. Our mom often gives her a manicure and pedicure so her nails always look nice. Will ask her to include a good soak and scrub, too!

As for the rings, I actually meant to have them made bigger. Fortunately, she hasn't lost much weight. I just wondered what your experiences were with wedding rings and the progression of ALS.

Thanks again!

 

[Toto's Dorothy]

I can't wear mine anymore the first joints distally are shrinking but the last section to the hand has swollen from a size 7 to at least a 9 husband wants a divorce anyway so I stopped wearing them wouldn't want to have to cut them off if they got stuck

 

[BrianD]

I have the same type of issue, and it has just usually taken soaking them in warm water, or after a nice long shower and scrubbing them with a washcloth. I haven't used it, but one of the CNAs I've had recommended "Pretty Feet & Hands" lotion, which has decent reviews on various sites.

 

[hangingon1]

Jen, I have noticed on my Pals that she too has some skin problems. She is a quad since Dec. of 2010. I work her hands and massage them and that seems to help a lot. I have also noticed little raised white bumps and I do not know what they are. They come off easily. I think if you get the blood flowing in her fingers that will be a big help to your problem. Heat can increase blood flow also.

 

[LizT]

My PALS has this on his fingertips. I just scrape them when I cut his nails. Maybe check with the doctor the next time she's in though. Just to rule out fungus.

 

[kbenton22]

My mom has the same problem with her feet and toes. We use Cerave cream(the one in the tub container, not pump) and it seems to keep the callouses to a minimum. She puts it on every night before bed and in the morning before dressing.

 

[notme]

I have that problem with my feet as I can't 'scrub' them (can't bend to do them) and it's either stand in standing water for an hour or use lotion a LOT. Mine is just dead skin, I'm sure.

Keep up with the ROM--especially on fingers--it helps slow contractures a LOT. Simply putting the fingers into a fist is a quick and easy way to do ROM for hands. It bends each joint in the finger.

 

[jb63]

I have use of my hands and LMN disease so I don't have spasticity. My knuckles are caloused and my palms very dry with some hyperpigmentation. Maybe meds?

 

[Pandora]

Before my husband got his mits, we used the toe spreaders. You know the ones they use at the nail shop. worked great, they are soft, flexible yet durable. We also used dermasil lotion, non greasy and not that expensive worked for him