Scott Webb (Host): Whether you are suffering from arthritis in your hands or maybe carpal tunnel syndrome or suffered an acute injury, my guest today can help. I'm joined today by Dr. Thomas Magill. He's a boardcertified orthopedic surgeon with Franciscan Health and he specializes in hand conditions and disorders.

This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about hands, right? And just two guys sitting around talking about hands and hand conditions and how you help folks. So, what are the most common hand conditions and disorders that people may experience throughout their life?

Dr. Thomas Magill: Well, we see a lot of problems with nerve injuries to the hand like carpal tunnel syndrome or numbness around the hand itself. Of course, I see a lot of fractures around the hand. Wrist fractures, of course, are the most common fracture. In adults, also a number of other hand fractures. And I'll see a lot of soft tissue injuries, of course, to the hands and fingers. Most of those, again, will heal on their own, but sometimes we get some, you know, pretty nasty stuff when people are sticking their hands in a lawnmower or snowblower, you know, something like that. And then, of course, arthritic conditions of the hands, particularly at the base of the thumb, but all throughout the hand. I'll see a lot of that different kinds of things in that realm.

Host: Yeah. So, lots of conditions from just normal part of aging, osteoarthritis perhaps, to more traumatic things that may involve lawnmowers and snowblowers and such. I'm assuming that, when we think about the symptoms, it's pain, discomfort, those types of things. Is it usually fairly obvious to folks that they have some sort of condition that might need your expertise?

Dr. Thomas Magill: Well, sometimes it's not obvious because sometimes people, for instance, think that it might be normal if they get less sensation because they're getting older, say, or something like that, which is not normal, or if they've had conditions like diabetes that might make their feet more numb, well, that doesn't generally make their hands more numb. Again, you're right though, most of the time, people will know when to come and see me. It's something that'll knock hard enough on their door to get them to come in.

Host: Yeah. I see what you mean. There's that part, I think, a lot of us where we're like, "Well, this thing hurts, but I'm older. And so, maybe things are just supposed to hurt," right?

Dr. Thomas Magill: Sometimes, yeah, we all think that way. And unfortunately, that's true sometimes, but it never hurts to get things checked out.

Host: Yeah, definitely. And I wanted to give you a chance here. Anyway, talk about the type of training, you know, that orthopedic specialists have or go through when it comes to you know, the realm of hand conditions and injuries, so maybe talk a little bit about your background.

Dr. Thomas Magill: I'm in the Midwest because I came from Colorado to go to med school in Michigan. And so, I kind of stayed out here with residency at Northwestern. And for a hand guy, we go through medical school, and then we go into an Orthopedic Surgery residency. And during that residency, I'm really a general orthopedist. In other words, I've studied all extremity care that we get with Orthopedic Surgery. And then, I have a special interest in the hand. But it's been five years after med school of just working with patients under the direction of other doctors, mentors, so to speak, at Northwestern before I came out to the La Porte area, to just do my basic, my private practice or my group practice in orthopedic extremity, and hand is a big part of that.

Host: Yeah, I'm sure. And we've talked about sort of the signs and symptoms, so pain, discomfort, things like that. As you said, a lot of these things will heal on their own, but we wouldn't know that because we're not doctors, of course. So when do you recommend that someone seek out care, maybe speak with their primary, get a referral, that kind of thing?

Dr. Thomas Magill: It's always good to talk to your primary doctor if you have a question. They will obviously be able to figure out whether you need to come in for a referral or not. But also, you can come right into the office. If you've had a condition that's just not getting better, it's been a month or so and it's not getting better or getting a lot worse or it's distracting you from sleep or something like that, you don't have to wait a month if it's bad enough to distract you from your everyday activities. Of course, if you've had an injury or you're, you know, worried about healing of a wound or something like that, then it's always better to come in sooner rather than later.

Host: Yeah. I see what you mean, right? If we know that we've sustained an injury and the pain and discomfort hasn't gone away, that's probably a sign to speak with someone, speak with primary first, get a referral, but you say like some of those other things like arthritis, you know, is this going to go away? Is this temporary? And then when you kind of find out it hasn't gone away, maybe that's time, right?

Dr. Thomas Magill: Yeah, exactly, especially for those degenerative or kind of chronic conditions where you know you didn't have an injury, then if you're not getting better, come in and have it checked out.

Host: For sure. Yeah. A lot of us suffer maybe in silence, maybe not, but a lot of us suffer when we don't have to. And there's obviously a lot of care out there, treatment options. And that's what I wanted to cover next, was the different treatment options. I don't know that we can cover every hand condition or injury. But generally speaking, what are the treatment options that you recommend and try before you get to surgery?

Dr. Thomas Magill: Well, of course, it depends upon the condition, but it's important to note that I'm a surgeon, but most of the patients I treat, I treat without surgery. We obviously use surgery as more of a last resort. Of course, I do a lot of surgery on the hand. But for instance, a degenerative condition, like a degenerative arthritic type of pain in the hand, oftentimes I've just told patients to go pick up a paraffin wax machine and use the hot wax, the hot soak for the hand, and that can be very helpful with the symptom relief. Sometimes, of course, with carpal tunnel syndrome, we'll try anti-inflammatories as well as maybe using a splint at night. And oftentimes, these can eliminate the problem or at least make it bearable, so to speak, and not worsening. So, that's just a small example of some of the things we can do.

Host: Yeah. I do find it is interesting. I speak with a lot of surgeons. And, you know, in my mind, I'm thinking, "Well, there's surgeons, so they can't wait to roll up their sleeves and, perform surgery." But it's not usually the case. I hear that as a common tale that, yes, I'm a surgeon, but it's a last resort for most folks.

Dr. Thomas Magill: And we all kind of think that way, even when I go see a surgeon. You know, I wonder, are they going to kind of be biased towards doing surgery? But really, I like to think of the patient, I would treat them pretty much just the way I would treat myself. You know, I've done this for a while now, so I know. And I've gone through medical conditions myself, and I know what it's like to be a patient. And certainly, surgery is a great answer for a number of conditions. However, surgery, like many forms of care is a compromise to some degree. You know, in the slightest circumstance, it's a compromise of a scar for treatment, of course, but there's benefits and there's also risks related with surgery and we always have to take that into account when we're treating a patient.

Host: Yeah. And I'm sure that it's a case by case, individual thing, it's a choice. You know, maybe a shared decision between you, the surgeon, and patients. And I just want to finish up here, talk about hand health and taking care of our hands, and it occurs to me that, you know, I remember being told when I was younger not to crack my knuckles, that I was going to regret that someday. And I don't know why, you know, my folks or grandparents told me that. And I find myself saying that to my children. My son's always cracking his knuckles and I always tell them, "You're going to be sorry one day." But I don't know if that's true and I don't know why I'm saying it. So, just finish up here and talk about what we can do to maintain proper hand health and just take care of our hands.

Dr. Thomas Magill: You know, I think that you're going to be okay if you want to crack your knuckles. I don't think that there's a lot of evidence that that's harmful in the long run. So, I think you're okay with that one. Of course, it might be harmful if you annoy your parents.

Host: Yeah, for sure.

Dr. Thomas Magill: But, you know, there are a couple of basic things that you might not think of. For instance, you know, smoking, try to reduce your smoking. Smoking affects small blood vessels. So, of course, it affects your feet more dramatically sometimes than your hand, but hand injuries or any injuries oftentimes are delayed in their healing, or more likely to have infection in people that are smokers. And we can actually see hand changes from the diminished pulmonary function you'll see in a long-term smoker. So, of course, that's one thing.

And of course, you know, general exercise is good, not just for your heart and your body, but it's also good for your hands. It keeps your joints limber, and it keeps them active and strong. And that helps prevent some of these overuse injuries. If you only do something very rarely, you're more than likely to get maybe a sprain that can affect your wrist or your arm, your elbow. So, you know, general exercise is also very helpful.

And then, of course, there's occupational exposures. I can't tell you how many times I've seen a professional person that works with sharp tools that has a serious cut. And I think it's because people that have been around that equipment for a while, you get a little bit cavalier about it. And then, next thing you know, it comes back to bite you, so to speak. So, it's important to get used to using your safety equipment and just make that a habit in what you're doing.

Host: Yeah. My grandpa, I remember watching him. He used to have these, I don't know what you call them, these little hand exerciser thingies that he would squeeze

Dr. Thomas Magill: Yeah, a grip strength or something.

Host: Yeah. And anytime he was sitting around sort of idly, he was always using those gripper thingies and trying to strengthen his hands. Is that something that you recommend just for overall hand health to keep our strength up?

Dr. Thomas Magill: Certainly wouldn't hurt. I don't know if I would tell somebody to spend a great deal of their life doing that unless they had, for instance, some type of gripping career or, you know, tennis. That's obviously very good for tennis or golf to increase your grip strength. You're less likely to have irritation around the elbow, tennis elbow, and so forth. And of course, we'll use that after an injury or with arthritis. You know, a thera ball, a squeeze ball sometimes keeps your joints warmer, and joints like to move. They don't like to stay idle. If you keep them moving, you can keep them more limber. And I sometimes compare an arthritic joint to a tire that's going bad. If you can get the motion out of that joint, if you can improve the motion, sometimes you're kind of rotating that bad tire. So, you can use another part of the joint that might have a little bit better cartilage coverage on it. So, you know, motion is good and strengthening is good to the extent that it's convenient for you.

Host: Yeah, I was never sure. Was he doing it to strengthen his hands or was he just bored? Was it like his generation's version of like the stress balls that a lot of us have on our

Dr. Thomas Magill: Yeah, it could be. Yeah, like those little-- I don't know what you call those things that my kids give to me for my ADHD, you know...

Host: Yeah, the little squishy balls. Right.

Dr. Thomas Magill: Yeah, exactly.

Host: Well, that's perfect. Great advice from an expert today. Appreciate your time. Thanks so much.

Dr. Thomas Magill: Oh, well, sure.

Host: And for more information, visit franciscanhealth.org and search hands and orthopedic specialists. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.