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Jeruba's avatar

What was the matter with this old woman's hands?

Asked by Jeruba (47504points) November 13th, 2010

When I was about 15, the church Young People’s leader signed us all up to spend a Saturday evening at the Sunshine Rest Home. Our task was to facilitate an evening of games for the residents—simple activities that mentally and physically decrepit old people could play in a spirit of mild competition and fun.

My station involved a simple game of suspending a wooden clothespin (the old-fashioned kind without a spring) over a narrow-necked glass milk bottle and dropping it in. That was a real challenge for these folks.

There was one old woman I’ll never forget. Her hands didn’t work at all. They were limp and very red, puffy, almost shapeless, and they hung from her wrists like a pair of rubber gloves half filled with water. The only way she could hold a clothespin was to press it between her two wristbones. As the game mistress for that station, it was up to me to pick up the clothespin and hold it where she could kind of clamp it between her wrists while her hands hung down and wobbled like dead things.

As a healthy adolescent who had never been exposed to much of anything in the way of illness or disability, I found this very disturbing.

What I want to know now is: what was wrong with her hands? or rather, what kind of disease or disorder can cause the condition that I observed?

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16 Answers

YARNLADY's avatar

I sounds like what we used to call dropsy, or Edema

Seaofclouds's avatar

It could also have been the severe effect of Rheumatoid Arthritis. I had a patient once that had severe Rheumatoid Arthritis and she couldn’t do anything with her hands. They were red and very mis-shapened. The joints bent in abnormal angles and her fingers actually looked shortened.

lillycoyote's avatar

I think that @YARNLADY might be right. It’s something that used to be referred to as “dropsy,” a form of edema. It doesn’t sound like arthritis. Arthritis wouldn’t present with the puffiness, I don’t think. But I’m not a doctor, I could very well be wrong.

Katexyz's avatar

As @Seaofclouds it sounds like very severe RA. That runs in my family, my mother has it for certain. On her bad days her hands get very red, swollen, and difficult and painful to use. Well really any of her joints.

http://en.wikipedia.org/wiki/Rheumatoid_arthritis

AmWiser's avatar

It’s possible she may have had an acute case of Kenbock’s (not sure of spelling) disease, where the bones of the wrist loses it supply of blood thus causing the bones to die.

faye's avatar

This sounds like rheumatoid arthritis to me, too. I’ve also had patients like this, feet as well. It’s very deforming and painful. Osteoarthritis will also cause swelling and redness of joints but RA really takes away function.

Jeruba's avatar

Hmm—I’ve seen people with rheumatoid arthritis, including an 80-year-old in my writer’s club whose fingers twist at odd angles and seem splayed like a child’s drawing. But this woman’s hands hung limply from her wrists like an extra appendage. There was nothing like stiffness. They looked like they had no bones in them. They were soft and slack and shapeless and just hung loose. She would have been more dextrous without them. Can RA be like that?

I’m kind of leaning toward the dropsy/edema explanation, which goes with the swollen appearance, but the limp slackness still puzzles me. It’s as if you tied a slab of beef liver to the end of a stick and then tried to use that as a hand. No matter how you maneuvered the stick, the shapeless red meat would just hang there in the way, without the ability to grasp or manipulate anything.

deni's avatar

OH MY GOD @Jeruba ...i saw a man with hands like this YESTERDAY and wanted so badly to know what it was. i cant believe you just asked this question. ha….anyhow it was really sad.

Seaofclouds's avatar

@Jeruba Has she always been like that? It could be a paralysis of sorts.

faye's avatar

Edema would give more form. Fluid fills the hand or foot so they can become hard not slack. If rheumatoid arthritis has been severe long enough, if that hand has been unused for years, the muscles will be wastedand the hand will have lost form. The redness could be inflammation or poor circulation because of lack of muscle tone.

Jeruba's avatar

@faye, that does sound like an explanation that fits the facts. Thank you. One more thing I hope never happens to me. Some kinds of loss just seem more bearable than others.

@Seaofclouds, I have no idea. I saw her during one evening more than three-quarters of my life ago. I didn’t ask any questions. There was no one to ask.

Disc2021's avatar

The only thing that I can think of that hasn’t already been mentioned are severe burns.

I worked with a guy who had severe burns, from head to toe – his hands were very… disfigured and bruised very easily. When he had to grip or grab things, he often couldn’t or had a hard time doing so and would ask others for assistance. Apparently his feet were even worse, he would get bad sores/blisters and holes would form and they’d just start to bleed. Though the guy was kind of weird, I really felt for him as the story is that he got burned severely from running into his house and saving his children from the burning building.

flo's avatar

It has been answered above, but to put a link:
http://en.wikipedia.org/wiki/Edema

Kayak8's avatar

I can think of several things not yet mentioned.

I would rule out various forms of arthritis for the reasons mentioned above. Also most forms of contracture as the fingers would be drawn toward the palm typically and your description would be significantly different.

One would be long-standing diabetic neuropathy of the hands—there could be enough nerve damage over-time that the hands would be about worthless.

Another would be untreated Kienbock’s disease (avascular necrosis of the carpal lunate) but I think you would have described wrist swelling. Untreated Preiser’s disease (spontaneous osteonecrosis of the carpal scaphoid) would be another possibility.

Jeruba's avatar

@Kayak8, there could have been wrist swelling. That’s a lot to remember about this stranger after more than 40 years. The main thing about it was the redness, puffiness, and above all the loose, hanging limpness. Diabetic neuropathy—now, that’s really scary. Thanks for enlarging the possibilities. I would prefer not to be haunted by this image, but I am.

Kayak8's avatar

Maybe I should have said, I am not sure she could have held a clothespin between her wrists . . .

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