Two helping hands

March 12th, 2018
Mitch Benner with Patricia Kuyper, an occupational therapist and hand specialit at the UCHealth Physical Therapy and Rehabilitation Clinic in Fort Collins.

Mitch Benner needed to make some changes in his life. It took nearly losing a hand—and a dose of brutal honesty—to make them happen.

Here’s the scene:

Christmas Eve, 2012. A healthy and strong 26-year-old man has a bit too much to drink.

An argument ensues, and he misguidedly takes out his anger on a window. His right hand flies through (and gets dragged back) through two panes of tempered glass, severing all the nerves, tendons, and arteries in his forearm.

“It was a pretty horrific scene,” Benner said.

At the emergency room at UCHealth Medical Center of the Rockies in Loveland, Dr. Christopher Tsoi, the on-call plastic surgeon, performs an emergency seven-hour surgery to repair the damage. He manages to patch up everything except Benner’s ulnar artery, which provides blood supply to the inside of the forearm and hand.

“At one point they thought about amputating my hand but my dad wouldn’t let them do it,” Benner said. “And thank God for that. Dr. Tsoi was a miracle worker; the fact that he was on call on Christmas Eve and that he was probably one of the only surgeons in the area that could have done (that procedure).”

‘One of the worst cases we’ve ever seen’

Then comes the hard work.

A week after surgery, Benner began work with Patricia Kuyper, OTR/L, an occupational therapist and hand specialist at the UCHealth Physical Therapy and Rehabilitation Clinic in Fort Collins. Kuyper initiated the early rehabilitation protocol for tendon rupture repair, which included painful scar tissue massage and range of motion exercises. It also included a particularly gruesome looking device called a dynamic splint, which involves inserting hooks into the fingernails that attach to rubber bands on a hard plastic splint that spans the entire arm below the elbow. The bands help healing tendons do their work without excessive strain.

“I remember meeting Patricia, and I said, ‘Tell me honestly what’s going on,’” said Benner. “She looked me right in the face and said, ‘This is probably one of the worst cases that we’ve ever seen. If you don’t do everything we’re going to tell you to do, you might as well just cut your hand off.’ Swallowing that was hard.”

By all accounts, things went well for the first few weeks, which, according to Kuyper, are critical for proper healing. Optimal recovery, she said, depends on doing exact exercises an exact number of times in a defined period of time. It is tedious and boring—and necessary.

Mitch Benner faced the possibility of losing his hand. After rigorous rehabilitation, he has 85 percent function of his right hand. “There’s nothing that I’ve not been able to do.”

At the same time, Kuyper also cautioned her patient that if he moved too much, like pulling his fingers in the middle of the night, or inadvertently moving them in the wrong ways, he could rupture the repair and be back at zero.

Sure enough, a couple of months into his rehab, Benner’s recovery stalled. Both parties acknowledge now that it had nothing to do with Benner’s clipped wing.

“By trying to make sure he understood that we didn’t want to have to do surgery again, I think I might have scared him,” Kuyper said. “When I started adding more to his program, he didn’t adjust. He had a hard time understanding the impact of what he needed to do to recover, and he didn’t always follow through.”

Coping with the depression of self-inflicted wounds

Kuyper worried that if her patient, who before the accident had been building cellphone towers with powerful, dexterous hands, continued along this path, Benner might irrevocably damage his chances at ever fully regaining function of his dominant hand. If he didn’t start thinking about returning to work, the therapist worried, he may never do it.

“There’s often a critical point (in a rehabilitation) where a patient can make a turn,” Kuyper said. “If they turn the ‘I can’t’ into ‘I can,’ they can often excel. But Mitch was stuck in this ‘I can’t believe I did this to myself,’ mindset. I think it was the impact of knowing he had a nice paying job and was on his way to taking care of himself and buying his own house, and all of a sudden he was without that, living off the support of his parents and using Medicaid. The emotional trauma and the financial part were huge.”

In Benner’s words: “Because (my injuries) were self-inflicted, probably for a month or two afterward I fell into the deepest depression I’ve ever felt in my life.”

Kuyper, drawing on her 22 years of experience as an OT, noticed that her patient had developed scar tissue adhesions around the structures in his wrist, making even the smallest movements difficult and painful. Once scar tissue binds to the tissues around it, Kuyper says, it’s hard to loosen up, especially in a confined space like a wrist, where many nerves, muscles, ligaments and tendons repeatedly slide over and around one another to accomplish highly complex and coordinated tasks.

But even as the therapists performed unpleasant yet necessary manipulations to help restore Benner’s dexterity, her most powerful tools may have been her words.

“Patricia said to me, ‘Look, if you’re not serious about this, what’s the point? Don’t waste your time or your money. I understand this is hard for you to deal with but if you don’t do the things I’m telling you to do, it could potentially ruin your life. And if you want to be handicapped for the rest of your life, that’s your decision,’” Benner said. “But then she said, ‘I don’t think that’s who you are. I know you’re a fighter.’”

‘Getting his head right’

The emotions flooded from there, as Benner began to address the causes of why he was drinking and why he punched the glass. Benner bravely admits that it wasn’t the first time his emotional issues had landed him in the hospital.

Patricia Kuyper and Mitch Benner spend a few minutes together. Both point to the area where Benner’s tendon ruptured.

With the help of his parents, Benner said he took about eight months to narrow his focus on therapy, paying medical bills, and “getting his head right,” Including significantly limiting his drinking.

“There were probably six months where all I did was literally sit and do the exercises that Patricia told me to do,” Benner said. “And then after that I was able to get a job, delivering packages for an auto parts company, and some odd jobs to get out of the house and get some stuff done.”

Part of his long and painful clinic sessions with Kuyper involved talking about how capable he was, and that his mistakes wouldn’t define him. Benner also mentioned an interest in real estate, a potential career that could allow him to control his income and his time. In eight weeks he finished his classes and passed the test, and had a job within three months.

Now, just over five years after the initial, horrific accident, the 31-year-old Loveland resident plays competitive softball, basketball, football, and even Frisbee. He has not yet recovered full dexterity, and struggles with buttons, putting on a watch, and pulling things out of his right pants pocket. He still hasn’t recovered all the feeling, and he drops the occasional glass. But overall, he couldn’t be happier with how things have gone.

“Everybody at UCHealth was amazing, great to work with, and very honest with me,” Benner said. “Everybody in the room was always happy to see me, and always very helpful. I started from not being able to move anything at all, to getting about 60-70 percent of it back after a year, and today I’ve got probably about 85 percent of my function back. There’s nothing that I’ve not been able to do.”

Nevertheless, the unpleasant memories of the incident still come up in family circles—Christmas Eve, every year—a fact Benner must deal with, even as he has become more mindful of his alcohol intake.

“There will always be a level of guilt of having put my family through what they went through. And there are times if I’m watching a movie and somebody breaks glass it’ll instantly remind me of what happened and it makes me cringe. But I try to use everything that happens in my life for good. That was the only decision I could make.”

Kuyper said she is thrilled with the progress that Benner made.

“We often don’t know what the end of the story is after a traumatic event,” Kuyper said. “With Mitch I was able to follow him and see him get his (real estate) license and his picture in print and it’s like, Wow! That was my patient! He turned his life around. It lifts your soul to a different level and makes me proud to be a therapist.”


About the author

Andrew Kensley is a Colorado freelance writer, published author and physical therapist for UCHealth Poudre Valley Hospital in Fort Collins.