Conference 7.286::digital

Hans,

	Thank you.  I am copying your paper, I am sure it will be very 
	useful.  As a software engineer, I too am concerned about RSI.

	The "New York Times" on March 3rd & 4th, 1992 ran a two-part 
	series on `Computer Hand and Arm Injuries' which I clipped and 
	copied for our nursing service to distribute.

	Please send mail is you would like a copy:

		PHONE::SWANT 
	
	Our nursing service in MKO (Merrimack, New Hampshire) is pushing
	strongly to service personnel with ergonomic studies and solutions
	to prevent or help RSIs.  It becomes very costly to Digital to
	treat as opposed to prevent these long lasting problems. 

				-- Julie

    I am not sure if the problem that I have is related to RSI or not.
    
    The symptoms that I exerience are pain in the forearm and loss 
    of sensation in part of my hand and the last two fingers.  I have
    had nerve conductivity studies done and the results show damage
    (possible bruising) to the nerve in my elbow.  Currently I am 
    scheduled for surgery to move the nerve from the bottom of my 
    elbow to the inside.  The Doctor has never mentioned this to be
    RSI nor do I know of any injuries that would have caused it.
    
    Is this something that I should mention to our local Health 
    Services??
    

    Re .3:
    
    I think what you are describing is Cubital Tunnel Syndrome.  And yes
    it can be caused by keyboard activity.  My neurologist who treats
    professional musicians sees this a lot in the left hand of violinists
    and says that computer keyboards can cause the same problem (I have it).
    One of the nasty things about the DEC LK201 keyboard is that if you are
    a touch typist to hit the RETURN key you may have to fully extend the
    little finger to its limit to hit the key.  If you also
    have your arms bent you are duplicating the problem that string players
    have.  When you stretch your little finger with the arm bent it can
    cause a compression of the ulnar nerve just below the elbow.  
    
    Quoting from an article titled Unique Upper Extremity Disorders of
    Musicians in the book Occupational Disorders of the Upper Extremity
    by Dr. Michael E. Charness:
    
    Ulnar Neuropathy
    
    "We  have encountered a large number of musicians with ulnar nerve
    entrapment at the elbow.  Most patients were in their twenties and
    thirties and were, on average, about 20 years younger than nonmusicians
    with ulnar neuropathy.  The ratio of women to men was about 2:1. 
    Elbow trauma was rare and contributed directly to the neuropathy in
    only two musicians.  The left side was preferentially involved in
    string players and the right or both sides in pianists.  The selective
    involvement of the left hand in the string players withulnarneuropathy
    suggests that sustained elbow flexion with finger movement
    (fingerboard, left side) is more important than flexion-extension (bow,
    right side) in the pathophysiology of this disorder."
    
    If you are a computer keyboard user I strongly suggest that you discuss
    this with your doctor and the Digital nurse.  You may also want to
    get another opinion as nerve transpositions are risky.  I suggest you
    read the available medical literature on ulnar nerve transpositions before
    having the surgery.
    
    Further discussion of Ulnar Nerve Compression probably should be
    moved to topic 739 in the MEDICAL conference.

    Thnx much for that entry.
    I am a touch typist too (rather fast, but lots of mistakes). My
    roughest key is the backspace/erase key.
    
    just a minor addendum.
    I believe the spelling is Carpal or perhaps Karpal, which should in no way
    detract from the thoroughness and utility of the discussion.
    
    
    			'preciate it
    			herb

    >I believe the spelling is Carpal or perhaps Karpal
    
    No, I meant Cubital which is different than Carpal.  Cubital Tunnel
    involves the Ulnar nerve near the elbow and Carpal Tunnel involves
    the Median nerve in the hand and specifically in the carpal tunnel.
    
    >withulnarneuropathy
    should have been - with ulnar neuropathy

    aha!
    
    thnx
    
    				herb

    I had surgery on my right hand in July 89 because of Carpal Tunnel
    Syndrome.  In my case, it started as numbness in my thumb and first two
    fingersof my right hand.  Then it progressed to pain at night which
    kept waking me up.  My doctor put me on naprosyn twice a day for a
    month to rule out arthritis.  He also took X-rays (Carpal Tunnel does
    not show up in an X-ray.  
    
    Next step was see an Orthopedic Surgeon who sent me for tests where
    they stick needles into your arm to test the degree of damage.  Mine
    was definitely a surgery case.  I now have a scar from the center of my
    palm to an inch below my wrist.  I went in as a day patient and was
    home in three hours and the pain was gone from the affected fingers
    immediately.  I was out of work over 5 weeks and it was covered under
    Workman's Comp. (I've been with Dec since 1974 so have been using a
    keyboard for a long time)  I know of someone who had it done by laser
    just last year at a hospital in Lowell and was able to use her hand
    the next day to write.
    
    Six months ago, I started to have pain in the same two fingers again
    and the fingers kept locking up on me.  I had to have a shot of cortizone 
    for tendonitis.  That helped a little bit but not enough so I had to
    have another shot.  It's still not the way it should be.
    
    The most important thing is the position of your hands when you are
    using your keyboard.  Hopefully if you are aware of the right height,
    etc of chair versus keyboard you might be able to avoid going through
    what I did.  Also if you have to have surgery..look into LASER surgery.
    
    
    little bit but not enough so I had to have  

	To those of you who are affected by these symptoms, may I strongly 
	urge you to request the ergonomic study from your nursing service. 
	I have been told that Digital as a corporate body is very 
	concerned about the injuries that result from keyboarding and is 
	pushing the study and resulting solutions.

	The Merrimack nursing service together with facilities adjusted
	all of my working surfaces:  keyboard, desk and chair are all
	lower, only my monitor stayed the same.  I now use wrist rests for
	keyboard and mouse. An ergonomic chair will be ordered as soon as
	we find one low enough (I am 5' 2"). 

	My doctor expects that within several months I will be pain free
	without undergoing medical procedures! 

	Your cost center pays for the equipment:  

		$32	wristrest for LK201 keyboard, #WR021AH
		 17	wristrest for mouse, #WR175
		127	video stand, VT2XX-AA            ----> soon to be
		 18	30" keyboard shelf, VT2XX-AE     ----> one unit
		350	ergonomic chair
		---
	      $ 544	

	What is the cost of doctor's visits, surgery, medications, lost
	time from work, etc.? 

				-- Julie

	P.S.  The photocopy of the New York Times articles includes a
	schematic of proper body mechanics at the keyboard.  (I need your
	mail stop to send a copy.) 

    >I have been told that Digital as a corporate body is very
    >concerned about the injuries that result from keyboarding and is
    >pushing the study and resulting solutions.
    
    Set FLAME On
    
    Yes, they become very concerned AFTER an injury.
    
    About TWO years ago I was told by one of the
    company nurses that there were meetings going on at the corporate
    level and that shortly there would be some sort of announcement.
    The only time they really become interested (in my opinion) is when
    someone walks into their office and complains of an injury.  As I walk
    by offices I see people using keyboards improperly and they are
    likely not even aware of it.  I'll be convinced that they care when
    they make an effort to inform the entire DEC population that there is
    a potential problem.  I submitted something to the DELTA IDEAS folks on
    4-Oct-1990 about RSI stuff and it has bounced from person to person
    and I still don't have what I consider a satisfactory answer.
    
    On 4-Oct-1990	Sent RSI stuff to DELTA
    On 13-Feb-1991      Nothing heard so sent an inquiry
    On 14-Feb-1991	From Delta - Your idea has been tracked to Product
    			safety, who sent it to another group.
    On 7-Mar-1991	Sent another inquiry
    On 20-Mar-1991	Reg NO:  DA2228  has been reforwarded to ENV, HTH& SFTY
    On 4-Jun-1991	Sent another inquiry
    On 5-Aug-1991	Received memo from Aichelmann in MRO which contained
                        a list of stuff they are doing and also said that
    			a corporate-wide awareness and training program is
    			being developed.
    On 20-Aug-1991	I send a memo complaining that they are still not
    			informing the general DEC population and that I
    			would not consider DA2228 closed until they do so.
    On 13-Sep-1991	DELTA tells me that I have been notified that
    			ENV, HTH& SFTY has responded and ask whether I
    			was satisified with the response.
    On 16-Sep-1991	I reply that the answer was unsatisfactory and I
    			want to see a corporate commitment.
    On 28-Feb-1992	I send out another inquiry
    
    In the meantime there have been articles about RSI stuff in magazines
    and newspapers and segments on the news.  Still DEC does not come
    out and say anything to the entire DEC population.  Just last week
    I had a friend from MRO call up and complain to me about an RSI injury.
    The interesting thing was that the DELTA response memo came from MRO
    where they claim to be doing all these wonderful things.
    
    In the mean time corporate meetings are probably still going on and
    they are probably still developing training programs but until they
    get the message out people are still going to be injured.
    
    Yes, I have an injury and yes they have been responsive, but my other
    friends and neighbors are only aware of the problem because I have
    spread the message to them.
    
    Set FLAME Off
    
    Ed
    
    

    Re .10:
    
    That reminds me of another time Digital failed to notify employees
    company-wide.  After Kevin Mitnick broke into a bunch of systems,
    "Network Security" or some such group send out mail to _some_ people
    (_some_ system managers) containing some lame suggestions about
    security.  Not only did they fail to get this information to the people
    who made mistakes that let Mitnick in, but the suggested acts would not
    have stopped Mitnick!
    
    Digital's not very good about fixing broken things or communicating
    with employees.
    
    
    				-- edp
    
    
    P.S.  One of the ways Mitnick got in was to call up a site and complain
    that he was out in the field and had forgotten a password.  Several
    times people gave him a password, and once somebody even spawned a
    process for a terminal line he had connected to by modem!  Digital
    should have sent out mail to EVERY employee saying "Don't give
    passwords or accounts to strangers!", but no such mail ever came
    around.  Mitnick could still get in the same ways he did before.

I agree strongly with Ed's (.-2) note,  I am also amazed by how many people
there are using computers in a setup that increases the risk for developing
RSI. I would like to see the company aggressively communicate to every
employee:
 - that RSI is real and is a rapidly increasing problem in the computer-user
    community
 - what employees can do to minimize their risk of developing RSI
 - what the company will do to support employees in lowering their risk
 - what options exist if you have started developing RSI pain

I have seen many employees who have developed pain keep "working through" the
pain, and thereby increase their injury, either through ignorance, fear of
talking to their management about it, or not knowing their options.

Has this been discussed at all in DTW?  I called them over a year ago and they
said they wouldn't publish anything until the company had studied it.

I have been doing what I can as an individual to spread the information that I
have, but THIS SHOULDN'T HAVE TO BE MY JOB!

						Hans
						

Re: the document I wrote on RSI which is described in .0:

 This document is now at:

    DECSIM::DSU$:[HEILMAN.RSI_PUBLIC]
      RSI_NOTES.PS, or
      RSI_NOTES.TXT

 I can also be reached at DECSIM::HEILMAN