Friday, September 28, 2007

A Funny Thing Happened On The Way To The Forearm

Like many mouse potatoes, medical transcriptionists are not always driven to exercise. Because their work requires them to be sedentary for prolonged periods of time while focusing their attention on computer monitors, many develop the kinds of aches and pains which can have a severe impact on their productivity. Such ailments come from repetitive stress injuries -- things we assume are supposed to happen to everyone else. But certainly not to us (after all, we’re only typing).

None of the printed material you read about ergonomics in the workplace will have deep meaning for you until you have suffered enough pain and discomfort to know that you can’t continue to work the way you used to. I say this from experience.

About 20 years ago, when I was new to the concept of working on a productivity basis, I injured myself in a very stupid way. At the time I was transcribing for court reporters who frequently needed a fast turnaround on depositions for cases that were going to trial. Faced with some tight deadlines, I kept working long hours without taking any breaks. I had a less-than-ideal secretarial chair and, as I strained to keep working late into the night to stay on top of deadlines, the muscles in my neck and back kept getting tighter and tighter.

Until that fateful morning when I awoke in so much pain that I couldn’t hold my head up, the closest thing I had ever known to an exercise program consisted of “calzone curls” (lifting Italian food from the plate to my mouth) or waddling over to Mrs. Fields for a high-calorie reward. But that morning, getting out of bed was an exercise in strategic planning. Standing under a hot shower only offered temporary relief. A friend graciously referred me to a chiropractor whose adjustments helped get my back into alignment. He also made me understand that my head weighs as much as a bowling ball and that, without proper support from my neck and shoulders, my earnings were headed for the gutter.

I was younger then, more resilient, and able to make a slow and steady recovery. Thankfully, I was not stupid. Even though I have always been loathe to exercise, I learned that simple things -- like getting up and stretching -- can alleviate tension in the body. Bizarre head-rolling exercises that can make you look really stupid can also reduce the stress accumulating in your neck. Perhaps the hardest lesson to learn was to walk away from my work station and do something which, in the short run, might seem to ruin my productivity but -- in the long run -- might save me from great pain.

This is a very hard lesson for transcriptionists to learn, especially when they are under constant pressure to increase their productivity. Or have been socialized to put the hospital’s, doctor’s or employer’s needs above all else.

About a year ago, someone complained to me about a hospital administrator who had unilaterally decided that medical transcriptionists could and should be expected to increase their productivity by 15% every six months!

Corporate bean counters who have never transcribed do not understand the burning pain that can build up between one’s shoulder blades after 30 minutes of listening to an ESL doctor butcher the English language. They do not know how our work’s intense concentration and ongoing frustrations can affect body language. They do not know how much pain you can experience when your back muscles lock up. They do not know what it’s like to visit a chiropractor or massage therapist (whose services are not cheap) and leave the session still hurting. Nor do they know what it’s like to have to stop working because the muscle relaxant you’ve swallowed has made you too woozy to transcribe. Instead, they think that medical transcriptionists -- like Greyhound bus drivers -- should be able to sit in their chairs without taking a break for three hours of nonstop work.

Survival of the fittest is an important factor for all information workers who, like MTs, are paid on a productivity basis. While knowledge and experience are valuable, there will always be someone younger and peppier who is all too eager to prove himself. How does one transition from being a sprinting newbie into a seasoned, cross-country medical transcriptionist? By taking care of one’s body.

In the 15 years that I spent as a frequent flyer, I did mind-numbing laps around more airport lounges than you ever want to imagine. The important thing to remember is that anything you can do which will keep oxygen going through your body and brain will help to keep you alert and make you more productive.

I’m no fitness expert. And given the slightest opportunity, I have a severe tendency toward sloth. But I’ve learned how to include a certain amount of motion in my computer routine to lessen the amount of daily neck and back strain. When a friend recently opened up a yoga studio, I went there for some introductory sessions. I won’t hesitate to tell you that hanging upside down in an “inversion” exercise did more to loosen my back and neck muscles than any combination of chiropractors and massage therapists ever accomplished.

Here are some simple suggestions for things you can do to keep your body loose and flexible in the workplace:

  • Start by examining how you sleep. If you experience problems with a stiff neck or muscle spasms in your back and shoulders, I heartily recommend the use of a buckwheat or soba pillow. These can be found in most drugstores for about $20 and are worth their weight in gold. I was first introduced to these pillows during a massage and instantly noticed a difference in support for my neck. I’m getting a better night’s sleep as a result of using this type of pillow.

  • Look at your office telephone and decide whether you want it to be your friend or your foe. If you treat the phone as a friend, you will learn to get up out of your chair and move around whenever you have to talk on the phone (a headset is highly recommended). If you keep the phone crooked between your ear and neck while trying to work on the computer (or look through a bunch of files), the phone will become one of your worst enemies.

  • Examine the frame around the door to your office. Get to know it intimately. Stand in the doorway with your palms facing forward against the door frame and slowly lean forward as far as you can go. This is a very safe and vertical variation on doing a pushup which will help to stretch your back muscles. You don’t have to be physically fit to do it and you don’t have to get your clothes dirty. Just lean forward and feel the stretch.

  • While sitting at your desk, use your hands to grip the sides of your chair seat. Then quietly lift your legs straight out in front of you underneath the desk and slowly work them like a pair of scissors, moving them together and apart while keeping them parallel to the floor. You’ll feel a stretching sensation in your thighs that will only make you want to move some more.

  • Think of that old folk song: “Gotta jump down, spin around and pick a bale of cotton, gotta jump down, spin around and pick a bale of hay!” Get some movement into your work pattern.

  • Keep a dish towel in your deskdrawer. Whenever you can, take a two-minute stretch break and do the following exercise. While seated, grasp the dish towel with your two hands behind your back. With your arms held straight, slowly raise your arms as far up behind you as possible. You will feel the stretch this provokes in your upper back and arms and welcome the sensation each time you perform this exercise.

  • Keep a broomstick in your office. This should not be used to suggest an alternate mode of transportation for your supervisor. Instead, when you have a spare moment (and preferably if no one is looking) place the broomstick on your shoulders and use it to help you do trunk twists and lateral stretches.

While consultants will occasionally check the ergonomic settings of your work space, they are not responsible for making sure that your body remains limber and flexible. Only you can do that. And if you make an effort to include a little exercise in your work routine, you might even become a happier person.

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