On the Alacrity mitts, I knit myself into a spot a didn't expect. I cast-on. I worked in the round. I introduced the thumb gusset using a bridge. I decreased away most of the thumb gusset. And then I got to the bottom of the gusset and realized I needed to work a reversible 5 into 1 decrease to keep everything in pattern. Yes, this is a reversible centered quadruple decrease. Park the five knits on one needle and the five purls on another needle. Use a crochet hook to enter the obverse stitches in order 3-2-4-1-5. Yes, you will need to park stitch #1 and remove stitches from the needle as you work. Using the hook, pull a stitch up through the whole stack. Place the stitch on the right needle. Turn the work. Repeat on the reverse. Turn the work back. Not fast, but it can be done.
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