Hand Fashion

Hand Fashion

Removable, with wiggle room, and white which goes with everything.
I had a green one just like this but it didn’t last long.
The ugliest of all, but very utilitarian.

I don’t blame anyone for not being interested in the various splints and casts that can be worn connected with CMC arthroplasty – medical speak for fixing an arthritic thumb joint (although I KNOW some who aren’t interested now will be in the future… just you wait.) I mean to finish this expose for those of you who are interested.

I am now in my second month of recovery after this major reconstruction of my hand. The doctor was fairly accurate in saying I would hate her for the first month. It’s been painful, awkward, inconvenient, and at times depressing. I’ve gotten a whole different way of viewing those with this kind of handicap.

Last Thursday the second of the hard casts was removed. The pin, the one that I was sure was causing most of my pain, was removed. It had worked its way out nearly an inch farther and was lying flat under the cast. At least that made it easy to remove. I didn’t take my phone/camera with me for this procedure. I was glad not to have it when I saw what skin looks like after a month of being wrapped up with no air and no washing. Gross.

I then got fitted for a new splint. It’s plastic that softens in warm water and was molded to the inside of my thumb, wrist and arm. Thankfully, it can be removed by simply undoing Velcro strapping. It is less bulky than the casts. I can wear my long sleeved shirts and my coats again which is great because it’s gotten to be winter up here.

I wish I could say that the pain was gone. It’s not, but the pain pills are. Ice bags have become my best friend. It seems that cold not only reduces swelling, it causes a distracting pain of its own which is much more tolerable than the pain it is covering up. The scar is especially sensitive with a burning pain that I attribute to nerves that are trying to heal. We’ll give them one more month…

I get to start occupational therapy tomorrow, at the crack of dawn. By 7:30 I will be doing thumb exercises which I’m sure will be quite strenuous. The whole imperative of not using the hand to do any lifting or thumb to finger pinching is hard for me to follow. Now that I don’t have to worry about getting a cast wet, and my fingers are more free, I find myself breaking rules all the time. I’m even typing with both hands now, in spite of it being a little uncomfortable.

I go back for another check-up December 19th. I am glad that the worst of this is over, although I’m warned that the second month is still not a “picnic”.

Give Me a Hand, cont… Distractions

November 1, 2, and 3, 2019

Life was going on smoothly with my new, blue cast, for a few days at least. We had a good, but short visit from the North Carolina daughter and another surprise visit from a distant cousin. Events like this are good distractions and I am easily distracted when pain is chronic and below a certain level. And then came Friday, with a totally new distraction.

I had an early morning appointment with the ophthalmologist (tempted to just write eye doctor) and was surprised to see the husband up and reporting to me that his leg had bothered him during the night. He thought it was swollen and felt different. I often don’t agree with his assessments, but I always check to make sure. It did look a little swollen and was slightly warmer. I sent a quick email to our doctor and she recommended we come to the clinic and see what was up. So we were there by 11:30, the husband being examined by a PA.

There was the possibility of a blood clot, a DVT, short for deep vein thrombosis. She ordered an ultrasound of his left leg and we set off down the hall to radiology. Halfway there, Dennis could not go any further. He was leaning against the wall and holding on to the handrail, looking scary. I ran for a wheelchair and helped him sit. He was weak and sweaty. At radiology he was feeling better so the ultrasound was done. I watched the screen as the tech worked and although I find it hard to know what I’m seeing, it was evident that something wasn’t right.

From there we were ordered directly to the ER and met with a whole squad of RN’s. They hooked him up to EKG, put in an IV and started monitoring his vital signs. It didn’t help that his blood pressure was 200/104. The ER doc sent him for a CT scan of the lungs and it showed multiple clots in both lungs – significant was the word they used, as opposed to massive. He was started on anticoagulants and admitted to the hospital. That’s where he spent the next two days until his blood pressure stabilized and his blood thinners had reduced the risk of additional clots.

I don’t remember thinking much about my hand the whole time this was going on. That is not to say that I’m recommending medical emergencies as therapy for chronic pain.

Give Me a Hand, continued

10-24-2019

Ten days after surgery I went back to have the splint exchanged for a fiberglass cast – the next step. The cast tech told me the thing I thought was a suture was actually a metal pin, holding bone and ligament in the right places and coming out of the skin in the shape of an L. Normally they stick out above the skin but my pin had migrated, moved, and was embedded in my flesh. A felt pad meant to keep that from happening had slipped out of place. He didn’t seem alarmed and said that it wasn’t uncommon and was probably due to my being more active. I got another 30 seconds of doctor time and then the head of the pin was pulled out slightly, cushioned with felt again and the cast was applied.

Hmm… there was a piece of metal in that hole.

This cast was less bulky and easier to live with than the splint. But a few days later I was still feeling that burning pain almost constantly.

10-29-2019

I decided to send the doctor a note about the unsatisfactory pain level and it was agreed that I should have the cast checked. It happened that I was going up to the medical complex anyway, for Mom’s dermatology appointment so they agreed to fit me in. Most of our specialists work in a city about 90 miles away so logistics are always in play.

The same tech who put the cast on greeted me with “So, what’s wrong with the cast?”, in a somewhat defensive manner. I told him it was the pin I was feeling mad at, not his cast. And sure enough, when the pretty Packer green cast was sawed off we saw that the pin had rotated again and was making another dent in my skin. The doctor didn’t look at it this time – just told him to put it back in position and wrap it up again. He labored over finding a way to keep the pin out of the sore spot. Vaseline gauze, felt padding and layers of cotton batting went on, covered by the last layer of fiberglass – denim blue this time, which I like better (no offense to the home team). I went home hopeful, but worried because it still hurt from having the pin moved. I was beginning to wonder about the wisdom of putting a pin under a tight cast that will always be putting pressure on it. Does that sound like a recipe for pain?

Such a pretty blue – goes with so many of my outfits.

To be continued…

Give Me a Hand

I realize that I completely dropped the ball (and the story) after the big build up about my surgery. The truth is I haven’t felt much like writing since then. Everything in life has become a one handed task, which makes typing pretty slow. But, it’s now time to complete the record. I just wish someone would give me another functioning hand…

For the record: (typed with one hand)

On the 14th of October, after weeks of anticipation, I had surgery on my left hand to relieve arthritic pain in the thumb joint. The hospital experience was very good, almost amazing. The only thing missing, in retrospect, was a detailed explanation of the process from the doctor. She came in to put a mark on my hand and was out again in less than 30 seconds.

I left several hours later with the hand wrapped in a bulky splint and totally numb due to a nerve block. The block took care of the pain for nearly 24 hours and then I began taking the prescribed pain med.

That first week I had far less pain than I had expected. It was similar to the way my thumb felt before the surgery. I even began using that hand for simple stabilizing tasks, even though the splint made it impossible to hold things. I remember one time when I was trying to get comfortable in my recliner and used both hands to push myself back. There was a significant jolt of pain that took several minutes of recovery time. After that I gradually became more aware of an annoying burning sensation under the many layers of cotton padding and elastic bandage.

I finally got curious enough to look underneath it all. It was uncomfortable to the degree that I thought a re-wrap might help. The incision appeared to be healing well but there was a single spot of inflammation farther up the thumb that looked like it had a very thick suture drawing it in. “What on earth is that?”, thought I. That is definitely the place that hurts.

Sorry if you find this too graphic. I’m a nurse so I’m immune.

To be continued…

Countdown, Three Days Left…

Today I was thinking of all the things I might not feel like doing for a week, or more (lots more) after the surgery.

There was the furniture moving, for instance. There were some heirloom pieces stored in the barn that I wanted in the house. They were things I’ve wanted to look at and enjoy for a long time – but it was unreasonable to get them to Florida. But now, I’m right here where they are so it was time.

One is a dresser that was in my grandmother’s bedroom for her whole life, I think. The other is her cook stove, a woodburning Monarch that weighs a ton even though it looks small. Years in the barn meant they were dirty. The cook stove even had ashes in the ash box from the last fire – I can only imagine when that was. Doing this kind of cleaning and handling of heavy things is probably why my hands hurt tonight and probably why they are in such bad shape overall. But isn’t work what hands are for? In my world, yes.

I did laundry. I shopped for groceries for next week. I talked on the phone to the pre-op nurse who asked me a lot of questions she already knew the answers to and told me to be at the hospital by 7 am on Monday. The surgery is at 9. I hope that means there aren’t too many people ahead of me, and that I will get home before the day gets late.

I’ve read a couple different accounts of how restricted I will be after the surgery. The video even showed how my hand will be wrapped up and cast. My doctor indicated that I will be in a splint of some kind until my first post-op appointment, when a hard cast will be put on. That will stay on for the next three or four weeks and then I will get a softer, removable cast for another month. My thumb will be immobilized but I think the rest of my fingers will be free to wiggle.

Initially the pain will be eased by the nerve block given during surgery. It must last a day or so, after which I will be switched to oral meds. So no driving while on pain medication. I will be dependent on my daughter to cart me around, if I feel like going anywhere.

One video I watched said that driving would be permitted as soon as I could grip the steering wheel with both hands. My doctor didn’t say differently, but she added that if there were to be an accident, my insurance might not cover it. I would be considered an “impaired” driver because of the cast. I’m thinking I will be less impaired than many others on the road – not going to worry about that.

Three days…

Yes, It Hurts

10-09-2019

A good part of my life has revolved around music and playing the piano. For a few years I even taught beginning piano students and had a studio in my home. A friend and I were pianists for our church as well. Many times she would say “You play today. I can’t do it very well when it hurts this much.” I was in early stages of arthritis in my fingers as well, but I couldn’t imagine how the hurt could be bad enough to keep me from playing. Playing piano didn’t hurt at all, really.

Now, I get it. The last couple of months have been the worst ever. I’ve had flares at times when one or two joints would swell with inflammation and be tender, but lately it’s more than that. My left thumb is the upcoming surgery site, but the right hand is equally painful in the fingers, not the thumb. One finger is swollen so much that I had to go to a jeweler and have the ring cut off of it. Almost everything I do with my hands has some degree of pain associated with it.

I’ve read that the 50% of the hand’s work is done by the thumb. My left hand knows that very well because it’s pretty much useless for holding on to anything that requires thumb opposition. But fingers are so important too. Unfortunately, I don’t think there are good surgical fixes for finger joints. Right now it hurts to:

⁃ manipulate, or lift pots and pans in the kitchen. They are heavy and have to be grasped.

⁃ Fold laundry, especially little movements like turning socks right side out.

⁃ Put on socks and shoes, especially pulling ties tight or pulling zippers on boots

⁃ Hold small objects tightly, goodbye any kind of handwork

⁃ Type, even on sensitive keyboards like my iPad

⁃ Pull the sheets and blankets when making my bed

⁃ Open lids of jars, milk and juice cartons. Most any kind of packaging is not my friend.

Most of the time I plow through these activities anyway because the pain of movement is short lived. But I have progressed into a different stage now where pain occurs out of nowhere, without movement. It is more constant and has a “burning” nature. All of this just emphasizes to me how important hands are to life.

I’m sure having my left thumb fixed will eventually make things better. My doctor said that I will hate her for the first post-op month, dislike her for the second month, and thank her after the third. Reports also say that this surgery is long lasting with good function up to twenty years later. So the countdown continues, five more days.

Countdown to Monday 10-14-2019

It’s evening and I’ve just finished watching a video of a surgery that I’m going to have next Monday. If you faint at the sight of cutting and bleeding, don’t click this link Basilar Thumb Joint Arthroplasty with LRTI, but know that it is a good surgery with a high success rate. It’s also probably the most common surgery done worldwide. It is called CMC arthroplasty and ligament reconstruction. Simply put, if all goes well, they are fixing my painful thumb joint.

I’ve encountered a number of people who have arthritis in the basal thumb joint so I know it is common, especially among women. I want to do a few posts on this experience, mostly to inform, but also to work out the pain of the recovery period. Writing is helpful to me when I’m in pain or stressed because it ascribes purpose to what I’m going through. I hadn’t heard of or considered this surgery until a couple of months ago and there might be others, in the same situation, who will find my account helpful.

It’s not known why some people get this problem and others don’t. My thumb pain started several years ago. I have treated it with NSAIDs, with cortisone injection, and with platelet rich plasma (PRP) injections (a precursor in the stem cell therapy family). Of all these, the thing that has been most helpful is the thumb brace recommended by the PRP therapist.

A large part of my problem has been the loosening of ligaments that normally stabilize the thumb. Loose ligaments have allowed more movement and that causes more pain. The Push thumb brace holds my thumb firmly in place and keeps that joint stable – it’s been protecting me from the most unbearable pain for two years now. I have recommended it to others and they have also loved it.

Unfortunately, the pain is now more constant and not only the result of movement. It is time for a more permanent fix. The surgery is outpatient, but it will be with general anesthesia. I’m not allowed to drive myself home so my youngest daughter has generously arranged to come and help with the day of surgery and the first week. I’m hoping the fun of her visit will greatly distract me from what my poor hand will be feeling.

Check back tomorrow and I’ll describe what medical science has come up with in this remarkably successful procedure.

Day of the Jaeckel

It’s been years since I walked for a cause – the three day, 60 miles breast cancer walk. Today I joined my brother and his wife and a couple hundred other people from our small community to walk a 5k for ALS.

John Jaekel is a Haywardite, former coach and educator at the high school, and friend and neighbor to most everyone he meets. He is also one of the longest survivors of ALS and a spokesperson for the cause all around the state of Wisconsin. The walk was started by his family and other supporters around four years ago and has become a regular event in Hayward.

We met at the Lutheran Church in town where John is a member, and went inside to look at the silent auction items. There is no fee to join the walk, so the auction is the fund raising portion of the morning. There is an online auction as well as the one we saw, and many Hayward businesses and individuals were represented there. I bid on a small piece of furniture. Lumber from the lumber company, 2 months membership at the local gym, hair cuts and beauty supplies, art and specialty food items, and tickets to Packer games(!!!) as well as other creative and tempting offerings were up for bid.

The walk was leisurely, led by John Jaekel himself in his motorized chair. There were parents with small children in wagons and strollers, elderly people being pushed in wheelchairs, and all ages in between. The weather was cooperative, actually could not have been more perfect. I’m not kidding, there were cheerleaders and encouraging signs along the route.

One family walking close to me came from a city 80 miles away to join the walk. They had lost a brother to ALS the year before and knew John through the support network they had been in together. I didn’t get to talk to John but it was clear that he was a beloved member of the community and had been successful in stirring people to action. One of the signs along the route pointed out that the purpose of the walk was to make sure that someday there wouldn’t have to be any walks. Research toward a cure is the goal.

At the end of the walk, volunteers at the church had breakfast ready for all the walkers. Someone had upped the ante on my table bid, so I pushed it up a little higher. I didn’t get it but it went for a better price and that was good.

This was a day to walk and talk with others, over a common interest – that of helping people like John Jaekel and others who are battling als. I admire his enthusiasm and dedication, and wish him well. I thank him for bringing our community together around a good cause.

Running Out Ahead

The husband keeps repenting of “running out ahead” of God. He is a problem solver and problems drive him crazy – it always seems to him that because he is aware of the problem, it is his to solve. He is not comfortable waiting for God. It’s usually in retrospect that he realizes his “running ahead”.

I am not saying that I condone inaction, waiting on everything because one is too lazy to address issues. That drives me crazy. When a problem is there to be solved, I am willing to pray about it and do whatever comes to mind in a reasonable fashion. Do something, do one thing and see what happens next…

Lately, almost daily, new problems are coming up on Dennis’s radar. He thinks about them obsessively. When there isn’t an actual problem, he thinks of a possible problem. He comes to me three or four times in the space of an hour, with more to say about the developing structure of the problem. It grows, takes shape in his mind and is often described as a dangerous situation, not just to him but to others as well. He must figure out what to do and intervene. He must convince others that action is required because he is not physically capable of doing what is needed by himself. What a dilemma. His world has a lot of anxiety in it.

The basement where his stuff is stored is likely going to flood because there are springs on the property.

The coming trip back home is dreaded because something in the truck is messing with his eyesight and making him sleepy. His wife will fall asleep and there will be an accident.

He hasn’t heard that the AC in his daughter’s house has been serviced in the two years she’s lived here. Danger, danger…

He might run out of vitamins, or pineapple on the trip home and his whole health regimen will go down the tubes.

There must be a reason he’s had the word “Fabian” given (by God) to him to investigate. Who is Fabian Farrington and how can he discover why he needs to know?

How can he keep from being further brain damaged while his wife is using the hotspot to access the internet?

How can he convince the code officials of the need to reverse their thinking about grounding rods in duplexes? People’s lives are at stake.

Who wouldn’t be anxious? It seems to me that the challenge is to be aware of possible problems AND aware that someone more capable than one’s self is working out the solution. Trust someone else. Trust God. Learn to wait without stressing out. Like the sign I saw yesterday in the barn I was in – ” Remember stressed, spelled backward, is dessert”. Yes it is, just sayin’…

Search me, O God, and know my heart; test me and know my anxious thoughts. Psalm 139:23

Birthday to Remember

April 8th, My Birthday 2019

Do you remember any of your birthdays? How you celebrated? A special gift you received? Someone who surprised you with a visit or a greeting of some kind?

I try to have something memorable happen on my birthday most every year, and I’m willing to come up with it and do it alone if no one is available.  This year I didn’t have to do it alone. My mom and I did something together. We got sick.

Food poisoning, but we can’t figure out what it was for sure. I spent the day barely able to move without passing out.  In spite of being very dehydrated, neither of us wanted to risk putting food or drink into our unstable stomachs.  I spent the day crawling from the bed to the recliner and back again. I cancelled the one appointment for the day – the gym – since there was no energy available for training.  In short, it was not the memorable event I had in mind.  I get a rain check, right?

Today is better. We are both on our feet a little more, but still glad not to have a lot to do today. It is amazing how dependent we are on vital elements, like water. Take away ten pounds of water weight, and I’m barely able to function.  It definitely reminds me of my episode of dehydration on the Appalachian Trail and the recent D post I wrote on dehydration. 

It all makes me think of how we are designed, with enough flexibility to cover the usual ups and downs of life. Most of the time we don’t have to think about how much we’ve eaten or not eaten, or whether we’ve had enough to drink. Food and beverage are available to us on a pretty regular basis, leaving us free to worry about lesser things.

But there are places in this world where it is not so.  What must it feel like to live in a body that is little more than skin and bones, where there is no food or water to be had?  It happens in our own country, where being homeless or in poverty can make it so difficult to be fed with something nutritious.  I was overcome with weakness, loss of motivation, pain and the need to rest somewhere safe.  I can’t imagine being out on the street in a city, or out in a desert village in Africa and trying to survive under those conditions.

I am grateful that I was at home yesterday, recovering slowly as I watched birthday greetings come in on Facebook. I got a delivery of flowers, several cards and a book I had ordered in the mail, a visit from my brother and his kind delivery of some Pedialyte.  I have reasons to remember this birthday, just sayin’…