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…

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.

Dog Therapy

Five days to go, then the adventure starts. I’m worried.

It’s another rest day, with only about 4,000 steps. My legs are feeling tired very quickly and there’s a hint of shin splints. I’m worried that this will continue, or that I’ll do something unwise like switch my shoes out, or forget something important, or get sick.

For some reason this is also the week when we have meetings with a lawyer to get our wills settled (a two hour trip to the city), and the week when paperwork for our house sale closing is being mailed back and forth, a physical exam for a new life insurance policy, and the week when youngest daughter is flying here to be with her dad while I’m gone. There is a lot going on. A lot to get ready for.

Yes, right around that ear, and don’t stop.

That is why I took time yesterday to run away to the empty sun porch over at my brother’s house. It was a time to just sit, do some journaling and thinking. It was a time for “dog therapy”. Scruffy came and sat on my lap.

Scruffy and I have gradually gotten used to each other over the last few months. I sometimes take him for a walk, and I’m usually along when his mom and dad take him for a walk. I always pet him and try to make him feel special. He didn’t always come up and want to sit on my lap, but we seem to have bonded now.  I pet him, and since he can’t really pet me back (but I think he would if he could) he licks my hand. I think that’s dog language for “pet me more”.

Scruffy and I have things in common. For one, we have hair the same color. We both love to go for walks and are easily distracted when we are outside. We’re both a bit aged. I could think of more, but that will do. All this to say that when we sit somewhere together and just chill, it is relaxing, for both of us, but especially for me. I think I worry about more things than Scruffy does. Dog therapy is quite effective since I take my cues from him and don’t worry about anything except whether my lap is comfortable for him to lay on. He is most definitely a lap dog.

Cricket, Ellie? Hope you’re having a good dog day!

Scruffy says hi to Cricket and Ellie and wants them to know he enjoys their astute comments. Dogs really have it together. Just sayin’…

Hands Speaking

My hands are telling me things lately. They are tired of being cut, scraped, banged up, painted, scrubbed… Most of all they are tired of hurting. The stiff and swollen joints still have to pull, pry, twist and grip in order to survive. My hands talk about pain and its very real presence. 

“Pain is like an angry neighbor. He is not moving away anytime soon. He is constantly looking over the fence and his stare, his piercing eyes, can be felt following our every move. Sometimes he scowls, sometimes he kicks the fence, sometimes he gets really confrontational and yells at us. Often he goes back in the house, angry, pouting and sits, but even then we can feel him looking out his window at us, wishing us ill.”

“But he is a neighbor and it’s better to get along than not.  we’ve gotten used to him. We know his name, his whereabouts, his nature, and generally how to pacify him.  We think we prefer him to others who are nastier, and more deadly. He is OUR pain, like him or not.”

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Health Advocate: Regenexx Procedure

Being your own health advocate means searching and researching. I’m following this new trail hoping to keep my hands functional for a few more years. 

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Needles, pain. I was all prepared for it. July 11, 2017 I was scheduled for my Regennex procedure on my thumb joint, left hand. I felt a little like a guinea pig, but this whole area of the body healing itself really appeals to me. As I said, I was all prepared for an afternoon in the recliner, watching NCIS reruns through a narcotic induced aura.

I arrived ahead of time and did a few inches of knitting in the waiting room, followed by a few inches of knitting in the procedure room. Next, I was ushered out of the procedure room and did another inch or two in another room while an emergency fluoroscopy on someone else happened. Then I was taken back to the procedure room and “laid out” next to a tray of needles and syringes. I laid there listening to the sound track to “Sense and Sensibility” for close to an hour. I practiced my deep, slow breathing which I supposed would keep me calm.

And then in they came, two nurses and the doctor. I told them I was driving myself home, didn’t want a nerve block, and to go ahead and hurt me. When asked, Dr. L said he frequently did thumbs, so I relaxed and let them position my hand and start injecting. He was very good with the local anesthetic. Those tiny needle pricks were really the only “hurts” I felt. The rest of the injections were more about pressure as the platelet infused plasma filled the joint spaces. And then it was done.

I drove myself home. The local anesthetic wore off and it still hasn’t started hurting. I think I’m in the clear. Now to wait and see if healing takes place. The only thing that bothers me is that it was supposed to hurt… and what if “no pain” means “no gain”?  Just sayin’.

Being My Own Health Advocate: Stem Cell and Platelet Therapy

Whatever your hand finds to do, do it with all of your might… Ecc. 9:10

That’s been my mode of operation for physical activity pretty much all my life. As a result, I have hands that are wearing out a little faster than the rest of me. I didn’t realize how serious a matter this was until recently when both of my hands were too painful to use for much regular activity. Count the number of joints in your hands and fingers and that’s how many sources of pain you can have if those joints are inflamed or worn. We use our hands for nearly everything we do and yet hardly ever give them a thought, until they hurt. Even something simple like holding a book and turning the pages can be too painful to bother.

I am aware that I must be my own health advocate, and I’m trying to encourage others to do the same. I’ve been researching what’s new in treatment of joint pain. Since I view surgery as a last resort, and never without its own bad consequences, the new information on stem cell therapy caught my attention. I’m convinced it’s worth a shot and I want to share the information with any readers who struggle with any level of arthritis or joint damage.

I’m scheduled to begin therapy next week, and I’ll be recording what happens as the days unfold. It’s not an immediate process since it involves healing over time. Here’s the basic outline of stem cell therapy, as I understand it without getting too technical.

We all have stem cells, lots of them when we are born and fewer as we age. They are produced in bone marrow and that’s where most of them are concentrated. Adult stem cells are the template from which other more specialized cells are made. The body signals when and where stem cells are needed to regenerate and heal damage. It’s pretty simple and it’s part of the awesome way we were designed.

These are not stem cells from human embryos, and no babies will be harmed in the publishing of this post. Much controversy has been raised over the use of embryonic stem cells, and rightly so. But, as I said, we all have our own stem cells and don’t need to use anyone else’s.

I happen to live in an area where there is a stem cell therapy practitioner. I had an initial appointment where my hands were tested and viewed with ultrasound. I am a candidate – both of my thumb joints are lacking the lining that makes things move smoothly. I have chosen the first level of treatment, mostly because it’s the one I can afford right now. Because this therapy is new, my insurance does not cover it. Technically, it’s better to call it PRP or Platelet Rich Plasma therapy.

I will go on Monday to have blood drawn, and they will extract my platelets from the blood. On Tuesday those platelets will be injected into the joint, guided by ultrasound for accuracy. Platelets in large numbers signal stem cells to get on the job. Hopefully I have enough of them to respond and make a difference. Meanwhile the doctor has recommended a new brace for me. I have had it for several weeks and it has made a lot of difference – the best one I’ve ever tried and I recommend it highly.  It is small enough to allow full use of my hand, doesn’t have to be removed when I’m doing wet things, and can be washed easily.

After treatment I will be sore for the rest of the week but that will wear off. The hoped for results are that the joint will be strengthened, and possibly some of the lining will be restored. I do want to tell about the other two levels of treatment too, but not today. Check in again for tomorrow’s post. It’s fascinating stuff.  More information at this link Regenexx.