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.

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.