Tag: CMC arthroplasty

Hand Surgery – 3 Months and Counting

Shirleyjdietz6 Comments

January 12, 2020 (Don’t you love typing that year? So easy.)

It has been, literally, months since I had CMC arthroplasty (basal thumb joint surgery) and I want to update the world of arthritis victims on my progress. This is such a common surgery, and any of you with pain in that thumb joint will consider it at some point. Maybe this will be useful for you.

Last week I had what will probably be my last follow up visit with the surgeon. It will be three months since surgery. If I had to say one thing that stands out in this experience, it’s this – I never expected it to take this long to heal. Outwardly, there is no problem. Inwardly, in the wrist where all those little bones and tendons have to get around and through each other, there is still swelling, stiffness, weakness and pain with some movements. But, I am told this is normal and it will continue to heal and get better in the next three months. Tendons take a long time to heal.

I have been bad. When the cast came off, and the removable splint was put on, I removed it whenever it bothered me. It bothered me a lot. When it came time for therapy to start, and I told them what I was doing, I was warned that doing things too soon could give some bad results. I did better after that and wore the splint most of the time. It got dirty. It got smelly. It made the nerves on the inside of my wrist burn and I would wake at night with shooting pains going up my arm for no reason I could determine.

My hands are really not this colorful. It’s the camera.

I’m now weaning off the splint. The therapist I saw this week knows my history of poor compliance. She kind of moved quickly through the “very light” and “light” activities (see sheet in picture) because I had already been doing those things and more. Although I’ve probably caused myself more pain by moving too fast, the doctor didn’t think I had displaced any of her work – my hand looked right from the outside and that was comforting. I fully expect the next few months to bring complete recovery of my thumb. I wish I could say the same for the other joints on both hands.

For those problems I am going to try something called palmitoylethanolamide, let’s just call it PEA. It’s a medicinal food, so I don’t need a prescription for it. It is getting a reputation for helping chronic pain from many sources, osteoarthritis among them. The research is compelling. You can read about it by clicking here. There are several sources but one that is known to be reputable, sourced in Europe, is peaCure. I have some coming from Amazon and will certainly be spreading the news if it is helpful. Thanks to Esther in Seattle for the alert on this product.

I don’t think I’ll be getting new hands this side of the grave so I’m planning on taking better care of the ones I have, in any way I can. (Bought a RoboTwist for lids – it works!) Just sayin’…

Give Me a Hand, continued

Shirleyjdietz3 Comments

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

Shirleyjdietz13 Comments

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…

Shirleyjdietz2 Comments

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

Shirleyjdietz8 Comments

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.