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finger/thumb Carpometacarpal (CMC) Joint Treatment?

Discussion in 'Other Joints Forum' started by Coppernob, Nov 15, 2014.

  1. SuperSnapper

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    HI @Coppernob Are you still waiting for a call for your surgery? Just wondered how things are going for you?

    Mary x
     
  2. Coppernob

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    Still waiting. Latest from surgeon's secretary is mid June so we shall see. Thanks for asking. How are you? Linda x
     
  3. skigirl

    skigirl SUPER MODERATOR Moderator

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    I have been looking at CMC surgery alot. So, in the US, the most comon surgery is to remove the trapazoid bone and then take a ligament from the wrist, roll that up and stick that in place of the bone. It is painful because you have an incision in your hand and in your wrist.

    There is a newer surgery, with an arthroscope to just remove a portion of the trapazoid bone---the part that is arthritic. I am hoping for this surgery---will see a surgeon next week.

    The final surgery is the joint replacement, which does not have a good track record---too many failures. the doc told me that since I am an artist and use my hands constantly, no one would do a joint replacement on me. He said that they are mostly done on older people who use their hands for eating and turning on the TV.

    I cannot do anything until after August since I have art fairs all summer, so I am not concerned by the wait. There is only one hand surgeon here, so I will see her on WEd.
     
  4. SuperSnapper

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    @Coppernob. I'm fine thanks. Sorry to hear that you are still waiting to get your op. I was thinking you might have had a cancellation. It's horrible waitin.

    My joints are going through a quiet period at the mo. It's funny how they do that, isn't it! I've had a few issues with IBS but much better now.

    I know my knee, thumb, hand ,shoulder or some other arthritic part of me will cause me grief again soon but I'm going with positive thinking at the moment
     
  5. Coppernob

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    I heard today that my surgery is going to be on Tues 13 June, so not too long to wait now. I have to go in at 12.30 for afternoon surgery and home the same day. Linda x
     
  6. SuperSnapper

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    @Coppernob

    Hi Linda,

    I'm pleased to hear that you now have a date and can get on with getting better. I spoke too soon! My other knee is now playing up with locking and pain - bummers! I know I'll have to sort it out.

    Hope all goes really well on the 13th. I'll keep checking back to see how you are doing.

    Mary x
     
  7. Coppernob

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    Thanks Mary. X
     
  8. skigirl

    skigirl SUPER MODERATOR Moderator

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    The new hand surgeon in town, who is a very attractive woman---will only do the old surgery with taking a ligament from your wrist and rolling it up to replace the bone. I just cannot do that---too long a recovery, so I have a new brace called a Push brace and will wear it. She told me I could go years with the brace, so that is my path right now.
     
  9. Coppernob

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    Yesterday I finally had the ligament reconstruction surgery on my left thumb. It was a very strange experience being wide awake for it all, but the thing I found the most uncomfortable was the nerve block in my arm prior to the surgery. Once that kicked in I could feel nothing other than some pushing and pulling. The surgery itself took an hour, after which I was given some tea and toast and then allowed home, so I was only at the hospital for three and a half hours altogether.

    I'm now in a temporary plaster-cast and huge blue foam sling for two weeks; I will then have a lighter cast on for four more weeks. Once the nerve block wore off yesterday evening, the pain gradually increased, and today it is painful but regular painkillers are keeping it reasonably under control. Getting comfortable and sleeping wasn't easy last night so I'm feeling pretty filleted today, but I'm sure each day will be a bit easier from now on. If, eventually, I'm pain free again, with a stronger, more normal looking thumb, then the current discomfort will have been worth it. Linda x
     
  10. SuperSnapper

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    Hi Linda, glad to hear your operation is over and you are recovering. I'm guessing the next few weeks will be a trial of your patience but fingers crossed (not yours!) for a great recovery and a more stable and useful joint.
    Let's hope also the pain reduces quickly and you get some sleep tonight.
    Mary x
     
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  11. kayak59

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    Hi @Coppernob I had the same surgery yesterday - trapezium removal and replacement with a ligament from the wrist. It also involved removing a large bone spur and calcification of the joint. I was sedated and had a nerve block under the arm. I was asleep during the process and don't remember a thing. It has been about 30 hours since the operation and not a lot of pain, thank goodness. But, I am taking Oxycodone and the nerve block hasn't completely worn off. @skigirl I bought the push brace too and it made paddling and other gripping activities much easier for awhile. But if I wasn't recovering from the knee and hip replacements, I think I would have had to get this surgery much sooner. Using the walker because of my hip replacement really aggravated the joint. I went to my hand surgeon to get a cortisone shot and he barely got the needle in the joint. He said I needed the surgery ASAP because the bone spur and general calcification was solidifying. Anyway, my procedure took an hour. I am wearing a "half plaster brace" that is like a bed for the arm - more of a splint perhaps covered by an ace bandage. Thumb is completely encased with only the nail exposed. I was not expecting the affects of the nerve block. It was like I had no right arm until this morning. Definitely affected my balance since I am still limping on my left hip. I will have this on for a week or two and then get a removable splint for 2-3 months. Physical therapy starts at six weeks. I think being patient will be worse than after my knee and hip replacements! Hopefully this is the last procedure for a very long time!

    At this time, I can move the tip of my thumb -- but probably shouldn't. Have no idea of what the incision looks like. Because the bone spur and growth looked like an egg at the base of my thumb and wrist, the incision might be in a different spot than some pictures I've seen of the surgery. And of course, did I remember to take a picture of my hand for later comparison? Of course not. @swmrgirl does this sound like what you have to get done?

    @skigirl I am interested in the new procedure you mentioned and that you referred to this as "the old way". My hand surgeon showed me other methods they had used in the path including prosthetics -- one looking similar to the femoral ball and spike prosthetic.. Another way was to put a porcelain ball in place of the trazezium. My doctor said all those methods had problems and even the ball would migrate - which is exactly what happened to my Mum. They had to go in and remove the ball from where it dislocated in her wrist and put a tendon in the trapezium space. Of course, as we all know, the surgeon's experience and expertise often dictate the method they use.
     
  12. kayak59

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    @Coppernob and @skigirl Hi Linda and Kelly. Thought you might be interested --this is what my hand/arm looks like, 4 days out. When to see the doc today and told him I HAD to get the splint off. He says I can take showers and leave the splint off to air the skin out but to keep it on as much as possible. I was right -- the skin was starting to react but its already calming down with some soothing lotion on it. I feel SO much better and more relaxed now -- and I am being submitted for a couple jobs by some recruiters so overall, much happier.
     
  13. Coppernob

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    @kayak thanks for the photo. Tomorrow I get to see what mine looks like when I get this first plaster taken off and a lighter fibreglass cast put on. I'll have to have this second one on for another 6 weeks. Hope you're continuing to improve. Linda x
     
  14. kayak59

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    Linda, I don't think the recovery is going to be anywhere near as restrictive as I expected -- but like the other replacements, it may take the expected length of time for full recovery. I am typing with my right hand and using my thumb for the spacebar. The joint is very stiff but I can move the thumb around without any pain as long as I stay within the "stiffness radius". I wonder why my doctor does not use the cast but I am SO glad he did not. When I am home and not doing anything, I leave the arm open to the air with Neosporin on the incisions to provide a barrier. The stitches were supposed to come out yesterday but I had a conflict and now I have to wait until Friday. Waaaahhhh. I'm going nuts with the inactivity again and while I am doing some land based PT for the hip, I can't wait until I can get back in the pool. This splint/half cast is all gauze and plaster and I don't want to risk getting it wet. I bought one of those cast protectors but I'm afraid it won't work well if I fall and totally submerged.
     
  15. Coppernob

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  16. kayak59

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    @Coppernob I like the purple! I still have my stitches, sigh..... My doctor travels a lot and I missed my Tuesday appointment so the next one in my area was Friday..... Oh well, ummmm. doesn't bother me too much if I don't wear the splint. Only when I am inside and not doing anything of course!
     
  17. Coppernob

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    Yesterday I had to have my cast changed as it had become loose so wasn't holding my thumb in the right position. As we're going to Wimbledon on Sunday (tickets for court no 1) I thought it only right and proper to have a purple pot this time.

    View attachment 58345
     
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  18. Coppernob

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    Believe it or not this wasn't made for me by the grandchildren out of Fimo, but by a specialist OT out of hard plastic! Despite 9 weeks in a pot my thumb still hasn't gone back to where it should be, so this is the latest attempt to relocate it. The splint will be remoulded every couple of weeks to try and encourage the thumb back. In the meantime I still can't drive and have very limited use of my hand. Frustration rules! View attachment 60974

    View attachment 60972 View attachment 60973
     
  19. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Gosh - you are really battling this @Coppernob ! Chin up - keep fighting the fight!
     
  20. skigirl

    skigirl SUPER MODERATOR Moderator

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    Coppernob, I have a cast that is similar to yours, but I could not keep it on my hand, so am back to the Push brace!! I am terrified to have this surgery because of the long recovery---but Kayak, you are making it look easier than I thought. I also hate casts---I just feel so confined!!

    I am sorry about your thumb, Coppernob---after all, that is the reason you had the surgery done--to increase the hand motion. I have to add that my thumb is very painful today and it does limit my hand motion. I am moving to Minneapolis and so don't want to do anything until I am settled. Right now I am busy packing and cleaning!!
     

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