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Finger/Thumb Left thumb joint's LRTI coming up May 21, 2020!

Grammyof2

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At least that's what my surgeon calls it--"resection arthroplasty with ligament reconstruction and tendon interposition (LRTI)." The original date was March 26, but we all know what intervened. My local medical center (Maine) is reopening for non-essential surgeries. This coming Monday (May 18) I'll have the prerequisite virus screening at their Express Care site.

I'm thrilled & scared. I'll be turning 73 this summer with arthritis everywhere but my earlobes. I've had two TKRs (2017 & 2018), so this isn't my first rodeo. But I'm apprehensive anyway.

I ignored the pain too long, I think. On X-ray, my right thumb joint's worse than the left, but surgeon was quick to ask which hurts more, so leftie's first in line. That's good because I'll soon get practice for the more challenging task of doing everything without much use of my dominant (right) hand. But not-so-good because the right hand's had two extra months to deteriorate! Now it hurts as much as the left did last winter.

I've been wearing one or another kind of splint since I saw an OT last fall for what we first thought was "just" carpal tunnel (confirmed by electromyelogram), but lack of progress had her tell me to ask my PCP for a hand surgeon referral. I've been wearing a spica splint since then to protect the area. The hand surgeon grimaced when I said, "my thumb joints are shot, aren't they?" and said, "You could say that."

Too much hitchhiking? (Maybe not. :wink: )

I couldn't resist doing yard work once spring started to arrive. Yard work as in shoveling dirt and moving dug-out grass clumps and rocks.... with some help from my husband (he's building a raised bed) and some from teenagers I keep hiring. I should have done zero. I know that. I tend to push myself past pain, and that's not necessarily a good quality. I'll have to be very gentle with my surgical hand.

Yesterday was my telephone intake with a nurse. Here are my notes, FWIW:

Hospital will call around 12:30 pm the day before surgery to say what time to arrive. Total time in hospital three to four hours: arrive 2 hours before surgery to get anesthesia going, surgery itself takes about an hour, recovery from anesthesia takes one or two hours.

She had an old medication list, so I corrected it.

I must try to get wedding ring off—if it’s not off and hand swells too much, surgeon might cut it off (ring, not hand ).

No food after midnight no matter when surgery is, but I can drink water until two hours before surgery: can take morning pills & black (no milk) tea.

I can wear my ComfortCool splints or not, as I prefer.

My husband can accompany me partway. He'll have to wait in the general (not surgical) waiting room. We must both wear our masks. She said which entrance to use. There are wheelchairs by the door. He can push me to what used to be the surgery entrance, where someone will take over.

Bring my Advance Directive!! She didn't know whether or not they have a copy on file.

Bring my CPAP just in case they decide they want to use it.

Bring my hearing aid charger—I need to wear them long enough so I can hear instructions clearly; they come out before surgery of course. They'd have used some other type of container, but I prefer my own.


I've gained weight, so getting my ring off was a real chore until I remembered that a jeweler once sprayed on Windex. I also chilled my hand a bit in cold water.

I've been reading up on the procedure. Watched one surgery video and one multi-part You Tube video by a woman about her own experiences before & after this procedure. I was delighted to learn that I'd misunderstood something my surgeon said about how the tendon is used and what happens to the part that remains intact. The actual facts are encouraging.

Dates have been set for my post-op OT and surgeon visits. Now I just need to sit back and relax... But I'm already practicing using just my right hand plus a few left-hand fingers for everyday tasks, and figuring out ways to keep my left hand elevated after surgery. Anyone have ideas for that?

I suspect I won't be able to use my handy-dandy new 4-wheel walker for at least several weeks... I need exercise! My newish knees are dandy, but spinal stenosis requires me to lean slightly forward. :sigh: I'll manage. Somehow I always manage. This is surely unrelated to what I just wrote, but does anyone know if drinking wine will would make my hand swell within its cast?
 
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Jamie

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Drinking alcoholic beverages such as wine could result in some swelling. To minimize that effect, be sure to drink plenty of water along with the wine next time. If you think this has happened, drink lots of water and keep away from alcohol for a few days until things normalize.

Good luck on your surgery!!
 
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Grammyof2

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@Jamie Thank you! My hand isn't swelling yet (pre-surgery) but it occurred to me that my face goes bright red after my nightly glass of wine, and I really don't want my hand to swell within a cast!

I'll stop wine entirely for a week or two after surgery, and resume with maybe half a glass plus a lot of water. I do tend to look forward to it.
 
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Grammyof2

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@Jamie (or anyone else who might know): What on earth will fit over my cast when I leave the hospital after surgery? Will they let me wear a johnny home? Or should I bring a lightweight blanket to wrap up in?

I own zero sleeveless tops; I can't just slice a sleeve off one of my husband's shirts, as I'm top-heavy compared to him.

This question just occurred to me, and Amazon's quickest arrival time is now the day after my surgery!

Once home, I'm fairly sure the cast will fit through the arm openings of my sleeveless nightgowns., though not any robe I own. I can turn up the heat in the house or wrap a blanket over my shoulders. It's getting back here that's worrying me!
 

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Hi @Grammyof2
I used a pillow stack at my side at night to elevate my arm and hand after surgery. I had a similar arrangement on the arm of my recliner. Similar to the stack in the image, but steeper, and I could curl a couple of fingers over the end to keep it in place.

I I live on my own, so I had it all set up on the bed before I left for the hospital. It worked very well, except that I put it on top of my duvet. I woke in the night with a very cold arm. I didn't make the same mistake for the next surgery!

Hope all goes well.

1589720563899.png
 
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Grammyof2

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@helenium Thank you for the suggestion about elevating my arm. I'll try the pillow stack method. And I'm also grateful for your warning about making sure my arm doesn't get cold in the night. I'd never have thought of that. So much to learn.

Did you find it difficult to get your hand through clothing immediately after your thumb surgery, for the ride home? I'd hate to slice up a summer shirt when I can't go into any store to try on a replacement.
 

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@Grammyof2, I had carpal tunnel surgery (a trapeziectomy was recommended as well for one hand, but I declined!). But I hadn't realised how much bandaging/padding there'd be for the first few days. My hand resembled a large boxing glove and, totally unprepared, I'd worn a long sleeved cotton top. The nurse got it back on me (and my bra!), but my daughter had a dreadful struggle to remove it for me. I thought we'd have to resort to scissors. Do you have anything short sleeved with a bit of stretch? Not sure what the weather is like in your part of the world but, if cold, perhaps a jacket or something over the shoulders would serve as a top layer?

One hand was pretty painful for the first few days, the second one nowhere near as much. I was very grateful for my pillow stack, it kept the swelling down and helped a lot with the pain. No cast for a CTD, so I was able to ice as well once the dressing had been taken down.
 

Jamie

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I purchased men's flannel shirts in size XXXL, which is 3 sizes larger than I would usually wear. You could buy a few inexpensive t-shirt in this size too and they may work. I also bought a couple of fuzzy ponchos to wear when it was chilly.
 
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Grammyof2

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@helenium Absolutely nothing I own has the slightest chance of fitting over the padding. I have an ancient flannel shirt I'd be happy to slice an arm off, but wouldn't you know, the temperature that day's suppose to hit 77.

I'm getting resigned to cutting an arm off one of my pretty summer shirts. I just hate the idea, but it's not like I'll be much of a fashion plate this summer. A smaller wardrobe should do OK. I've been buying all my clothes at Goodwill for about 30 years, and won't be venturing in there for 12 to 18 months (or whenever a reliable vaccine is mass-produced).

I do have summer nightgowns with large arm openings, so I figure I'll laze around the house in them until the bulky stuff is removed.

Thank you for trying!
 
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Grammyof2

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@Jamie, My husband and I are in our mid-70s. We don't go out in public except on very rare occasions, like twice-monthly grocery shopping and of course this surgery.

So I can't go into any store to buy larger clothes. I've checked Amazon and several other retailers, and the soonest anything could arrive would be Friday--the day after I come home.

I don't have any friends my size who live anywhere near us (we downsized recently and moved to another part of the state).

I really wish the nurse who did my extended pre-registration had mentioned this potential problem. I'd have had time to get something in the mail. C'est la vie.

Thank you for trying to help!
 

Jamie

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Did you check online sites for Target and Walmart? Is it possible to have a friend or neighbor go shopping for you?
 
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Grammyof2

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@Jamie We recently moved to a new community. We have a few acquaintances, but they have serious stuff to contend with. Among our closest neighbors, for example, one man's wife has cancer, another's was just diagnosed with dementia, one woman is 91 years old, one woman's husband has kidney failure, and another's has dementia. I don't feel comfortable asking any of them for help.

This morning I did email this community's developer to ask if he knows anyone who might have a large old T-shirt to spare.

I'll double-check Walmart's and Target's online sites, but I suspect my husband would still have to go into a store to pick up a shirt.

Thank you so much for trying to help. :thankyou:
 

Jamie

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Be sure and ask if the stores would do curbside pickup. Sometimes you can buy online, drive up to the store, call them, and they will bring our merchandise out and put it in your trunk or back seat for you.
 

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@Grammyof2 I have just updated my thread about my trapeziectomy 6 months ago. I would definitely recommend a shower sleeve. Mine came from Limbo Products in the UK, but I'm sure similar are available in the US.

1590213659908.png


The big plaster cast with all the padding was only for 2 weeks so I managed with sleeveless t-shirts and a couple of men's shirts. The splint I had after that could be taken off and put on after dressing which made life easier.

I wish you well with your surgery and will continue to check on your thread.
 
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Grammyof2

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Good news! Surgery went very well. Though someone I spoke to earlier at the hospital told me no one can borrow or be given a "Johnny," today I was sent home in a hospital T shirt big enough to fit the padding!

I'd worn a normal shirt & brought one of my husband's T shirts after cutting off one arm; when I tried it on yesterday, I looked like I was wearing one of my grandmother's whalebone corsets from my neck to my hips. I could barely breathe. So being given the big T shirt was an incredible relief.

I'll be wearing it w slacks or else one of my nighties for the next 2 weeks... self-quarantining, of course! Once padding is gone I'll wear regular shirts.

Pain in the surgical hand is still OK, 15 hrs post-surgery. I'm taking either an OTC or 1 oxycodone when I sense pain's starting, as I did w my TKRs.

Dr. told me not to do any exercises until 1st OT session, but it's OK to wiggle & slightly clench fingers. They get a lot of use anyway. I practiced doing many usual tasks without the left thumb for weeks, and have pretty much had to do that for months due to pain. So I know how.

Thank you, @EmEm , for mentioning shower sleeve!

Keeping hand elevated whenever it's not in use. Dr. told me not to bother with devices I saw on Amazon; I told him someone (Hi, @helenium!) had shown me how to make a pillow stack. It lies between me and my husband in our bed, like Puritans' "bundling." I made another stack in the spare room with my knee-elevating padded dealie as its base, plus a pillow. I'm dividing my night between the rooms due to restlessness.

I'm very pleased--delighted--with how things are going so far.
:thankyou:
Sharon
 

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@Grammyof2 Welcome to the other side! Sounds like your op went very well. And you sound very organised! Well done!

I look forward to following your journey!
 

Jamie

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Grammyof2 - you may notice that I removed the website link to the shower sleeve that EmEm posted. We don't allow links that take our members offsite here on BoneSmart. But that is an excellent product. I checked and it is available in the US. You can purchase it from Amazon. If you decide to buy one (or for any Amazon items you purchase), we ask that you sign up for the smile.amazon.com program and make your purchases that way. You designate our parent organization, The Foundation for Research in Advancements in Medicine, Inc. (FARM), and Amazon sends a portion of your purchase amount to them. FARM gives it directly to BoneSmart. It costs you nothing, but the donations help us to keep BoneSmart up and running for everyone who needs us.
 
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Grammyof2

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That's fine, @Jamie. I already bought it. :)

The hardest thing for me to cope with today is the near-absence of pain... thanks to careful use of pills. I keep everything written down (type of med, dose, time taken) to make sure they're spaced as directed. And I take something when pain's just starting, so I don't have to feel it at its worst.

But this delightful fact leaves me yearning to do more than I should with the surgical hand. I keep reminding myself: It was repaired just two days ago, for heaven's sake! Let it rest, let it heal!

The yard beckons. Such a bright but mild temperature day. I did manage to drag a hose around with my "good" hand to water some very thirsty plants, and persuaded my husband to water the rest when he had time.

We're making a really long new raised bed, It's newly filled with dirt from brought by Paul, our little 55-plus development's developer. Trouble is, it's full of rocks of all sizes. We've got local teens coming Tuesday to dig out more of the big ones, but they ignore the little ones (also, removing smallish rocks would be a waste of their time when there's so much else to do). I was just outside staring at those little rocks. I could keep my left hand pointed skyward like a good girl and pluck rocks with my right, drop them in a bucket...

But. The right thumb joint's X-ray showed it's even worse off than the left. It pangs and aches now and then, despite protection from a Comfort Cool spica. It's got to keep being usable for ordinary tasks for at least 4 months, maybe 6, until the left hand's ready to take over, and Surgery #2 can put the right hand in a cast of its own.

So this afternoon's project--which might last no more than four or five minutes--will be to stand at my 4-wheel UpWalker, my husband at my side, and figure out if there's some safe way to use it now. I'd settle for walking a block... even half a block... though I yearn to walk my usual mile. My forearms rest on concave plastic, letting me bend forward to ease my lumbar spine as the walker rolls along. My right hand grips the right-side handle, but can the four fingers of my left hand grip the left-side handle enough to stabilize me?

That's what I aim to find out.

i'm attaching a photo from an UpWalker ad.
UPWalker-Lite-Woman-User-Shot-P.jpg
 
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Grammyof2

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Did it!! We walked the equivalent of a block and back. :egypdance:

The road's flat, no traffic, no need to brake. My husband walked at my left in case of any problems, but there were none. My right hand held steady and the four fingers of my left were good-enough grippers.

What a glorious afternoon event.
 

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