Watch 2020 JRAD Videos

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

EmEm

member
Joined
May 17, 2017
Messages
249
Age
64
Gender
Female
Country
United Kingdom United Kingdom
@Grammyof2 congratulations on the walking and especially on finding a comfortable walking aid. When I had my hip replacement the physio wondered what I would be able to manage as I have a fused wrist. Thankfully I could manage with canes without stressing any hand joints.

I understand your concern about your other hand. I gardened yesterday and I can feel the ache in my right (non-operated) thumb this morning. I will have to be careful this morning when I go out into the garden. The problem is I just can't stop seeing the weeds and my husband doesn't think they exist!
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
Worried... My surgical thumb joint now and then produces a ratcheting sensation--click-click-click--when I turn or slightly flex my wrist. This is new today.

Good sign, bad sign, neutral?

I'm being very careful. I received no specific warnings apart from Don't get the cast wet and Don't lift anything heavier than a gallon of milk. I partly turn doorknobs, gently attempt to turn bottle caps, use 4 fingers to urge the refrigerator door closed. Now and then I use a couple of left-hand fingers to help the right hand type.

Paperwork from doctor encouraged me to flex and "pump" my fingers and thumb (obviously within the confines of the hard dressing), and I've been doing this. I stop as soon as it starts to hurt; then it hurts for a while. I'm still taking one or another pain med every 2 hours. I keep that hand pointed skyward most of the day. I took a very careful shower using the sleeve, gripping the safety bars as I turned.

Should I be concerned about this new sensation?
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
31,946
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
Very early days for you @Grammyof2 ! Sounds like they did lots of work about that joint. Nothing is firm against it yet. Just give it time. But if you start getting pain with this clicking you might want to check with your doctor.
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
Thank you, @Jaycey . If this continues I'll call tomorrow.

I wish people could have a preliminary chat with their OT-to-be within the first week. Quite soon after each of my TKRs, I had home visits from a PT and nurse. They explained so much, answered questions, gave good advice about how to move and how not to move. I guess recovery from hand surgery must be considered relatively straightforward and minor, like recovery from a broken bone!
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
31,946
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
I guess recovery from hand surgery must be considered relatively straightforward and minor, like recovery from a broken bone!
I think it is probably more about social distancing and the chaos that continues. Were you given any phone numbers for following up post op?
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
60,403
Age
71
Location
Kansas
Gender
Female
Country
United States United States
Congratulations!!!! Small steps forward....:yes!:
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
@Jaycey I have the surgeon's office number; I saw him in late Feb. or early March, when he reviewed my x-rays and set the surgery date for March 26 (soon postponed to May).

I have an appt. to see him and his OT June 2. The OTs are in the same office suite, so a call to the main office should reach someone, at least by voicemail. My state (Maine) is gradually reopening. (Time will tell whether or not this is wise.)

I'm accumulating questions! Just got back from a half-mile walk. I'd taken an Aleve beforehand to ward off pain. Now that the pain's returning, I'm wondering if perhaps I shouldn't have pre-medicated. Pain can serve as a warning not to do something or to do less of it. The road's smooth, but of course the walker doesn't glide evenly. It gives a slight lurch with each step I take. My right hand doesn't mind feeling that as it grips the handle, but my left's not sure! I'm hoping this didn't amount to more than the equivalent of holding a gallon of milk.

The walk felt lovely. Guess I'll take some pills, prop my arm, and rest.
:sleep:

Later... come to think of it, I seem to recall being scheduled to see the surgeon's OT before the surgery, but that got cancelled along with the original procedure. The surgery did happen, but somehow the OT Pre-hab appt. got lost.
 
Last edited:

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
31,946
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
I'm wondering if perhaps I shouldn't have pre-medicated. Pain can serve as a warning not to do something or to do less of it.
This is a mistake many make. Indeed pain is a sign you are doing too much. Masking pain can often lead to over doing activity. Try it next time without pre-medicating. That way you will learn your true limits and can build from there.
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
Just talked to one of my surgeon's OTs. She's not familiar with the sensation I described (sort of a soft clicking or ratcheting deep in the thumb joint of the surgical hand), but didn't sound worried.

She answered my other questions, too:

*Don't grip the head of my cane with the fingers of my surgical hand, since that can lead to leaning on it which applies pressure to the joint. It's OK to switch back and forth now and then, just don't grab-and-lean.

*It's fine to grasp the vertical handle of my UpWalker with the four free fingers of my surgical hand.

She came across as warm and friendly. I hope she'll be the one I work with next Tuesday!

@Jaycey Thank you--I'll do that from now on. :thankyou:

A couple of teenagers put in four hours of gardening this morning, and they'll come back tomorrow! The new raised bed is almost ready for seeds, the transplanted blueberries have been mulched, and the flower bed-to-be that encompasses two sides of our new house has been de-rocked and raked smooth. Soon, we can buy more perennials! :flwrysmile:

I have so much energy. It's such a relief to have kids to hire to do these things so I don't feel tempted to tackle any of it myself.
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
Hurrah! My post-surgery cast and wrapping came off this morning, and it seems I'm doing very well.
  • I now have no new cast, just a wonderfully small molded plastic brace that covers the thumb joint plus about half the back of my hand (for stability), plus an optional thin cotton fingerless glove (with a thumb) to wear under it most of the time.
  • The cast stays on 24/7 except when I'm washing my hand or the cast.
  • My hand was clean under the old wrappings, the skin perfect, only a dab or two of blood on the gauze that probably happened right after surgery. The surgeon was amazed and pleased, and so was I.
  • He doesn't use “K wires;” he has a different method. The constant pain I've felt around the wound was not ((as I'd fantasized) from wire ends rubbing the interior of the cast, but merely hypersensitive skin (the OT gave me some fabric samples to caress it with--desensitization).
  • Half a dozen mini sort-of-Band-Aids that had held the wound together got peeled off in the doctor’s office. The surgical lines beneath barely graze the epidermis, though of course I must keep them clean. The thin plastic fishing line (melt-away stitching?) was snipped close to my skin.
  • I have no forearm wound from harvesting a bit of tendon—he has a special device that goes in low on the palm and reaches the tendon from there. The wound on my palm is small and nearly healed.
  • I can shower without the brace if I wish, but for now I plan to keep it on just in case I slip and grab a hand-grip. Getting the wound wet is OK (just no soaking) but I plan to wear my plastic sleeve for now.
  • I can do whatever I need to do, within the confines of the sturdy new brace, just no pinching or heavy lifting. That means that within six months, when my right hand gets its turn, I’ll be far less immobilized that I’d feared.
  • I was given lots of written instructions, always a good thing.
  • The surgeon confided that another patient who had this surgery the same day told him she plans to use both hands for work, starting immediately, and ignore the instructions. He said it should be interesting to compare how we both are doing as the weeks and months go by.
  • Weekly OT appts have been scheduled through August, and a phone conversation with the surgeon's assistant four weeks from today.
Happy camper here! I can't clap my hands, but I can almost jump up and down with glee!
2020 June 1 S's left hand with post surgery wrapping, palm view.jpg
2020 June 2 S's left hand palm view scar.jpg
2020 June 2 S's left hand side view scar.jpg
2020 June 2 S's left hand palm view.jpg
2020 June 2 S's left hand side view.jpg
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
60,403
Age
71
Location
Kansas
Gender
Female
Country
United States United States
:yay: We'll clap for you!! What a wonderful report. Thank you for all the details and especially for the great photos. I can't wait to hear more good reports like this. I think you're wise not to push things like your surgeon's other patient. That person may regret going back to full work so fast.
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
Thank you, @Jamie! I'm feeling great, rarely need painkillers now that wretched cast is off, and have been resting up.

It's astonishing to be able to do so many ordinary things thanks to that nice, sturdy brace. My surgical hand is now my good hand. Just need to give it time to stabilize and get stronger. Then (at the surgeon's discretion, which means 4-6 months), on to surgery on the right hand! I'd been gearing myself up not to fear doing it again, but now I feel there's nothing to fear. Just 10 days or so of discomfort. I can handle that.
:SUNsmile:
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
You're welcome, @Jaycey. With so much to do in our yard (40 more plants arrived this afternoon!), it's always tempting to do more than I should, even with a crew of teenagers to do the heavy work.

I'm getting two types of pain:

1) Immediate pain, which stops me short (Yikes! Put that plant down NOW!); and

2) Pain that only hits later. Delayed pain forces me to learn from experience. That requires pausing now and then to reflect on what I did in the hours before pain started.

Thing is, my thumb joint and related muscles and tendons are getting just a bit stronger every day. So what was too much today might be OK next week. I'll see my OT every Tuesday for a while, and keep asking her advice.

The hypersensitivity pain is long gone (hmm, that was diagnosed only three days ago; time passes both too quickly and too slowly during recovery). What I get now is either a short, sharp, shock or the deep ache of muscles and tendons that haven't been used for a while and must get accustomed to being slightly rearranged.
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
I had a very disappointing OT session this afternoon.

Last week when she found I'd once assessed people of all ages for all sorts of cognitive, emotional, and behavioral issues, she went on at great length about her son's ADHD. That wasn't so bad when she was merely cutting off the original cast and fitting my brace, though it was mildly annoying.

Today she jabbered about her house, which she and her husband bought years ago from a local psychiatrist we both knew slightly 25 years ago. I managed to fit in a few of my "thumb" questions, and she gave brief answers. But mostly she disparaged me because the top of the palm of the fingerless glove I wear under the brace had once been dirty! She said I mustn't use that hand at all.

Well, she told me last time and again this time that I can move my fingers and thumb in any manner I wish within the confines of the brace, as long as I don’t lift anything heavy. I’ve hewed to that. She had not said not to use the hand at all.

When I mentioned that my hand often aches, she criticized me for “doing too much,” and ignored me when I said it aches now and then no matter how little I do. I can move my fingers, which after all are inevitably attached to every other part of my hand including the thumb. Sometimes moving my fingers seems to tug on something that doesn't want to be tugged. I never know until at least half an hour later. Then I try to figure out what it was, and I don't do it again.

She insisted that I must not do anything that hurts, but immediately gave me some exercises—which hurt—and said to do them despite that.

She demonstrated these on her own thumb. I can never learn that way. I must practice using my own hand. When I began practicing them on my own, and asked if I was doing them correctly, she barely glanced at me. She'd spent so much time talking about her house and that psychiatrist that she was now in a great hurry to retrieve a photocopied exercise sheet full of very poorly done drawings of hands. These will be extremely little use as I try to figure out how to hold my surgical joint in place while very slightly moving the top joint of my thumb (as far as I can tell, that's the point of the exercises).

At least she tossed me two more of those fingerless gloves, which unravel fast, and gave me nearly three feet of the Velcro strapping I need to keep the brace on. Of course she also chastised me for wearing out the first Velcro strap (they get fuzzy), citing that as proof that I do too much.

I like to keep that glove clean and dry, so whenever it might get damp I remove it and replace the brace. When I'm done brushing my teeth or using my right hand to move a sprinkler, I remove the brace, put on a fresh glove, and put the brace back on. How can that be blameworthy? Her jabbering had taken so much of our time that I had no chance to explain this. I'm not actually sure I want to!

Randy thinks I should ask to work with a different OT; but next week I’m simply going to keep redirecting this one. And yes, I will try to do even less with my surgical hand that I've been doing. For example, typing hurts slightly, even though I use only fingers...

After I've calmed down a bit more, I'll see if I have a list of questions to post here. Otherwise, I'll just keep doing the best I can. :bored:
 

Jamie

ADMINISTRATOR
Senior Administrator
Joined
Mar 24, 2008
Messages
60,403
Age
71
Location
Kansas
Gender
Female
Country
United States United States
I don't blame you for being upset. You are paying good money for a therapist, not a conversational buddy. If you are comfortable doing this, I would start your next appointment (even before you sit down) with eye-to-eye contact and a rather firm statement like, "I have some things I need to discuss with you before we begin our session today." Then explain the things you've outlined here. Have a list of the points you want to make in your hand so you don't miss anything. If she starts to speak before you are finished, ask that she wait and let you address every concern you have first before starting any discussion. That way you won't get deflected from the things you need to say with some type of denial from her. If she does not agree to conduct your appointment in a more businesslike manner, that's fine. Just tell her you don't think the two of you are a good fit and ask to speak with the clinic manager so you can reschedule with someone else. That way you won't be billed (or shouldn't be) for that visit.

The therapist should be able to accept this type of constructive criticism and adjust accordingly. If she cannot, then you really do need to get someone else to help you.

Your second option is just to skip all this and call to ask to change to another therapist. If you do this, you should make the request with the clinic manager so you can provide feedback for them about the poor performance. A little chit chat is fine during the "dead" times of a session. But when it takes over the appointment to the point that you cannot talk about your concerns and questions, that is wrong. You should always question when someone gives you unclear or conflicting recommendations too. That makes the session pretty much worthless.

Good luck and let us know how it goes!
 
OP
OP
G

Grammyof2

member
Joined
Dec 8, 2017
Messages
138
Age
73
Location
ME
Gender
Female
Country
United States United States
@Jamie, Thank you! I'm feeling validated. After all, both these sessions were mine, not hers! They were meant for me to get the help I need. I left feeling so ragged.

Now I'm looking forward to next week's session, and a gentle confrontation with her.

I really think I'm doing well by this hand of mine. I make a series of quick decisions all day long and into the night about what to do, whether to do it, and how to do it. If I never used it at all, it would seize up and grow weak. If I use it to much, it aches. I'm reasonably sure that nothing I do is damaging the surgical area, but if somehow I am, my OT should patiently explain the mechanisms involved and advise me specific ways to do things differently.
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
31,946
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
@Grammyof2 I really agree with Jamie. These are your sessions and they should address your concerns. Sounds like this therapist is using you to discuss her problems, not yours. If you think you can be firm going in next week - go for it. But she may resist. If so, it's time for a different therapist.

Please let us know how it goes.
 

lionsm13

senior
Joined
May 31, 2010
Messages
273
Age
67
Location
United States
Gender
Male
Country
United States United States
It appears that she is more into her own issues rather than her job.

I would just get another OT G-of2 if I were you.
 

New

Active Antibacterial

BoneSmart #1 Best Blog

Staff online

Members online

Forum statistics

Threads
51,614
Messages
1,384,424
BoneSmarties
32,304
Latest member
barrj46
Recent bookmarks
1

Top Bottom