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finger/thumb Thumb Trapezium Replacement 6/16/17

Discussion in 'Other Joints Forum' started by kayak59, Jun 17, 2017.

  1. kayak59

    kayak59 senior
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    First my knees, then my hip, now a new thumb joint. Last procedure for many years to come I hope! This may be a mistake but at least having my right hand splinted will prevent me from trying to do too much too soon after my hip replacement!

    So far, not too bad but I think it will get worse before it gets better. Boredom will be my biggest problem, I am sure. Thank goodness for family and friends and ice cream.
     
  2. Jamie

    Jamie ADMINISTRATOR Administrator

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    So sorry to hear you're needing another surgery. Here's hoping all goes very smoothly and you're back on the road to recovery soon.
     
  3. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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  4. kayak59

    kayak59 senior
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    Thanks @Josephine . My doctor showed me that and a couple other variations and said he doesn't use them anymore, except sometimes for elderly patients.
     
  5. kayak59

    kayak59 senior
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    Pain level is not too bad today but the edge of the plaster splint is really irritating my skin. Got to find some padding. You know, after having foot surgeries, hysterectomy, knee and hip replacements and now this; I can say that the knee replacements was the most painful -- but only one of them. That was because of the swelling I think, because I can remember having a lot of swelling after a arthroscopy and it really hurt. Also after that knee replacement I had a lot of excruciating cramping. Once I realized what was going on, I could address the cramping and not let it get that bad. The hip pain was bad but it was more of an annoyance because I was sitting on that area -- a literal pain in the butt. I also experienced some cramping with that too, but massage and arnica really helped. I am already typing with my right hand so I don't think this experience will be as bad as I feared -- although I probably will have a high risk of "overdoing it". At least it will prevent me from doing too much for my hip too -- which is one of the reasons I did this so soon. And also that I need to get to a point where I can get hired for a new job!
     
  6. nonny

    nonny junior member

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    It's so difficult to hold back when you are basically a healthy, active person. I'm so glad that the surgery is not as painful as you feared. At least it is the time of year when you can be outside. I'm impressed that you did this so soon after hip replacement, but I see the reasoning. My surgery is August 16 and I want to be able to go to a fifty year high school reunion in central Jersey and drive there myself six weeks after. We'll see. At the moment, I'm just dragging my sore butt and leg and hip around like Igor in the castle. Hope you found a good solution to the plastic splint irritation; it's often the little annoyances that irk one the most. Here's to a full recovery for you.
     
  7. kayak59

    kayak59 senior
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    Arrrrrggggghhhh, has it only been four days? This splint is driving me crazy! Can an arm have claustrophobia? The doctor told me to make an appointment 5-7 days out. It was today or Friday so I hope he'll take it off today. I am really concerned that the skin is badly irritated underneath but as soon as it is exposed to air and I can put moisturizing cortisone cream on it, that should get better. This has happened after every recent surgery and bandages -- even from one of the EKG patches after the hip surgery. Overall, this hasn't been as bad or inconvenient a time as I thought. I can use my fingers and the tip of my thumb a bit. Can't grip anything of course so I can't open jars and have to modify how I put certain undergarments on. Hip is doing better although I am walking like Quasimodo.

    I think I could handle a job interview at this point but I would have to explain that I cannot put on make up. Mascara with my left hand.... no, don't think so. I am really beginning to miss picking up my cats. I could do not it at first because my hip was too weak, now of course this splint. Going to try to refill my hummingbird feeders today. We will see how that goes.

    @swmrgirl I am going to ask the doctor how similar my situation was to most trapeziectomys. Do most patients have a bone spur? Or does the bone sometimes just deteriorates? I actually looked at that pictures and videos of the operations and those people did not have a bone spur like mine. (Mind was the size of an egg covering the base of my thumb and wrist.) Going to get some pictures of the incisions too.
     
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  8. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Gosh @kayak59 , you are a real pro at this joint replacement thing! Glad your recovery is going well but I can well understand the frustration you must feel in that splint!
    Sounds like a project for you! I trained myself to use a left hand mouse at my MAC due to repetitive stress pain. Too a bit of getting used to but I managed. If that's your only option why not try?
     
  9. kayak59

    kayak59 senior
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    @Jaycey You know.... of all the things I could practice using my left hand with, I don't know, mascara isn't up there. :) If I were to get a job interview and wearing makeup or not was really an issue, I don't think I'd want to work there anyway. :) My immediate project is going to figure out a way to use my camera to take hummingbird pictures. Its a heavy camera and lens and there is limited space for the tripod but as my Mum says "where there's a will, there's a way".

    By the way, I noticed that I had been made a senior member. I don't know if that was because of time on the forum, participation, or number of replacements! :) I am really really lucky in that my recovieries have not been as hard as many people's have been but I am going to try to stay on and continue contributing as much as I can.
     
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  10. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    You have certainly contributed a wealth of experience here. Thanks for your continuing contribution.
     
  11. kayak59

    kayak59 senior
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    Ahhhhh..... Happiness is eating ice cream and letting my skin air out. I have to keep the bandages and splint on until after the stitches come out in one week but I can let the skin air out and shower. Bet this is going to turn some interesting colors!

    I asked the doctor some questions about the trapeziectomy and he touched on something else that comes up on this forum. He said approximately 80% of trapeziectomies were because of bone spurs and my level of arthritis was a 4.

    He said however, whether or not surgery is indicated is dependent on the person's level of pain and impact on their lives and ability to do what they need or want to. He said he has seen plenty of older people with far worse arthritis than mine, but their activity was less and the pain could be controlled by non-surgical means.

    This explains by hip specialist's immediate willingness to do my hip replacement but not my first (and older) doc's unwillingness -- and he knew me and what I liked to do better than anyone! But oh well. Glad the other docs were different.
     
  12. kayak59

    kayak59 senior
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    Two weeks post-op and Freedom! Stitches out and just a small thumb brace that I already own and am used to. No PT and no restrictions other than "don't be stupid". Kayaking at the end of next week! (In a tandem so not paddling all on my own.) This was no way near as bad as I feared. I still can't grip or carry much weight -- and the hand lets me know as soon as I do -- but I can live with that. Ah..... sleeping in my bed with no arm cast, no back pain, no hip pain, no knee pain...... Back in the pool next week AND to top it off, the recruiters seem to have discovered me! 5 contacts in 3 days! Woo hooo! (Still hoping for that work for home job.)
     
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  13. Coppernob

    Coppernob senior

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    Good to hear your stitches are out. Enjoy your freedom! Linda x
     
  14. kayak59

    kayak59 senior
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    There was a post and lively discussion about cortisone shots and whether or not you should have them prior to you surgery. Many doctors said the surgery would have to be 3 months after the shot. Well..... I think I am finding out why they say that. I had a cortisone shot in my thumb a few days before my hip replacement -- and my hand surgeon knew that. I was not expecting him to tell me that it was time for the thumb surgery. He said wait until you can walk normally but did not give any specific period or say anything about "because of the cortisone shot".

    So it was 7 weeks after the cortisone shot that I had the thumb surgery. My doctor knew why I wanted it so soon after my hip replacement -- to be ready to start a job ASAP and he did not try to dissuade me.

    Two days and two weeks out since the thumb surgery right now and I had the stitches out at exactly two weeks. Half of the incision is not completely healed and there is occasional drainage -- an odd yellow orange color. The doctor was puzzled about that then he said it was exactly where he had given the cortisone shot and that had weakened the tissue and skin. That is probably why the splint aggravated it so much. And I wonder if keeping Neosporin on the wound actually kept the skin softer. Sigh.... He said there is still a real possibility that the incision can split open to the bone!

    So challenge for me: keep that hand in the splinted position without being in the splint and letting the skin and tissue heal. @Josephine do you have any suggestions for me? I'm being really good about not using the hand for anything more strenuous than typing...... maybe the mouse too much but I'm stopping that and using the touchpad with my left hand. Thank you
     
  15. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    This is supposed to be true but I've never seen any factual evidence about it.
    I think this to be a very unlikely explanation. There are two types of cortisone and it seems to me the doctor is mixing them up. Prednisolone is the cortisone likely to interfere with healing in this way but the injection you had was unlikely to be that. Intra-articular cortisone, pharmaceutical name Methylprednisolone, (trade name Depomedrone) is a synthetic form and to the best of my knowledge has very limited effects such as that.
    Unlikely.
    Even more unlikely.
    If it does, it will not be due to the cortisone shot.
     
  16. Lynnallison175

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    @kayak59. Hi I've been reading about your thumb replacement and am so glad that it hasn't been horrible for you. I do agree with you that knees are just an awful recovery, pain wise. I am 8.5 months after my second knee replacement. While I was off for knee #2, I was diagnosed with arthritis in my left thumb.

    Can you tell me how your thumb progressed on the downward spiral? I'm so tired of surgery and doctors and hospitals. I'm not ready to take this step again. This past weekend I had a really bad flare in my thumb and it was splinted and I was on Tylenol all weekend, with not much relief. Is the thumb protocol the same as the knee, ie, physical therapy and cortisone shots? How did you make the decision to have your thumb replaced. Thank for any thoughts or advice you have to share. Lynn

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  17. kayak59

    kayak59 senior
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    Hi @Lynnallison175 I know what you mean about being tired of surgery and hospitals after two knee replacement, a hip replacement, and now this in 18 months! My incision still hasn't healed all the way but its getting better every day. Looks like there was a fluid build up but that drained on Monday and since then, there is steady improvement. My hand is also getting stronger every day so in terms of getting back to full activity and being able to do a job, I think it was a good decision.

    I told the doctor that I did not need hand physical therapy because I had actually done it a couple of years ago and still had all the instructions. He basically said to do what I could and not do anything stupid. I don't know if my recovery is typical. @Coppernob (Linda) can give you her perspective?

    My history: I have been having pain in my thumb because of a bone spur growing between the base of my thumb and index finger and have been getting cortisone shots and wearing thumb braces on and off for years. At times the pain would be pretty severe and I would have trouble gripping and carrying things. Last year my hand was really hurting from the walker and cane and when kayaking and the bone spur bump seemed to be getting bigger and bigger. Last year when I got the cortisone shot, the doctor said I would need surgery sooner than later. This year, as my hip got worse and I again had to use the cane and walker, the hand got more and more painful so I went in for another cortisone shot. I could also not hold things like a cup of coffee and I was constantly dropping small things like pieces of paper. The doctor had to reposition the needle about 6 times to get it into the joint and he said it was time for surgery. I therefore decided to get it done as soon as I could walk unaided. I did not want anything stopping me from kayaking, cycling, hiking, needlework and anything else I wanted to do.

    The surgery took an hour and I went home with a plaster splint and ace bandage although Linda (coppernob) had a cast. I had full use of my fingers within 48 hours and except for the problem with the incision, have been very happy with the recovery progress.

    I hope this helps you with your decision.
     
    Last edited by a moderator: Jul 6, 2017
  18. Lynnallison175

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    Thanks, it seems the decision is just like the one for my knees. Quality of life and loss of functionality. That cortisone is a beautiful thing pain wise, but boy does it hurt going in!!!

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  19. kayak59

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    Waaaahhhhh. I thought the bottom half of the incision was finally healing but yesterday it split. I was like "Eeek! What is that white stuff in the wound?! Then I realized it was the tendon. Slapped Neosporin on it and a bandaid and called the doctor who got me right in. He said to keep it totally dry and just cover it with gauze and a light wrap and wear the brace 24/7! I will see him next week and he said to change the dressing daily and watch for infection, then come back next week. He may have to pull the tendon out and clean it but is hoping it heals on its own. Doesn't want to try more stitches -- yet -- thinks the skin is too compromised. I am surprised that he doesn't even want me to try to keep the edges together with a butterfly bandage or something. It might have been better to do this before I lost all the weight. There is nothing but skin and bone on my hands so no "cushion". This is going to be a long summer, sigh..... I hope I get a job soon.
     
  20. Lynnallison175

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    @kayak59. Please take care of your incision. I had one split open on my abdomen once. Fluid was flowing out like a faucet. Follow Dr's orders. Keep us in the loop when you can. Rest well.

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