About 2 1/2 years ago I started have pain in the fatty section of my palm of my right hand. It would come and go. At that time taking Ibuprofen and resting my hand worked. Then for awhile I had no problems with my thumb at all. It would come and go. The pain I could tolerate and I was able to still use my hand. Slowly the pain increased and using my thumb to pull up my slacks, cut my food, put my hair up, became difficult but, I managed as the pain was not severe. Finally I went into see my doctor and she referred me to a Orthopedic doctor. I went in for my appointment and Dr. G. had me make a fist, try to squeeze his hand, have me try to pick things up with my thumb and index finger which was very painful and hard to accomplish. He decided to try to treat the joint with an injection of Cortisone directly into the joint of my thumb that attaches to my hand. This was rather painful but I could feel the joint expanding. He said that if I had anymore pain with in the next 2 weeks to come back and he would use and x-ray machine to view my thumb while injecting another round of cortisone.
My thumb seemed to improve after that for quite sometime, and then it started to bother me again. I avoided going back in because it was not that bad. I was able to use my hand and thumb with out extreme pain so I just left it go until this past January 2006 when just typing became difficult. I would have constant stabbing pains. I love to be on my computer writing or corresponding, and this was becoming almost impossible. My hand, thumb, palm, and wrist would swell up. It didn’t even look like my hand. Then we went through 5 weeks of almost steady minus 35 degree weather here in Wisconsin which made it even worse. Once the freezing snap was over my thumb started to improve but, I still had occasional pain. I started using my computer more, and was getting ready to start some early spring cleaning, yes I know it was in the winter, but with my hand the way it was I wanted to get a head start. I was doing fine until April, where the stabbing pain got to be to much and the Ibuprofen no longer even touched the pain. I made a doctors appointment and went in to have my thumb looked at. Doctor Z. pushed and prodded on my hand, and then called for them to take x-rays. They took 3 x-rays, one with my hand flat, and then the technician brought over what looked like a black foam staircase which when up one side and down the other. She positioned my hand in 2 different ways and took the x-rays. I went back to the doctors office and waited for the results. The first thing he said when he walked in and put the x-rays up was did you ever consider surgery. Well of course I hadn’t no one had ever suggested it.
Dr. Z. explained the procedure he would do if I decided on surgery. He called it Ligament Reconstruction with Tendon Interposition. Now this was a mouthful for me. He took my hand hand showed me where he would cut. Then showed me with the x-ray which bone he would take out. After that he explained that he would take 12 inches of tendon and as he said ball it up and place it where the joint had been. Then the tendon would be reattached by drilling holes in my hand and thumb joints. He was all set to have me have surgery but, I told him I needed to talk my husband first. He then said I could either have the surgery or wear a brace for a very long time. Basically which meant the rest of my life as my thumb was 1/2 out of joint and more toward my wrist now. He called it an unstable thumb. I asked him if I could get some photocopies of the x-rays. He got them for me plus he ran of the surgical procedure step by step with pictures for each step. Which I thought was great at least if I would have the surgery I would know exactly what they would be doing and there would be no surprises.
Well I discussed the surgery with my husband and he said that I should get a second opinion. So I called my Insurance companies Surgical nurse and asked about the surgery and who they prefer me to go to. She sent me a list of Orthopedic Doctors within a 25 mile radius. She also sent me the names of 2 hand specialists. I went through the list and talked to a few people I knew that had had orthopedic surgery. With there help I selected Dr. B. and set up and appointment. I had my x-rays sent over to the clinic. Then went in for my appointment. Dr. B. had my squeeze his hand. Told me to relax my hand and actually pushed my thumb in and rotated it. He could feel grinding, which meant the joint was bone on bone. He looked at the x-ray and then explained that there were at least several different surgeries that could be done on my thumb, but, that he would prefer me to try Physical Therapy first to see if I would gain any relief from it. He said he also wanted them to make me a splint to protect the joint, and to do exercises. He said once they go in and do surgery there is no turning back. So physical therapy appointments were scheduled. I attended Physical Therapy 2 times a week, where they did heat therapy, and also deep heat therapy with paraffin, they would have me dip my hand in and out of hot paraffin 4 to 5 times and let it dry till it was white in between dippings. Once all the dippings were done and the paraffin was white they put a plastic bag over my hand and then rapped my hand in a towel. This would be left on for about 20 minutes and then would be peeled off. I really didn’t care for it. I felt the other heat therapy was much better it was a machine you put your arm into and there was some type of corn in there, which to me felt like corn meal. I thought to myself and how is this suppose to work. Well they then switched the machine on and the corn just blew around it made my hand feel like it was floating in water, and the heat would get warmer and warmer. When I was done, the joints of my hand did not hurt at all. Then my Therapist massaged my hand in the fatty area of my palm. She said I had a knot there and proceeded to try and get it out. Which she was surprised, she was unable to get it out. It actually took 3 sessions before the knot finally came out. Which helped relieve the pain. She also made me a splint out of white plastic that was molded around my thumb and hand with a Velcro strip to hold it on across the top of my hand. This would protect my thumb and the palm of my hand. I put this on and had no pain. It was amazing I could even drive my car without pain. Then she gave me stretching exercises to do with my thumb and hand, next she gave me a light putty to do strengthening exercises. Now when we started therapy she tested my hand with equipment to see how much strength I had. At that time some strength in my thumb and index fingers. She had me pinch them together using a device that read how much strength I had. This was all recorded. And then was done 2 more times. Once about midway through all of my therapy sessions and once on my finally day that she say would be graduation if I passed. Well those reading I gained strength in my hands but, I lost strength in the pinching with my thumb and index finger but, she said since I had gained more movement, and had some days without pain that these days would grow more and more and then I would have some bad days. So that ended my therapy sessions with her ordering a special rocking cutting knife, a scissors that I would just push to cut and it would release on its own, giving me one less motion to do with my hand. There also was ordered strips of foam to put over pens, silverware, cooking utensils, etc. So that I would not have to make such a tight grip, this would help eliminate pain. I was done with physical therapy and had a doctors visit the following week.
At this visit Dr. B. asked how my hand was doing. I explained I could no longer sew, cut, embroider, quilt, even more difficulty doing my hair and things that we take for granted when we have to good hands, like just stirring something in a kettle was painful. He said we could go with another cortisone shot that could help for a couple of months. I asked if it didn’t help what was the next option, and he said surgery. He pulled out the x-rays and explained about removing the diseased joint and putting in pins through my thumb to my hand to hold the thumb in place and then a pin from one joint to by hand to hold it in place while scar tissue formed and more or less the scar tissue forms a joint. I made the decision to go with the surgery, as my Medical Insurance would be up in January from he job that I had worked at as a Photographer. My surgery is scheduled for August 13th. It was explained to me when signing hospital forms that this is the surgery he is planning but, that once he opens my thumb up that he will be able to see the actual damage, which at that time he might have to change the type of surgery I will have, such as taking tendon from my arm to form a joint. He wanted me to know that and OK it, so that if he felt he needed to change the type of surgery planned that he could as I would be sleeping and he really couldn’t ask my permission. Dr. B. also informed me that when they open up the thumb that the blood vessels and nerves are right there, and they have to move them out of the way to do surgery which means there is a possibility of nerve damage or blood vessel damage. He asked me if there was any other questions, I said no as I felt he told me everything I needed to know. So we walked over to his nurse where she was to set up blood tests and and ekg for today. With those out of the way. All I have to do is show up at the hospital at 11:30 a.m. and my surgery is scheduled for 1:00 p.m. Mind you know food, drinking or smoking for 12 hours before surgery. So I guess I will be staying up till 1 p.m. I will report how the surgery goes as soon as I am able which will be part 2. Then after the cast comes off in 6 to 10 weeks depending on how I heal I then will report on those results as well.
