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CMC Arthroplasty with Artelon Spacer Expand / Collapse
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Elizabeth12
Posted Monday, December 18, 2006 12:53 PM


 

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KeaC -- I feel so silly for not thinking about the preparation ahead of time. I am also right-handed and will be having the surgery on my right hand. Recollecting how awkward and uncoordinated I was last spring when I was wearing a removable splint, I imagine this will be 100 times more difficult (at least back then, I could take the splint off if I really needed the right hand!).

NanaSusan -- just a quick comment about doctors if you do indeed decide to have the surgery. I'm having my surgery done in Richmond, VA, so I know nothing about NY docs, but when I was doing my research, I called several doctors to learn whether they've done the Artelon spacer surgery. I understand that there's quite a learning curve (as we would predict, for obvious reasons) for any doctor doing it, regardless of how good a hand surgeon the doctor is otherwise, so I encourage you to find someone who's done many of them. I found a doctor in Richmond who has done 60 of them, and I asked him lots of questions. Here are a few you might want to consider: How many procedures have you done? What is your complication rate? What were the nature of the complications? Have you done the procedures on individuals in my age range? Have you seen any difference in results in different age groups? And, of course, the age-old "If your wife/daughter were having this same issue, would you recommend the surgery to her vs. the arthoplasty?" I learned a LOT from the answers. It's always an individual decision whether you're comfortable with a physician, but I'm an information-gatherer, so I thought I'd share a few thoughts. Good luck!

Elizabeth
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NanaSusan
Posted Tuesday, December 19, 2006 1:11 AM


 

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Elizabeth....Thanks so much for all your information. I will make a copy of your list of questions to have on hand! Wishing you luck with your upcoming surgery. Please keep me posted. (my left hand requires the surgery, I am right handed so for you I can imagine it will take alot of patience. But the end result will be so worth it!
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KeaC
Posted Wednesday, December 20, 2006 1:18 PM


 

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Cast off...and removable splint in place as of this morning. Skin was dry, peeling and overall pretty ooky (I'm sure there's a technical term, but this word seems appropriate) looking. Nice to get the cast off after 4 weeks!

The PT involved heat treatment first (insert hand into a chamber half filled with buckwheat, which is whirled around via hot air blown into the chamber), followed by wrist stretches, thumb stretches, and an attempt at ball scrunching which ended abruptly with sharp pain and no scrunching of the ball whatsoever (next week, perhaps). The therapist said this is to be expected the first "cast-free" day. All stretching exercises to be continued several times a day for short durations. Moist heat can be applied, and also light massaging of the thumb/wrist area. Was given a swivel stick of "Palmer's Cocoa Butter Formula with Vitamin E" to apply onto and around the incision area before massaging. The massage is important to regain skin elasticity, and also to increase blood flow to the area, according to the PT folks. The splint is to be worn 100% of the time for the first couple of weeks, even while showering. After today's PT session, I'm fine with that! I report back to PT weekly to gauge progress and add more exercises. See the doc again in 4 weeks.
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KeaC
Posted Wednesday, December 20, 2006 1:44 PM


 

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A few more things you can do to prepare for living life as a "lefty" for a while (or a "righty" if you are left-handed)...
1. Prepare hard boiled eggs in advance and peel them after they've cooled. Wrap individually in plastic wrap so they're readily available after surgery.
2. If you don't have small kids at home, be sure to ask for your medications in the "easy open" bottles at the pharmacy.
3. Make a little chart for your post-op meds...across the top put the name of medication(s) and how often to take it. On the left side put the hours of the day (say, 7am through 11pm). Then, starting with the morning, write in the time you took your first dosage(s). Then you won't forget later...it's easy to get mixed up while on the pain meds. Keep things as simple as possible!
4. Open up as much packaged items as possible before surgery...it's really difficult later, with just one hand. Things like: milk carton, OJ, butter/margerine, sour cream, yogurt, peanut butter jar, cereal box and inner bag, etc. Everything you can think of. Also, tell family members to PLEASE don't screw lids on tight after usage!
5. Buy comfort food in advance. It really helps to just have on hand what you really LIKE, post-surgery. If you really like ice cream, prepare several servings in individual plastic containers and keep in freezer for one-handed use after surgery.
6. Pre-cut things like cheese, deli meats, lettuce, veges, etc., and wrap in individual servings.
7. Make a list for family members to do each day to help you out, if you have anyone to help out. Laundry for example...folding and hanging clothes is frustrating for one-handers! So is taking out the trash, sweeping the floor, etc. Washing dishes by hand is close to impossible, so be sure to have dishwasher soap on hand - that dishwasher will be a good friend post-op!
8. Buy canned soup that has the tab-top lids (which can be opened with a little practice)...using a can opener is impossible.
9. If you like freshly ground pepper...forgo it for a while and use the already ground variety...operating the pepper grinder is also impossible.
10. Bathroom tasks - oh my. Get one of those inexpensive rotating toothbrushes (Crest, etc.) to make the job MUCH easier with the non-dominant hand). Eye makeup...well, go without or get used to minimal makeup; it's frustrating with the left hand! You'll just have to get used to clumbsily using the non-dominent hand for other bathroom duties.

You'll start thinking of all kinds of things you can prepare in advance, and the more you do, the easier your first few post-op weeks will go. ~Kealani
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LovesFrance
Posted Wednesday, December 20, 2006 2:57 PM


 

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Hi, thumb buddies.
I've written before, on the other surgery thread.
My situation: 44 years old. Have had the thumb problem in both hands for about 2-3 yrs now. Did the whole injection, splint routine. . . you know it. Anyway, now I'm doing fairly well with alternative medicine: acupuncture, supplements, nutrition, diet, but am curious about one aspect of the artelon spacer surgery that I haven't seen addressed:

I am a yoga teacher and am wondering about putting weight on my hands after surgery. As you may know, a lot of yoga puts weight and pressure on the hadns (sometimes balancing all of your body weight). This is, as you would expect, important--and painful--for me to accomplish right now. Has anyone heard from a surgeon about that aspect?
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mommabird62
Posted Tuesday, January 02, 2007 1:08 PM


 

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Hi! I had my left hand done last tues (26th) and so far things are going great! The only glitch was when the nerve block didn't take. The anesthesiologist said that it is harder to get it to go correctly on thinner patients! (hmm...oh well)I wound up with a general anesthesia. And the surgeon had planned on me staying over night anyway. All in all, the pain has been not too bad. After the first few days I was able to take minimal "relief".

Actually, my right hand is in more pain because it's doing all of the work. LOL It will be done soon after my cast comes off. I have been very pleased so far and the surgeon is really great. He's very optimistic and a "go getter";-)

I have not been too needy and can manage well considering. My family including hubby have been very mother henish, but they know how I am. I've even been driving after cutting the pain meds way back and in addition had the first in a series of three, injections of Synvisc in both knees. I'm giving it a shot to hopefully prolong the knee replacement surgeries. I've had lots of steroids over the years and don't really need any more. Don't want to cause any other unwanted damage.

Anyway, just thought I would check in and so far, I don't regret getting this done at all! Other than having it done a few years sooner!

I'll keep ckecking in and still look for more news. I still don't quite know what will go on with pt, though I've had it before many times on my hands. I'm sure this will be different. Right now, my instructions are to wiggle the fingers and elevate when possible.

Y'all take care and have a wonderful New Year;-)
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KeaC
Posted Thursday, January 04, 2007 9:14 PM


 

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Just completed the first 2 weeks of PT (post-cast removal) and things are going really well. The first splint covered palm, lower half of thumb, and extended to mid-forearm. A week later, it was made much smaller to cover just the palm and lower thumb. That was a little scary - to have the wrist so exposed while still so weak, but those muscles and tendons are amazingly resilient. They strengthened up in a couple days. Today the splint was made even smaller, into a narrow little thing that still protects the lower thumb area.
PT was expanded to include removing/replacing wood blocks that are velcro'd down...yes, similar to what you'd find in a pre-school. Great exercise for strengthening the thumb, uncomfortable at first blush, but all part of the process to return to "normal". PT said the splint might be unnecessary in another 2 weeks. :-)

To Mommabird62: glad to hear your surgery went well! The first week is the hardest, based upon my experience so far, so you're doing great.

To LovesFrance: Not sure if this answer helps, as we're all different... I am 7 weeks post-surgery, and at this point, am NOT inclined to place any weight onto my hand (as in, a yoga pose) just yet. I can handle 1 pound weights as used in PT to strengthen the wrist (flex up/down 20 times), but nothing more. PT did say that people heal at different rates, so your progress might be faster (I'm 51).
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Cecelia11
Posted Thursday, January 11, 2007 7:16 PM


 

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Question to Elizabeth 12: I too live in Richmond VA and I'm scheduled for surgery at Johnston-Willis Hosp. in June. The doctor I chose was my "third" opinion, Dr. Rawles at West End Orthopaedic. He says he is very experienced in this surgery and I liked him very much. Just want to know who did your surgery? Sounds like it was a success. Thank you kindly, Cecelia
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bumThumb
Posted Saturday, January 13, 2007 10:04 AM


 

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So glad to have found this site. Very encouraging to see the results. I am scheduled for the proceedure on 1/19. Anyone have any pre-surgical suggestions?
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Elizabeth12
Posted Monday, January 15, 2007 5:31 PM


 

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Had the surgery on Jan. 3. Had some problems post-surgery with nerve pain (apparently, a nerve block on thin peo[ple can indeed create problems. That was actually the most painful part of the entire recovery process thus far, but the nerve irritation is getting much better. Hard to type, particularly at the end of the day, when my fingers are swelling a good bit. I will have the stitches taken out tomorrow (hooray!) and a waterproof cast put on (halleluiah -- can;t wait to take a shower again!). I'll write more later when I have a bit more use of my dominatn hand, but wanted to respond to Cecelia quickly. I also went to West End Orthopedics, but had the surgery with Dr. Desai -- what a coincidence! He said everything went "great", and he even cleaned out some bone spurs that were not impacting the CMC joint -- why not go ahead and take care of them while you're in there, right? The outpatient surgery center was fantastic -- the nurses and PA were terrific, and the anesthesiologist was great (despite my problems). Good luck to you, bumThumb. Re: pre-su rgical suggestions, I do recommend KeaC's good advice. I live alone, and I had lots of friends offer to help, but it really helps to have things prepared ahead of time -- if only for your peace of mind . One BIG recommendation -- figure out what clothes, coats, etc. will fit over what will surely be a huge, bulbous cast! I has to wear my brotherin-law's XL flannel shirt for a few days until I could handle the pain of stretching a sweater over the cast (which moves the cast despite your best efforts and hurts like the dickens). Also, make sure you have extra strength tylenol if you have problems with pain meds. I could take the prescription meds after the first 24 hours because I was so dizzy and nauseous. Ouch. But once I got enough food in me, they settled much better on my stomach, so I could resume them after three days as needed. Elizabeth
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Cecelia11
Posted Wednesday, January 17, 2007 6:26 PM


 

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Elizabeth 12 - ~Thank you for such a quick response. So sorry to hear you had post-op problems with the nerve block and I hope it will continue to get better each day. Dr. Rawles says he is using general anethesia, do they do a nerve block along with general anesthesia? Anyway I'm not thin so hopefully it will go well. Thank you for the excellent advice about clothing, I had never given it a thought. Take care & keep us posted, Cecelia
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Piano Rick
Posted Thursday, January 18, 2007 2:53 AM


 

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Here we go. Friday 19th is my day. Loma Linda hospital makes their surgery schedule one day before, so it's most annoying not knowing my Friday time until Thursday 3:00PM. We're going with a nerve block and some fantasy-sounding thing called twilight sleep. Well, I don't really want to be aware when he starts chiseling on those little bones. Have you seen the little surgery pictorial on the "Small Bones" website?--things I don't really need to know. They all say the doctor's great, but at pre-op appointment, I saw everyone on the whole hospital staff except him--Physician's assistant, nurse practictioner, resident, etc. BumThumb--Good luck same day as me. We'll have a race to see who can play the piano first--unless you don't play the piano. Doctor set me up with a 2-week post-op appointment. That's different than everyone else's timetable. KeaC, how it goes with you? and Mommabird62?
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Elmer11
Posted Thursday, January 18, 2007 12:35 PM


 

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Wait a minute! You mean I'll be able to play the piano after this surgery??? That's great! I always wanted to play the piano!!! ;-) Hey, Rick, report in as soon as possible after your surgery so I'll know whether or not to go through with it on Feb. 6th. I'm scheduled to have my left one done that day, and I'm hoping to be able to wait until fall for the right one. I have high hopes for the artelon procedure. They tell me that I should be back to normal in 3 months. Is that what most of you guys are finding? I would really appreciate any and all input on this thing. -Elmer
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Piano Rick
Posted Thursday, January 18, 2007 6:02 PM


 

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My last two-handed message for a while. In case I was having any second thoughts about how much I needed to do this procedure, being off Celebrex for these 2 weeks preceeding the surgery convinced me how really screwed up my hands are. I'm ready.
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KeaC
Posted Friday, January 19, 2007 8:21 PM


 

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Piano Rick and BumThumb - you've been in my thoughts today; hope all is going well with you both.
LovesFrance - regarding putting weight on the hand (yoga)...I can't put weight on my hand yet (such as getting on the floor - hands and knees), 9 weeks after surgery.
Today's progress report - I am now 2 months post-op, and am doing really well. The constant joint pain that was 24/7 prior to surgery is simply GONE. Saw the doc today and was told to use the thumb splint (which is now much smaller, providing no wrist protection, only thumb protection) when cooking or cleaning, but otherwise - leave it off - yay!! Still doing PT exercises each day - stretching and strengthening - and can use light weights (up to 3 lbs now). Thumb strength and mobility is still quite limited, as expected at this point in the healing process. Writing is uncomfortable still, so I simply don't do it. My non-dominant hand has become quite strong and much more coordinated having to "carry the load" all this time, so I figure that once the right hand has healed up completely, there will be a lot of ambidextrous-ness in my life...an added bonus. ;-)
BumThumb - you'll find a lot of pre-op tips in the previous entries. Just scroll down the page. Feel free to ask specific questions to anyone if you'd like...we're all in the same boat here, and sharing knowlege and experiences really helps.
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Piano Rick
Posted Saturday, January 20, 2007 4:24 AM


 

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Checking in, y'all. I actually have 4 full length fingers showing, but using them in any way makes the thumb hurt, so i'm not tempted. Typing with non-dominent hand takes a long time. Went with general anesthetic at the last moment. No apparent swelling. KeaC, thanx for the news.
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sharon1
Posted Saturday, January 20, 2007 4:37 PM


 

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Hi every one I haven't been on here in awhile. My docter told me I could go back to work at ten weeks out. Said my hand would get better with use. It's still sore but it does feel better every day. Everyone hang in there it's worth it in the end. Best wishes Sharon( the dog groomer)
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Elmer11
Posted Monday, January 22, 2007 9:39 AM


 

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Thanks for the quick update, Rick! It's encouraging to find that you were able to sit down and think straight that soon after the surgery. Hope all continues to go well with you! -Elmer
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Elmer11
Posted Monday, January 22, 2007 9:42 AM


 

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Thanks for the update, Sharon! It sounds good that you'll be able to go back to work at 10 weeks. I assume your doctor thinks you'll be "good as new" by then? I have surgery scheduled for 2/6 and I'm not looking forward to it. -Elmer
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Piano Rick
Posted Monday, January 22, 2007 9:48 PM


 

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No pain meds after first day--encouraging. I'm going back to one-handed school teaching tomorrow. Can't do much but talk, so I hope students are in the mood to listen and help.
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