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Old 05-10-2010, 08:53 AM   #1
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going through the basal joint surgery process - at least, my story

This thread is for anyone who is considering this surgery.

I had joint pain for several years and tried many different treatment modalities: NSAIDS, therapy, cortisone shots, accupuncture, etc. to no avail. After much research and reading on other threads, I determined to seek out a surgeon. I was fortunate to be in a large city which is supported by many well qualified hand surgeons. I finally decided to go with the surgery on May 1 of this year so I'm only a week out.

Suggestions of what to do BEFORE the surgery:
- talk with others about surgeons
- find a surgeon who has performed the surgery for several years (mine was 26 years with no re-dos)
- once the surgeon is selected, set a date that works for you. I live in FL so the temperture is usually mild - we still have a winter, however, and I would caution anyone considering the surgery in a cold climate as dressing becomes difficult following the surgery and it is best to be able to wear sleeveless, pull-over shirts and pull-on pants/skirts. Sweaters and jackets would be very difficult to work with.
-Once the date is set, look at your wardrobe for items such as those listed above. I found great deals at Sports Authority for pull-on shorts. I bought two pair of pull on pants and a couple of pull on skirts. I cannot use zippers or buttons at this point.
- Arrange for family and friends to assist with cooking, washing and transportation. If you have pets that need to be cared for, you will need to arrange for someone to do that the first few days following surgery. In fact, it is imperitive that you no be alone those first few days, especially as you will be taking pain meds around the clock that tend to make you sleep 3 out of the 4 hours in between and you need to make sure that someone is monitoring those meds as you're not thinking too clearly. Transportation is important that 1st 10 days but the cooking and laundry will be needed a little longer.
- Make sure that you have sufficient entertainment available such as movies, magazines and books, preferrably of the electronic variety as it is hard to hold a book open.

I hope that this info will be helpful. I get my hard cast today and will update later.

 
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Old 03-05-2011, 05:54 AM   #2
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Re: going through the basal joint surgery process - at least, my story

Had this surgery about 3 years ago and it has been very successful - had it done by a plastic surgeon. I would do it again in a heartbeat.Good luck on your recovery.

 
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Old 03-06-2011, 09:57 AM   #3
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Re: going through the basal joint surgery process - at least, my story

I wasn't very good on updating...I'm almost a year out now. Although I didn't think I would ever regain the strength, I would say that I'm at about 90%. I kept working with my trainer who gradually upped the weights and resistance. Yes, I would do it again and may have to with my right hand.

 
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Old 03-06-2011, 12:05 PM   #4
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Re: going through the basal joint surgery process - at least, my story

Hi Dajo,
Tho I am now reading your post 5 months after you posted it, I want to thank you for posting your valuble tips. I am due to have surgery on my left thumb on 2nd May. So far, all I know about my surgery is that it will be, Arthoplasty & Ligamentoplasty. I see my surgeon in 3 days to discuss the op in more detail.
I tried searching for your follow-up post about your operation & as a "newbie" here was unable to find it. I hope your surgery went well & that you have fully recovered.
Haydena.

 
Old 03-06-2011, 12:12 PM   #5
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Re: going through the basal joint surgery process - at least, my story

Quote:
Originally Posted by Haydena View Post
Hi Dajo,
Tho I am now reading your post 5 months after you posted it, I want to thank you for posting your valuble tips. I am due to have surgery on my left thumb on 2nd May. So far, all I know about my surgery is that it will be, Arthoplasty & Ligamentoplasty. I see my surgeon in 3 days to discuss the op in more detail.
I tried searching for your follow-up post about your operation & as a "newbie" here was unable to find it. I hope your surgery went well & that you have fully recovered.
Haydena.
I made a mistake Dajo,
I thought your last post was posted 5 months ago. I see you joined this forum 5 months ago. Sorry about that.

 
Old 03-07-2011, 06:33 AM   #6
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Re: going through the basal joint surgery process - at least, my story

I wasn't very good about updating so that's probably why you couldn't find any.

I was in the hard cast for about 4 weeks instead of the 5 that my dr. initially told me so that was good. I went for a bright yellow cast and then my 20 year old son drew red flames on it. It was quite the conversation piece! I continued exercising although the emphasis was on lower body.

Once out of the cast, I began therapy two times a week for about an hour each. Starting out, I had no strength in my left hand. I was instructed to do various exercises bringing my thumb toward my palm, trying to touch the other fingers, etc. The thing I liked most about the therapy sessions was the initial heat wrap and gentle massaging and then the follow up ice pack after the "workout".

After a few weeks, I was able to do the movements noted above so they started having me grip "tweezers", using them to pick up various objects. Finally, I moved on to a putty like substance in which they had placed 10 bb's. By using my left hand only, I had to manipulate the putty to remove each bb. My hand would be sore after doing that but it sure helped. I also picked up change and buttons with my left hand to improve dexterity.

At 3 months (I had my surgery May 1) I was still weak and wondering if it was going to get better. At 5 months post I felt much better. At 7 months, my thumb started aching and I was worried that something was wrong. My dr. said that this was normal and that it would stop hurting. 9 months, the hurting was gone and my strength was greatly improved. I should also note that in October I was riding my bike and fell forward, catching myself by placing both hands on the pavement and then rolling over. I thought, great! I just blew out the tendon! However, the dr. x-rayed the hand and all was just as it should be. whew!

Now, I'm almost 11 months out and I am able to grip, lift, pull, etc. without pain. I do notice some aches when the weather turns cool but, overall, I am happy with the result. I will be interested to see how your surgery goes. I know that it will go well. Just be patient with yourself.

Good luck!

 
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Old 03-07-2011, 07:09 AM   #7
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Thumbs up Re: going through the basal joint surgery process - at least, my story

Hi Dajo,
I am pleased to read that you recovered so well & I want to thankyou so very much for answering my post. After reading about your recovery & physio, I somehow feel more confident.
I have been surfffing the internet to get as much information as I can, please know that your reply gave me the most information.
I have full trust in my orthopedic hand surgeon,who has been operating on hands for yonks, he has also written over 150. articles on this subject & btw is a professor.
I was more concerned about the physiotherapy which I will have after 4 weeks of wearing a hard cast.
I guess its fear of the unknown!
I am due to see the professor this coming Wednesday when I will bombard him with questions.
I am patient with myself & do laugh at how long it takes me get tasks done.
I thank my lucky stars that my kids are young adults now & dont need me as much as they did when they were babies.
I am fortunate to have a very supportive, caring husband who helps me with everything.
I hope I will be able to choose the colour of my cast! Bright yellow with red flames sounds so cool !!
I will keep you informed about my surgery & once again thankyou for caring 7 for the valubale information.
Take good care Dajo.

Haydena

 
Old 03-10-2011, 12:20 PM   #8
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Re: going through the basal joint surgery process - at least, my story

Dajo, thanks for your contributions to folks like me. You were one of the people whose information encouraged me to go ahead with this surgery on 1/6/2011. My hand hadnít deteriorated to stage three, but Iíd been limiting my activities so much that I had lost muscle on my left side, and general upper body strength, and was getting out of balance to the point of having back and neck pain. I would encourage people with symptoms requiring cortisone injections to go ahead and get this done before things get even worse. My hand Dr. is of the opinion that the prognosis is better Ė faster recovery, less damage to overcome.

Iím nine weeks out now, and doing really well. The scars are hardly noticeable, and Iím even doing wrist flexion and extension exercises with 3 lb weights, and biceps and triceps. It feels good to be doing something to gain strength. How soon were you able to do real weights again? I want to join a kettlebell weight training group as soon as I can, and my PT thinks mid-summer would be reasonable. Iíll tell him about the BBís in the putty Ė great idea.

I was lucky in only having the hard cast from the second to the fourth week Ė I donít think I could have taken another day! It was very tight and came to just below my elbow; I couldnít even turn my hand palm up. Iím going to suggest to my Dr. that they consider making the casts a few inches shorter for people so theyíd be less cumbersome and heavy.

Haydena, maybe you can talk your Dr. into letting you out of the cast early if you promise to be good and wear the splint except for showering. I wish you the best!

My cast was purple, no flames though, and so is my acrylic splint which I wear whenever I'm likely to be tempted to do too much.

 
Old 03-10-2011, 02:17 PM   #9
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Re: going through the basal joint surgery process - at least, my story

Hi Chiacat,
Wonderful to read that you have made such good progress.You sound like a "fighter" & "acheiver." (like I am)

My doctor prescribed a splint, he told me to wear it when I am in pain.It protects the thumb & just covers the wrist. I find that it restricts the movement & only wear it when I know I need to carry stuff, like shopping. At home, I hardly wear it.

My osteopath told me not to allow the thumb muscle to go to waste as healing after the op would take longer.I try to use both my left hand & my right hand.(I am somewhat ambidextrous)Opening & closing bottles etc is difficult with left hand.I dont force my left hand at all. I count myself very lucky in that I am still able to tie the laces of my sneakers with my right hand, using my left hand aswell.

I had no cortisone injections & refused all anti-infammatory pills as they did not help.
The orthopedic hand surgeon who will operate suggested operation on my first visit because I have lost all the cartilage between the last 2 bones on my left thumb.
As far as I understand he will take part of the tendon in my lower thumb & wrap it round where the cartilage has been lost.

I know this is a very successfull operation. I also know there will be quite alot of pain involved. I'd rather fully re-gain the use of my left hand,than continue
as I am at present. I have noticed that the muscle in my left thumb is less than in my right thumb, which of course is a sign of muscle loss.

I will have a cast up to the elbow & if I feel its too tight, I promise I wont suffer!! I will ask for a new cast. I think its better to be in the cast for 4 weeks totally than go into a splint. I guess its best to play it by ear & see how I feel.

Physio I will have as soon as the cast is removed.
I will let you know how I manage as soon as I will be able to type (here.)

I appreciate your advise & thank you for it.
All the best for your contuned progress.
Haydena.

 
Old 03-11-2011, 01:32 AM   #10
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Thumbs up Re: going through the basal joint surgery process - at least, my story

Hi Haydena,
I had a splint like yours, with much the same history of wearing it before the surgery. It was good to have it, but like you I mostly wore it when I had heavy tasks to do. My current splint comes about halfway up my arm, and my PT shaped it to hold my thumb more out to the side to allow plenty of space for the new capsule to form around the interposed tendon. For the past week, Iíve been using it more like I used the old one. I think you will do very well because you have been continuing to use it in spite of pain, youíre getting it done while you are still functional, and you have that tough, determined attitude. Good for you!

It sounds as if you are doing a very good job of getting prepared for this. I agree with dajo about all of her great tips, but I live in a climate more like yours so I can add a couple. Where I live, near Seattle, Washington, early May is usually still quite cool (low 60ís F), with a few nice warm days (low 70ís) scattered in. If you have a wonderful, supportive spouse, youíre halfway there!

Slip-on shoes are a necessity. I also stocked up on a few cute, warm vests at the second hand store where I work since I couldnít wear sweaters or jackets. Spandex is your friend, also shirts with wide arms. Buttons and zippers, not so much until you are free from the cast. Yoga style work-out pants are a blessing, and also make you look very sporty Ė like a jock whoís rehabbing a sports injury. After all, thatís what you are, right?

Ice, ice, ice . . . and then ice some more. Keep it up on a regular schedule, and have several of the blue ice bags in rotation in the freezer. Itís another thing your sweet spouse can help you with, as well as when and how much pain medication youíve had, and when you can take some more. Itís going to hurt for the first four or five days; youíre right about that!

Plan to have someone take you to have a mani/pedicure for your first trip out; your feet and right hand will appreciate it, and you deserve it.
If you use any meds or supplements, make up daily (or twice daily Ė whatever your schedule) packets to last you for at least as long as youíll have the cast. I got little plastic zip bags at the pharmacy. I also picked up an arm cast cover for showering.

If you will be getting a big dose of an antibiotic with your surgery, you might want to think about having a probiotic supplement ready to use after to help restore the good digestive critters. I wish Iíd figured this out sooner, but five weeks after the surgery, when I did finally use a seven day (once/day) supplement regimen, I really began to feel much better. That sounds funny, but before that Iíd had a lot of stomach upset and fatigue. I started getting more sleep after I was less barfy. At first I had attributed it to the oxycodone, but it persisted after I quit taking that.

Get yourself a Carter Arm Elevation Pillow if you can. This wonderful invention allowed me to have my arm at head height effortlessly, which kept swelling Ė and pain Ė down post-op (and I think contributed to my speedy healing time so far), and I used it a lot even after the initial two weeks post-op just to have a comfy place to rest my arm to relieve the discomfort of carrying the cast around. If you get your doc to write a Ďscript for it, insurance might cover it Ė cpt codes are on the website. Although I guess in the UK, insurance works differently than in the US. I think it cost me $45 USD + shipping, and it was worth much more than that. I have a neighbor who needs to have this procedure, so Iíll loan it to him when he does. I might eventually have to have surgery on my right hand, too . . .

You will not be able to do very much for a few weeks, so take dajoís suggestion about stockpiling some entertainment. I was lucky that there was almost constant American football on TV for my first week, and that I enjoy college football. It was engaging when I was awake, but if I dozed I didnít miss much of the plot.

I have a horrible time with general anesthesia, and will do anything to not have it; I went without it for this surgery (just had the block), so I didnít have to recover from that. I just got dressed and my spouse took me home, and we even got something to eat on the way, although having an absolutely dead fish of an arm is a bizarre experience. When I leaned over to greet my dogs when we got home, this thing in a sling swung out in front of me, and then I realized that it was my arm. The block began to wear off about ten hours after I got it Ė eight hours after the surgery was over Ė and then I wished I had it back! I think that in Europe, procedures like this are usually done without the general, and if youíve been living with this condition for awhile, youíre already pretty darned tough . . . and good at removing yourself psychologically from whatís going on with your hand. I did have an IV, and the handsome and charming anesthesiologist was standing by in case I changed my mind, so I got into a good conversation with him to distract me Ė after all, distraction is one of the best ways of dealing with discomfort. At one point I could sort of tell that there was a strange sensation out there on the other side of the blue drape, but my mind didnít interpret it as pain and I just ignored it. It was easier than having a crown prepped at the dentist, and everyone was really in awe of me for doing it that way!

Get your house clean, stock up on easy meals, pay all your bills ahead, and do any errands before your surgery so that you can just relax and heal without worrying about anything.

Wow, I didnít plan to write so much, but maybe this will help other folks, too. It is so good to be on the other side of this looking back!

 
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Old 03-11-2011, 01:54 PM   #11
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Re: going through the basal joint surgery process - at least, my story

Thanks Haydena and Chiacat. I appreciate the feedback and I am so happy that the post was so helpful to others.

I know that you will be happy with the result but don't hurry yourselves. It will get better!

Dawn

 
Old 03-11-2011, 02:00 PM   #12
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Re: going through the basal joint surgery process - at least, my story

It sounds like you are doing great with the hand weights. My trainer started using the handweights with me after my dr. cleared me - about 2 weeks after therapy was discontinued. What I found out was that, while I may be able to do "hammer" curls, i was not able to to regular curls. That was the case up until about a month ago. WE're still building up the weight as I had to start over with 3 lbs, then 5, then 8, and I'm still working up from there. You'll know what's right - if it HURTS, then STOP - readjust and try something different.

 
Old 05-06-2011, 09:52 PM   #13
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Re: going through the basal joint surgery process - at least, my story

hi chiacat, dajo and all,

i have had my surgery. 2 may 2011. am pleased to report all went well. i stayed overnight as the surgeon requested, i received a great cocktail of very helpfull painkillers. hand has a hard plaster cast in shape of a ball, in the ball of my left palm, with the original bandage wrapped around my wrist and hand. surgeon explained that he didnt want to contribute any pain whilst removing plaster and bandage straight away. i will have this all removed tomorrow afternoon. yes, thats sunday.
(at the moment i am living in israel where the working week begins on sunday.) i think i will go into some kind of splint; i was somewhat out of it when surgeon expained this all to me.
i hardly have any pain now, only the ocassional throbbing when i reach for the ice pack and take a mild pain killer, not voltaren nor nurofen, but something like your tyrenol, every 4 hours. i sleep with the arm raised and in a sling during the day. showering is easy thanks to both your excellent advise-s. i again want to thank you so very much for taking the time in explaining your tips. you were of great help to me.
as time goes by i intend to let you know whats happening to my hand.
all the best to everyone.
huggs, haydena.

Last edited by Mod-S4; 06-13-2012 at 09:07 AM.

 
Old 05-08-2011, 05:18 PM   #14
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Re: going through the basal joint surgery process - at least, my story

That's ok. I just had my 1 year anniversary post surgery and all is well and in place. I have most, if not all of my hand strength back.
I know that the next few weeks ahead of you will be frustrating but it will only get better.
God bless and here's to wishing you a speedy recovery!

Any questions, just post.
Dawn

 
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Old 05-08-2011, 05:37 PM   #15
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Re: going through the basal joint surgery process - at least, my story

hi dawn,
just to update. i now have a light splint since yesterday. 6 days after sugery the hard ball of plaster in palm of my hand was removed. ah, what pure joy....relief. surgeon was pleased with my hand in that the healling is going very well. i have a piece of thermo plastic shaped to my fore finger and thumb, covered by pieces of velcro. velcro also is wrapped around hand just above wrist. fingers protude. hardly any pain, some throbbing-i reach for the ice pack. ( a medicated gauze like ligt bandage covers the stitches)
stitches will be removed next sunday. i will wear this splint for 6 weeks. of course no driving for me and i will not be using the hand. i do need to move fingers and bend the top of my thumb hourly. no need to sleep with arm or hand raised.
the worst is over tg.
you wrote that you may need to have your other hand done. any news about that ?
all the best to you dawn.
hugs haydena.

 
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