Post LRTI thumb basal joint surgery concerns
Hi, I'm new to healthboards and hoping for some insight/input regarding my post surgical experience so far. My surgery was just over two weeks ago on Jan. 25th, on my non-dominent left hand.
I have read many posts here and it seems so many have had a different experience with this surgery along with the post surgical treatments varying too.
The following is description of my experience so far and also my concern prompting me to write today. Please forgive the length of this as I wish to fully explain the sequence and facts of my experience.
X-rays were done prior to initial appt with orthopedic specialist. No follow-up pictures have been done since surgery.
At initial appt I was informed this was the "surgery of choice" to correct this problem and also informed of the cons regarding other two types of surgery and why he wouldn't recommend them. Otherwise, he made it unmistakingly clear with no doubt whatsoever that this procedure would completely resolve pain issues and there wouldn't be any adverse hand function of any sort from it. I inquired about his background with this type of sugery and was told he's been practicing over ten years and has done many of these...all with great results. He also stated how he is now the head of the whole Orthopedic Dept. for Gutherie. I must say, he made the surgery sound straight forward and really fairly simple...just have to do steps one, two, three. He explained I'd have a cast when waking from surgery and would return in two weeks for physician assistant to remove it along with stitches. Then I'd be given a new cast to wear four weeks at which point cast would be removed and I'd see him for follow-up then. He spoke of the type of Rx pain management medication being Hydrocodone/Acetaminophen...which it is. When I inquired about whether this surgery is really painful he shrugged and said more for some than others, but you'll have the medicine to use you are having pain. I also inquired whether physicial therapy is needed afterwards for this type of surgery and he said most don't need it, but some do. He never brought up physical therapy, I had to inquire about it. Also, he never spoke to me of any usage limitations with surgicle hand so I assumed I'd have use as tolerated while recovering. Please note that before meeting with him I had talked with some folks in my area about his reputation and heard he was an excellent doctor.
Surgery was outpatient on Friday morning (Jan. 25th). I was put completely asleep for it. Discharged soon from recovery. Afterwards, at home, my hand swelled throughout the day making the cast become very tight...although my fingers did not turn discolored or cold. I used elevating and ice packs to try and help and also was relentless in taking pain meds timely as pain was very significant.
By Monday I was so tired of the pain and discomfort of cast tightness...along with the feeling of my thumb, index, and middle fingers having that feeling like a body part gets when circulation has been curtailed that I called his office. They had me come in and one of his nurses cut a section out of the cast to help relieve the pressure. The cut was a V-shape cut on inside section of thumb next to index finger. By that evening the thumb swelling began to show past the V-shape cutout. I tried to bare with the discomfort and continued routine of elevating, icing, pain meds, and also turned to taking Xanax to help with anxiety during day and sleep at bedtime. I managed to make it through most of the next day, but by that evening it became apparent to me that my swollen thumb was being cut inside by one edge of the part of the cast that had been cut away. I was unable to manage to fit any cushioning into that spot due to the swelling...certainly not for lack of trying either. I decided to just keep relying on pain meds and Xanax to get me through the night and called their office first thing Wed. morning. Again, they had me come in and this time they removed the cast and gave me a splint which would accommodate swelling with the Ace bandage which I could adjust. This helped me get through the days to my original two week appt date.
It was this past Wed. which was my two week appt. and I returned for the stitches to be removed and was given a new cast to wear for four weeks. Unfortunately, this cast was wrapped way too tight around my knuckles at the base of my fingers and whole hand right up through the wrist area...leaving my fingers and hand in a cupped shape. The rest of the cast which went almost to my elbow wasn't as tight or uncomfortable. This cast was also hurting the incision site from the pressure against it and causing irritation/soreness to the V-nook area between my thumb and hand. I literally found myself that evening trying to use my kitchen scissors to cut the cast down and away from around the knuckles of my fingers to relieve some pressure so I could get by with it...especially because at this point I'm feeling like I'm such a pest of a patient. But by the next night (last Thursday) my stamina collapsed due to the discomfort of the cast along with the surgical pain I'm still dealing with too...and the knowledge of the impending arrival of the nor'easter on Friday afternoon and a long weekend ahead for me if I didn't do something about it soon. So I called the doctors answering service and was told he was on call that night. Soon after my call I received his call...this was my first conversation with him since the day of my surgery...don't know if this is typical for your surgeon not to see you at all during the 6 weeks after your surgery. I explained the problem and he advised I go to his office in the morning, but that he would be in surgery so one of his assistants would see me. Of course, they were so happy to see me again...NOT! But, at least I did end up with a new cast which has been more much comfortable. And it's only been since this two week appt that the scab from the cut in my thumb finally fell off too...so it was a good thing I didn't let the other cast from before continue to cut me.
Why I am writing here now...because of my post surgical history of pain and with cast changes too...and the fact that I don't have anyone I can call on to help me with things around here...making functioning extremely difficult...that over this past weekend while trying to open a number of pill bottles (needed to restock my pill tray for next two weeks) which are hard to open because all bottles have those child resistant caps the pharmacy uses...during my exertion to open one of the bottles I felt the worse pain which shot right up my arm along with a tearing sensation at base of thumb site...since then I have been in much more pain and my pain Rx is not handling it well. I spoke with the doctor's office manager this morning and she advised giving it a couple more days and if not better then I could come in and be seen by physician assistant, but stated to me that "after all you have had a number of cast changes already".
Presently, I remain scared and worried ever since this happened that something is seriously wrong because of the continuous pain...I actually broke down in tears this morning...although this evening feels somewhat better then the rest of the day has...it's still painful though. Should I try to stop worrying and just wait it out until the pain does eventally subside and trust that come March 7th, when this cast comes off, if something is wrong the doctor can fix it? As far as this cast goes, it is comfortable enough for me to manage till then...although not perfect, but so much better than the last one was.
Thanks for listening and I hope someone can tell me if they also think waiting it out is good enough at this point. - Mary