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Old 03-19-2013, 10:21 PM   #1
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Advanced Basal Joint Arthritis/Surgery

For about a year now I have been suffering from what the orthopedic surgeon calls one of the most advanced cases of Basal Joint Arthritis he has ever seen in my left thumb. There is no tissue between any of the joints at all and it is all bone against bone.

I have been getting cortisone injections every 4 weeks but the pain is absolutely intolerable. I do have a brace that I can wear when the pain gets acutely bad, but that does little to help and is very cumbersome. He has told me that the only option will be surgery.

So this morning I am going to see the doctor for another shot and I am going to schedule surgery.

I am concerned about how long the recovery time will be. My sister is a nurse and she may be able to come up from Florida and stay with me after the outpatient surgery and take care of me.

I am wondering what the recovery time is going to be. I will need to be able to use two hands.

How long do most people have their one hand that had the surgery on it have it out of commission? How long is the arm in a sling and not useable? Do the doctors allow you to take your hand out of the sling at all for a period of time? I suppose I won't be able to drive either for a period of time???

I just would like people's advice on their post-surgery recovery and how long to plan being down and out and what their lives were like after the surgery.

I may as well get this done as I need to travel in June and July for workshops and other events and I know the pain is going to get worse. Right now I am dropping things because of the problems with my grip, and I suspect it is only going to get worse.

Thanks so much!

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Old 03-20-2013, 05:16 AM   #2
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Re: Advanced Basal Joint Arthritis/Surgery

Welcome to the club. Your story sounds very familiar to me. Right now I'm 4 weeks post surgery from a left thumb CMC Arthroplasty and will also have my cast removed today.

I'll try to answer all your questions. I really only wore the sling on the way home from hospital. You do need to keep it elevated the first two weeks after surgery. So if you are around the house or not standing/walking for any long periods you will be ok. I had a large pillow to rest it on while sitting. Otherwise, if I was out of the house, I held it across my chest. This is really a issue the first week. Gets better by week 3.

My wife helped me out the first few days. You really need to just do nothing the first 3 days so you can rest your arm and body. Having your sister there would be a huge help. After that I started to feel like I wanted to get moving again and do things for myself. The two largest obstacles were buttoning my pants and tying my shoes. I would practice those things before surgery.

I was driving 5 days after surgery. Not really a big problem.

Being a auto mechanic, I won't be returning to work for at least 2 to 3 more months. If I had a desk job I feel I would be able to work in 5 to 7 days.

Having been in a cast for 4 weeks I feel completely self sufficient. It's amazing how helpful people are out in public if you need help with something. You could certainly do your travels for workshops.

Good luck. I'll include you in my prayers.

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Old 03-20-2013, 07:12 AM   #3
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Re: Advanced Basal Joint Arthritis/Surgery

Hello, I am so glad to hear from you.

I had been debating surgery for 1 year now. I have the best Dr., that's number 1 for sure, get lots of references and make SURE he is a hand specialist. I'm told from my Dr. (incidentally, he just rebuilt the whole arm of someone who was supposed to have amputation and it came out, after over 2 years, totally normal!! It was said to be impossible by other physicians).

Well, I'm told by him that you are FULL casted, hard cast for 6-8 weeks, then the removable casts and very painful therapy than needs to be done for the best result for the rest of the year. It is a ONE YEAR recovery and you won't be able to lift with the hard cast and maybe not the removable one. I can't have my HAND SHAKEN. It will send me through the roof. My basal joint condition in both hands is stage 4, very severe in which the trapezium bone is actually crushed---the thumb is beyond bone on bone---it was that then is continually crushing into the trapezium bone.

So recovery, if you have a good Dr., is 1 full year and you are not in a sling so you know!! You have to have your hand elevated above your heart for months and a sling is absolutely not to be used I'm am told. Some people get one of the foam squares to put their arm in so it hold your arm up during sleep and even going places as it get tiresome, wearily holding yourself like that. For me, I will lose my job!!!! So my situation needs to have careful consideration. On the other hand, if I don't do it, for me, I won't be able to play piano! My thumb will continue to collapse into the palm of my hand. RISKS my dr said are 2%, not bad, infection like any operation and you can come out with PAIN---2% chance----one other Dr. I was not at all comfortable that he even knew what he was doing, well, he said you can lose strength in the operated hand. I don't know if he means less that you already have?

My Dr. say you can gain strength back! And the sooner the better for the Dr. and the outcome. Once thumb collapses into the hand, the operation does not bring it back! maybe just some. I have collapse in the right hand that actually almost stopped having pain----the right is escruiating at times like the left was. It's condition is the better of the 2. I'm on the fence and in a bad way here as a pianist/organist---and a very accomplished one at that. I am been trying to find pianists who have had this done! Can't find any yet on this board. I'm told the top of the thumb and four other fingers are out of this hard cast. You my be athletic and your joints in your shoulders, if in good shape and flexible, may be able to pull this off!

It was so nice to hear from you, but i'm certainly not glad you have the condition!

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Old 03-20-2013, 07:45 AM   #4
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Re: Advanced Basal Joint Arthritis/Surgery

this is dgarafa1 again. I forgot to mention that my Dr. said if cortisone does not help pain and even if it does, too many and even one can do more damage than good-----surgery should be the only option. I am only quoting what my dr. said. I am not a dr. It does affect the tendons and muscles---that's his cautions about the choice. I'm glad I was able to talk to you. I have been doing a lot of praying as to what to do-----leave it alone and let the hands deform maybe won't be as much as my moms, or fix. I was leaning towards doing nothing as I have read and have proof that the pain sometimes stops as those bones so bad stop moving together as they fuse together making you pain free. My left hand has done that! I may just let nature take over.

 
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Old 03-20-2013, 12:32 PM   #5
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Smile Re: Advanced Basal Joint Arthritis/Surgery

Hello,

I understand your concerns about being out of commission for an extended period of time. I have to use my hands every day as well so I had similar concerns.

I had my thumb surgery the Thursday before Christmas. I was in a dressing for two weeks, then a cast for two weeks followed by a removeable brace. I wore that 24/7 except for during showers or hand exercises for another 4 weeks. As soon as I was in a cast I was driving again(check with your state laws and insurance). I was out of pain(and off pain pills) except when I moved it or bumped the dressing at 5 days. I could type slowly at a week and without problems at 2 weeks. I was back to work right after Christmas break. My recovery was right on schedule. When the cast came off I started hand therapy twice a week and followed the rules exactly. I finished therapy last week, and although I need to continue strengthening my hand, it has healed perfectly. Most people have their hand strength back completely at 6 months but it can continue to improve for 6 years. I suppose if you have been babying it because of pain you might build up more strength than before. I will be having my left hand done in summer.

You will be unable to use your thumb for about 8 weeks. The only things that I had difficulty with were tying my shoes(I used elastic laces) and cutting steak. It takes a little longer to get dressed, but you get better after the first few days.

You will be amazed at how much more energy you will have when you no longer are in pain. I wore a sling home from the hospital and then never again. I did keep my hand elevated as much as possible(but not continuously) at first by holding my hand to my shoulder, but that and icing was it. After a couple of weeks I didn't have to elevate during the day at all. At night I elevated my hand if a foam cube I found on the internet.

I wish you well as you make this decision. You may want to look at the thread entitled Basal Joint Surgery started by Haydena. She is in the process of recovery from her second cmc surgery and has loads of good suggestions to make your recovery easier. Keep posting and let us know of your progress.

God bless you.

Linda

Last edited by Administrator; 03-31-2013 at 08:01 PM.

 
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Old 03-29-2013, 11:57 PM   #6
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Re: Advanced Basal Joint Arthritis/Surgery

Thank you all for the wonderful, thoughtful and helpful replies.

I received all my pre-surgical paperwork and co-payments (of course) in the mail and had my secretary send them in to the doctor and the surgery center.

I did "ok" so far with my thumb getting sore every now and then. I guess the last cortisone shot helped some as I am not in too much pain (yet) (knock on wood).

I appreciate the recommendations.

I am surprised that many people mentioned keeping the thumb elevated after the surgery. The doctor did not tell me that yet. But I still have to call the nurse and speak to her which I'll do after Easter.

I guess that is one thing that will be more informative.

The one thing I am not looking forward to is that I'll have to stop taking my daily dose of MOBIC which is an anti-inflammatory for my back. I have been on it for years and even if I miss a daily dose, my back goes into spasms.

The pre-surgery sheet says I need to stop it for TEN DAYS!! I am not sure how I am going to manage or what I am going to take in its place as I really need this anti-inflammatory.

Did anyone here have to stop taking similar medications for such a long period of time before their surgeries? What did you do?

Thanks again for all the help and Happy Easter!

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Old 03-31-2013, 05:33 AM   #7
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Re: Advanced Basal Joint Arthritis/Surgery

Happy Easter.

Great news to hear you are able to move forward to surgery.

I can't offer any help for your question about medication protocol.

 
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Old 03-31-2013, 06:57 PM   #8
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Re: Advanced Basal Joint Arthritis/Surgery

Usually, the only thing you are allowed to take for pain before surgery is Tylenol. Non steroidal anti-inflammatories (like Mobic) are not allowed.

 
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Old 04-03-2013, 09:41 AM   #9
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Re: Advanced Basal Joint Arthritis/Surgery

I think everone heals a bit differently. I had my surgery 2 weeks ago. I am getting my half cast/dressing off today and getting a new hard cast on for 4 weeks. I started using my fingers a few days ago. I still cant type with that hand because the casted thumb gets on the way. thats the only reason why. I just stopped pain pills. I have only been taking them at night for about 5 days (i think ) now. Hard to remember specifically.

my surgery was 15 days ag0. I still prop my arm up because my fingers will swell a bit, but they arent painful. I just keeo icing over the dressing. The hardest part of the surgery was the first week. The first few nights were rough, but things are progressively getting better by the day. I am very glad I did it!

 
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Old 04-06-2013, 01:56 PM   #10
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Re: Advanced Basal Joint Arthritis/Surgery

Quote:
Originally Posted by andrew683 View Post
Thank you all for the wonderful, thoughtful and helpful replies.

I received all my pre-surgical paperwork and co-payments (of course) in the mail and had my secretary send them in to the doctor and the surgery center.

I did "ok" so far with my thumb getting sore every now and then. I guess the last cortisone shot helped some as I am not in too much pain (yet) (knock on wood).

I appreciate the recommendations.

I am surprised that many people mentioned keeping the thumb elevated after the surgery. The doctor did not tell me that yet. But I still have to call the nurse and speak to her which I'll do after Easter.

I guess that is one thing that will be more informative.

The one thing I am not looking forward to is that I'll have to stop taking my daily dose of MOBIC which is an anti-inflammatory for my back. I have been on it for years and even if I miss a daily dose, my back goes into spasms.

The pre-surgery sheet says I need to stop it for TEN DAYS!! I am not sure how I am going to manage or what I am going to take in its place as I really need this anti-inflammatory.

Did anyone here have to stop taking similar medications for such a long period of time before their surgeries? What did you do?

Thanks again for all the help and Happy Easter!
Hi Andrew,

I know what its like getting off an anti-inflammatory for that week or so before surgery. The tylenol even with added caffeine at the maximum dose really doesn't cut it. You might want to ask your doctor if you can have some pain medication or muscle relaxers during that time off of Mobic. I found that my doctor was willing to give me something that didn't stay in my system or cause a bleeding risk(like anti-inflammatories) instead to manage the pain. I was only off of everything for the 24 hours before surgery.

When is your surgery scheduled? Hopefully it won't be too long until you are the one writing about your successful experience.

Margarita

 
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Old 05-30-2013, 01:27 AM   #11
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Re: Advanced Basal Joint Arthritis/Surgery

hello! anyone here been diagnosed with "pantrapezial arthritis"? thx in advance!

 
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Old 06-11-2013, 11:09 AM   #12
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Re: Advanced Basal Joint Arthritis/Surgery

how are you doing Andrew?

 
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Old 02-09-2014, 11:12 AM   #13
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Re: Advanced Basal Joint Arthritis/Surgery

Quote:
Originally Posted by andrew683 View Post
For about a year now I have been suffering from what the orthopedic surgeon calls one of the most advanced cases of Basal Joint Arthritis he has ever seen in my left thumb. There is no tissue between any of the joints at all and it is all bone against bone.

I have been getting cortisone injections every 4 weeks but the pain is absolutely intolerable. I do have a brace that I can wear when the pain gets acutely bad, but that does little to help and is very cumbersome. He has told me that the only option will be surgery.

So this morning I am going to see the doctor for another shot and I am going to schedule surgery.

I am concerned about how long the recovery time will be. My sister is a nurse and she may be able to come up from Florida and stay with me after the outpatient surgery and take care of me.

I am wondering what the recovery time is going to be. I will need to be able to use two hands.

How long do most people have their one hand that had the surgery on it have it out of commission? How long is the arm in a sling and not useable? Do the doctors allow you to take your hand out of the sling at all for a period of time? I suppose I won't be able to drive either for a period of time???

I just would like people's advice on their post-surgery recovery and how long to plan being down and out and what their lives were like after the surgery.

I may as well get this done as I need to travel in June and July for workshops and other events and I know the pain is going to get worse. Right now I am dropping things because of the problems with my grip, and I suspect it is only going to get worse.

Thanks so much!
I had basal joint surgery a week ago tomorrow. ONE WEEK AGO tomorrow. My doc also said it was one of the worst cases of basal joint arthritis he'd seen. My joint was "bone-on-bone" for six years. My doc does NOT harvest a tendon and roll it into an "anchovy" and place it where the trapezium was removed. Instead, he connects the thumb to a remaining bone in the hand with a web-like material. This may be the reason why I have experienced minimal pain and little swelling while others report much more. In any event, it's a good question to ask your doc. I have kept my hand elevated and iced except while typing (as I am now using both hands) and doing other chores. I was on pain meds for 12 hours after the surgery. It initially felt like I accidentally banged my hand, and now it is a little sore at the end of each day so I take an ibuprofen. I find I am capable of doing a lot even with my hand still in the cast, which will be removed in a week and replaced by a splint. PT starts in three weeks. Good luck!

 
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Old 02-09-2014, 11:44 AM   #14
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Re: Advanced Basal Joint Arthritis/Surgery

Quote:
Originally Posted by FeelinGr8 View Post
I had basal joint surgery a week ago tomorrow. ONE WEEK AGO tomorrow. My doc also said it was one of the worst cases of basal joint arthritis he'd seen. My joint was "bone-on-bone" for six years. My doc does NOT harvest a tendon and roll it into an "anchovy" and place it where the trapezium was removed. Instead, he connects the thumb to a remaining bone in the hand with a web-like material. This may be the reason why I have experienced minimal pain and little swelling while others report much more. In any event, it's a good question to ask your doc. I have kept my hand elevated and iced except while typing (as I am now using both hands) and doing other chores. I was on pain meds for 12 hours after the surgery. It initially felt like I accidentally banged my hand, and now it is a little sore at the end of each day so I take an ibuprofen. I find I am capable of doing a lot even with my hand still in the cast, which will be removed in a week and replaced by a splint. PT starts in three weeks. Good luck!
I had my surgery April 30 2013. I wish I had done it sooner! I had a bad case and need the left done too. I was not in much pain until they took the surgery splint/cast off. Then it's nerve pain, but that's expected. And it was bad, I'm not going to say it wasn't, but after my hard cast was taken off and PT started it was downhill fast from there.

You'll be glad you did it. My hand is totally normal and I am a pianist by career and am back playing. I don't even know I had it. I was alone after day 1. You can manage and I managed to write left handed. It was slow but I could do it and got better at it. You can't use the surgery hand until PT, and even then it has to be put back in the removable cast until about 6 or 7 weeks if I remember correctly. Then it's no splints forever! Simple exercises and not many. Just do them at least 3 times per day. I did as many times as I could especially when watching TV. The nerve pain goes away with therapy---the tingling and numbness. Don't worry that you have that after surgery, it goes away completely if you have a good surgeon. They have to move a large nerve aside during surgery and it flares up.

I was given Lyrica after surgery for 2 weeks. Protocol for this dr to help with nerve pain. Any more questions, please write.

 
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Old 02-09-2014, 11:53 AM   #15
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Re: Advanced Basal Joint Arthritis/Surgery

Quote:
Originally Posted by FeelinGr8 View Post
I had basal joint surgery a week ago tomorrow. ONE WEEK AGO tomorrow. My doc also said it was one of the worst cases of basal joint arthritis he'd seen. My joint was "bone-on-bone" for six years. My doc does NOT harvest a tendon and roll it into an "anchovy" and place it where the trapezium was removed. Instead, he connects the thumb to a remaining bone in the hand with a web-like material. This may be the reason why I have experienced minimal pain and little swelling while others report much more. In any event, it's a good question to ask your doc. I have kept my hand elevated and iced except while typing (as I am now using both hands) and doing other chores. I was on pain meds for 12 hours after the surgery. It initially felt like I accidentally banged my hand, and now it is a little sore at the end of each day so I take an ibuprofen. I find I am capable of doing a lot even with my hand still in the cast, which will be removed in a week and replaced by a splint. PT starts in three weeks. Good luck!
I DID have ligament/tendon reconstruction----and it went well and my hand is as strong as it was when I was 30 years old. It's just "normal". I totally recommend this surgery if anyone of you out there need it. I was scared and procrastinated and didn't think I would be able to play the piano and didn't understand how it would work without a bone, but it does! And my hand no longer looks deformed!

 
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