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Osteoarthritis Thumb surgery


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Old 04-22-2016, 07:26 PM   #1
Crafter417
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Thumb surgery

Hi, new here.

I am expecting to have surgery on the base of my left thumb (CMC Joint) in a few months - the usual one where they remove the bone and replace with a tendon taken from the arm...

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Old 04-26-2016, 07:08 PM   #2
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Re: Thumb surgery

I had the surgery on both thumbs - April 2014 and December 2014. I'm very pleased with the outcome. Be aware that you're in for a lengthy period of recovery; probably 6-8 weeks in a hard splint or cast, then a gradual resumption of activity over the next 8 weeks with full recovery taking about a year. The thumb I had done first is great - far better than it had been in a long time prior to surgery. The other is very good but I've developed arthritis in an adjacent joint that is causing me some stiffness but not much pain.

Have you decided on a surgeon? I talked to two; one who does a newer procedure that offer the possibility of a quicker recover but decided to go for the traditional surgery as it seemed more proven.

Good luck with whatever you do.

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Old 04-26-2016, 10:13 PM   #3
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Re: Thumb surgery

Yes, I have a surgeon. The one my doctor recommended based on my profession as a musician, and my hand therapist also said she is the one he would choose. She is conservative in that it will be 6 weeks in cast and then 6 weeks in a splint before any weight bearing is allowed. The therapist says she has the lowest failure rate in our area.

I did ask about a less invasive surgery on my milder hand, but she does not think it worth it, I guess, or maybe it's not done here at all.

My income is going to take a hit with no music teaching for a while, and then reduced teaching for at least the rest of the year. I'm planning on being able to teach my beginners in January. We will see! (I have another teacher lined up to take all my students in September, and most of them the full year.) I'm hoping the other hand will give me a few more years. I've managed without any steroid shots in that one yet. That thumb is more integral to my instrument (using a bow), and I don't know what surgery on that one will mean to my teaching. :-( I DO know that if I did not have the surgery on my left hand I would definitely have to give up teaching and playing due to the pain, so it wasn't too hard of a decision to make.

Maybe more than the reduced income (mine is not the primary income in the household), and maybe more than the painful recovery, I worry about life with no music and no crafts for three months or more. Hoping I can figure out something creative I can do with one hand.

Sorry to hear your adjacent joint is affected now. I also have some other fingers starting to complain, and do worry some that being in a cast for 6 weeks will allow them to stiffen up.

Thanks for your support!

 
Old 04-27-2016, 07:54 PM   #4
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Re: Thumb surgery

Hi
It sounds like you have done a good deal of planning already and that will pay dividends. You aren't expecting on getting back into your regular activities too fast and that is important; if you rush into things too quickly, you will hinder your recovery. There was an auto mechanic on here a few years ago (d j) who had the surgery and went back to work in 3 months and later said he should have waited longer.

You may surprise yourself at what you learn to do with your other hand while this one is immobilized. I'm sure there are things you can do one-handed as you recover. I missed out on some gardening when I did my first hand but I managed to get some enjoyment still from being out there with one hand. Oftentimes since I couldn't use my hand, I would use my elbow to help hold or position things. You'll adapt and after you recover, you'll be so glad you got this taken care of. I can do things now that just hurt too much to do before surgery - I even have been able to knit which had just become too painful. Plus I'm more ambidextrous now which has come in handy on several occasions.

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Old 04-27-2016, 08:22 PM   #5
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Re: Thumb surgery

I crochet, but only a limited amount now due to the pain. I have a sock loom I haven't learned to use yet... but I think that would also be awkward and require a jig to hold the loom.

I've decided to start a basket for movies to watch and books to read - seems I never have time for all the ones my friends recommend, word games, etc. Probably I can spend more time on genealogy again, too.

I've started to take one flower bed out of the yard as I've not been able to keep the weeds out of it. Will be replaced with lawn or a low maintenance bed. Any veggies this spring will be for fall harvest. Never have more than a few veggies, anyway.

Thanks for sharing your experience, it's encouraging.

Last edited by Administrator; 04-27-2016 at 11:01 PM.

 
Old 04-29-2016, 09:13 AM   #6
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Re: Thumb surgery

The best advice I found here was to keep my hand elevated all the times (yes, 24 hours a day) for as long as possible. The first time around, I stopped elevating after my post-op appointment 9 days after surgery and the next day I was in tremendous pain because of swelling. The next time around, I elevated for 6 weeks. Yes, I know that is a long time but it was well worth it for me.

Best of luck to you and keep us updated on how things go for you.

 
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Old 04-29-2016, 10:15 AM   #7
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Re: Thumb surgery

Did you use a Carter pillow or just adapt towels, pillows etc.? In the older posts someone was recommending the Carter pillow...

 
Old 04-29-2016, 10:23 AM   #8
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Re: Thumb surgery

I did use the pillow - "my blue buddy" as I called it. Later on I was able to switch to using pillows but at first it's perfect as it totally holds up your forearm while you're sleeping so there's no chance it will fall. That was great for me because I had a nerve block and couldn't feel anything in my entire arm for about 18 hours.

I also carried it around with me during the day, putting it on the arm of a sofa next to me. There is also the "sausage" pillow technique which works pretty well, too - using two standard bed pillows, you put one pillow on top of another, pin them together at the short ends, then thread your arm through the center. I found it would sometimes topple over unless I positioned it just right and hugged it toward me.

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Old 04-29-2016, 11:16 AM   #9
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Re: Thumb surgery

Does it work for side sleeping or only on your back?

 
Old 04-29-2016, 11:23 AM   #10
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Re: Thumb surgery

It works very well for side sleeping, but you have to sleep on the affected side (e.g. right side if you have your right thumb worked on). That got old after a few weeks because I like to switch sides.

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Old 07-03-2016, 07:18 AM   #11
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Re: Thumb surgery

Surgery is scheduled in mid July. I've read more old threads when there was a great support group of sorts happening here. I really appreciate all that everyone shared.

I have my arm elevation (Carter type) pillow and some cast covers for showering. Someone mentioned buying a sling, but I was thinking I'd be given one at the hospital. I guess I should look into that. I will look for Traumeel lotion or arnica, too. Took inventory and I think I have enough elastic waist, pull on clothing.

Pre-surgical screening phone call told me to expect being at the hospital for 7-8 hours, and that the surgery should be 75 minutes. That answered one question I forgot to ask my surgeon.

I have a very capable husband as well as grown sons here, but I'm not looking forward to being so dependent on others. :-/

Anyone else out there having this done this summer?

 
Old 07-18-2016, 06:56 AM   #12
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Re: Thumb surgery

Just thought I would report in...5 days post surgery...
No nerve block for my arm, but since my thumb was numb I asked, and yes, I did have an injection... The feeling seemed to be back in 24 hours, but no pain! So far I've only taken 1 extra strength Tylenol on each of the last three days, for what has really been minor intermittent throbbing or pinging. Right now the itching is bothering me more. On a nurse's suggestion, I am scratching near my elbow which is a bit of help. May try ice if it gets much worse. My fingers were sore the first few days, which seems odd, but maybe there was some inflammation.

I am in a plaster splint and tensor bandage over the dressing, and it will be changed for a cast when the stitches come out at two weeks. My fingers are free and I was instructed to move them lots and keep the arm elevated.

The arm elevation pillow (blue foam block) has been helpful, and I find I can twist enough to even kind of switch sides for sleep! The Curad cast protector has worked well in keeping my arm dry in the shower. I was not given a sling, and when I asked, the nurse told me it's because they want you using your arm and shoulder muscles. I guess that makes sense. I was thankful for a pillow to hold my arm up for the long drive home from the hospital, though.

The elbow does indeed become quite useful! And I found I can use my sock loom to knit by holding it between my knees. Not for long periods, though, as my hand isn't elevated when using it. Mostly focusing on rest and recovery, even though I am feeling much better than I expected so far. I do realize that the pain might increase as healing progresses, and my pain meds are standing by!

So thankful for my husband who has taken over laundry and most of the cooking, etc!

Last edited by Crafter417; 07-27-2016 at 04:22 AM. Reason: Correction

 
Old 07-18-2016, 08:52 AM   #13
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Re: Thumb surgery

Sounds like you are doing great - that's wonderful news! Congratulations - the first few days are the toughest time from my experience. I'm glad to hear your husband is helping out so much. Keep taking it easy and let your body heal up.

 
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Old 07-19-2016, 07:35 AM   #14
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Re: Thumb surgery

Hi, I am in the early stages where the hand surgeon has discussed possibilities about various ways we could handle my thumb problems...a the surgery you had sounded so scary to me! I've had three spine surgeries so am not afraid of the pain or long recovery...just fearful of what the results would be.

I wondered if you could tell me what you were experiencing with your thumb that made you realize you needed the surgery. Any thoughts are welcome!

 
Old 07-19-2016, 09:36 AM   #15
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Re: Thumb surgery

Hi teteri66, sorry to hear you are experiencing problems, too.

I began developing arthritis years ago with what I thought was a temporary reaction to Cipro. It didn't stop when the course of medication finished, but seemed to respond well to glucosamine. In time it was mild and only flared up here and there seasonally. Because it didn't bother me all the time I became lax about taking the glucosamine.

About three years ago it became a more constant issue. At that time I was 51. I am an amateur cellist and teach part time as well. This is NOT the cause of the arthritis as my non-musician family members are also affected. But the arthritis has impacted me in that area to the point where I had to give up performing and practice other than what I did while teaching, and I was at the point of also giving up teaching if I did not have the surgery. As sad as I would be to give up that part of my life, the decision for surgery was based on more than that.

Other things which caused pain: getting dressed, washing my hair, cooking, gardening, house cleaning, typing (I don't know why using my index finger made my thumb hurt!), holding a book, crafting (I found that as I did less with music I wanted to do more crafting), moving my thumbs "wrong", and sometimes of course they would just ache while doing nothing at all. And of course I was getting weaker and weaker. As well as weak joints, using my hands less meant using my arms less too.

Pain meds mostly didn't help much (though they did at first), and seemed to be causing ringing in my ears. I went to a hand physiotherapist, and he made thermoplastic splints which allowed me to use my hands with less pain/more strength, and he said would protect my joints. He had me wearing them for anything that stressed the joints, but not all the time. Initially they seemed quite helpful, but in time I was getting some very sharp and sudden pain, even in my right hand which was not otherwise as severe as the left.

The physiotherapist suggested corticosteroid shots, and if that didn't help, then surgery. I also began taking Joint Complete, a formulation of glucosamine, chondroitin, and msm. It seemed to help my right hand to the degree I held off any shots in that hand, but not the left. I had X-rays, and, surprising to me, they only showed "a little narrowing". Actually, only the surgeon later said that. The radiologist said, "nothing significant."

I was quite optimistic after the first shot as I had relief from my pain for close to six months. It did not relieve the sudden sharp pain, which the doctor surmised was something catching on the bone spurs he found while doing the injection using ultrasound. But with pain relief I mostly stopped wearing the splints. I think wearing them caused something to weaken or loosen and become prone to catching on the Spurs. Sadly, the second injection only gave relief half as long, and the third did not give any at all.

I had, in the meantime, also tried several dietary changes, but all to no avail. Because of music and crafting, using rubs wasn't practical for me, though on days off sometimes they helped. The most helpful was one that only acts by confusing the nerves to feel heat rather than pain. But it was not a smell my family or I wanted to live with all the time! Anyway, it didn't give me any strength, only helped with the aching.

The surgeon, looking at my X-rays with only some narrowing of the joints, wanted me to really think about the surgery as there are no guarantees and it may fail in time. I read online it usually lasts 15-20 years. So, I thought, I could retire now, give up all my hobbies and sit around waiting to have the surgery when I'm older in order for it to last a lifetime, or I could have it done now, and hopefully be able to work and live a more productive life for 15 or 20 years before I have to give things up and act old. And who knows, maybe there will be more advances by then to help us. I've been really tired of not being able to do anything without pain, though I feel like a bit of a wimp as I know there are people who experience much worse chronic pain out there.

The surgeon did concede that everyone experiences pain differently, and my family doctor also explained that some with worse X-ray results have less pain, and some with less severe arthritis on the X-ray have worse pain. Made me wonder why I had X-rays! Not only that, but by the time of my surgery, the X-rays were a year and a half old. I'm curious as to what the surgeon encountered and whether it was much more advanced than the X-rays showed. She has a long wait list as a rule, though, so I guess it's not unusual for her to work from old X-rays.

Well, I'm sure that's a much more detailed response than you expected, but maybe it will be useful to you or someone out there needling to make a decision regarding what path to take.

In some older threads here I've read many encouraging accounts and noted that most who have the surgery, even if they question the decision while in recovery, are happy enough in the long run to go on to have the second hand done.

Best wishes!

Last edited by Crafter417; 07-19-2016 at 09:41 AM. Reason: Spelling

 
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cmc arthroplasty, lrti, osteoarthritis



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