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Pain after basal joint arthroplasty
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jmast52 posted:
Had basal joint arthroplasty on my left hand over two months ago. Swelling of hand and fingers is still quite apparent. Also limited mobility,lack of strength. Pain is fairly constant, worsening at night. Have had to ask for Vicodin as Ibuprofen doesn't cut it. Haven't slept through the night since the surgery. Have had to get Ambien for sleep. Every professional (surgeon, hand therapist) I've asked tells me this is normal. The thing is, I wasn't made aware that this would be my hand's post surgical condition prior to surgery, just that the recovery period was three months. I was not aware that I would have the pain and swelling and stiffness that I do. The reason I had the surgery was for elimination of pain. I have basal joint arthritis in my right hand also and was planning for the surgery on that hand next year. Now I'm having second thoughts. Every professional tells me I will regain full dexterity and strength in my left hand, but I'm dubious due to the pain and weakness I'm now experiencing. Any comments, suggestions? Thanks.
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marigolds responded:
can understand both your pain and frustration. i, too, need surgery on my right basal joint, but am hesitant to have it done. Was to do it this october, but so afraid of how long the recovery period would take. i am an avid flower gardener and put a lot of wear and tear on my hands, so i definitely would go for the surgery if i knew i would be up and running in about 2 months. however, on some of the forums online, they all seem to experience some of what you are saying. recovery time is very long, some say about six months, but in the end, it was well worth it, and many said they would do the other hand, if need be. keep in touch. would love to hear your outcome.
 
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_swank_ responded:
You've been told by every professional that what you're experiencing is normal. They told you the recovery would take three months. I'm not sure what else you want anyone to tell you. Healing takes time, there's nothing you can do but wait it out and follow doctor's orders.
 
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marigolds responded:
Was wondering if they told you how long you would need to have the hand therapy? Also, did they give you an axillary nerve block prior to surgery for the pain? If so, how long was it effective for?

My hand was pretty bothersome this morning until i took some aleve and then it calmed down. I shutter to think what it will be like when the cold weather comes.

Are you able to use that hand at all right now? My husband works long hours out of town and i would be on my own for just about everything all day long, which kind of makes me have my doubts about having the surgery.
A person cannot very well cook and do a lot of personal things for oneself with one hand. Had carpal tunnel on both of my hands about 3 years ago and did just fine tho. I do very well with pain, but just worried about how long recovery will drag on for.

would appreciate hearing from you......
 
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jmast52 replied to marigolds's response:
marigolds,
I'm not certain how long I will need therapy. My surgery was May 27, 2010, so it's been nearly three months. I must say there has been a decrease in pain in the last week or so. The pain, stiffness and swelling isn't gone but more tolerable. I did have an axillary nerve block. My entire arm from the shoulder down was paralyzed more or less. My anesthesiologist recommended the whole arm block. My surgery was at 8 am and I was able to slightly move my fingers late in the afternoon of the following day. There was a possible effect of the nerve block I may not have been aware of. After my surgery and during the first three or so weeks after, I had very little to no pain. I was uncomfortable due to the cast and swelling. My fingers and thumb were numb and tingly to the touch as though they were asleep. I assumed that when I was fully able to move fingers and arm again that the effect of the nerve block had disappaited. I'm thinking now that perhaps it lasted much longer as I began to have more pain in the second month after surgery. I was not aware that my hand and fingers would be as swollen as they were after surgery. That seemed to be to be the major cause of pain, the swelling and stiffness that it caused. I had minor, fleeting pain at the surgery site. I can understand your concern. As I stated in my initial post, I had my left hand done first, as I had more pain in that one although my surgeon said my right is in worse shape. I'm right handed. I am going to wait until my left is 100% back in working order before I attempt to have the right done. I'm also going to try and make myself as ambidexrous as possible in the interim. I see my therapist in the morning. She doesn't feel I should go back to work yet, but I don't know if my disability can be extended. We'll see. Will keep you posted. One thing you might try is something my hand therapist has me doing. Contrast baths. Fill basins or a double sink with warm (not too hot) and cool water. Start with the cool and swish your hand for thirty seconds, then thirty seconds in the warm. I was told to do this for 15 minutes, but I do it longer. Finish with the cool water. Good luck.
 
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marigolds replied to jmast52's response:
Thanks so much for replying. Curious to how many times a week you go to therapy. Dr told me that some therapy is involved and most of it is done right at home. Is that really so? I think they try and make it seem less complicated than it really is. Do you agree? Also, were you asleep during the surgery? I am pretty sure you have to be awake during the axillary block right?

Last couple of days the bones in my wrist are really making cracking noises. It's funny cuz i am left-handed and it is the right one that needs the replair. When i concentrate on what i am doing during the day, i realize that i if i am using the bad hand, i am not utilizing the thumb at all. Funny how you do things and are not aware of it huh.

Our insurance deductible is all paid up for this year, so it would be in my best interest to get this done before the end of the year. Can you use that hand right now to do anything? What about cooking? That is my biggest concern. Most things can be done with one hand, but not that.

I could even consider doing this between Thanksgiving and December. Kids are all grown up and on their own, so a little less work for the holidays would do me good.

Keep me posted as to your therapy progress and what you are able to do. I was happy for you to hear that the pain seems somewhat lessened.
 
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marigolds replied to marigolds's response:
Was just now looking at some forums about your surgery and one man was well in just two months. Physical therapy and all.
Another woman said on a site she read, patients who had this surgery were still well 12 years later and 98% of them said they would definitely do the other hand if they had to.
Last article said that it can take a full 6-12 months for it to heal completely.
Things are looking up for you....sounds like you are over the hump, Wish i were in your shoes.
 
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jmast52 replied to marigolds's response:
marigolds,
I started therapy about three weeks after surgery, when the sutures were removed. I have been going weekly (about 8 weeks) but my therapist wants me to start twice a week to build strength. I was given some exercises to do at home. Yes, I was asleep during the surgery and no, I was not awake during the block. I agree that it would be in your best interest to have it done in the same fiscal year that your deductible was paid up. Mine turned out to be that way. I am able to use the hand more now but I have very limited strength and still have mobility issues. I've been told by my Dr. and therapist that everything is going along in a standard progression.
 
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marigolds replied to jmast52's response:
Thank you for replying to my questions...you hang in there, too, and keep me informed as to your progression. I know you will be good as new soon.
 
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marigolds replied to marigolds's response:
WAS WONDERING HOW THE INCREASED THERAPY IS GOIING FOR YOU.....ARE YOU GETTING TO WHERE YOU NEED TO BE?
 
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jmast52 replied to marigolds's response:
Am slowly (emphasis on slowly) making progress. Left hand is still very weak compared to the right. Still have swelling, stiffness and pain in the joints of left hand. Am told there is still fluid in the joints and tissues of that hand. I can feel it. Saw my surgeon last week. He gave me an injection to help decrease the swelling and inflammation. It's been five days and I don't notice any appreciable difference yet. My hand therapist keeps telling me that it will take a year to completely get back to normal, but I am still dubious as to what kind of "normal" it will return to. As I stated, I had some arthritis in the other joints of my hand but was told it wasn't bad. The surgery, or rather, the aftermath of surgery, i.e. swelling and inflammation, exacerbated that arthritis. I'm just hoping that it is not a permanent condition.
 
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alb7039 responded:
I'm scheduled to have basal joint arthoplasty on my non-dominant left hand...and the blogs I am reading are causing me to re-think this surgery. I wear thumb immobilisers 24/7 and the pain is controllable as long as I don't overdo it. If you had to do it over again - would you?
 
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jmast52 replied to alb7039's response:
alb7039,
As of last May 27, my surgery anniversary date was one year. As of this date, June 18, I have been the closest to "normal" as I've been since the surgery. There is stll stiffness and weakness in the joints of my fingers, but it is slowly improving. I don't know if my case was normal or not as my hand therapist felt that I was a slow healer. I've spoken to others who had the surgery and they did not experience the pain and stiffness in the fingers of the hand that had surgery as I did. I play guitar (for pleasure, not professionally) and as of now, I can play guitar, but not as well as I could prior to surgery. I also have to take into account that I essentially laid off playing the instrument (although I tried) and there was a usual "rustiness" that occured. I have basal joint arthritis in my right hand as well and at this point, I don't think I will have the surgery on my right, only because I really don't want to go through the pain and discomfort that I experienced for such a long time with my left. Also, I know that I have a lot more arthritis in the fingers of my right hand (my dominant hand) and if the swelling and trauma of surgery possibly exacerbated whatever arthritis I had in my left, I don't want to chance that happening with my right. And like you, if I'm careful, I now know how to control overdoing it with my right. I don't want to influence your decision regarding your upcoming surgery, but I do want to be honest with you regarding my experience. As I said, others I've spoken with who had the surgery did not report the pain and stiffness that I experienced. Also, I know I wasn't "wimping out" regarding the pain I experienced as I've had a number of chronic conditions that were quite painful so I am aware of the level of discomfort I can tolerate. Talk to your surgeon regarding your concerns. As I said, my hand is slowly returning to normal, it may take two years for me to get back to where I was pre-surgery. Best of luck to you.
 
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alb7039 replied to jmast52's response:
Thank you for your honesty. Taking all things into consideration, I have decided to postpone my surgery. I still have function of my hands and I wear a thumb immobilizer on both hands 24/7. I'm going to wait until I start losing function to have the surgery.
 
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hhump replied to alb7039's response:
no


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