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Medical Forum / Diseases and Disorders / Arthritis / April 2006Elbow Update.
I posted a couple of weeks ago about the excision of my radial head I was due to have done, then I had some high ALT results. Well I took your advice & I'm now taking Milk thistle the ALT levels were getting near to normal so all being well I should be able to go ahead with surgery on the 20th April. I had a pre-op assessment last week where they took blood, swabs etc. I aslo saw the surgeon, he tells me that if the left one goes well, then he will do the right one about 6 weeks later. He also said that I would need them replacing sooner rather than later. Although I would welcome relief from pain & the potential for more ROM I really feel reluctant to do it because of my relative young age (38), the shortish life of the joint & the weight you can lift sounds restrictive in itself. What age was anyone who has this replacement & what was their experience of the replacement. No answers, Dave, just wanted you to know your post had been seen. Good luck on the surgery. DeeTee >I posted a couple of weeks ago about the excision of my radial head I > was due to have done, then I had some high ALT results. Well I took [quoted text clipped - 11 lines] > restrictive in itself. What age was anyone who has this replacement & > what was their experience of the replacement. Dave I had my elbow replaced about 16 months ago. I was 42. It works wonderfully ..no pain and great extension and flexion. Rotation is still limited by the RA damage in my wrist. But you are right I am limited in what I can lift. I am supposed to be limited to 5 lbs of lifting though I will admit I cheat a bit up to 10lbs (not repetitively and not very often). My tricep is still much weaker than the tricep in the other arm. My elbow had locked and it was non-recognizable as a joint. It had begun to split the humerous and the ulner nerve was compressed to the bone with scar tissue...so I was not a candidate for the radial head excision surgery you did. The surgery itself took about 4 hours. For me the replacement was the right decision. I wasn't looking to do a lot with the arm I just wanted to perform the activities of daily living with reasonable effort and pain. We are nursing the other elbow along with cortisone trying to buy it some time but I suspect we will be replacing that one before the end of the year. If you have specific questions let me know. I know there aren't a lot of people out there you can ask about elbows Karen >I posted a couple of weeks ago about the excision of my radial head I > was due to have done, then I had some high ALT results. Well I took [quoted text clipped - 11 lines] > restrictive in itself. What age was anyone who has this replacement & > what was their experience of the replacement. Karen Thanks for the reply. I'm glad it was a good result for you & hope the other elbow doesn't cause too much trouble. I also have almost total fusion of both wrists which compounds the elbow problems, fortunatly I still have reasonable shoulders & I'm still able to work, but only 30 hours per week, as an electronics/draughting technican. Are you able to work? I guess I'm still being a bit unrealistic about how this disease affects me, it's like me brain is still writing cheques that my body can't cash. I struggle with activities of daily living, some of which are impossible, but I still think I don't want a replacement because it will limit what I can do, when in fact I can't do thoses activites anyway. (DIY, shopping, lifting etc.). It's a hard balance between acceptance of limitations while not giving in to the disease, I tend to spend most of the time in denial. That's enough self pity. I'm still hopeful for radial head excision & will keep everone updated. Dave > I'm still hopeful for radial head excision & will keep everone updated. > > Dave Hi Dave,,, I thought about doing that to my brother more than once. :-) What is that anyway? Harv Hi Harv, It does sounds like a severe punishment, I think we all feel the same about siblings & family at some point. What's the saying "you can choose your freinds but you can't choose your family", having said that the support of family & freinds is fantastic at the time when you need them most & in that way I'm very lucky. Excision of radial head. Bsically it's the removal of the head of the radial bone where it meets the humerus at the elbow, the theory in removing it being it will allow the elbow to rotate the forearm so you can acheive palm up/down movement, this movement is lost as a mechanical block is created as the joint deteriorates, along with extension & flexion. This procedure should increase the range & reduce the pain ie. a win win situation. Thats the theory. I'll see how the practise goes next week. Regards Dave > Hi Harv, > [quoted text clipped - 17 lines] > > Dave Let us know how it goes Dave. Harv > > Hi Harv, > > [quoted text clipped - 20 lines] > Let us know how it goes Dave. > Harv OOps Dave please let your doc know about the milk thistle. it can increase bleeding. Important to know before surgery. > > Hi Harv, > > [quoted text clipped - 20 lines] > Let us know how it goes Dave. > Harv Kate. I've stopped the milk thistle last week along with my Humira. This week I've stopped MTX & a coxII inhibitor, only got Tramadol & Paracetamol left at the moment so I'm feeling increasing pain, still I know this is only temporary, only 5 days to the Op. I'm not feeling too nervous yet, there's still time for that. This is my first surgery for damage caused by RA & I hope this doesn't open the flood gates. I've had three ops on a badly broken femur & thumb but that was about about 17 years ago. Karen You say that you've got reasonable ROM after the elbow replacement, do you have any idea what it is? At the moment I have flexion contractures of about 65 deg & can bend to about 100-110 deg. ie a range 35-45 deg. I have no supernation or pronation on the left wrist & about 20-30 deg on the right. I only have 10-20 deg ROM in both wrists. Luckly although stiff at time, I have little reduction in ROM of hands & shoulders. 5 days & counting. > Kate. > > I've stopped the milk thistle last week along with my Humira. This week > I've stopped MTX & a coxII inhibitor, only got Tramadol & Paracetamol > left at the moment so I'm feeling increasing pain, still I know this is > only temporary, only 5 days to the Op. I feel for your Dave! I've been there just recently with having to stop meds for a procedure. At least, you should get some stronger pain medication to take afterwards! I hope the results are good enough to make it worth all of this. > I'm not feeling too nervous yet, there's still time for that. This is > my first surgery for damage caused by RA & I hope this doesn't open the > flood gates. I've had three ops on a badly broken femur & thumb but > that was about about 17 years ago. depending on how many majorly damaged joints you have, it might be worth having the floodgates open. Decreasing pain and increasing function can ultimately be worth it. Still, I know my dad was very tired of surgeries after several years of annual joint surgeries. Remind us the day before your surgery so we can turn up the ASA remote healing machine!  SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare Dave..My pre surgery ROM was similar to yours. Now it is -5 ext and 135-140 flex. I can supinate about 75%...but the stop comes from the wrist now not the elbow. They detach the tricep during surgery so post-op ext will never be 0 but at -5 it is definitely functional. The tricep still remains weaker than in the other arm but I only realize it when I am doing tricep exercises. I am pleased with the overall outcome. I have had both shoulders replaced. My right wrist is self fused and left wrist (the one with the replaced elbow) has well less than 10 degrees ROM. Right thumb is surgically fused. So you can see I don't have any good parts in my arms left. We have been discussing replacing the left wrist since I already have the limitations set by the elbow but my right elbow decided to scream for attention so the left wrist is on hold right now. My right elbow is down to about 100 deg of flex..it was 125 last Dec. Supination is about 50% of norm. A bone spur is causing pressure on the ulner nerve. I suspect we will be replacing the right elbow before too long but we are trying to prolong things as long as possible. I was working full time until late Feb. I am currently on a Leave of absence from work. I went into a major flare in Jan-Feb. My job requires me to be on a keyboard 8-10 hours and between totally exhaustion and the issues going on in my right elbow I just couldn't deal with it so I took some time off. Right now the current plan is to return to work in about 3 weeks Good luck with the surgery..let us know how it goes Karen > Karen > [quoted text clipped - 8 lines] > > 5 days & counting. Karen, Thanks for yoru post, it really is dificult to find someone with elbow experience as well as wrist, & I really appreciate your post in particular. It's made me think more about the possible benefits of replacement, & also when to give in & get it done!! I'm fortunate as I've had remmision for about 8 months now, since Humira kicked in following 8-9 years where I was permenantly experiencing disease activity, my particular course of this disease seems not to follow the typical flare/remmision pattern but remain as a chronic permenant inflamation. I'm really sorry your having a tougher than normal time at the moment I hope that your flare is short lived & you get back to remmission soon. I only hope I don't lose remission since stopping the DMARDS. I hope you get back to work, as it's one of the few things that keep me on the right side of sanity & feeling "normal". I also have to spend time on the keyboard, do you have any specialist equipment to help with ergonomics? I've fairly recently started using a split & camber adjustable keyboard, which has improved my stamina at the keyboard, I also use an L shaped desk that supports both arms & a roller mouse that works well for me. The other thing I use is a speaker phone which means I don't need to do hand to ear for long periods as the hand gets stuck up near ear as I'm sure your familiar with. All the best. I'll post updates, thanks for all the post, I'm feeling quite posative & empowered . |
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