Thumb - excision arthroplasty?

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A/B/C/E Floro - 22 Apr 2004 17:09 GMT

Anybody been through that one? I've just been told it's in my future, and
I'm starting to look for any info I can find.

Here's a link I found this morning:
http://www.handuniversity.com/topics.asp?Topic_ID=25

Anyway... Hand Doctor says it's just a matter of time, and the decision
will be up to me. Gee, thanks...?

Meanwhile, I continue wearing the splint I got as a souvenir of our last
visit, and I continue taking all the meds I'm already taking for various
twinges in the hinges.

Monday I have a pre-op stop in with Foot Doctor, and bunion surgery is on
for next Friday.

It's a darned good thing the Easter bunny brought me chocolate!

Thanks for being there, everybody. Just listening to your caring and your
wisdom, sharing your humor and encouragment, has helped me through so much,
you'll never know. :-)

Slowly creeping out of lurkdom,
Beth

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Caroline Marold - 22 Apr 2004 20:20 GMT

Didn't Gwen just have this done?
the thumb I mean
We will try to remember to raise a salt rimmed lime flavored drink in
your honor next Friday. Come on everybody -- help me to remember.
Keep us posted.
Duckie

> Anybody been through that one? I've just been told it's in my future, and
> I'm starting to look for any info I can find.
[quoted text clipped - 20 lines]
> Slowly creeping out of lurkdom,
> Beth

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A/B/C/E Floro - 23 Apr 2004 15:42 GMT

> Didn't Gwen just have this done?
> the thumb I mean
> We will try to remember to raise a salt rimmed lime flavored drink in
> your honor next Friday. Come on everybody -- help me to remember.
> Keep us posted.
> Duckie

:-) I appreciate it!

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AChrist787 - 22 Apr 2004 22:21 GMT

Hi Beth,

Gwen has had it done and I had it done on 2/24. I am 8 weeks post surgery, out
of the cast with the pin and stitches out. I'm doing PT 3 days a week. What
would you like to know?

Anne

AAC/AAF/AFBV62.0844.AZ
http://www.tckworld.com/opfoot

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A/B/C/E Floro - 23 Apr 2004 15:50 GMT

> Hi Beth,
>
[quoted text clipped - 3 lines]
>
> Anne

Umm... everything? :-D

First I guess I need to know if I've got the "right" procedure? She said
Something Arthroplasty and "excision" is what I found first. Are there
other types of -plasty? She did say it would *not* be an artificial joint
or replacement, and she said she'd be "moving soft tissue & tendons".
Afterwards would be a cast for a month, a splint for a month, and regaining
abilities for up to a year - sound right? If not, point me in the right
direction, please and thank you. :-)

Second... how did you know *when* to have it done? She tells me there's
nothing more to be done in "conservative care" (splint & Vioxx), but said
the surgery is completely elective and I would "know"... and that it's
"just a matter of time". I asked her if "time" meant weeks or years. She
said "It won't be years". She said that one a couple of times....

Thanks, Anne (and all).

/Beth

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AChrist787 - 24 Apr 2004 01:34 GMT

Hi Beth,

>First I guess I need to know if I've got the "right" procedure? She said
>Something Arthroplasty and "excision" is what I found first. Are there>other

types of -plasty?<

Did she say CMC arthroplasty? That means carpal metacarpal arthroplasty. It's
pretty much the same thing.

> She did say it would *not* be an artificial joint
>or replacement, and she said she'd be "moving soft tissue & tendons".<

That's exactly what the procedure is. I had a couple of bones removed, rather
than one, because mine were so destroyed. And I had one tendon and part of
another moved. I had a steel pin from my thumb to my little finger to hold
everything in place. I had 6 incisions. The one the drawing shows, over my
thumb. One on the top of my hand above my wrist, one below my wrist. On the
other side of my arm I had 3 small sutured incisions where he anchored the
tendon in place. My stitches and pin remained in place until the 6 weeks were
up and my cast was removed. My stitches didn't dissolve and were taken out at
that time.

>Afterwards would be a cast for a month, a splint for a month, and regaining
>abilities for up to a year - sound right? If not, point me in the right
>direction, please and thank you. :-)<

Yes, Gwen was lucky, I think, in that she didn't have hers in a cast as long,
but mine was in a cast for 4 weeks. I am now 3 weeks into the rehab and while
it's going well, it's not going fast enough for me. I am inpatient and am
being forced to slow down so that I don't damage the work that was done. I am
in a spika splint and will be probably for at leat the nest 2 months. I hope
the year rehab isn't right, because we're doing my other hand in October. It
is not a pain free surgery, but if you can take pain meds, you'll do fine. I
can't and I survived, but it was painful.

>Second... how did you know *when* to have it done? She tells me there's
>nothing more to be done in "conservative care" (splint & Vioxx), but said>the

surgery is completely elective and I would "know"... and that it's >"just a
matter of time". I asked her if "time" meant weeks or years. She>said "It
won't be years". She said that one a couple of times....<

I knew 5 years ago and this was coming and put it off longer than I probably
should have. And she's right, you will know. When the pain in your thumb is
worse than the thought of the surgery, then it's time.

Let me know if you have any more questions. :-)

Anne

AAC/AAF/AFBV62.0844.AZ
http://www.tckworld.com/opfoot

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Gwen Love - 23 Apr 2004 04:30 GMT

Beth, that is an excellent site, perfectly describes the procedure and the
scar. I had an arm block, but was also out of it--didn't know a thing
about what went on during surgery.
The part taken out was replaced by a tendon taken from the inside of my
wrist.
He also did some work on the next joint down to get it shaped as it should
be. That was worse than the basal joint. The were two small incisions
made for that. That's where the pin was and be sure they deaden the thumb
when they pull it out if you have one. They didn't mine and it nearly
killed me!
The stitches and pin stayed in two weeks. I had a splint on for the first
week and then they put on a cast. Left a hole in the cast over the pin and
I had to drop alcohol on it every day. They put a bandaid over the hole
and someone asked me if my cast had an owie!
I only went to therapy once a week, but they gave me a sheet showing all
the things I should do at home four or five times a day. I didn't do them
that often, but had very good results for the times I did do them. I only
went to PT for a month because I had done so well that I had the range of
motion and was able to touch all my fingers with my thumb by then.
However, it took six months for everything to heal. The back of my hand
alongside the scar stayed swollen a lot for a long time and it is still
more puffy than the other hand, which I will have to have done at some time
in the future. Just waiting as long as I can.
It isn't a lot of fun while you're going through it, but I surely am glad I
had mine done. Good luck to you on yours. I had bunion surgery also, and
that wasn't bad at all; hope yours will be very easy for you.
Gwen

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************************************************************
"Your present circumstances don't determine where you can go; they merely
determine where you start." - Nido Qubein
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| Anybody been through that one? I've just been told it's in my future, and
| I'm starting to look for any info I can find.
[quoted text clipped - 20 lines]
| Slowly creeping out of lurkdom,
| Beth

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A/B/C/E Floro - 23 Apr 2004 15:57 GMT

http://www.handuniversity.com/topics.asp?Topic_ID=25

> Beth, that is an excellent site, perfectly describes the procedure and
> the scar.

Hmmm, now I'm *really* wondering if I'm looking at the right operation!
She showed me the scar would be on the palm side - this page seems to show
it on the back. Doctor's choice? Or different operation?

> The part taken out was replaced by a tendon taken from the inside of my
> wrist.

I think she mentioned that.....

> The stitches and pin stayed in two weeks. I had a splint on for the
> first week and then they put on a cast. Left a hole in the cast over
> the pin and I had to drop alcohol on it every day. They put a bandaid
> over the hole and someone asked me if my cast had an owie!

:-) I remember reading about your Owie Cast - before I knew I might be

facing one, too!

> However, it took six months for everything to heal. The back of my hand
> alongside the scar stayed swollen a lot for a long time and it is still
> more puffy than the other hand, which I will have to have done at some
> time in the future. Just waiting as long as I can.

OK, since Doctor Hand tells me the timing is up to me, how did *you* know
when it was time to do one hand, and why are you waiting on the other?
Pain? Finances? Function?

> It isn't a lot of fun while you're going through it, but I surely am
> glad I had mine done. Good luck to you on yours. I had bunion surgery
> also, and that wasn't bad at all; hope yours will be very easy for you.

Thanks, Gwen <and all>. I'll see Doctor Foot on Monday morning, and I'll
probably be right back here on ASA with another load of questions that
afternoon! :-)

/Beth

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Gwen Love - 23 Apr 2004 23:50 GMT

Beth, the decision for me was function and pain. The other thumb is not
that bad yet, just hurts at times if I move it the wrong way or pick up
something wrong. The left one was hurting all the time and I could not
pick up things with it. I don't know about the incision being on the palm.
I guess the work could be done from the inside as well but I have no
experience except my own.
Gwen

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============================================================
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long life; that they can live the life God gave them, not the life they
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| http://www.handuniversity.com/topics.asp?Topic_ID=25
| > Beth, that is an excellent site, perfectly describes the procedure and
[quoted text clipped - 35 lines]
|
| /Beth

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AChrist787 - 24 Apr 2004 01:37 GMT

> Left a hole in the cast over >> the pin and I had to drop alcohol on it every

day. They put a bandaid >> over the hole and someone asked me if my cast had
an owie!<

That's where Gwen and I differed. My surgeon cut a window in my cast, checked
the pin, put in new dressing and then put the removed piece of cast back and
taped it in place.

Also, my scars, while visible, aren't a bit swollen and are barely visible.
There are things they can do to keep the scar tissue from forming keloids.

Anne

AAC/AAF/AFBV62.0844.AZ
http://www.tckworld.com/opfoot

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Squirrely - 24 Apr 2004 06:26 GMT

I hope your bunion surgery goes well on Fri Beth.

Sending prayers, good thoughts and healing thoughts.

Hugs and TLC to you

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Love and hugs to all
Good thoughts coming your way too.

Squirrely Jo

> Anybody been through that one? I've just been told it's in my future, and
> I'm starting to look for any info I can find.
[quoted text clipped - 20 lines]
> Slowly creeping out of lurkdom,
> Beth

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speedy1 - 30 Oct 2005 01:43 GMT

Just had my right thumb done Oct 11th. Had a splint for two weeks, then
got stitches out and a short "real" cast until Nov 9th. Then he said I
would get to wear the elastic velcro brace for another couple of weeks. I
didn't have a pin, but he pulled a tendon up in a curl to fill in the now
empty space where that bone was removed. I am going to do all the
exercises required because I have a motorcycle out front calling my name.
Left hand will be done in the future alomg with left hip. Right hip was
done in 1995. Guess I'm just falling.

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