Friday, April 23, 2010

The Surgery that Almost Wasn't

At the age of 14, I sustained a serious soft tissue injury to my (dominant) right hand. It used to be broken bones I was afraid of (my first break was at 4), but I rapidly learned that serious strains and sprains were worse.

If they are severe enough, they don't heal well.

Bones get 'bed rest' via a cast, they get set. You can have surgery if you need it where they'll pin the bone in place or give you a steel rod. Bone regenerates. A break will heal very fast.

Soft tissue injuries don't have as many treatment options and they aren't immobilized as well as a broken bone, so they don't get much 'rest' to heal. You're left with R.I.C.E and a nifty collection of ace bandages. Soft tissue tends to develop a chronic inflammation response and pain. It heals at the speed of a paralyzed glacier.

Worse, doctors don't really know what to do for soft tissue injuries that become chronic. (Massage therapy can help in many cases, but I didn't know this until it was far too late.)

So my hand doubled in size from the swelling and stayed that way for months. I had problems with it from that point forward. It truly was a bad injury.

By the time I was 25, I had literally lost my grip. I couldn't hold a cup. Couldn't write. Couldn't make a fist and squeeze. Push-ups were out as was carrying grocery bags. Forget opening jars or even stirring--when I baked the hubby would have to stir the cookie batter for me. Handwriting was incredibly painful as was typing. I used the computer mouse with my other, non dominant hand.

I had over a dozen ace bandages and I wore one every day. The pain was constant and it eroded my emotional reserves, wearing me down to the point of tears on a regular basis.

But my primary care physician wouldn't give me the referral to a surgeon or any place else (like physical therapy). I asked. She said no. I asked again. She said no. We did this dance for a year.

Which was incredibly frustrating.

Then my husband happened to need surgery for an avulsion fraction of his finger -- the result of a tag football game gone wrong. I was impressed with the surgeon and wanted him to fix my wrist/hand. (This is a great, albeit unusual, way to vet doctors.)

I went back to my PCP and listed out all the ways I couldn't use my hand. Then I begged, "If it's like this at 25, what will 30 be like? I am going to completely lose the use of my hand at this rate. We need to do something. Please."

I got the referral.

The surgeon ordered an arthogram-- they inject dye and see how much of it 'leaks' through' tears in the muscle (at least that's how it was explained to me)--and it showed nothing.

I was crushed.

I thought the negative arthogram was the end of the road. Especially after having been ignored and poo-pooed by my PCP for so long--maybe she had been right. Maybe I was a big faker too--this is always my default assumption in these situations, that I'm an idiot. Yet oddly enough, I'm the one who is usually right and it's the docs who are missing things. Weird.

Thankfully, the surgeon really was as good as I thought he was. He spent several long minutes palpating my wrist, popping bones in and out of place (everything was loosey goosey in there) and said we should do the surgery anyways. He told me arthograms miss things about half the time.

I was SO relieved. There was still a chance to get my hand back.

They allotted an hour for the surgery, but ended up needing three. For my little wrist! I am kind of tall, but I have teeny tiny hands. So how they found anything to do for three hours in my teeny wrist is amazing to me.

There were some issues with the anesthesia team during surgery (another post for another time) but the surgery went well overall. The surgeon told me I would probably need more surgery in the future because the damage was much worse than he'd anticipated. He'd run out of time to do everything that needed doing. However, more than ten years out from the surgery I have NO complaints. My right hand, on a good day--of which there are many--is at 90-95% which is amazing.

I have no plans to seek additional surgery. I'm good. Also, enough high medical weirdness has happened since then, that I am not anxious to do anything I don't have to, you know?

While my bum wrist was a major factor in my inability to continue with massage therapy, the surgery made a huge difference for me. Let me count the ways...

-I can mostly open jars--I'll always be little weaker than someone with a regular wrist.

-I can carry a full cup without spilling.

-I can carry grocery bags as well as a baby in an infant carrier.

-I can do push ups, although there's arthritis in the wrist and sometimes this doesn't go over well.

-I can cook, but also use a Kitchen Aid mixer to spare my hand. Kneading bread is hard and used to require the hubby's help, but now that I low carb that's not an issue.

-I still sometimes have to switch the mouse to my non-dominant hand and watch how much I type, but that's a minor quibble.

-Handwriting continues to be painful, avoided and illegible anyway because I can't control the fine motor movement very well. Computers allow me to compensate pretty well.

-Breastfeeding was hard because of how much the hands are used to support the baby (and also an anesthesiologist screwed up my other hand during labor-which is another story). I was able to work through that using massage for the muscle tension and the My Brest Friend pillow --which makes breastfeeding ergonomic and takes the strain off the shoulder girdle and arms, much better than the Boppy.

-The overall pain level has been reduced by 95%. It can still flare up at times and there are problems with all the muscles in my forearm up to the elbow, but mostly, I have my wrist and hand back.

It was scary to ask for surgery, but I am so glad I did. This one had a happy ending.

Now I should write up the story about the anesthesia team because it was actually kind of funny. They had a really difficult time knocking me out. All they need to do was say 'it's okay' but somehow they thought the answer was more drugs.

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