L hand update :(

Chicago Sandy · #1 06-27-2018, 05:03 PM

Saw my orthopedic hand surgeon today, and the news isn't good. Though I slightly nicked both my R radial head (elbow) and neck (wrist end of the bone), they're healling well and need no treatment other than common sense measures.

But the "waist" of my L scaphoid (bone beneath my thumb) is fractured. And the TFCC disc (wrist cartilage) is torn. I will need surgery: the scaphoid needs to be screwed together to promote "union" (it's a bone that doesn't often heal well by itself, and if it does heal "unaided," it could take 6 months in a cast or hard brace). The TFCC needs to be debrided--the part I tore is central, w/o a blood supply, so it can't be sutured. And the reason it tore? It didn't tear in that first fall, just got inflamed when I strained (but not sprained) the surrounding soft tissue. But after 2 mos., when it felt just about healed, it tore when I propped myself up on my L hand to turn over in bed. The inflammation made it vulnerable.

But what caused it to tear was that when I bore weight on that hand, the pointy end of my ulna pierced it. And why did that happen? Because I have a congenital "positive ulnar variance:" my ulna is 3-4mm too long (who knew?). And if I get the TFCC debrided, that pesky ulna might poke it once again. So I will also be getting an (ugh) ulnar reduction osteotomy: the surgeon will saw the bone in half, shave off a 3-4mm "wafer" and then screw the bone back together, reinforcing it with a plate. (One more thing the TSA's gonna have to wand when I fly).

So July 10 is the big day. I will be in a cast for a week; then a "Muenster brace" (pretty cheesy, no?) 24/7 for at least 6 weeks and then at night for another 6-8. I might be able to play Fox Valley Labor Day weekend, but probably my Sep. 14 Molly's Cafe and definitely Oct. 7 Grove Folk Festival gigs. (Might still hurt, but not as much as it did last week at Taste of Tippecanoe).

So meanwhile I will be practicing harmonica and learning R hand scales on keyboards. Maybe even retuning my dulcimers to Ionian mode and relearning how to play with a noter (which doesn't require L wrist rotation). Funny thing--that's how I first learned to play way back in 1980!

cotten · #2 06-27-2018, 07:59 PM

Wow, Sandy! That's all I can say, Wow! Except that I will be hoping and praying for a speedy, successful outcome to your surgery and recuperation. Oh, and that from now on, I'm going to try not to turn over in bed!

cotten

Bob Womack · #3 06-28-2018, 06:24 AM

I'm sorry to hear of your prognosis. We'll just pray for a speedier than expected recovery.

Bob

Chicago Sandy · #4 06-28-2018, 09:54 PM

My singing partner says that he can cover my instrumental parts--apparently my songs, vocals and wisecracks will still carry the day. So if you happen by Chicago's Uncommon Ground on 7/22 and see a bespectacled zaftig blonde sporting a plastic shell on her left arm...say hi. (It'll be a "dueling duos in the round" with NH's Dan & Faith Senie, a rerun of what we did in Madison last year).

Otterhound · #5 06-29-2018, 05:38 AM

Broke the scaphoid in my left hand in 1993 . Broke it at around 130 MPH at Daytona .
The blood flow was not displaced and it healed in 6 weeks . Silly little bone that is both very limited blood supply and a 1 way trip for blood supply .
Best wishes on your situation and please consider finding and taking a good multivitamin during the healing period so your body has all the nutrients it needs to facilitate the healing .

MikeBmusic · #6 06-29-2018, 07:51 AM

Yow! Safe healing.

imwjl · #7 06-29-2018, 09:24 AM

Good luck healing.

On a more funny or not so funny note, you're not so far away to have a pair of surgeons with super reputation for hands that I know from our ski club. The funny part is how different they are but as a team and an incident with one that made me think of you.

Visualize a serious uber athlete German guy working with a not into that sort of adventure Jewish guy. Hobbies for one are sports and racing. Hobbies for the other are building models, arts, food and piano. The thought of you at an earlier time was when one of them volunteered for an event but asked me for help because he'd never grilled anything with pork before.

I have to think your area has plenty of talent. My nephew who now works at the level 1 trauma center said the real answer is stay away from hospitals but we don't always get that choice. Your husband probably knows why my nephew feels that way.

Good luck!

TBman · #8 06-29-2018, 04:47 PM

Ouch Sandy, feel better, take it easy and relax. It'll be feeling better before you know it.

Silly Moustache · #9 06-29-2018, 05:29 PM

Hi Sandy, so sorry to hear you are going through this, but you've been through worse,and you're a fighter.

I have confidence in your fast and full recovery.

All the best,

Andy

Photojeep · #10 06-29-2018, 07:34 PM

Sandy,
So sorry to hear what you're about to go through but then, when it's all over, you'll be much better!

I hope it all goes well.

All the best,
PJ

Chicago Sandy · #11 06-29-2018, 10:52 PM

Thanks, guys! Otterhound, my surgeon actually prescribed a multivitamin and 500 mg. of C daily, along with the painkiller I hope not to need more than 2-3 days before switching back to OTC stuff.

imwjl, we were so Reform growing up that on Saturday mornings we had bacon & eggs (bagels & smoked fish were for Sundays). My dad brought home fried shrimp & scallops on Fridays, and taught me how to eat raw oysters & cherrystone clams. Once or twice a year, we'd go out to Lundy's for lobster. My mom cooked a mean veal parmigiana. The only "treyf" she wouldn't make were pork chops--she was terrified of trichinosis, and the one time she tried to cook them they were nearly shoe leather. (I think having grown up in Kosher homes made my folks rebel).

I'm seeing a really good hand guy (the top one in the NorthShore system, who both skis and shoots hoops). But some friends on other forums asked if I'd sought a second opinion (he'd done my second trigger thumb, and is well acquainted with lymphedema risks, so I hadn't really thought about it).

When I Googled "ulnar shortening osteotomy," among all the dry medical articles and Wikis was a link that screamed "don't have barbaric ulnar shortening." Clicked on it, and it was for a chain of stem cell therapy clinics. The hucksterism was palpable--every other paragraph said "revolutionary" or "what the orthopedic community doesn't want you to know." Yes, the chain is run by M.D.s, but they are full of hooey: they claim that a "positive ulnar variance" is no big deal and that all you need to fix a TFCC tear (or any arthritis) is to withdraw some stem cells from your hip, have them purified, and then injected back into the bloodstream, where they'll somehow "know to go where the body most needs them." They also say the most effective "gold standard" therapies are done in their Cayman Islands clinic (takes 2 visits 2 weeks apart). Now, I know that while embryonic stem cells have the ability to grow into whatever doctors intend them to, adult stem cells can grow up to be only what they're taken from--IOW, more hipbone or marrow. And there's a big risk of infection and a small risk of tumor formation, acc. to Consumer Reports. And here comes the biggest telltale sign: it's not covered by insurance or Medicare because it's "experimental." (OK, so decades ago that was the case with Synvisc knee shots, but normal orthopedists--not maverick clinics--offered them; now they're standard).

Just for spits & giggles I looked up anyone in the Chicago area offering it--and to my surprise found the name of the hotshot orthopod who patched together my shattered tibial plateau 22 years ago, after a car bumper smashed it. (He later left the Rush group under strained circumstances). He now treats mostly runners and offers stem cell and plasma therapy for arthritis & athletic cartilage injuries--but only embryonic stem cells (which can morph into the cells of the tissue into which they're injected). Messaged him to see if I was a candidate (knowing his site also seemed sorta "snake-oil-y"); he wrote back that because of my age (67), the scaphoid fracture and the positive ulnar variance, stem cells wouldn't work for my TFCC tear and that I should have the surgeries instead. Imagine--honesty in a huckster!

And as to avoiding hospitals, I try to avoid being an in-patient as much as I can--the infection risk is just too great. (I had my lumpectomy at the "ambulatory-surgery unit" at Evanston Hosp.--checked in at 7am, home by 4pm). My husband was fluid-overloaded nearly into heart failure a few years ago at another hospital after being admitted for "medical management" of a botched colonoscopy (done at a GI office). And where did I fall? In a hospital corridor, walking toward the elevator to the bridge to the outpatient clinic where I see my surgeon; had I gone outside instead I wouldn't have fallen. I will be having my surgery done at an outpatient ambulatory surgi-center.

aknow · #12 06-30-2018, 11:20 AM

Good luck in recovery. Hand surgeries are among the most complicated, scaphoid fx 's are common. When I was a med tech in a large L.A. hospital, I used to sneak into the OR to watch one particular hand surgeon perform miracles. He was the only dr. on board that was humble and genius.
Best of luck in recovery, be patient.

Barb1 · #13 06-30-2018, 05:58 PM

Sandy,
Good luck with the surgery. Refuah sheleimah! Wishing you all the best.
Barb

Otterhound · #14 06-30-2018, 07:35 PM

Quote:

Originally Posted by Chicago Sandy

Thanks, guys! Otterhound, my surgeon actually prescribed a multivitamin and 500 mg. of C daily, along with the painkiller I hope not to need more than 2-3 days before switching back to OTC stuff.

imwjl, we were so Reform growing up that on Saturday mornings we had bacon & eggs (bagels & smoked fish were for Sundays). My dad brought home fried shrimp & scallops on Fridays, and taught me how to eat raw oysters & cherrystone clams. Once or twice a year, we'd go out to Lundy's for lobster. My mom cooked a mean veal parmigiana. The only "treyf" she wouldn't make were pork chops--she was terrified of trichinosis, and the one time she tried to cook them they were nearly shoe leather. (I think having grown up in Kosher homes made my folks rebel).

I'm seeing a really good hand guy (the top one in the NorthShore system, who both skis and shoots hoops). But some friends on other forums asked if I'd sought a second opinion (he'd done my second trigger thumb, and is well acquainted with lymphedema risks, so I hadn't really thought about it).

When I Googled "ulnar shortening osteotomy," among all the dry medical articles and Wikis was a link that screamed "don't have barbaric ulnar shortening." Clicked on it, and it was for a chain of stem cell therapy clinics. The hucksterism was palpable--every other paragraph said "revolutionary" or "what the orthopedic community doesn't want you to know." Yes, the chain is run by M.D.s, but they are full of hooey: they claim that a "positive ulnar variance" is no big deal and that all you need to fix a TFCC tear (or any arthritis) is to withdraw some stem cells from your hip, have them purified, and then injected back into the bloodstream, where they'll somehow "know to go where the body most needs them." They also say the most effective "gold standard" therapies are done in their Cayman Islands clinic (takes 2 visits 2 weeks apart). Now, I know that while embryonic stem cells have the ability to grow into whatever doctors intend them to, adult stem cells can grow up to be only what they're taken from--IOW, more hipbone or marrow. And there's a big risk of infection and a small risk of tumor formation, acc. to Consumer Reports. And here comes the biggest telltale sign: it's not covered by insurance or Medicare because it's "experimental." (OK, so decades ago that was the case with Synvisc knee shots, but normal orthopedists--not maverick clinics--offered them; now they're standard).

Just for spits & giggles I looked up anyone in the Chicago area offering it--and to my surprise found the name of the hotshot orthopod who patched together my shattered tibial plateau 22 years ago, after a car bumper smashed it. (He later left the Rush group under strained circumstances). He now treats mostly runners and offers stem cell and plasma therapy for arthritis & athletic cartilage injuries--but only embryonic stem cells (which can morph into the cells of the tissue into which they're injected). Messaged him to see if I was a candidate (knowing his site also seemed sorta "snake-oil-y"); he wrote back that because of my age (67), the scaphoid fracture and the positive ulnar variance, stem cells wouldn't work for my TFCC tear and that I should have the surgeries instead. Imagine--honesty in a huckster!

And as to avoiding hospitals, I try to avoid being an in-patient as much as I can--the infection risk is just too great. (I had my lumpectomy at the "ambulatory-surgery unit" at Evanston Hosp.--checked in at 7am, home by 4pm). My husband was fluid-overloaded nearly into heart failure a few years ago at another hospital after being admitted for "medical management" of a botched colonoscopy (done at a GI office). And where did I fall? In a hospital corridor, walking toward the elevator to the bridge to the outpatient clinic where I see my surgeon; had I gone outside instead I wouldn't have fallen. I will be having my surgery done at an outpatient ambulatory surgi-center.

Good for him !
Now get busy healing .

Chicago Sandy · #15 07-02-2018, 10:30 PM

Aaargh--though my L hand feels better (it's probably pleading "I promise I'll be good, please don't cut me"), my R forearm is getting problematic. It hurts (along the length of the radius) when I push on anything with my palm facing down, or pull against resistance. Tons of fun closing my car's tailgate or reaching for a dinner plate. Feels like I'm aggravating the R radial fractures. Messaged my surgeon, who explained that since there are hairline fractures at either end, the bone will hurt when stressed, and the soft tissue will "protest" to tell me to back off; but because we're doing one arm at a time and the radial breaks are tiny & non-displaced, the L surgeries take priority. Besides, he's thinking ahead to physical therapy--which I will need starting several weeks after the cast comes off, and with which Medicare is sorta stingy. We can't do it on the R arm till the radial fractures heal, and he also doesn't want me to have to deal with two casts. So now I'm wearing braces (with palmar stays) on both hands. I have opposable fingers & thumbs, but stuff is getting dicey. (I have permission to remove the R brace from time to time).