L hand update :(

[Chicago Sandy]

Having 2d, 3d, 4th thoughts about this surgery. Seems my surgeon (possibly the best hand guy in Chicago) is minimizing the aftereffects and downplaying the pain & difficulty of recovery. Everything I've read says that pain aside, I will be unable to care for myself for weeks--no using L hand for anything, not even pulling up my pants or undies, no holding or lifting anything heavier than a pencil (so no tugging on anything either), no opening jars, bottles & cans (how could I care for my cats?). No cleaning my glasses either.

And that's with an intact R arm & hand--my R has hairline fractures at each end of the radius and it's often painful to do stuff like open & close doors, my car's tailgate, operate the shower diverter, dry & style my hair, pull on my jeans, fasten my bra (front or back), work a zipper or buttons, toileting, etc. I am not willing to cut my hair short so it could dry by itself--it would look awful, and I am not about to accept suddenly looking like a fat(ter) dumpy unfeminine old lady. I might even need a caregiver or even several weeks in a rehab center for self-care and OT to learn how to do it on my own. (For all intents & purposes, it'd be like I had a hemiplegic stroke but could still walk & talk).

Can't use my mouth to hold stuff, as I have some teeth that are so sensitive (one might be loosening) that I can no longer eat corn on the cob, ribs, bagels, crusty breads, fruit out of hand--and can't have them stabilized lest I get osteonecrosis of the jaw (ONJ) from the Prolia shots I've had to prevent osteoporosis from the anti-cancer pill I have to take for at least another 3 yrs. That's if the sensitive teeth aren't already ONJ symptoms.

I know my L hand and arm will not heal w/o surgery. But it might not get any worse. I can cope right now--and accept that I can no longer play an instrument and that w/o surgery I never will. But the surgery is no guarantee that I will ever play again anyway--and even the best case scenario may not restore me to much (if any) more functionality than I have now. I have accepted that with or w/o surgery, my performing career (except vocals) is over and I will need a collaborator to play any melodies & chords I might write should I continue to write. I just hope that life as I know it isn't also over.

I am in for agonizing bone pain--and even after the acute pain of surgery is over (and I've weaned off the prescribed opioids--surgeon thinks I'll need them only 3 days, but primary care doc thinks more like 3 weeks), I will likely have extreme pain resting my arm on anything (even pillows) thanks to the hardware irritating soft tissues. Surgeon admits I will have some permanent soreness & stiffness of my wrist, and will have bone pain spasms in cold & damp weather so long as the hardware stays in--and it can't be removed for 1-2 yrs, and that's if the bone fully knits.

Surgery is scheduled for Tuesday. I'm supposed to fly to NY 8 days later--surgeon says that should be fine, but he's not the one having to cope. I wrote him, asking if I shouldn't wait till I get back from NY (Bob can't go alone, as the purpose of the trip is a presentation we must both attend--the hotel is non-refundable, though I could apply the airfare on SW for a future trip w/in a year). Or at least after I have had several OT sessions pre-op to learn and practice how to live one-handed.

I'm terrified. Talk me down off the ledge. Has anyone here successfully coped with anything like this?

[Pitar]

Exercise it if you can. If not, I had a similar incident with the left thumb that prompted me to learn to chord without use of the thumb. It was interesting and I was getting pretty good. The upshot of that was the slow but steady returning use of the thumb, which the white coats claimed would probably never be fully recovered, and before long I was pretty much using it as I did before the injury. If it had not mended as it did I probably would have learned to chord without the thumb and at least developed in that direction.

Pain was and remains with me. It's not something I let become debilitating. I've learned to use a hand squeezer that taxes the thumb until it becomes numb and I can fall asleep. So far I've managed without meds of any kind and the pain, though I could say becomes acute at times, isn't as bad on my soul as the neighbor who doesn't return what he borrowed.

[Chicago Sandy]

Thanks, Pitar. What I'm having done is having a screw inserted into the L scaphoid to stabilize it, arthroscopically clean up the torn flap of cartilage in the center of the TFCC disc (no repair, as it has no blood supply); and (what scares the bejeepers out of me) a plate and 6-8 screws inserted into my ulna, a slice of bone cut out of the middle, and the two halves of the ulna "smooshed" back together with the pressure screws in the plate. THAT will be the primary source of the pain. It's called an "ulnar shortening osteotomy," without which I will likely reinjure the TFCC at some point because my ulna is too long and was likely the "straw that broke the camel's back" either when I fell the first time or propped myself up with my L hand. (There's a chance that due to aging, my TFCC might even have torn spontaneously from the pressure of the ulna on it).

The source of my increasing inability to play with my L hand was the swelling from the TFCC tear--started with inability to make barre chords, progressed to pain on contortions required for certain movable chords way up the neck. My first gig (a 1-hr solo set) after the accident wasn't too bad; the next--a dulcimer festival with a 1-hr. duo concert, 1-hr duo demo workshop, and two solo hourlong workshops--was ok on the guitar songs we chose for our set but pretty painful when it came to the solo dulcimer stuff. The last gig, an hourlong outdoor duo set in 95-degree heat in central IN, wasn't bad guitar-wise, but making dulcimer chords--especially 2nd & 3rd position--was torture. In fact, that first 2nd-position dulcimer chord & suspension was such an unexpected and sudden sharp pain that I actually had to wince, rub liniment on my wrist, and start over--this time expecting the pain and knowing I had to push through it. I had been warned back in May that each gig would hurt more than the last, though not actually cause further injury. And then three days after that last gig I fell again, breaking my L scaphoid and hairline-fracturing either end of my R radius. So here I am.

My thumbs & fingers are fine, not injured and not involved in the surgery. My ROM in the R wrist is normal--no pain when I rotate it, only when I use my R hand to push or pull stuff--and I feel the pain only in the radius and the soft tissues supporting it. I have had arthroscopy in both knees, and from that I know to expect my wrist to be much more painful, swollen & stiff than what caused me to have the surgery, and to be that way for a long, long time. I will never get back the full ROM in my wrist I had before the TFCC tear. And it's increasingly apparent that except for vocals & harmonica, I will have to cancel all the gigs I have booked, till Oct. and probably beyond.

At 67, I realize that my dream isn't necessarily my destiny. And I got to enjoy a helluva lot more of that dream than anyone except a virtuoso has any right to expect. But what is bumming me out is that the remainder of my life--even the smallest things, including being able to dress flatteringly, maintain my looks, travel, care for my pets, exercise (other than just physical therapy & walking), and sleep uninterrupted by severe pain--will be altered for a very long time.

[frankhond]

That just sucks. I can relate - after chemo that put me in remission, I have strange joint issues, the most acute in my left shoulder. Nothing helps. I haven’t played guitar for about 9 months and I can’t see myself going back for the foreseeable future unless my shoulder improves. I bought a weissenborn, we will see, it’s nice but not the same.

I have no concrete advice, except maybe to consider that the guitar is a physically difficult instrument and many have trouble as they age. Sometimes I wish I stuck with the piano. Maybe that will be the way to go. Or do like Bob Dylan, get a band and stick to singing. A dream is no fun if it just brings pain.

Maybe your hand surgery should be considered from a completist perspective. Is it necessary to live a normal life, or are you just trying to keep playing guitar. If the former, maybe the bullet needs to be bitten. If the latter, is the possibility to play again worth all the trouble.

I wish you the best no matter what you choose and hope you continue living a dream, even if it turns out to be different.

[Jim Owen]

No words of advice here, Sandy. Just good luck.

The aftermath of the surgery seems daunting in that you'll have a hard recovery. But that period will be finite? So if the surgery improves your quality of life once the finite recovery period is over, then the benefit seems to swing in its favor?

[Chicago Sandy]

Supposedly I will eventually have more ROM and less pain in the wrist than I have now--but that could be as much as a year post-op with extensive physiotherapy. There is always the possibility that I may never have sufficient pain-free mobility to pick up where I left off before the injury, and even that I might never be able to play again. It is definite that I can expect some permanent stiffness & soreness, as well as very sharp pangs in the ulna in cold weather or if I rest my arm on anything, so long as the hardware remains in.

I guess I should stop complaining--I did dodge the chemo bullet, after all. (But the drug I must take to keep the estrogen-driven breast cancer from recurring may have been responsible, despite taking bone-strengthening Prolia shots, for weakening my bones--were I not on anti-estrogen therapy, I might not have broken my R radius).

Very few people get to this age without something going blooey, I guess.

[cotten]

Well, it's Tuesday. Sandy, I can't send you anything except my prayers, best wishes, and encouragement. I know you are a realist, but at moments like this it might be better to be an optimist. It's all the same price, and expecting the best might be better, even if your recovery were to turn out a bit less. Keep us posted. You have a lot of friends and fans here pulling for you!

cotten

[Chicago Sandy]

Thanks, John! L arm & hand still totally numb after 7 hrs—typing one-fingered on iPad Pro since laptop suddenly stopped charging. (Can’t unplug or replug cable into/out of USB-C ports, charging brick, power outlets, etc—mystery because other things plugged into that power strip are charging. Just ordered two more cables—first one failed w/in 2 mos., and now this braided one seems dead).

Eventually (soon, I hope) the regional block will wear off—even pain will be a welcome sign as I would be able to at least steady or brace things w/my L hand. I am in a hard splint covered by a pressure dressing. In 2 wks it will be replaced by a short forearm cast, and 2 wks thereafter a short rigid brace for 6 wks. Surgeon suggests that when I want to start trying to play again I should start with electric, because I will lack the grip strength for acoustic for quite some time. Fortunately, I have a Fender Mustang (and a Danelectro that needs some power-jack work). So I could probably use some advice, when the time comes, about a pedal that would more closely approximate an acoustic sound.

[cotten]

Thanks for the update. Still praying for a full, speedy recovery, even if it does mean you have to dabble over on the dark, electric side for a while. Keep us posted on your progress!

[Jim Owen]

Heal well. Hey—Mustangs are fun guitars. Highly underrated. Shorter scale than Teles and Strats. And lots of folks like the wiggle stick better than the strat unit.

[Chicago Sandy]

My Mustang was "neutered," alas. The previous owner removed the whammy bar and actually epoxied the bridge in place--which was why I was able to get it for $175. But the pickups are pretty versatile, especially the out-of-phase setting. (Perfect for Motown & reggae rhythm playing).

I have full sensation back in my fingers, which for now is a mixed blessing. I'm doing the tomahawk chop and fist-making exercises but my knuckles are rebelling against being confined. Beginning to slowly wean down from the painkillers, but it is an ordeal. (Visualizing what is causing the various aches & stings is strangely calming--a mental exercise I learned in Bradley birthing classes decades ago).

Monday I will be getting my cast--so my fingers will have a bit more freedom.

[Glennwillow]

Sorry about all this, Sandy! You will recover -- just hang in there.

You are right -- few of use approach age 70 without needing a few things fixed. It goes with the age territory! Here's to your FAST healing!!

- Glenn

[Chicago Sandy]

8 days post-op. Sitting here in my NYC hotel room, L arm elevated. Monday my surgeon was so pleased with my progress that we skipped the plaster or fiberglass cast and went straight to an EXOS brace, which is essentially a custom-fitted adjustable removable cast. Starts out neoprene over soft plastic, but after heat-activation is molded to fit, and then it hardens. Can be re-molded as the swelling lessens.

Since I had scaphoid fracture fixation, my brace has a thumb “spica,” which prevents full rotation of the CMC joint. And that’s the problem—my thumb & fingers are so short that my thumb can’t reach across the rigid “divide” to meet my forefinger. A pediatric size would correct the situation, but then it wouldn’t fit my forearm or even palm. Basically, my L hand lacks an opposable thumb and is therefore darn near useless. I need help putting on my wristwatch & bra and even opening packets of stuff (will have Visiting Angels in next week for a “life-hack” lesson or heaven forbid, helping me dress & undress on days my housekeeper is off and my husband is working long hours). I also bought some caftans for days when wearing a bra is not an option and “the girls” must roam free undetected (TMI, fellas, I know). Even typing is a chore—the edge of the cast-brace brushes the wrong keys.

Believe it or not, I am going through with my gig on Sunday—singing and playing harmonica one-handed. Monday I will go back to the ortho clinic and see if they can remold the EXOS so that the thumb spica is closer to my forefinger and I would be at least as dexterous as a chimp.

[Otterhound]

Consider yourself fortunate that you are not left handed .
I am and it was the scaphoid on my left hand .
In the 6 weeks of wearing that cast , I easily adapted to everything except for one very basic thing that we all share in common .
I seriously doubt that I will ever find myself even remotely comfortable wiping my backside with the wrong hand .
Hang in there and try to keep in mind that your first movement of that wrist will likely not be comfortable . It will get better afterwards every time you use it .

[Chicago Sandy]

Thanks, Otterhound! Today I was able to get the EXOS brace re-molded to give me an opposable thumb again, so I’m now able to drive and pull my jeans up. I hear you about the one thing that’s impossible with a L hand “in jail.” I get all sorts of strange looks when I wash just my R hand in restrooms (because I don’t use the L for...you know). Also, I’ve taken the brace off to shower and boy is my wrist stiff and sore. Dorsiflexing my hand is extremely painful, but in two weeks I start physical therapy and will have to get used to it (and revive the saltier parts of my vocabulary).

Had a gig last night, just singing and playing harmonica (where my guitar & dulcimer solos usually are), and there were a few hitches. My partner forgot that on one song we usually do in Bm (with my dulcimer tuned DAD and he playing Am progression capoed up 2) I’d told him we had to do it instead in Am so he could lose the capo—I don’t have a Bm harp. On another we do in B flat (we capo up 3 and play G progression) I was going to play my guitar solo on my B flat harp. Of course, he did precisely the opposite on the latter song—ditched the capo, and when I launched into the intro on my B flat harp...well, let’s just say it was the Arnold Schoenberg arrangement of my original. It was way at the bottom of my vocal range too. When he began to riff before the solo, I grabbed the G harp. Whew!

I also had to rely on two a cappella songs I hadn’t done in at least a couple of years, and of course had senior moments on the lyrics...my OWN lyrics. The duo with whom we played in the round—who are at least 10 years younger than we are—had all their songs on an iPad mounted on their mic stand. Hey, if they’re not too proud to do that, then I’m justified in following suit. So I ordered the same model holder they use.

We have our next gig coming up 9/14, just us as the duo. I’m not taking any chances—I’m sending my partner chord charts and .mp3s for all my solo original stuff, in case I still can’t play strings by then and have to resort to padding our sets. He says that’s a great idea. And now that I can drive, I can go up to Madison to rehearse.