Hand surgery

[Guest guest]

Hi Cassie,

I have had the same inflammation and swelling of that area of my right hand and

my rheumologist prescribed colchichine (an anti-gout medicine) for me. I

suggest

you ask your doctor if your symptoms may be a sign of gout or a sprain.

Sincerely, Bill in DC

[Guest guest]

Hi Cassie,

My hand surgery was done about 9 nine years ago as an out-patient by a

plastic surgeon in the Hand Clinic at the University of Texas medial

branch in Galveston and I'm very pleased with the results.

The incision was not done the way most orthopedic surgeons do in at the

wrist where they simply release the band to relieve pressure on the

nerves but was done in the palm of the hand so that he could examine

each nerve to each finger as well as do the release in the wrist. It is

difficult to even find the scar today unless you know it's there.

It was done under local anesthetic called 'Beard Block' where the

anesthesiologist applies a blood pressure like cuff that has two areas

of pressure instead of the usual one, then " milks " the blood from the

hand up into the arm with a very tight elastic like material; he then

applies pressure in the cuff to keep the blood from returning to the

hand and removes the elastic material; hence, a very " clean " operation.

Although an IV drip was started " just in case " , I was awake throughout

the entire procedure but felt nothing other than the hint of pressure.

Nosey me wanted to observe the procedure (blood does not bother me) but

they wouldn't allow that. Bummer!! There are some very good sites

online if you want to see the anatomy of the hand which I find

fascinating; just bear in mind that they are very graphic.

There was some pain due to the swelling and instructions were to keep

the hand/arm elevated. The plastic surgeon examined my hand within a

couple days and asked me to touch my thumb to the base of the little

finger; although I couldn't accomplish the task due to the residual

swelling, he seemed pleased with the attempt I made and instructed me in

some simple exercises until the final visit.

Hope this helps a little,

Patty B in the sweltering Pineywoods of East Texas

[Guest guest]

Hi Cassie,

I am still taking the colchichine one tablet every day and the swelling

on my wrist has slowly shrunk during the past year. But, I am currently

scheduled to take about 12 different pills, ointments or medications

each week for the various ailments I have, such as asthma and PA.

Therefore, it is hard for me to tell whether a particular medication is

effective.

I hope you are feeling better. Have you had a MRI of both wrists? By

looking at both wrists you and your doctor can compare them, since

one hurts and one doesn't. Sincerely, Bill in the District

[Guest guest]

Hi Cassie,

> Patty B, your hand surgery sounds a little like for carpal tunnel.

Yes, it was a carpal tunnel release. My main reason for posting was to

distinguish the differences between the techniques used by orthopedic versus

plastic surgeons. But swelling from whatever cause -- arthritis or something

else -- can cause the carpal tunnel syndrome, IMHO.

> ... I had injections at the base of it

Tried that for mine, too, with minimal relief. I just wish I'd had the right

hand done when I had the opportunity. In those days, with some of our children

still at home, we qualified for more assistance at UTMB and paid only $50 for

the surgery; once they left home, it went up to $500 which we couldn't afford.

Now the wrist, thumb and heel of that hand stay swollen, painful and

dysfunctional all the time. True, the carpal tunnel release wouldn't have helped

that but it might keep the pain down from the swelling in the wrist itself.

Surely there have been improvements in the procedure since then.

> ... You said you wanted to watch the surgery when yours was done. I watched

the surgery on my foot a few years ago and I think it hurt more just because I

was watching

You're probably right about that.

> ... What is an EMG

I had those done, too. They inserted long slender needles into the muscle and

attached electrodes to monitor function or dysfunction due to nerve impairment.

At least, that's how I understood it.

> ... And yes to

> I think we all tolerate more pain than others because we live with it

everyday. Others without chronic pain don't know and don't possibly think we

could be in as much pain as we say we are

That seems to be just another facet of this little jewel we call PA. Unless the

stress of our discomfort shows in our face where those who are more inclined to

be sensitive and caring can see, people just don't realize the truth of our

'complaints'. It's been my experience lately, to just say that I'm not going to

do something without offering the reasons. Looks like we've got to become more

assertive in our own protection and forget their impressions and inability to

understand or believe.

> Have you gotten the thick pens made by Pilot called " Dr. Grip " ? They help. Pat

B

More and more companies are recognizing the need for " fat " pens and aren't they

great!

Patty B in the Pineywoods of East Texas where we received the blessing of an

early morning, long, slow drizzling, drought helping rain.

[Guest guest]

patty....have any of you tried those parrafin baths for your hands . they are

wonderfully soothing . it looks sort of like a crockpot and it comes with

parrafin wax. you melt the parrafin inthis crockpot. it gets wonderfully

warm. it is very low heatr and takes about an hour to melt the parrafin. you

dip you hand or your feet in several times [it is warm[] not hot and

incredibly soothing you wrap your hand in plastic and or a mit and wait

fifteen or 20 minutes it peels right off and as a bonus your skin is smooth

and soft. you should put lotion on your hands and feet first. there cost

approximatelly 75 dollars or 100 dollars. ypu can get them at almost any

medical supply store.i wish i had one years ago! think about investing in

one .they are well

worth it. cathy from mass

[Guest guest]

Shar Pei <phatsharpei@...> wrote:Has anyone here ever had surgery to

correct demage in

the hand's joints? Í was advised to have it and would

like to know if it's worth having it...

Thanks

C.

Please visit our Psoriatic Arthritis Group's informational web page at:

http://www.wpunj.edu/pa/ -- created and edited by list member

aka(raharris@...).

In August 2001 list member Jack aka(Cornishpro@...) began to

conduct extensive research which he publishes as the Psoriatic Arthritic

Research Newsletter monthly in our emails and digest format. Many thanks to

Jack. Back issues of the newsletter are stored on our PA webpage.

Also remember that the list archives comprise a tremendous amount of information

(Over two years of messages and answers).Feel free to browse them at your

convenience.

Let's hear from some of you lurkers out there! If you have a comment or question

chances are there is a person who has been around a while who can help you out

with an educated guess for an answer. If not we can at least steer you in the

right direction with a good website to go to for the answers.

Blessings and Peace,

Atwood-Stack, Founder

Alan , Web & List Editor

Jack , Newsletter Editor

Pat Bias, List Editor

Ron Dotson, List Editor

and many others who help moderate (thank you!)

[Guest guest]

I just underwent toe surgery to straighten my 4th right toe on Thursday, 5 days

ago... it took me 2 years of investigating and deciding whether or not to do

it... I finally decided to. I am on MTX and have had PA for 10 years or more...

I have experienced many sausage toe and finger joints, taken steroid injections

that always helped to reduce swelling and therefore reduce the pain... but, this

one toe took on the 'retracted toe' position and I could not wear shoes for over

a year... only slippers and sandals... the bone was 'fixed' up 90 degrees and

then went down 90 degrees... so, joint damage would have occurred if I had

continued to wear shoes.

I took 3 digital photos of the foot today... they are quite graphic and I am

willing to submit them for our photo section... I would have appreciated it if

someone else had done so.... anyway, this is up to the moderators or whoever to

let me know... there are three incisions and a temporary Kirschner wire sticking

out the end of the toe... it will be removed in 6 weeks from the time of the

surgery, if all goes well.

There are many risks involved and they can be serious: the full anesthesia,

gangrene, infection, possible amputation if it doesn't work out, and so on....

but I had to decide. I had already done two simpler procedures and they didn't

work, the orthopedic surgeon said my extensor tendons were just too strong... I

had two 'tendon releases' ... for some folks this will work, everyone is

different.

The surgeon also removed the toe's midjoint (it was not yet damaged, but it had

to be done in order to procede with the 'hole in peg' procedure... by using the

end of the bones, one becomes a hole and the other the peg that inserts into

it...), etc. You can find more graphic details on the internet if you like... I

am an Occupational Therapist and love to know all the details, but most of us

with PA could be doctors by now with our experiences....)

I don't want to encourage this procedure, but I noticed that lately there were

many entries concerning 'bone fusions', hand surgery, and so on.... I am still

waiting to see how my situation turns out... so, I will keep you informed.

Again, I am willing to submit these 3 photos to the groups photo section...

Take Care & wishing good/better health for all of us,

#2

Shar Pei <phatsharpei@...> wrote:Has anyone here ever had surgery to

correct demage in

the hand's joints? Í was advised to have it and would

like to know if it's worth having it...

Thanks

C.

[Ed. Note: #2, thank you very much for offering your photos for posting on

the PA forum - Yes, I think that would be wonderful! Please send your photos to

-owner and one of us will post your photos for

you. I have the condition you're describing on my left foot - it's called

" Hammer-toes, " though in your case it sounds like it's much more severe than in

mine. I get by with just wearing shoes with a large toe box and using a callous

remover (see photo section) to shave off the callous caused by the downward

protrusion of the base of the joints of my toes towards the bottom of my foot. I

also get callouses on the middle joint of my toes because they rub against the

tops of my shoes, but I can live with that. :-( Please put something like " PA

Photos " or some such thing in the subject line of your email so we know it's

from a forum member rather than Spam. Ron]

[Guest guest]

June of 2000 I had forefoot reconstruction surgery on my left foot. All of my

toes were hammer toes. My surgeon fused the big toe and repaired the hammer toes

, I had the pins in all my toes but I also had to have the metarsal bones

removed because the padding that covers them was gone . Unfortunately he has to

redo that surgery on my toes because the second and third toes are turning

outward. My third toe is bent so far over it is down behind my little toe. It is

impossible to get a shoe on. My surgeon said he has never seen this happen

before. He thinks because of my knees being so bad I was not walking right may

have contributed to causing those toes to turn. I still have to have my right

foot done but he wants to correct the left one first. maureen

Khoury <nut_tree58@...> wrote:I just underwent toe surgery to

straighten my 4th right toe on Thursday, 5 days ago... it took me 2 years of

investigating and deciding whether or not to do it... I finally decided to. I am

on MTX and have had PA for 10 years or more... I have experienced many sausage

toe and finger joints, taken steroid injections that always helped to reduce

swelling and therefore reduce the pain... but, this one toe took on the

'retracted toe' position and I could not wear shoes for over a year... only

slippers and sandals... the bone was 'fixed' up 90 degrees and then went down 90

degrees... so, joint damage would have occurred if I had continued to wear

shoes.

I took 3 digital photos of the foot today... they are quite graphic and I am

willing to submit them for our photo section... I would have appreciated it if

someone else had done so.... anyway, this is up to the moderators or whoever to

let me know... there are three incisions and a temporary Kirschner wire sticking

out the end of the toe... it will be removed in 6 weeks from the time of the

surgery, if all goes well.

There are many risks involved and they can be serious: the full anesthesia,

gangrene, infection, possible amputation if it doesn't work out, and so on....

but I had to decide. I had already done two simpler procedures and they didn't

work, the orthopedic surgeon said my extensor tendons were just too strong... I

had two 'tendon releases' ... for some folks this will work, everyone is

different.

The surgeon also removed the toe's midjoint (it was not yet damaged, but it had

to be done in order to procede with the 'hole in peg' procedure... by using the

end of the bones, one becomes a hole and the other the peg that inserts into

it...), etc. You can find more graphic details on the internet if you like... I

am an Occupational Therapist and love to know all the details, but most of us

with PA could be doctors by now with our experiences....)

I don't want to encourage this procedure, but I noticed that lately there were

many entries concerning 'bone fusions', hand surgery, and so on.... I am still

waiting to see how my situation turns out... so, I will keep you informed.

Again, I am willing to submit these 3 photos to the groups photo section...

Take Care & wishing good/better health for all of us,

#2

Shar Pei

wrote:Has anyone here ever had surgery to correct demage in

the hand's joints? Í was advised to have it and would

like to know if it's worth having it...

Thanks

C.

[Ed. Note: #2, thank you very much for offering your photos for posting on

the PA forum - Yes, I think that would be wonderful! Please send your photos to

-owner and one of us will post your photos for

you. I have the condition you're describing on my left foot - it's called

" Hammer-toes, " though in your case it sounds like it's much more severe than in

mine. I get by with just wearing shoes with a large toe box and using a callous

remover (see photo section) to shave off the callous caused by the downward

protrusion of the base of the joints of my toes towards the bottom of my foot. I

also get callouses on the middle joint of my toes because they rub against the

tops of my shoes, but I can live with that. :-( Please put something like " PA

Photos " or some such thing in the subject line of your email so we know it's

from a forum member rather than Spam. Ron]

Please visit our Psoriatic Arthritis Group's informational web page at:

http://www.wpunj.edu/pa/ -- created and edited by list member

aka(raharris@...).

In August 2001 list member Jack aka(Cornishpro@...) began to

conduct extensive research which he publishes as the Psoriatic Arthritic

Research Newsletter monthly in our emails and digest format. Many thanks to

Jack. Back issues of the newsletter are stored on our PA webpage.

Also remember that the list archives comprise a tremendous amount of information

(Over two years of messages and answers).Feel free to browse them at your

convenience.

Let's hear from some of you lurkers out there! If you have a comment or question

chances are there is a person who has been around a while who can help you out

with an educated guess for an answer. If not we can at least steer you in the

right direction with a good website to go to for the answers.

Blessings and Peace,

Atwood-Stack, Founder

Alan , Web & List Editor

Jack , Newsletter Editor

Pat Bias, List Editor

Ron Dotson, List Editor

and many others who help moderate (thank you!)

[Guest guest]

> Has anyone here ever had surgery to correct demage in

> the hand's joints? Í was advised to have it and would

> like to know if it's worth having it...

> Thanks

> C.

I had my left wrist and thumb joint fused about 6 years ago with only

limited success. I was in plaster for 6 weeks in which time the

tendons on the back of my hand adhered to scar tissue around them.

This meant that there was very limited finger curl movement. severely

limiting my pince grip and my ability to form a fist.

The thumb was so painfull and prone to flare ups that I had another

op 2 years later to remove the pin (that worked OK) and try to free

the adhesions. I went into serious physiotherapy straight after the

op. to keep the tendons supple and maximise the finger movement, but

had to stop when a tendon snapped, leaving me with a

permanently " hanging " little finger.

So all in all it wasn't a great success, but it did permanently stop

the severe pain I had in my left wrist.

But I think you should here some good news as well. My local nurse

has RA and she has had both wrists fused WITHOUT POST OPERATIVE

PLASTERING and her fingers are fine. It was a different surgeon -

perhaps her wrists were not as badly damaged - who knows.

So - ask if your hand will need plastering and then decide.

Wishing you the very best

Mike from Wiltshire

[Guest guest]

Pat....I personally decided not to have surgery. The first reason was

because my sister-in-law has now had five surgeries on her feet and each one has

led

to other problems. She still has trouble walking for any distance, but after

five surgeries she said she is through. And they really do not work any

better than when she started!!!

The main reason however, is that in spite of being rather ugly to look at,

my hands work really great. They are not as strong as they once were, but I

own a flower shop and am consantly hauling and lifting and cutting stems and

branches, etc. Since they work fine I do not want to chance having them look

good but not function properly. (Sort of like Barbara Streisand when asked why

she did not get a nose job!!) I do stained glass and ride horses so I opted

for the minimum of treatment to keep me functional. And trust me...at 58,

looks are not as important as comfort and function!! Just one persons opinion.

Martha

[Guest guest]

Dear Marti, thank you for your kind words.

I had surgery on my right hand on July 8 to repair the two ruptured tendons. The

surgeon also cut down my wrist bone which was quite enlarged (that was the

culprit). I woke up with bandages from fingertips to my elbow and was kept

overnight to make sure there was no sign of infection. I had shots of demerol

every 2-4 hours so was pretty drugged. I also got a prescription for oxycodone

to take every 4 hours and that kept me drugged for most of a week. I weaned

myself off that nasty stuff because it made me ill and went back to taking

diclofenac. I was out of work for 10 days, then went back to work half days for

2 days, then pretty much full-time. My right hand was in various splints for 8

weeks and I couldn't drive. That was the biggest headache-being dependent on

people to get me to and from work and to my weekly occupational therapy

appointments. But everybody pitched in to help.

My work support was tremendous. I had voice-activated software installed on my

work computer so I didn't have to hunt and peck so much. My boss, who is across

the campus in another building, just wanted me to get better and let me keep a

flexible schedule. I have a very busy job as a university administrator, but

everyone arounnd me was great. By the time students returned for the fall

semester I was able to drive again, and although the hand isn't 100% yet; I'm

good..

The left hand, which is being operated on tomorrow, has 3 tendons to replace,

but the bone is no longer swollen. I've been on Enbrel since June and it has

been wonderful. I'm flaring right now but think it is just a temporary stress

thing.

I'll let you know how it goes.

Cheers,

e

[Guest guest]

-good luck with your second hand surgery Adriene!

Marti

-- In , e van Gils

<avangils@e...> wrote:

> Dear Marti, thank you for your kind words.

>

> I had surgery on my right hand on July 8 to repair the two ruptured

tendons. The surgeon also cut down my wrist bone which was quite

enlarged (that was the culprit). I woke up with bandages from

fingertips to my elbow and was kept overnight to make sure there was

no sign of infection. I had shots of demerol every 2-4 hours so was

pretty drugged. I also got a prescription for oxycodone to take every

4 hours and that kept me drugged for most of a week. I weaned myself

off that nasty stuff because it made me ill and went back to taking

diclofenac. I was out of work for 10 days, then went back to work

half days for 2 days, then pretty much full-time. My right hand was

in various splints for 8 weeks and I couldn't drive. That was the

biggest headache-being dependent on people to get me to and from work

and to my weekly occupational therapy appointments. But everybody

pitched in to help.

> My work support was tremendous. I had voice-activated software

installed on my work computer so I didn't have to hunt and peck so

much. My boss, who is across the campus in another building, just

wanted me to get better and let me keep a flexible schedule. I have

a very busy job as a university administrator, but everyone arounnd

me was great. By the time students returned for the fall semester I

was able to drive again, and although the hand isn't 100% yet; I'm

good..

>

> The left hand, which is being operated on tomorrow, has 3 tendons

to replace, but the bone is no longer swollen. I've been on Enbrel

since June and it has been wonderful. I'm flaring right now but think

it is just a temporary stress thing.

>

> I'll let you know how it goes.

> Cheers,

>

> e

[Guest guest]

e, thanks for sharing your hand surgery story with us. I was especially

interested to read about it because I'm having PIP joint replacements on my left

fourth and fifth fingers on Oct. 26th, as well as some tendon work on the fourth

finger to repair the DIP joint, and a pin in the fifth finger's DIP joint to

help it " auto-fuse " into a better position. I'm REALLY scared about the surgery,

because my finger functionality is especially precious to me as a pianist; but

the way I see it, those four joints are so bad that I haven't got anything to

lose at this point. I mean, they're permanently stuck in the positions they're

in, with little or no mobility currently, and they are deformed in unnatural

ways that don't make them very functional. It's still scary though!

I hope your surgery today has gone well. :-)

[Guest guest]

Hi Kay

Have not had this myself or even heard of someone that had the proceedure.

But, I can sure sympathise with the pain at the base of the thumb. I get

that once in a while but worse than the thumb is the pain at the base of my

left big toe. It is unbelieveable some days. Of course when I am playing

with Pooky (Miss Silky) she brings her ball or other toy to my feet then if

I don't grab it quick, she drops it on my left big toe. New exquisite pain

sensation. After I get down from the ceiling she comes over and licks me

better.

You really get to realise how much you need thumbs and big toes when they

are throbbing in pain and you cannot get anything done. I am using our

wheat bag, same as rice bag but with wheat kernels, and wrap it around my

big toe when it gets real bad. Methinks I shall have to make some new ones.

I use long white sports socks to make some of them. They are ideal for a

sore neck as well.

Fr. Dave

[Guest guest]

RE: hand surgery. I have not had that particular operation-though I know

someone who did-but I have had my wrist fused. Either way is painful for a

while. The friend who had her thumb operated on is doing much better but it

took her quite a while to heal. She is in her 60's. My wrist healed fine but

I now have talked to the dr about my thumb because it is so painful. He is

not eager to do that particular surgery yet so I am trying other things

first. Like shots and therapy.

Good luck with your surgery.

*Unnecessary amounts of quoted message removed by moderator for poster.

[Guest guest]

Hello guys,

Has anyone had any experience with thumb surgery? I have CMT-X & have

had 2 forefoot reconstructions in the past 12 months. I have now been

referred to a hand surgeon because of difficulties with both my thumbs

& would appreciate hearing from anyone who has had operations to help

with this problem.

Many thanks

[Guest guest]

My sister had the hand surgery about 3 years ago. I'll see if she can offer any

info.

[Guest guest]

Hi ,

I have had both my thumbs fixed as well as my ulnar nerves relocated. I had the

left and right done a year apart. Both were incredibly successful! Before the

surgery if I tired to hold something or do something using that " opposing " thumb

the object would just drop out of my hand. Now I can carry a turkey platter!

Note: I had GREAT therapy post-surgery. I think that is essential!

Good luck!

Penny

[Guest guest]

Hi -

I'm new to this forum - am a 53 year old female with CMT, I live in

central California. Has anyone had hand surgery for CMT? I have read

some articles about tendon transfers and joint fusions, but have yet

to make contact with anyone who has had surgery.

Thanks - Vicki

[Guest guest]

I had carpel tunnel surgery on left hand aout a year ago. My issue was impaired

function & numbness rather thsn pain. I had a prominent doc here in Houston who

seemed to know about neuropathy, he elected to use a general rather than local

anesthetic. BIG PROBLEM! My left leg is now almost totally numb, it like the

whole leg was shot up with novocaine. This condition has not gone away a year

later. So even though my right (dominant) hand has impaired function...writing,

small motor skills, etc...I refuse to have surgery on my right hand becsuse I

dom't want to lose function in my right leg and no longer be able to drive.

Be very careful. BTW, the left hand is a bit stronger but motor skills are no

better, the gain was not worth losing my left leg.

I have HNPP

>

> Gretchen and Elinor,

>

> So sorry to just now be getting a thank you out for your responses, but

thanks! I will ask for the Voltaren when I go back to the doc next week. I am

going early as the pain is getting worse and increasing in both wrists too. I

believe the doctor is going to want to give me cortisone injections, and I am

concerned about ANYTHING done to my hands.

>

> Are there folks who have had injections and/or hand surgeries with CMT? I am

concerned, of course, of losing strength and function. But don't know how much

to worry about the cortisone. Seems like the cortisone injections will just

keep me from knowing how badly I am damaging my joints, however! And, well,

with the surgery, I will be casted for 3-4 weeks -- can't be good for preventing

atrophy. . .

>

> Maybe injections and cutting back on work hours to see it that is the problem.

>

> Mandy

>

[Guest guest]

I don't have CMT [husband and children] but I have bone on bone arthritis in

both my thumbs. I had the surgery on my right dominant thumb where they took

out one of the bones out of my wrist. The recovery was so awful that I wear a

brace on my other thumb and won't have the surgery. The pain is gone in my

right hand, but it is not as strong as it was before and has less muscle the

surgery, and I would worry about that if you have CMT.

As far as Voltaren is concerned, my insurance company stopped covering it for

some reason. I didn't think it was that great that I wanted to protest. I

think this injury is going to become much more common as video playing baby

boomers age, and they will eventually develop an artificial thumb joint. If

you live in New York someone was doing a clinical trial of injecting Synvisc in

the thumb joint.

Elinor

[Guest guest]

Sorry about your terrible experience with your leg! I think I would only

consider this surgery as a last resort to increase function. Don't think I want

to give up muscle in order to decrease pain at this point. Thanks for sharing

your experience.

> >

> > Gretchen and Elinor,

> >

> > So sorry to just now be getting a thank you out for your responses, but

thanks! I will ask for the Voltaren when I go back to the doc next week. I am

going early as the pain is getting worse and increasing in both wrists too. I

believe the doctor is going to want to give me cortisone injections, and I am

concerned about ANYTHING done to my hands.

> >

> > Are there folks who have had injections and/or hand surgeries with CMT? I

am concerned, of course, of losing strength and function. But don't know how

much to worry about the cortisone. Seems like the cortisone injections will

just keep me from knowing how badly I am damaging my joints, however! And,

well, with the surgery, I will be casted for 3-4 weeks -- can't be good for

preventing atrophy. . .

> >

> > Maybe injections and cutting back on work hours to see it that is the

problem.

> >

> > Mandy

> >

>