Basilar Joint fusion

mom23reds
on 12/19/10 8:49 pm - Bryan, TX
I have osteoarthritis in my knees and hands. I've lost 150 lbs that I've kept off for the last 3 years since my gastric bypass surgery in September 2007. I still need to lose another 70 lbs to reach my personal goal. The surgeon never set a goal for me.

Now my left (dominant) hand is having so much pain that I cannot lift more than 1 lb with that hand, cannot grip things, can't pinch, etc. My family doctor initially diagnosed deQuervain's tenosynovitis, which I probably did have. Because I can't take anti-inflammatory medications, he immediately put me into the thumb spica splint. The DQ seems to have resolved with the splint. However, I still have pain in my thumb/wrist. We took x-rays in October, but my family practice doctor didn't see anything physically wrong. When I was still in pain (and still in the splint) at the end of November, he referred me to the specialist. I saw the specialist on December 14th. His response in seeing the x-rays was, "Oh, you ruptured your volar beak ligament which means your thumb isn't in alignment with the trapezium bone and you've got bone on bone grinding when you use your thumb."

Great. So what are my options?

Well, we start with anti-inflammatory medications. Umm, I can't take those because I've had gastric bypass surgery.

Oh. Then you have rest. I've been "resting" it for 3 1/2 months and it's NOT getting any better.

Then we have surgery options. There are two surgeries, neither of which I like to do on someone as young (!) as you. [I'm 45.] Main reason is they will probably only last about 15-20 years before I'm in pain again.

At this point, I'll take pain 15 to 20 years down the road vs pain now, thank you very much...

The surgeon suggests that the better choice for me is to fuse the trapezium bone to the metacarpal of the thumb so that I'll have a bit less flexibility but no pain either.

Has anyone else had this fusion done on their dominant hand? How long before you were able to return to work? I spend 50+ hours a week at a computer keyboard, though I don't use my left thumb as much as my right thumb (after 3 1/2 months in a splint I've re-trained myself to use the right hand instead of the left for typing).

I take Tylenol (3000 mg a day) split in 3 doses for pain management though I don't see that it's really helping these days.

Thanks,
Susan
 
jdruski
on 12/27/10 7:20 am - Philadelphia, PA
Susan,

I can feel your pain.  I have to have both of my knees replaced.  I can't walk any further than a city block and I am in pain.  I take percocet bu****ch them carefully and because they only make you stupid and dull the pain, I gave up and ask my Orho doc for Celebrex.  I am 4 years out and it may not have been the best decision but until I can have the surgery I have to be able to have some sort of life.  

Check with your gastro surgeon as to whether or not you can take a NSAID and which one..  I am sure that the amount of tylenol is doing as much damage to other organs as the anti-inflam.

Good luck to you.  I really hope that your pain comes to an end.


Jeanne
mom23reds
on 12/27/10 9:31 am - Bryan, TX
I'm taking 3000 mg Tylenol maximum per day, usually closer to 2000 mg max simply because I don't want to kill my liver.

My surgeon has said NO NSAIDs at all, not even 3 years out. I don't take percocet either because I agree that they dull the pain and make one quite slow in reactions. I can't afford to be slow-witted.

Susan
 
mom23reds
on 2/16/11 8:44 am - Bryan, TX
Well, I had joint fusion surgery on 1/21 and now have a beautiful black cast on my left hand/arm for the next 8 weeks... I'm gonna go insane with itching I can already tell.

The doctor discovered I had no cartilage in the joint at all and had some damage to both bones which he smoothed to fit. I have 3 pins and a tensioning wire (and screws) holding the bones in place while we wait for fusion to take place.
 
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