I'm weighing up surgery on my thumb joints

Hi Jeannie...i laughed when i saw your post...no need to apologise. I live in a suburb of Sydney called Caringbah. 

No, i haven't had the surgery. I'm coping with painkillers and an amazing cream called.....something. I can't name it otherwise it'll be canned...see above. 

Im also looking into a stem cell process which i can't name either. Basically i'm desperately trying to avoid surgery. My main concern is the long recovery time. Two thumbs means at least a year for full recovery. I'm 71 and work full time in my business and love to hike and ski. A year is too big a slice of what fully active life i have left. 

PM me if you want more info on my alternative strategy. 

I really wish you well with your surgery and praying for a great outcome for you. 

Keep us posted on your progress. 

Peter 

I'm actually having second thoughts as well now that I see the recovery time. I know everyone is different and heals differently but I too am no spring chicken and thinking of possibly losing a year makes me wonder. I am so tired of the constant pain though! What to do, what to do???

Jeannie, I understand. I guess it all depends on the level of your pain. Private message me and i'll tell you about some promising alternatives to surgery that i'm investigating. 

I know it sounds stupid but that cream i was telling you about works really well for me...there's over 12000 positive reviews. It reduces my need for painkillers. Doctors are using it for themselves and reccomending to their patients. 

Hi caringbah,

I am new to the group and needing the basal joint surgery too.  I also have a full time business that requires me to lift and tough to find help.  My pain is only bad if I move in a strange way or take off the brace.  I don't know how to PM you on this site. Please feel free to PM me too.   I am 63 and scared about the surgery.  My kids are pushing to forward but are they going to be here to help?  Probably not. My thing is this...lost my other full time job in July and I have full coverage insurance with no deductable to pay for the rest of the year, which means surgery is fully paid for. I have heard good things, but scared about the recovery. I even spoke tand therapist I used previously.  She was very honest..said it hurts like heck and the recovery is rough but as long as you do your therapy you will be okay. Thank you for your comments and advice.

Its late at night here (Australia), i'll reply tomorrow. 

Cheers 

I'm scheduled to get the surgery this coming Wednesday and like a idiot I went to the Internet to research how the procedure is done and it's a lot more than I thought. I was having second thoughts as well but now that I've thought about things I want to be out of this pain and be able to do as I once did and live a normal life. I lost a great job making excellent money because of my hands and that's just not fair. My doctor says he can fix my hands with this surgery so I've decided to duck it up and trust that he will do what he says. I'm aware of the down time and I'm hating that but ultimately in the end it will be for the best. If I don't get the surgery done in time paralysis will start to be a issue as well. I don't know if you are aware of that. I'm a very independent person and honestly I'm not looking forward to having to depend on someone else to do things for me but for once I have to accept it. It's a hard decision but you have to make up your own mind how you want to live, with pain, or without. Good luck!

Jeannie

Hi jeannie5639,

Yes, I looked at the internet too...bad idea for me too. I too am having second thoughts, as I currently work for myself and 4 months is a LONG time with no money.

No I was not aware of the paralysis.  My hand therapist from a different surgery did say that after a while my thumb will pull inwards and make it difficult to use my hand.  

Plese let us know how your surgery goes.  I will be very interested, since mine is scheduled for Dec.

I did just make an appiontment as a second opinion with a new doctor to ease my mind.  It appears, they have some other, not so invasive way, to do this.  I will let you know how the appointment goes.  Unfortunately you are far away.

I will pray for success and for you to be great with minimal pain!

Yes I will definitely come back and update everyone on my prognosis. It seems everyone has similar questions and worries so I'm not sure how long after the surgery it will be before I'm able to respond but as soon as I can I will be here to meet you know how things are progressing. I'm trying to focus on staying positive through this because that's just so I am. Thanks for any and all prayers to help me through this upcoming process that I hope I'm not sorry for being a willing participant in! Lol

Bare with me with some of these words that somehow change from what I type, my tablethas a mind of its own, and I'm not proofreading like I should! Ugh!

I had the surgery 2 days ago. For the first 18 hours I needed the pain meds around the clock but now the pain is not bad at all. With the exception of not being able to use my hand things are ok. I dont regret my decision so far. Just thought I would check in and let you know how things are going. Will check back later and keep you informed.

YAY!  Soooooo glad to hear that!  Did you have the one that takes your tendon and puts it in place of the joint?  Makes me not feel so bad. I have another appointment next week with a new doctor.  Thanks thanks.  Keep me (us) informed. Mine will be coming up soon.

Yes they took my tendon to replace the joint that had arthritis. I also had a cyst removed while he had me asleep that had formed at the base of my thumb. I'm doing fine! The only thing I have is frustration from this bandage and being immobile and unable to do things I would like to do. I know in time they will be able to be taken off and things will be good again. I do not regret the surgery and Im glad I had it done. A lot of people seem to be making a mountain out of a molehill! Get it done, quit worrying about the what ifs, and trust your doctor to do what he went to school for.

For the record tomorrow will be a week since my surgery. I even managed to write my name once! It was ugly but I did it! Lol I would recommend my surgeon highly to anyone, he said he could fix my hand and he did just that. I'm very pleased with my outcome. Can't imagine things going south now, just going too good to be anything but positive. I go on the 1st to get my stitches out and I assume a cast for the healing process to continue in a forward motion. I'm not even needing pain meds of any kind.

Y

Hi Jeannie5639.  Went for my second opinion.  Same symptoms but he tells me he can fix this with less invasive surgery.  Ever heard of De Quervain's Tendonitis surgery?

Hi Kavon.  I was diagnosed with De Quervains tenosynovitis many years ago in my 30's.  Treatment consisted only of being told to avoid repetitive movements that triggered pain and to take anti inflammatories (eg ibuprofen).  Im now 60 and have developed OA in both thumb joints.  Only option to me now is full removal of the trapezium or joint replacement, both of which I would rather avoid at present.  If youve been offered less invasive surgery, that sounds a much better option

Thanks Loxie.  I do have OA in both hands.  He just feels that the surgery for the tendonitis will help, without the invasiveness of basal surgery.  I am 63 now.  I have had OA in my hands for a while.  Hey if this helps, great!  They go in and cut the sheath that covers the nerves, clean it out, etc.  You still wear a splint, but no cast.  He said first week is the toughest and then it gets easier.  Just surprises me how 2 doctors can be so different on surgery choices for what is wrong.  Scheduled for Nov 10th.  I have another call in to him to better explain the differences.  Of course I want the easier way, but mostly want the right one!

Glad to hear you’ve been given more than one option though, that’s great news.  Each time I see a doctor regarding my hands, I’m told either have the thumbs fused/removal of trapezium, or ‘live with it’.  Even full joint replacement is not available (due to costs).  I’ve decided to …as they say….’live with it’.  It’s terribly painful and there’s lots I cant do but after researching the surgery option they gave, I determined that pain and restriction would be even worse afterwards, so there it is.   I did manage to speak to a rheumatologist who was seeing me for another problem (possible FMR and ruptured bicep tendon) about my thumbs and she said that if it had been treated correctly thirty years ago when first diagnosed, I may not have had the OA issues I now have with my hands.  Hey ho.   

Glad to hear you’ve been given more than one option though, that’s great news.  Each time I see a doctor regarding my hands, I’m told either have the thumbs fused/removal of trapezium, or ‘live with it’.  Even full joint replacement is not available (due to costs).  I’ve decided to …as they say….’live with it’.  It’s terribly painful and there’s lots I cant do but after researching the surgery option they gave, I determined that pain and restriction would be even worse afterwards, so there it is.   I did manage to speak to a rheumatologist who was seeing me for another problem (possible FMR and ruptured bicep tendon) about my thumbs and she said that if it had been treated correctly thirty years ago when first diagnosed, I may not have had the OA issues I now have with my hands.  Hey ho.   

Don't you love it when they tell you, if only... If only I knew back then.  I am really sorry.  Have you asked about the surgery for the tendon stuff I am having done?  Maybe it would release some of the pressure and pain.  I am scheduled on November 10, so I will tell you what happens.  I did have a serious discusseion with the doctor yesterday about the differences in what surgery I needed.  This doctor specializes specifically with the thumbs and non-invasive surgery, so he said he can see things others miss.  Have you checked any non invasive surgeryplaces there, if you have them?  I am going this afternoon to see another doctor about the issues with my feet, but we will not even go there now. That is a whole different game.

Not sure where you're located Kavon but here I am constricted by what the NHS is prepared to offer.  It's taken over 4 years to even get to a point where I've been assessed by a rheumatologist for another matter who I dared to question about other issues.  For years my GP has brushed off any requests for help with my thumbs, insisting that the only thing I could do was take anti inflammatories.  It's only since it's become life restricting that any discussion at all has taken place about surgical options and I wasn't given any referral, just told that I would only be offered major surgery which would be both painful and remove the flexibility of the thumb, so I just said   'no thanks'.

So sorry to hear that. I am in the states and have a private insurance plan through the company I used to work for, at least for about another year, as long as I pay. I have seen a Rheumatologist and they never said anything about my OA. I do understand.  I cannot do steroid shots, allergic and inflamatories mess with my stomach. I will be thinking about you and praying for you Loxie.  Where are you located?

I’m in the UK Kavon – unfortunately I don’t have private medical insurance.  We pay through the nose (currently I pay 12% of my total income as ‘national insurance’ contributions) for our ‘free’ National Health Service so affording private insurance on top is not practical for me. 

 

The problem here is that we aren’t permitted to raise more than one health concern at a time with our general practitioner local doctor, so end up waiting for ever for referrals, often having to see the same people twice for similar, but different, medical issues.  I’ve waited six months for a consultant appointment, who then requests tests – eg MRI, ultrasound, etc., then wait three months for the test, then another three months for another appointment with the specialist, then waiting again to see someone else about the next health issue, even if they are interconnected.  If physio is recommended, it can take six months to get a physio appointment in my local area – by which time either the problem has resolved itself, or gotten so much worse, its back on the carousel for specialist appointments all over again. 

 

I have OA in one ankle, resulting from a major accident I had which killed off the cartilage; I now have it spreading to the neck and upper spine and one knee, plus the tenosynovitis in the thumbs has now developed into OA.  For the ankle they’ve offered fusing of the joint only, which I’ve declined as I would lose all flex in the joint.  Otherwise, the only treatment offered for any of my OA symptoms has been to take anti inflamms – which mess up my digestive system so badly, I’ve had to stop taking them.  I too have allergic reactions to some meds – I cant take any opiates for example.  My GP has declined to refer me for any specialist assessment for the thumbs, stating that I either take anti inflamms or undergo major surgery, which she doesn’t feel is appropriate at the present time.

 

A recent appointment with a rheumatologist resulted in a long awaited ultrasound, which showed that I have ruptured tendons in the shoulder and ruptured bicep tendon.  I went back to my GP following the results and she actually asked me ‘what do you want to do?’ – I’m like – I have no idea, youre the doctor! She ‘reluctantly’ referred me for an orthopaedic surgeon appointment – however, I’ve since done some research of my own and for the type of tendon damage I have surgery as the first port of call is not recommended.  I now have to wait three months to see the ortho and if they recommend physio etc., I’ll have to wait lord knows how long to get seen. 

Hopeless situation – I suggest you all in the USA avoid buying into ‘obama care’ at all costs!  Nationalised health care doesn’t work. Period.

Thank you for sharing.  I am so sorry about the issues you are having. Oh, not to worry...I am VERY against Obabma care! I wish you could come stay with me and get your things taken care of.  I really am sorry...

What is the life span of replacement?  I am 52 years old and an accountant, so I type on a keyboard for 10+ hours per day and have to work another 15 years.  I am considering the surgery in January (new plan year for medical) as the splints and cortisone shots did not provide relief for very long.  I cant imagine living with this pain as I am still relatively young.  I am hoping this is one and done and I would not have to redo the surgery in 20 years or so....

Don't really know life expectancy, but since the arthritic bone is replaced by tendon, I would assume longevity would be many, many years. Can't put in

artificial replacements like titanium or plastic, etc, which could wear down over time. See surgeon next week and will ask.

I'm at 1 week now and there's very little pain just the inconvenience of not being able to use my dominant hand for fine motor stuff. I can still type pretty well but not play the piano. 

When I had a c-section, I had a horrible allergic reaction to something they put on my skin so under the bandages I got this rash that was so itchy it was painful. The surgeon had to put me on a prednisone pack - where you take a large dose then taper off over 5 days. Well, 5 days into this surgery, same thing under the bandages. I couldn't stand it - it was so itchy and i could feel the rash/blisters under the bandages. I cut the cotton/bandages off and took off the splint to put on benadril lotion. That helped a little but I sent an email to my hand surgeon and he thinks I am allergic to the betadine/antiseptic soap they used to disinfect the skin - which they left on. He told me to come in and have the cast removed (hahaha -  i did tell him I already took it off) and wash my arm /hand really well and then put a new cast back on. Just did that today and it feels better. 1 more week with this cast/splint - then I get a removable one. 

Hi.  Any updates since your surgery?     Getting mine in sept.   

Hello, new to the forum and asked this question to KavonK, too.  I'm 70 and a life of holding heavy equipment in my hands, extended from my body i think has contributed to the 2 different diagnoses I've received:  severe arthritis of the STT joint and severe arthritits of the CMC joint.  I'm retired now but was a competitive golfer, skier and whitewater kayaker.

All those sports are very difficult to perform at a high or almost any level now.  Golf--cannot make certain swings so can't compete anymore.

Have tried many natural therapies, none worked, and am interested in finding out what surgeons do this tendon transplant procedure for addressing thumb OA?

Can you give me his/her name?  I live in the Pacific NW but my research into this only shows a 2015 medical paper authored by a Narihito Kodama.  In that paper a 71 y/o woman is operated on and the results--because this is bio material--are less recovery time and less likelihood of degeneration.

Hi rick8326713,

I live in Portland, OR and next week, Sept 14th, I will be having surgery that will remove the trapezium bone at the base of my thumb and then a tendon in my wrist with be used to fill in the space where the bone was.  

My V.A. hand doctor wanted to fuse the bones but I decided to get a second opinion.  I asked my civilian doctor for a recommendation to a hand doctor she would see if this were her and she suggested Dr Rolf C. Sohlberg at Orthopedic + Fracture Specialists in Beaverton, OR, phone # 503-214-5200.  I made an appointment and saw him.  I was very impressed by him.  Without knowing it, he told me things that my V.A. doctor should have told me, but didn't.  Dr, Sohlberg said he does 2-3 of these surgeries a week, for the past 23 years.  He listened to all my questions and never made me feel rushed.  While I don't look forward to the long recovery time, I do feel confident that I have made a solid and wise choice.

My most recent research shows this procedure to have a 96% success rate and since the trapezium bone is removed that eliminates the possibility of arthritis returning.  I'm pretty jazzed about that!!  

Hope this helped.   

Good luck with your surgery. 

I had mine done on July 20th & just had my cast off end of last week. I'm now wearing a thumb spica splint at times ( not at night unless I feel the need). 

Procedures & after recovery plans seem to vary from country to country (I'm in the U.K.) & also from specialist to specialist. It's good to get this done by a hand surgeon as it's something they do frequently. I went to a hospital a little further away to go with a hand surgeon I was recommended to. Makes for a better approach if you have confidence in your surgeon, whatever method they use.  :-) 

still on fence.  How severe was yours.  I have  bone spur and bone on bone but only pain if I overuse it. Not sure I'm at the surgery stage yet and I will have little help keeping up at home and getting myself to PT, especially in winter.

Pain meds are my enemy.  I have severe GERD, no spleen and react to most everything!!  That is one of the things holding me back from the surgery., among others.

Don't leave it too long or your options may be limited. I made that mistake without raising it with my finger, PT you do yourself at home so it's not an issue you just go to see the exercises but if you don't do it every day as you are advised movement will not return 

Hi Rick,

I’d call local ortho clinics and ask which hand surgeons do a lot of LRTI surgeries, then search online to see what those doc’s patient satisfaction reports look like.  Or find out what PT does the post-op hand therapy in your area and ask him/her what surgeon is best--who they’d use if they needed the same surgery.  I’m a recently retired RN and that’s how I do it.  

I’m 66 -- a lifelong skier, WW kayaker, and also a runner, gardener and cyclist, so feel your pain when you talk about being forced to give things up! I had LRTI surgery on my right thumb in 2014 and will have the left this winter. It didn’t put me back where I was when young, but I skied last winter without giving the thumb a second thought. I did stay out of big bumps, but that was because of a recent medial meniscus tear. I can paddle with padded gloves, which I generally wore anyway, and can bike, but am researching electronic gearing, as repetitive shifting is hard on my thumbs/hands. I’d do the surgery over again in a heartbeat -- it gave me back 95% use of my right hand. My grip strength isn’t what it used to be and I’m not 100% pain free, but the difference is huge. Don’t lose too much strength and function before having it fixed -- from what I’ve read and experienced, you’ll be less likely to get it all back.  

Best wishes to you!   

Hi Tamara,    

Hope your surgery went well yesterday.  Keep us posted when you feel up to it.

Best to you.

Linda

It's been a week since I had right thumb tendon interposition arthroplasty (Thursday, Sept 14).  I was in and out of the surgery center in under five hours (I was home before noon).  I had done lots of research prior so was well stocked and prepared.  I knew that icing my hand for the first several days was crucial, and there was no way I would be able to scoop ice into baggies every hour or two so I had purchased 96 one handed squeeze Instant Cold Packs.  Am I ever thankful that I did. At 1pm I went to bed and slept an hour, awoke and was up 1-2 hours then back to bed, always with an ice pack.  This cycle continued until 3am Friday morning when the pain started getting worse.  I was icing, taking 5mg Oxy every 3 hours rather than the prescribed 4-6 hours, and popping Extra-Strength Tylenol like it was candy.  The pain kept increasing and I was thinking that this was just part of the process and it would start to decrease in a day or so.  Thankfully at 11:30 that morning a surgery center nurse called to see how I was and I told her what was going on and she told me that it would be okay to take two 5mg Oxy every 4 hours, along with the Tylenol and 2 Aleve, staggering the time intervals in which I take them (i.e., don't take them all at once).  I also told her about not sleeping well and that I hadn't slept again since 3am and she said it is rare but some people have an opposite reaction to the Oxy in that respect and it looks like I'm one of them.  After talking with her I took 2 Aleve and iced.  I found that watching a show or movie helped also.  It distracts me from the pain.  After an hour I took 1 Oxy (Not the 2 she suggested. I'm not keen on taking drugs, let alone the hardcore kind).  Another hour 2 Tylenol.  By that evening the pain had gone from being a 9-10 down to 7-8.  Adding the Aleve was the kicker.  I have since faced each new day with a little less pain and a little more movement, not just in my hand but all over.  I'm up and about and testing my limits.  Next Tuesday this original half splint with padding comes off and I get a half cast which I'm told I will be in for 3 weeks.  This was done on my dominant hand an depending on how much the pain increases, if any, I will probably have the other thumb done next year.

I just want to say thank you to everyone who posts to this site.  Reading your stories, experiences both good and bad, and personal opinions, really helped me prepare for this journey.  Again, Thank YOU!!!

Wow, you were dosed up with painkillers.  I had very little pain when I had mine done 9 months ago, just a couple of days with Panadiene Forte.  I am alergic to the heavy opiates, so have to make do with the lesser stuff. I did not really need any painkillers after the first couple of weeks, maybe I was lucky.  No icing either. The right thumb is pretty well normal now, not as much strength as previous, but no pain and can pretty well do most things except undo caps on softdrink bottles.

I see my surgeon in 6 weeks with the view to having the left thumb done, (non preferred) hand. You just have to be patient and do the exercises that the hand therapist recommends, it worked for me.

Hi Tamara, oh boy, sounds like I'm in for more than I bargained. Have not seen such detail as to pain. My surgery is 9/25 and your description of the pain sends chills. The only other surgeries I've had to compare were carpal tunnel on both hands and, have to say, they were both a "walk in the park", had minimal pain, only took about 4 of the prescribed Rx. This sounds like a whole other story. Thanks for the ice pack tip, will get them today! Will ask my Dr. about combining with Aleve which works well for me normally, Tyneol not so much. I will also up my Netflix subscription and head to the library for more, perhaps several comedies! Hope your recovery continues smoothly. It sounds like your protocol is very similar to what I've been told regarding mine, I'll be looking and hoping for your positive updates.

Hi Kathleen,  Don't let me scare you.  I detailed in hopes someone can know how to possibly avoid what happened to me.  Tylenol is not real helpful for me either.  According to the nurse the Tylenol aids the Oxy with the pain (helps boost the Oxy without over-doing) and the Aleve is an anti-inflammatory, Tylenol is not an anti-inflammatory.  I believe if I had started this regime of meds the moment I got home, I don't think the pain would have ever gotten so strong.  The proof is in the fact that it got under control within 5-6 hours.  From the sounds of it you're getting well prepared.  I think preparation is 90% of getting through this without too much grief.  Best of luck! 

Hi Tamara, well, I'm post op two wks. today and doing great. Was a little freaked out re pain but maybe that was a good thing b/c it was not nearly as bad as I anticipated, took last Rx oxy at 40 hrs. post-op and then Aleve a few nights to help sleep and have not had anything last week. Cast removed at 10 days,, replaced with full splint 24/7 for next 3 mos. and then to a half splint. Start PT tomorrow. Did take your ice pak tip, got smaller sz. and tucked in my hand under fingers as was sent home with 2 packs that wrapped my arm to elbow. Had no noticeable swelling. Still use ice for pain, effective for me. Also took your tip on stocking up on movies, got thru most of them. So thank you for the tips...hope you are continuing to improve. It's a long journey!

The pain cream is called Diclofenac Sodium Topical Gel 1%.  You can only get it through a doctors prescription .

Did your hand surgery go well?? Out of pain??

Hi there- did you end up going thru w the thumb surgery?  I had mine 3 days ago!

I"d love to hear your experiences!