Hi,
A couple of posts ago I promised to give you a more thorough accounting of what my surgery will entail. It is scheduled to happen tomorrow, so here’s what my basic symptoms are, and what I’ve been told will happen during and after the surgery.
Symptoms: I was very flexible when I was younger. Until I was 40 or so I could even put my legs behind my head (one at a time). Not any more. I’ve had severe arthritis for decades, and for the most part I’ve just put up with it. The pain in my knees finally got bad enough that I had both of them replaced (a decade apart from each other, 2008 and 2018). All of my joints ache, a kind of low-level constant pain, but something that’s manageable. For a while I treated it with a couple of ibuprofen each night just before I went to bed, and that seemed to work fine. A few years ago I developed A-Fib, though. I’ve mentioned that before, so I won’t say more here except to point out that (because of the Eliquis I now have to take, and possible internal bleeding complications after taking Eliquis and NSAID-type pain killers together) I can no longer take recurring doses of ibuprofen, and I’m allergic to Tylenol (which isn’t an NSAID). So, I’ve just been putting up with the pain. Over the last year it gradually got so bad, though, especially in my wrists and my right hand, that I knew something was wrong. Obviously, not being able to use that hand impacts almost everything I do (operating a computer mouse, typing, exercising, household tasks, mowing, driving, etc.) so we made the decision to have surgery on my right hand, and see if we can minimize the pain and regain some of the functionality I’ve lost.
The Surgery: This is a very common surgery. It’s called a trapeziectomy, and it involves removing the trapezium, a small bone at the base of the thumb (see the X-ray above). The suffix -ectomy is from the Greek, and means “the act of cutting out.” According to surgical images I’ve seen, a slit will be opened up along the side of my wrist and thumb. To get to the trapezium, they will pull the radial nerve and the radial artery to the side (they obviously don’t want to sever either of those). The trapezium and maybe part of the trapezoid will then be removed, and a metal pin will be inserted through a couple of the remaining bones. I assume that’s to lock the thumb’s metacarpal and the scaphoid bone in a fixed position while the surgery heals. Then they will make another slit in my lower arm to shave a lengthwise piece off of one of my tendons, and use that to fill the gap left between the scaphoid and the metacarpal. The tendon will provide some cushioning to replace the bone-on-bone pain I have been experiencing.
Tomorrow we have to get to the clinic by 5:30 AM (and it’s a 40-minute drive). The surgery will happen about 7:00 AM, and will be over by 9:00. My entire right arm will be deadened with a nerve block anesthetic, and that whole arm will remain numb for up to 24 hours. They also said I will actually be awake during the procedure, but under partial anesthesia, so I likely won’t remember any of it. If everything goes well I should be home before noon. Minay will be driving me there and back, of course. I won’t be able to get through most of this recovery without her.
Post Surgery/Recovery: This is the tricky part. I can only tell you what they’ve told me, but I’ve been through surgeries before so I have some idea what it might be like. Since I can’t take any NSAIDs or Tylenol for post-surgery pain they will probably prescribe Tramadol for me (a mild opioid). I’ve used it successfully after my other surgeries, and it won’t conflict with my blood thinner. I usually stop taking the Tramadol much earlier than they recommend, and don’t notice much difference in the pain level when I do, so that should be okay.
After the surgery I will be in a splint that will go from the tip of my thumb to partway up my lower arm. I can’t get the splint or the surgery site wet for at least two weeks, and I’m supposed to keep it elevated as much as possible. About five days later I can start taking my blood thinners again. The day after the surgery I will start doing some specific hand exercises. My fingers won’t be covered by the splint, but my thumb obviously will be. Since the palm of my hand will be covered by the splint, using a computer mouse will be difficult (if not impossible) for a while. You can see from the image below that my mouse is designed for right-hand use. I’ll try it with my left hand, but my muscle memory will fight me when I try to use it, I’m sure. It will be slow going, but it will be better than nothing. 😊
I have appointments to see the doctor every two weeks for a month-and-a-half. The first one is just a quick check to see that everything’s okay. That first splint might be replaced with a removable one then. I will still have to wear that one continually, except when I shower. The pin might also be removed at that appointment. At the third one (if everything is okay), I’ll be given final instructions for how soon I can drive (probably at least a few weeks later), about which exercises to continue with, and when I can remove the splint permanently (probably another two or three weeks from then, although I will still have to wear it for a while when I sleep). Exercises will continue for maybe another three or four months. By sometime around March or so my hand should have regained as much strength as it’s going to.
I have no idea at this point how that will affect my ability to write. I do intend to keep working on Flood and Fire and on Jagged Man the rest of the day today, and will try to use Dragon Naturally Speaking after that. It might help me continue to write, at least on a limited basis.
In the next post, I hope to have a brief update on how the surgery went, although I probably won’t be able to type it myself. I might have to dictate the update to Minay and talk her through the process of uploading it to the blog. The next few posts after that (probably through the rest of the year), will have very brief updates, but I’m assuming that I will do very little writing during November and December. I could be wrong, but we’ll see.
Hope to see you then,
Michael
[“Two hands clap and there is a sound.
What is the sound of one hand [clapping]?”
Hakuin Ekaku, Buddhist monk,
circa 1686 to circa 1769.]
I guess I’ll need to start practicing clapping with just my left hand so I can find out. 😊
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