Wrist Fusion -physical therapy progress 3/5/13

2 physical therapy sessions and a lot of home exercises have improved my supination, grip, and flexion. My fingers still get really stiff, but I'm making progress. Still can't hold my coffee cup for any period of time, but getting there.

The therapist gave me purple putty to work on strengthening my fingers. I am also using an exercise band and weight to help my supination. I wrap the band around my wrist and tie a 1lb. weight (can of beans at home) on the band and let it pull on my arm for 15 minutes. It hurts like crazy. This week we added heat with the stretch. I also use my left hand to force my surgery hand into the supination position throughout the day. As you can see from the photo, I have improved my supination greatly.

I have a PT appointment tomorrow. We'll see if she has any other torturous moves for me. I've decided I am in the wrong career after going to PT. I could be getting paid to inflict pain on people and they keep coming back. I am considering making this my last appointment. I feel like I'm making good progress and can do all the therapy on my own time. We will see what she has to say.

Physical Therapy - post wrist fusion

My first PT was the same day (actually within the hour) of getting my cast off. I knew my fingers would be stiff and my muscles would need to be strengthened, but I did not realize I would lose my supination (palm up) function. I was told I would lose wrist function and maintain pronation and supination.

After being evaluated, the therapist determined I would only need PT once a week for now. Se measured my degree of flexing my fingers and supination. I was sure she was trying to make me scream as she bent my fingers and "massaged" my scar tissue. after torturing me,she gave me exercises to do for stretching my tendons and regaining supination. She also told me to perform scar massage (very uncomfortable to do on myself) - 6-8 times daily.

The picture shows me trying to get my palm to face up. This freaks me out that I can't turn it more. It's like it's stuck. I can't say it's painful to move because it just won't go any further. It feels really tight, like there is something holding it back. I sure hope therapy helps or I may never have a bicep on my right side! Freaking out!!! And doing constant exercises to improve my movement.

Wrist Fusion - 2 month reveal

So, Wednesday February 20th was my 2 month post op check. Yay! I finally get my lovely purple cast off. A day I had nervously been anticipating. I was unsure of whether I would be put in another cast and whether the bone fusing was actually working.

I had serious anxiety about how skeletal my arm was going to be after being confined for 2 months. The nurse that removed my cast was great. She had me shove a plastic stick in my cast (I guess some people think they are going to be cut by the cast saw) for my comfort. This was a challenge since it kept getting caught up in the nylon wicking stuff. She then made the first cut and used a plier looking tool to separate it and cut the inside lining. For the next cut I had to lay down and maneuver my arm so she could cut the underneath of the cast (I couldn't just move my arm to "palm up" position- it wouldn't budge). She pried open the cast and cut the inside mesh again and wha-la ... my skeleton arm was revealed. I anticipated my arm being smaller, but I had no idea I would have manly,dark black hair growth where the cast had been. It was freaky! I couldn't stop petting my new growth. Lol. Thank goodness it's already lightening up.

After giving my arm a soapy bath, I was escorted to X-ray. Oh, by the way, there was not any foul smells when the cast came off, nor was my skin gray or grossly discolored. Thank goodness for my waterproof cast!

Finally, the Dr.,and I'm assuming an intern, came into my room. He showed me on the X-rays where the fusing was taking place. Great news for sure, but I was anxious to see what he had to say about another cast. After some discussion, he agreed that I could wear a wrist splint for the next 3 weeks. Whew! Of course he stated I needed to wear it at all times except for showering and therapy. I am doing my best with it :). I was told I could only lift 2lbs. with this hand and he prescribed physical therapy 2 times a week for 6 weeks. And again, he told me I could NOT fall (like I have any intentions to).

To my surprise he had his nurse call and get me an appointment for physical therapy immediately after I left his office. On his way out the Dr. told me I made this look "easy". Ha! I took that as a compliment (if he only knew the daily struggles I went/go through).

January 23 - 4 week check up

Today was my 4 week post surgery check up. The X-ray was done with my cast on. Dr. says its looking good. He was only checking the positioning so I still don't know if the fusing is working. He told me at my next appointment they will X-ray with the cast off and he would be able to tell then. He did offer to change my cast, but I didn't feel it was necessary. I still remember how hard he pressed this one at my wrist to form it - ouch. My cast is actually holding up well - even with all the showers I take. It's impressive really.

I talked to him about the lack of movement and stiffness in my fingers, which I thought wold be fully functional after surgery (ha!), and he said it would not hurt anything to use them for things such as typing. Problem is my cast was positioned so far up my hand I couldn't bend my fingers very much. He suggested trimming some of the cast away so I could have more movement. This was kind of scary. The cast saw reminded me of a tool they may have used in the movie Saw. It didn't hurt, but the vibrations made my fingers kind of tingly - like pins and needles. I also talked him into trimming the cast on my arm so I could bend it more. It's kind of freeing with it trimmed up. I can already feel soreness from using my hand more. Yay! That means I can start strengthening my digits. My tendons are freaking tight. It's like there are really tight rubber bands pulling on my fingers when I try to use them and my joints are sore. Nothing time and work won't cure though.

So, in 4 weeks I should get my cast off for good if all goes well. Just in time for my Vegas vacation!

Jan.15th

A little over a month since surgery and I am pretty much pain free. I still get the occasional stabbing, throbbing pains, but nothing I can't deal with. I've been completely pain med free for a while now.

The worst part for me has been adapting to being one-handed. It's all the little things, like not bring able to put my own hair in a ponytail, putting my earrings in, multi- tasking while driving, and the list goes on. I'm not one that likes asking for help, therefore I have managed to do a lot by myself. Thank goodness my knees are good! I use them to hold stuff while using my left hand. Who knew knees could be used in so many ways. I have been come very resourceful.

I have been attempting to start running again. It's amazing how quickly one can lose their endurance. Focusing on the miles, instead of speed is my current mindset. Tonight I actually had sweat dripping out of my cast. I am so glad I have a waterproof cast - it definitely needed acgood rinsing. I couldn't imagine having an old fashioned one.

Next week is my follow-up appointment. I'm looking forward to seeing the progress. I have been taking additional supplements - vitamin D, calcium, and fish oil in addition to eating pretty clean. Hopefully it pays off...

Jan.7th

Today was my first day back to work. It was a bit overwhelming, but I was glad to be out of the house. I realized even more how much I rely on having two hands to do everyday tasks. I'm pretty sure the 100k cashiers check I had to sign today will be questioned. My signature was bad before- now it's unrecognizable.

By the end of the day I was hurting. The vice grip feeling in my cast is back with a vengeance. So, to get some quality sleep I will take a Vicodin. I have meetings all morning- early.

Dec. 28th... The big reveal

Today was my post surgery follow up appointment. I was escorted into a "casting" exam room where I was asked a questions about my pain and how I was doing overall. The girl then started to remove my bandages/wrap. When it came to the bottom half cast she seemed to not know what she was doing. She had no idea where my incision was and made my really nervous. After speculating momentarily, she said she would be right back, and left the room. Apparently she wasn't sure how to get my half cast off. When she returned she said she needed scissors to cut it off. She had to ask me where my incision was and I suggested she would be safe cutting the cast off toward the side. She said it made her nervous not knowing where my incision was... What? I replied that it also made me nervous that she didn't know. After she finished removing the bandages I peeked at my wrist. It was swollen and looked deformed to me. The incision looked great though. There was only one stitch that the dr. Had to remove - the rest had dissolved.

I was then taken to X-ray. I was very nervous not having my cast. They gave me a pillow to lay my wrist on for support while walking to and from X-ray.

After returning to the casting room, the Dr. came in looked at my incision and X-rays. Everything looked really good. I'm not going to lie, it was freaky to look at the X-rays and see the screws that were now in my wrist. After the short exam, the Dr. casted me up to my elbow. The cast is freakin water proof and purple! Yay! The worst part of the casting was when the Dr. squeezed my wrist to form the cast correctly. Ouch!

After discussion about my return to work, I agreed to wait another week. I originally planned a week and the Dr. told me at least 2 weeks - guess he won. Truthfully, I wouldn't be very productive with the pain and being so tired all the time.

That evening, the pain was back with a vengeance. I would imagine it had to do with the casting and disruption. The Dr. prescribed me a different pain med, Tramadol. Vicodin makes me sleepy and woozy. I hate taking pills of any sort, and most of all hate not being in control so I am always nervous taking something new. This one kicked my butt, but it took away the pain. Needless to say, I will not take it again unless I am desperate.

Pictures to come...

Dec. 29, 30, 31, New Year's Day

The swelling has decreased tremendously and so has the pain. Adjusting to the cast has been my biggest challenge. It's nearly impossible to get comfortable when trying to sleep. Since I will be in this cast for at least 8 weeks I sure hope I adjust sooner than later.

The biggest disappointment for me has been the lack of strength in my fingers. I am not sure why, but I thought I would come out of surgery and be typing the next day. I can't write, I can't do my own hair (thank goodness for my 17 year old daughter who does my ponytails for me), I can't shave my left armpit, and the list goes on. The good news is my left hand is becoming more coordinated and stronger. I am able to move my fingers better since the swelling is down, but nothing like I anticipated it being. It's frustrating for sure.

With the holidays it has been hard to be good with resting. Thankfully, I have my husband and kids here to help.

Dec. 26 & 27 days 6 & 7 post op

Wednesday Dec.26 was pretty good. Still a little swelling and pain, but more tolerable. I only took one dose of Vicodin and ibuprofen to supplement.

Thursday Dec. 27 was busy. I woke up at 6am in quite a bit of pain. I think I may have slept wrong or something. I took a Vicodin and slept until 8am. Today was the first day I had no choice but to get moving. Christmas at my house. With the help of my daughter, we cooked and cleaned for family to arrive at 2pm. I did okay until 5ish with only taking 800mg. Of ibuprofen, then I put my arm up and took a little nap. Company left about 8pm. Pain isn't too bad, but I'm exhausted. Tomorrow is my dr. Appointment for my surgery follow up to get my stitches out and casted. I am anxious to see my incision. I'll definitely be taking pics. Hopefully all goes well.

Christmas Day - day 5 post surgery

Today has been better. Swelling is down some and I have only taken Vicodin once this morning and 800mg of ibuprofen about lunch time.

Santa came and everyone was pleased with their gifts. Boys got mostly money, Marissa and Bre got their concert tickets to Luke Bryan (Bre was super excited- it was priceless!) and Olivia got her iPod touch.

On a bad note, Olivia was up at 2am with a fever of 102. I gave her some ibuprofen and she was good through the morning, then her temp spiked again. We had to miss Christmas at the Schaefer side, but Aaron brought us food. Lasagna hit the spot! He is bringing gifts for Liv when he comes home. She has been vtalk ing with them. She is sad that she can't be there. Hopefully she will be better for Christmas at our house with my side of the family tomorrow.

I'm about ready to hit the Vicodin ... Pain is different than the swelling kind. It's kind of a sharp pain instead of a throbbing pain. Can't wait until my Friday follow up appointment - stitches out and hopefully my real cast. The road to recovery is on ...

Christmas Eve ...

Woke up today in a pissy mood. I'm sick of this swelling! I want to be freed from the confines of my recovery area, but I can't do anything without my arm feeling like it is going to explode. That pretty much sums up the day :)

Day 4

My swelling has definitely peaked. I am losing my elbow to the fluid. Hopefully this is a good sign that its disbursing and going away. That's my logic anyway! Everything is throbbing like crazy which I'm sure is due to the swelling and I am itchy under the very tight bandages. All of this is bearable and soon shall pass - especially with the aid of Vicodin.

My family have been supportive and are taking good care of me. My husband decided he needed to buy a new tv for me for our bedroom (aka my recovery room). This is funny, especially if you know me. I actually hate television. I think it's a waste of time and have no need for it. He has been bugging for years to get a new one and he waited until I was at my weakest. It is actually nice, but you won't find me in front of it once I am recovered.

Day 3 12/22/12

Today has been uneventful. I feel like my fingers are more swollen and turning black and blue. I'm trying to keep it elevated and iced more. I took my last Vicodin at 7:30am and I'm going to try ibuprofen for the rest of the day. I hate the way the Vicodin makes me feel. So far the pain is bearable with the ibuprofen.

Not takin the Vicodin caught up with me about 7ish. The swelling is now to my elbow. I look like the stay- puff marshmallow man.

Day1 and 2 post surgery

Thursday -Friday 12/20,21/2012

The first day/ night after surgery went well. I did not have any pain at all due to the block lasting the full 12 hours. It finally wore off about 4:30-5 am Friday morning. I was uncomfortable all night due to weight of my dead arm and figuring out how to position it.

After the block wore off the throbbing began. I started taking Vicodin every 4 hours. The pain was not unbearable and the Vicodin took the edge off. I did find it hard to sleep comfortably with my arm properly elevated. I found the best way was to lay flat on my back with a pillow on my chest and my arm on the pillow. I rolled a towel under my wrist area to elevate further. The hardest thing for me at this point is the lack of activity I am doing. The Vicodin makes me woozy and a little dizzy so I am not moving around much.

My clavicle area where they shot me up feels like I was punched repeatedly. I have sticky stuff all over from the monitoring stickers and I needed a shower. I waited for the meds to wear off and attempted a shower. It wasn't too bad. I simply dumped shampoo on my head guessing how much was actually coming out. Conditioning was a little trickier. I put the squeeze tube between my knees and squirt it into my free hand. It was comical I'm sure, but I'll get it mastered. I've yet to figure out how I'm going to shave my pits. One good thing, I'm sure I'm building up my right shoulder muscles with holding my hand up in the air so much.

I'm sick of laying around already!

The Surgery...

My surgery was scheduled for 12/20/12 @ 4:30pm.

I was instructed to stop eating and drinking at 8am the day of surgery. The eating thing didn't bother me, but not being able to drink my water was torture. I decided I would go to work for half a day to stay busy. It wasn't too bad. I swished my mouth out with water frequently and used scope mouthwash to replace my gum addiction. I had no idea gum faked your stomach in thinking it was eating! No wonder it helps me not eat so much.

I arrived at the ortho hospital at 1:30p as instructed. I still cannot figure out why you have to get there so dang early. Anyhow, once they got me registered and checked in I was shown to the pre- op room. I was asked to change into a lovely hospital gown (only getting to keep my panties on). It was ginormous and could've wrapped around me many times. They also gave me a pair of non- skid socks to wear.

They asked me all the same questions the phone nurse did the day before (annoying). Then came the IV. I have teeny tiny veins especially in my left, non-dominate hand. The nurse found the vein she wanted and proceeded to "make it mad" by smacking the top of my hand. It was thoroughly pissed by the time she was done. It still didn't make it easy for her to get though. Once the IV was in place they started fluids. Then came the long waiting game. I should mention that during this wait it was discovered that the IV would stop if I moved my hand in certain positions, but told it would be fine.

About 4:45p the anesthesiologist came to start my clavicle block (I think that is what he called it -they  numbed my right arm from the shoulder down) and kicked my husband and Aunt to the waiting room. They put happy stuff in my IV and that's all I remember until I heard music and talking in the surgery room. I could hear the Dr. Telling his assistant or whoever to look " there's no cartridge" and then I heard sawing, drilling and hammering noises. He also explained to her why he wasn't using the plate they normally do since my wrist is thin. It was surreal! I kept going in and out of sleep. They had placed a warming blanket on me and I was so hot I remember trying to kick it off and the anesthesiologist helping remove it. I also kicked off my non-skid booties. Toward the end I was essentially wide awake and asked if I could see. They eventually took the tent down and he was finishing up the casting and ace wrap. I didn't get to see anything!  

My arm felt like it weighed 100lbs. It's the strangest thing ... Felt like I was touching someone else's hand - not mine.

Here is a good link that explains the surgery ...

http://www.pncl.co.uk/~belcher/information/Wrist%20fusion.pdf

History...

I decided to document my experience with SLAC wrist and my wrist fusion surgery to hopefully help others. When googling information for myself - there is very little "real-life" information. So, here I go...

As far back as I can remember I have had right hand pain. In 2008-09 I finally decided there may be something going on when I could barely twist the combination lock on a safe deposit vault without wanting to cry from the pain. Thinking it was carpel tunnel I made an appointment with an ortho dr. 

The initial appointment consisted of an array of questions, X-rays and such. I was diagnosed with arthritis at the base of my thumb. This started my 2 years of cortisone shots. If you have ever had one, you know how pleasurable this is. The shots helped a little, taking the edge off the pain. 

At an appointment (2 years after my initial appt)I was speaking with the PA and he decided it would be a good idea to get a current X-ray and see how things were progressing.  

About 15 minutes after the X-ray, the PA and Dr. came into the room. The Dr. started questioning me about the original X-ray, where it was taken, who the dr. was, blah blah blah. He was freaking me out! His office did the X-rays and diagnosed me. Long story short, he informed me that I had SLAC wrist and would need a total wrist fusion. That was about 2 years ago. 

I continued to get cortisone shots with this Dr. He did the injections himself and asked me every appt if I was ready for surgery. After close to 2 years of this and family bugging, I got a second opinion. 

The diagnosis was the same. Total wrist fusion was the best option. However, this ortho Dr. gave better explanations, and surgery options.  

Being a runner, I had no interest in them taking bone from my hip for the fusion. This Dr. said there was a synthetic called inFuse that works great.  Also, since I have really small wrists the metal plate they use would have to be removed in a second surgery - this Dr. used or repositioned my bones so he did not have to use a plate. I liked his ideas ... So, here I sit typing with my left hand, 3 days out of surgery.