So, for a quick timeline, I have had:
- Fall – Jan 2016
- Hand Braces – July 2016
- Steroid shots on both wrists – Sept 2016
- Swelling on Left began – April 2017
- MRI & X-ray on Left – June/July 2017
- Aspirated Ganglion Cyst – Nov 13, 2017
- Ganglionectomy # 1 – Jan 30, 2018
- MRI – Left Wrist – Return of Lumpy – February 16, 2018
- MRI – Left Wrist – March 22, 2018
- Ganglionectomy #2 — April 24, 2018
- MRI – Left Wrist – Return of Lumpy – September 10, 2018
- Ganglionectomy #3 – October 29, 2018
- Return of Lumpy & Bumpy – January 2019
- MRI on Left – June 29, 2019
- X-Rays on Right – August 2019
- De Quervain’s Tenosynovitis Surgery – Dorsal Compartment Release – Left Hand – September 24, 2019
- De Quervain’s Tenosynovitis Surgery – Dorsal Compartment Release – Right Hand – TBD
I have struggled with my hands since 2016, having numerous ganglion cyst removal surgeries on my left wrist, and yet the pain continued.
I had braces. Many of them and many different kinds. I had brought a bag of them with me for my last hand specialist surgery for effect – something has to give.
I had tried paraffin treatments. MRI’s and x-rays.
I had tried exercises and strengthening. Occupational therapy and physical therapy.
I had tried numerous steroid shots. General surgery and hand specialist surgery.
I had been diagnosed with De Quervain’s Tenosynovitis years ago, but the ganglion cysts took charge and I had to wear the braces on both of my hands for years. Still, something was causing pain.
I fail the Finkelstein test with every hand specialist and hand surgery clinic appointment, and with movements like picking something up, opening a doorknob or twisting my wrist a certain way, there would be a pain in my wrist and up my arm. This happens on both wrists. There is a certain area that gets inflamed and that would be the tendon sheath.
De Quervain’s Tenosynovitis is inflammation on the thumb side of the wrist, where a tendon sheath covers the tendons of your wrist. These tendons or the sheath itself can become swollen or inflamed, causing friction with wrist movement, which causes pain. This is happening on both of my wrists.
Dr. D and his care team have seen me as a patient since my third ganglion surgery, once my ganglion returned again. After wearing my brace for another month and steroid shots, we knew we were going to have to have another surgery as the braces and steroid shots have not helped the inflammation.
Going in for another surgery, I know the drill by now. I cannot eat or drink after midnight the night before, I need to clean the surgery site with Chlorhexidine the morning of, and I usually try to get the earliest appointment they have. The sooner I get there and get done, the sooner I can have coffee and go home.
This surgery was no different, as I was the 8 AM surgery on the books, the first for the day. This means an arrival time of 6:30, with time to get ready, have an IV put in after blowing one vein – it always takes two pokes, then I speak with my surgery team and anesthesiologist, and sign paperwork for the surgery to come.
They usually ask me for a pregnancy test, protocol, and I am given calming meds and antibiotics before I go under the knife. This surgery, a First Dorsal Extensor Compartment Release, would be a quick surgery and no external stitches. There would be only one continuous internal stitch, but I wouldn’t know that until days after my surgery and looking at my wrist.
I would need to keep a splint cast on until my follow up with the surgeon in a week. I already had a sling from my three ganglionectomies, I would need to keep it dry and elevated, and I was to ‘baby’ the hand and not even attempt to use it for small things like holding my phone.
I had a broken arm in elementary school, and with three prior surgeries, I am a professional at wrapping up my arm up in Kroger grocery bags to keep it dry in the shower. I am not, however, talented enough to do my hair with only one hand though. I always have major struggles not being able to use both hands at will.
I had my Carter Block pillow from previous surgeries to help me keep it elevated as I slept, but I kept worming my way out of it during the night after my first two nights of using it.
All the while, I was on vacation two days after this surgery and had to be in my splint for the wedding, for photos, sight-seeing and everything else.
It is hard keeping your arm elevated without a sling, I kept mine off for the most part because the sling rubs my neck raw. Without even thinking, your body wants to keep your hand by your side, so I had to make a conscious effort and be mindful to keep my hand elevated as much as I could.
I wanted to keep using my left hand, but I learned really quickly that with each motion to grab something, that the tendon area was extremely sore. I unwrapped and rewrapped my bandages only twice, and that was not pleasant to look at or feel because it was crazy sore just days after the surgery and not wearing the hard splint left my left wrist to feel every motion. It felt very weak and fragile for the first couple of days.
After the surgery and follow-up, I got to unravel the splint off of my wrist and finally wash it after 10 days of keeping it dry.
I had already left the VA, but when I got home and washed the incision site, there was an inch long stitch sticking out of either side of the incision site, and because I couldn’t cut them myself with kitchen scissors, I had to drive back to the VA and have them remove the loose ends with sterile scissors that could get it as close to skin as possible.
This surgery bruised more so than my prior three, but with the tendon sheath being cut and a larger incision site, I can see why it did. It has been very tender to the touch, and poor Bilbo went to lean on my arm and it caused me some pretty severe pain at the incision site, so I would say I am still healing. It has only been 44 days since this surgery, I need to remember to be careful with it.
The surgery site has been quite tender, it has lost a lot of body fat from the steroid shots and it is very weak from all of my brace wearing and surgery splint. If I touch the site, it is sore. It has nerve pains that tingle up my hand and in the surrounding area. I can still see the small ganglion cyst from before surgery, I wish they would have removed that in the operating room.
Now, I know I have this problem in both of my wrists. I had my surgery follow up with the general surgery team, but I requested another follow up with Dr. D, the specialist, to discuss contralateral surgery and performing this surgery on my right hand next.
This would be my 5th hand surgery, but only my first on the right hand. I can only have surgery on one hand at a time and the left took precedence for surgery since I am right-handed, too. Since I am right-handed, so this would/will be a very difficult surgery and recovery for me to get through without trying to use that hand.
I will see Dr. D in November, as he is only rarely at the VA because he works full time at other locations. I assume that there will be a check-up on the left hand and a look at my right in this appointment. I have only had one steroid shot in my right hand, it has caused me the exact same pain in the same location but has been looked over in the past year because of my recurrent ganglion cysts on the left hand.
Otherwise, I wait and try to heal in-between visits, and hopefully, these hands will stop fighting me so. There will be a follow-up blog about how my thoracic surgeries are healing, about my Crohn’s disease management, and everything else that I am going through.
For me, It Could Be Worse.
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