Finally saw another hand surgeon today

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/21/2009 4:43 PM (GMT -7)   
Hi Folks,
I finally saw a hand surgeon today who actually knows about this avn problem that I have. We actually spent well ovoer an hour and a half talking with him. I was so pleasantly surprised, it was unreal to have a doctor actually take their time  to sit and explain things, and to go over x rays, reports, and films and have no problems whatsoever with the amount of time he spent physically in the exam room with us. He even personally walked me to his xray, took it himself, and then developed it and brought it back in with him. yeah
 Now, for the not so good stuff- I'm sure that I am going to forget some
of the things he said, since we talked about so many different things, so
bear with me.smile Instead of being a 3a as the first surgeon that I saw here, near
me said, he said it is a definite 3 b. He also found a fracture through
the middle of the lunate- whether it is new or not, I don't know since it didn't show in
the first X-rays I had done. He also did X-rays while I was there to
properly stage where I am at, and to see how things looked that way, not just the
MRI. I was a bit surprised he didn't put another cast on since he said
that there is a definite fracture of the lunate but then again, I am not a
huge fan of them now anyway. shakehead He said that the scaphoid bone is rotated up and to 90 degrees instead of
the 47 degrees that it should be rotated to.
He also said that there is a problem with the capitate bone ( hope that is
the name of it), he is not sure whether it is arthritis, gout, a cyst or
RA, although he suspects it is RA. He said that it appears to be
disintegrating, so he is concerned about it. He said the lunate is dead but that it is
fragmenting as well as that fracture and is rotating/moving in the joint.
From the sounds of what he said today, there has been some significant
changes since the MRI, which is also not good news.sad He asked how long I have
had problems with my wrist and asked for the original films taken in early
November. I think he wants to try to compare those to the images he took
today. shocked He also said that he is concerned about that bone "bruise" on the end of
the ulna I think is where he said it was. I can't remember now. He said that
it might be masking something else so he is concerned about what is causing
it. confused The pin hole tear he said is there but will be fixed with surgery. He also
said that he believes there is nerve damage to my wrist and hand now since
I have some areas of numbness in my hand still. He said that may come back
after surgery or may not, depending on how long it has been that way.confused
As far as surgical options go, he said that he could try to do a prc
( where they take out all four bones in the first row of the wrist joint)but it
would depend entirely on how the other bones in my hand look and that some
of them appear to be either arthritic ( osteo or rheumotoid- he didn't
say) or damaged in some areas. It is the capitate, lunate, scaphoid and some
other bone , as well as the end of the one long bone that he is concerned
about.cry He said if that is the case, then I would be left with no choice but
to fuse it, either a STT fusion( fusing the little bone closest to the thumb joint,
the one below that and into the fingers) or STC fusion ( little bone under the joint of the thumb,
 the bone in the 2nd row closest to your fingers and the center bone in that same row) 
and again it would depend on
the condition of the bones around the lunate. confused
He said that he would prefer to have the option to make the decision about
what procedure to do during surgery since he said that it appears to be a
lot more damaged than on the MRI report.
So anyway, any suggestions or guesses as to what I should choose? Or what
to do now?
Sandi


PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


Screaming Eagle
Forum Moderator


Date Joined Sep 2009
Total Posts : 5005
   Posted 12/21/2009 5:18 PM (GMT -7)   
Wahoo! Sandi! Sounds like you found a Dr that knows his stuff. I'm sorry that you are having to make this kind of decision, and I wouldn't have a clue as to what direction you should go through. I'm sure there will be Pro's and Con's of what ever you decide to do. Hopefully someone will come up with a sensible suggestion for you to chew on for a while. Take care, and I'm glad you took the time to update us here.

Michael

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 12/21/2009 5:18 PM (GMT -7)   
Sandi,
I'm having trouble posting as you know, so will make this briefer than normal.

From reading what you're saying, I'm not sure you have a lot of choices. It comes down to whether you trust this doctor (well, at least that seems like one major factor IMHO). I don't know anything about the conditions he's diagnosing other than what you've told us. Since it seems to be getting worse fairly quickly, it would seem (and I say "seem" because I don't know) that waiting is not a good thing.

Are there any other options? That I don't know. Maybe it's just dealing with what we all hate - having to face reality.

If I don't respond to you regularly it's the computer thing, which is getting very, very frustrating to say the least!

Hugs,

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13481
   Posted 12/22/2009 5:58 AM (GMT -7)   
Sandi so glad you found a dr that knows about the situation you are dealing with. At least he did not sit and try to paint a pretty picure, but was honest enough to say I would rather reserve my thoughts until I actually see the condition of things on the inside. Sounds like he is a keeper.

If you like and trust him that is half the battle. Now you have to decide which way you want to go with this thing. We already know sitting and doing nothing is out of question. Let us know what you decide.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 9:36 AM (GMT -7)   
Hi SE,
Thanks for the post. He does seem to know what he is talking about , which is to my benefit and he has done these before, so it wouldn't be a guess on his part.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 9:42 AM (GMT -7)   
Hi PA Lady,
No, you're right, there are not a lot of choices. Basically, it is choosing between two types of fusion ( where I would lose at least part of the flexibility) or removing a row of bones near the top of the wrist joint and hoping that the other bones are in better condition than it seems. The big problem with either fusion option is that I only have less than half of the flexion and extension that I should have , which means that if I loose half of that to a fusion, I am only going to have about 30 degrees of up and down motion. And most of the decision can't be made until the doctor actually sees the condition of the bones, since they don't appear to be in good condition as it is.
Have you tried to delete your old temporary internet files and do a disc fragmentation? If not, I would suggest that you do that first. It might help you or is it your connection that isn't working well?
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 9:47 AM (GMT -7)   
Hi Stray,
I really did like him, which is really unusual for me. I couldn't believe the amount of time that he took with us, and how willing he was to not only explain things, but to show us where he was talking about. He acted like doctors should act, and his office staff was just as nice and pleasant to be around as could be.
It is really to his favor that he not only knew about things with this condition, but has handled it before and not just once. And he has not had a bad outcome so that helps as well. His version of outcomes is like mine, good remaining function, little to no pain, and no repeat surgeries.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 12/22/2009 12:43 PM (GMT -7)   
If you trust him like this and he sounds like a good/very good doctor, then get a schedule of how soon he could do this surgery...sure wish you had other options but it seems like your hand is get worse each day, I just wish I knew what else to tell ya, it's a scary decision regardless and I'll keep you in my prayers...try to get threw Christmas for now...
Lots of soft caring hugz...
((((((((((((((((((((((((((((((((((((Sandi))))))))))))))))))))))))))))))))))))))))))))))))))))))))
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********


PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 12/22/2009 1:05 PM (GMT -7)   
Sandi,
Just a quick thought. If the fusion doesn't work out (meaning if you have it, and after a few months or years it's all getting worse) I wonder what mechanical implants or devices might be possible. I see what they're doing with soldiers with severe injuries, plus I have neighbors who use prosthetics - husband is in a wheel chair with one leg and limited use of one arm, the other arm was amputated, and his wife has two prosthetic legs and one arm and you'd never know it when she has pants and longs sleeves on. She's pregnant for the second time!

Now I'm NOT saying you should have your hand amputated or anything - PLEASE don't read that! Just trying to think out of the box if there might be some implants or devices down the road that could give you more flexion if fusion plus what I imagine will be a lot of PT doesn't work out.

And re: the computer, I'm not going to do much of anything until after the Christmas rush, as that's my hunch about what's going on. If next week this is still happening, then I'll think about things. But with Mac's you don't need to do the cleaning out that PC's need! :-) Having a dial up connection, though, is a limit, and I think what happens is that the various providers keep decreasing the amount of lines available. I can't afford anything else though, so it is what it is.

Hugs and try to relax a bit for at least one of the holidays!

PaLady

skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 12/22/2009 1:09 PM (GMT -7)   
Hi Sandi,

Sorry to hear the bad news about your wrist, but it's fantastic that you found such a great doctor who knows about your disease. Sounds like this doc is definitely a keeper. Now you have a big decision to make. Take some time to think it through and do some research. In the end you'll know what is best for you!

hugs,
Skeye

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 1:59 PM (GMT -7)   
Hi Chatreux,
Yes, it does seem that I really lucked out with this doctor. I expected another one who didn't know the first thing about it or how to stage it, or would even bother to look at the MRI. So, I got the opposite and more. In fact, there is a PM group downstairs and he said that if I was not happy with mine, he would gladly make a recommendation for me to go to them. He said they are fabulous. Something to keep in mind should I ever need it.
I am going to try to make it through Christmas and worry about the surgery and outcomes afterward. My kids are all excited, counting down the days, so I don't want anything to disturb that.
Hope you have a wonderful Christmas.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 2:03 PM (GMT -7)   
Hi PA Lady,
Currently there aren't any implants or devices that work out well as implants in the wrist simply because of the dynamics of the wrist. They have tried to make stainless steel, titanium, plastic, jelly type replacements for that bone and others and it doesn't work out because of the way the bones in the wrist work to manage the stresses on the joints. They are much like the hips, lots of stressors in small areas. The implants have had problems with breakdown and wear and tear which causes synovitis in the fluid and that creates a whole slew of other problems. It isn't a possibility now for that to happen. Should a partial fusion fail, they would simply fuse the entire joint.
Like I said, not many options.........at least not now. Maybe later on.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too


mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 12/22/2009 2:04 PM (GMT -7)   
Thanks Skeye,
I think I found the right doctor, but will do at least one more consult to make sure. I want to be sure in my own mind that I made the right choice. I hope that I will know which surgery is the right one. I have a feeling though, it is going to wind up a partial fusion. Simply due to the state of the various bones.
Sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too

New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, December 11, 2016 6:48 AM (GMT -7)
There are a total of 2,736,304 posts in 301,366 threads.
View Active Threads


Who's Online
This forum has 151461 registered members. Please welcome our newest member, jalertaan.
246 Guest(s), 12 Registered Member(s) are currently online.  Details
John_TX, Fl Drifter, TotesMagotes, tickcheckguy, mrs. george, Dr WHO, Lynnwood, ChickenArise, Ed Ski, CCinPA, dkob131, stixandstonz


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer