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.
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.
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.
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.
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
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
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.
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
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.
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?
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