oesteoarthritis wrist & fusing

mandy1967

I was diagnosed with OA in my left wrist about 18months-2years ago. At the time they suggested fusing the wrist. I turned them down as I was waiting for a diagnosis on my ankles, knees and lower back from another surgen. i still use my wrist as normally as possible but have found I have "adapted" and do things slightly differently to the way I used to.

My other joints have been diagnosed as sponyloarthritis caused by crohns disease. I now have signs of getting this in my right wrist.

The OA in my left wrist is getting much worse and I know that at my next appointment, 3rd Aug, they are going to tell me I have to have the fusing. I am not able to take any antiinflamitries due to my crohns so panadol is the only pain releive I use except for an aromatherepy lotion which has great short time releive.

I have several issues with this one of the main ones is that I run my own business and would like to know from other people how long I will have to take out after the op? How will the op change the way I do things (my business involves printing ribbons and I work by myself).

The absolute main issue is that I am scared to death of having an op of any kind. I have made it to 43 years old without ever having to have one. Unforuantly my godmother had a very minor op about 15 years ago and didnt come round from the anesthetic due to side effects and this weighs very heavly on my mind. I think I am now using everything else as an excuse for not having it done.

I would be very gratful for any help or advice.
Mandy
x

valval

talk this over with surgen they like to put you fully under less than they used to so might have different whey to do it for you if you do not ask you will not find out. but it is your decision in the end it your life but they have the knowlage and at the end of the day you have to trust them . leaving you hugs incase you need them val

skezier

Hi Mandy,

I am sorry your in this position just now. Operations are scary things and because of your godmother you will be more scared and that's natural. You would be able to talk through your fears with an anaesthetist if they go for an op.

I too have duff wrists and do wonder what the future will hold for them but for me as long as I can use them I don't think too much about it I guess. I think you need to have a talk with your consultants and find a way forward that works for both the crohn's and the bones.

I have crohns and am very lucky as I take 2 slow release diclo's every day and backed up with lansoprozole and it works ok. It makes no difference when the crohn's flares if I take them or not. So maybe you could find a anti-inflammatory that you could take?

I am lucky to have pa as that has meant originally the sulfa and now the mtx and thankfully both are very good at controlling the crohns. Are you having to take something to keep yours quiet?

I really don't know what to advise but with my wrists I might skip fusing (if they don't do it them selves) and go for either a resurface or a replacement but Mandy for me only when I can no longer cope or use these ones I think.

Go see what he has to say in the appointment and you don't have to decide there and then so you may as well go see what they think...... Its not easy I know and sending a ((( ))) and so many hopes you can find some help that helps and doesn't up set the crohns cus crohns is evil! Nice to meet you. Cris x

speedalong

Hi Mandy,

I just wanted to say welcome.

There are several wrist peeps on here and they are much better at discussing wrist op and recovery etc and no doubt will be along shortly. Is a fusion operation the only operation they can offer. Have they considered a wrist replacement? Iris has had both ops - so she will be able to give you tons of info.

You say the arthritis is worse in the left but has now started in the right wrist too. Are you left or right handed?

Re the anaesthetic - you can explain your worries and about your godmother with the anaesthetist, some prefer not to use GA anyway and prefer nerve blocks and local anaethesia. They are very good at weighing up the risks and are very unlikely to put you under undue risk. Also anaethesia is improving all the time.

Take care,

Speedy

marion1952

Hi Mandy

I'm not an expert on wrist fusing but there are people on this site who have had that done and will be along soon to to give you some good practical advice.

I have RA and OA in my wrists and hands so I know a bit about that searing nerve pain you can get.. and it always seems to be worse at night.

You sound like a strong and organised person and I do hope everything works out for you. Do let us know how you get on ..

Marion

dorcas

Hi mandy...nice to meet you.

I can well understand you're reluctance to have any surgery given your fear over what happened to your god mother....but anaesthetics has come a long way and they are so much more sophisticated and safe.

You will be able to chat this through with an anaesthetist (if you decide to go through with the wrist op) at pre op assessment and again on the day of the op....you will be listened to and you will be given lots of advice and re-assurance. Some hosp will do a wrist fusion with a block anaesthetic but my particular surgeon wouldn't. (I did have a block anaesthetic when I had a radial head excision op a few years ago and it was very effective)

I had a wrist fusion last year (April) on my left ..non dominant wrist. I've also just had a total wrist replacement on my right...dominant wrist... 5 weeks ago.

Before the fusion I had virtually no movement in the left wrist, the bones in the hand had collapsed and the wrist displaced and very painful!.
I wasn't offered any other type of procedure, maybe because of the extent of the arther damage..although I know that for some people a partial fusion or a resurface is possible, but I don't know the criteria for those!

I would not hesitate in recommending having a total wrist fusion and can honestly say I have not regretted for one minute having it done the result has been worthwhile in that I now have a very strong wrist which is pain free and useable.

there are restrictions of course...the wrist itself is completely immobile although the plate is fixed at a slight angle to allow for proper finger movements/ use.
Some things are more difficult...picking up very small objects for example and personal care... as you need a bend in the wrist for some actions. :oops:
other 'lost' abilities return..being able to lift & carry bags, do housework and drive, for example.
I was surprised at how I adapted to the fused wrist and the 'sacrifices' have been minimal when compared with the pain and restrictions of an arthritic, almost useless wrist.

The op itself? 2hr op; in hospital for three days post op; hand in PoP to begin with and elevated at all times (which is really really important); stitches removed and light weight cast fitted at one week; cast on for a further 8 weeks; able to drive again at 12 weeks; hand therapy after that.
The recovery period for wrist fusion is 4 to 6 months and that is how it was for me..... it was the need for follow up hand therapy that took time.

My surgeon said to me that for the non dominant wrist he would always recommend a fusion rather than a replacement as it provides strength and stability. Replacements are more fragile but provide flexibility and movement so are better suited to the dominant hand.

There is a 'window of opportunity' for having these types of surgery, especially the total wrist replacement.

I hope this has helped you...but please ask any questions about any of this as I know I have skimmed through some of it!

Iris x

airwave

Things are different these days, anesthesia is easy, the last time (the Polish) anesthetist spoke kindly to me, I was under(didn't want to count to ten but just talk) and next thing I knew I was wide awake and wanting a cuppa. Brilliant. None of the feeling half awake, half asleep for a few days of old.

As for joint work, leave it until the last moment, consequences change, but then I've only had toes done.

8) Its a grin, honest!

mandy1967

Wow what a help everyone has been. I already feel better than I did when I posted this earlier today.

skezier - I had the same thought as you that I wouldnt do anything with my wrist while I could get away with it. But I get a lot of pain now and it has started to affect the use I have in my fingers and if I just slightly catch my finger on a table or something it jars the wrist and hurts.

speedalong - I am right handed but didnt realise until I had trouble with my wrist just how much you use your non-domient wrist/hand.

marion1952 - thanks I am very well organised and thjat is one of my problems I worry about not being organised!!!

Thank you to everyone for your help and advice
Mandy
x

skezier

Hi Mandy,

I am so with you there.... I don't know where mine will take me and sine they have never been xrayed I wonder what they really are up to :roll:

Like you I don't know which is my dominant hand...I am right handed but use my left wrist so much more than the right for the heavy work...... You take care flower and keep us posted. I really hope they can help you get yours comfortable. ((( ))) Cris x

ironic

Bumped up for Cancan.

Rhonddaborn

I had my right wrist fused 3 years ago. I have had no problems and little pain since, I have the odd ache but nothing to what I had before. I had the scaphoid bone removed as well.

There are things I cannot do but you get around these. I have had a plate into my spine since then as well.

When you hear the word operation you automatically panic, i am of the mindset that its their job to do these no one questions me in my job and my bosses trust me, I have 100 % trust in the medical people , just relax and go for it .