what to do

lavenderlady
lavenderlady Member Posts: 409
edited 2. Aug 2010, 07:58 in Living with Arthritis archive
as most of you are aware I'm waiting for a TWR well this morning got letter for op on 27th September but also got letter from surgeon saying that the CT scan and xray showed I have severe arther through out my wrist and it includes the "radiolunate joint"
he then says Wrist replacment has the advantage of maintaining a useful range of movement but as I'm relatively young ( love that bit)we dont know how long these TWR lasts it may come lose after 2 to 3 years if so I would then have to have a fusion which is harder to do as the op is techinically difficult to do, it maybe I will get problems such as a dislocation or infection,
I can choose a fusion to begin with but will have no movement at all it maybe after the op I will still need a fusion at a later date, I am thinking if by then I have problems things are changing all the time so far as TWR becoming easier to do and as common as hip and knee replacment, I know they have to cover themselves but i guess I'm just apprenhensive and know i need the TWR, and having been chatting with Iris has helped enormously, just now mentioning the radiolunate joint is bad as well, ????? oh well roll on 27th September, :?

Comments

  • speedalong
    speedalong Member Posts: 3,272
    edited 30. Nov -1, 00:00
    Hi Lavenderlady,

    If the consultant thought the state of your "radiolunate joint" was incompatible with a TWR he would say just that, I don't even know where that joint is - but I suppose he is saying it makes it more complicated.

    When I had my first THR done at 30, they were reluctant to do it as I was considered to be very young for such an op, and they too said it might only last 5 years due to my levels of activity ... they told me if it wore out I would need it revising and with each revision it would be less successful and in the end I would be jointless!!! I imagined my leg hanging there like a lump of meat!! They have to cover their backs though and 13 years later it is still working fine. Have just had a resurface-replacement the other side and once again there is little info on how well this newer op lasts particularly in woman ...

    You can't go on like you are forever and if you do wear it out then you can have a fusion ... they will just have to work harder to perform it. If your wrist is very painful and spoiling your life - you have nothing to lose and plenty to gain. Feeling nervous is normal, convincing yourself on good days that you don't need the op yet is normal ... ultimately you will know when you can't go on as you are ...

    Take care and other wrist peeps will no doubt be along to post.

    Speedy




    he then says Wrist replacment has the advantage of maintaining a useful range of movement but as I'm relatively young ( love that bit)we dont know how long these TWR lasts it may come lose after 2 to 3 years if so I would then have to have a fusion which is harder to do as the op is techinically difficult to do, it maybe I will get problems such as a dislocation or infection,
    I can choose a fusion to begin with but will have no movement at all it maybe after the op I will still need a fusion at a later date, I am thinking if by then I have problems things are changing all the time so far as TWR becoming easier to do and as common as hip and knee replacment, I know they have to cover themselves but i guess I'm just apprenhensive and know i need the TWR, and having been chatting with Iris has helped enormously, just now mentioning the radiolunate joint is bad as well, ????? oh well roll on 27th September, :?[/quote]
  • skezier
    skezier Member Posts: 11,333
    edited 30. Nov -1, 00:00
    Hi Lavender lady,

    Its really not surprising you are apprehensive there. Its such a difficult choice to have to make...... Maybe the fusion would be best for now. If you trust the surgeon it makes it easier and maybe ask him what he would do if it was his wrist? I so wish I could help you but sending a hug and as much support to help you. Cris x
  • dorcas
    dorcas Member Posts: 3,515
    edited 30. Nov -1, 00:00
    Hi lavenderlady :D

    well...I for one am pleased you've got your op date through cause you've been suffering badly and worrying about the op since your last consultation?!

    The radioulnate joint is the 'meeting' between the radius and ulna..at the side of the wrist (the bump ). Having arther there won't stop you having the TWR or a Fusion... as the surgeon will remove the head of the ulna which removes the problem.

    I had the ulna head removed when I had my TWR in June and just to be extra careful the surgeon additionally transferred tendons to straighten up the wrist and support that side. (he is very pleased with the result on x-ray )

    I had a wrist fusion last year but didn't have the ulna head removed..wish I had ...as I need to have another op done due to arther now showing his ugly face there.

    The decision about which op to have is a difficult one...and if your being left to decide... that just isn't easy!

    all I can say is that I had the Fusion on my non dominant wrist on advice from my surgeon...so that I now have a strong though immobile joint on my left hand/wrist. I am able to turn the hand palm up/ down (pronation/ supination) but there is absolutely no other movement in the wrist due to the metal fixings. I've managed very well with a fusion...but as I cannot bend the wrist any longer some things....like personal care, are more difficult to manage.

    I had the TWR on my right/ dominant wrist ..again on advice from the surgeon as he said it gives greater range of movement and that managing with 2 fusions would be quite difficult... so he would not recommend it. As I'm still recovering from this op I can't say yet what I can/ cannot do!

    Both ops should result in a pain free wrist...and that's fabulous.

    All the warnings you've been given about TWR dislocation, infection or failure of the prosthesis after 1 or 2 yrs...I was given too. The surgeons are obliged to tell you so that you are fully aware of all the possible complications and outcomes.

    A TWR can be 'converted' to a Fusion later if required......but a Fusion cannot later be 'converted' to a TWR ...so that's worth considering.

    Sorry for being so long winded..there's no short way of saying it all.

    As before...please let me know if there's anything I can do.

    (((hugs)))

    Iris xx
  • lavenderlady
    lavenderlady Member Posts: 409
    edited 30. Nov -1, 00:00
    thankyou all so much for you messages as Speedy says about her hip lasting 13 years when i know they often say it will last anything from 2 to 10 years, and if it does last around that long at least the operations and treatment for Arther would be far advanced by then, my Dad had a valve replacemtn 21 years ago and told it would last 10 years at most so I know they have to protect themselves by saying it , so the Ulner is the nobbly bit, I would like to have some movement as I've got alife filled with 3 young grandchildren and I have 2 dogs and 10 guinea pigs so need some movement and maybe the fusion would stop that, I would of course work hard with physio,
    I'm going to ring my first surgeon I saw on the Island who referred me to Mr Warwick in Southmpton who's a top DR with books hes written and works with injured service personel, so that helps, I think I'm more for the TWR with a little doubt but will keep finding out the info needed I know I must let him know soon as he has to order the replacement joint, thanks everyone it definatly helps xxx :)
  • lavenderlady
    lavenderlady Member Posts: 409
    edited 30. Nov -1, 00:00
    well have just confirmed hospital addmission for 27th Septemebr op is the next day have to go in day before as I'm diabetic and will be first in morning for the op, have also notified Dr Warwicks secretary that I am going for the TWR op not fusion. Iris has helped me enormously by telling me what to expect, I'm in 2 days not inc day before so in Monday 3pm Tuesday have opthen out home hopefully Thursday, am gong to start doing bits now that I wont be able to do later for a while like sorting out kids drawers etc, no doubt worrys will kick in the closer i get , also got cardiologist this Thursday to check on my breathlessness, hope alls well, am happy to know the pain will be gone by christmas I hope and can book a holiday for next year,
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    You are sounding pretty positive lavenderlady, good for you. One can only make a decision based on the info that's available at the time: I cannot offer any advice as my problems are so different, but hopefully you will feel more settled now that the decision has been made. I am sure dorcas will have plenty of practical advice regarding coping after (and other wrist people too!) so, get on with the organising and planning - I wish you well. DD
  • angel1
    angel1 Bots Posts: 1,464
    edited 30. Nov -1, 00:00
    I applaud the stength of character that you are displaying Lavender, by taking the plunge. Having Iris as such a fantastic mentor must be a great help to you.

    At the end of the day, only YOU can make the final decision about the surgery, having weighed all the pros and cons, and listened to the experts, and people like Iris.

    I ummed and aahed for far too long, with regards to my TKR over two years ago, enduring horrendous pain. I did so much research that I could probably have performed the op myself! I was lucky though, in that I had a surgeon who understood my need to do this. All he said, when I finally agreed to go ahead, was that I must now put everything I had learned away, and my complete trust in him. I did just that, and had the most amazing results. I came out of hospital after just three days, using just one stick, and with no pain whatsoever. I have never looked back.

    Follow your own instincts, trust your surgeon, and I`m sure all will go as well for you........Ange.

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