Trapeziectomy

susan100
susan100 Member Posts: 14
edited 20. Oct 2015, 13:08 in Living with Arthritis archive
Hi, I'm Susan and I've just joined this site.

I've got OA in lower back, right knee, both thumbs, 1 finger, big toe. I've had all sorts of physio for my back but have been told that, basically there's nothing else that can be done.

My main concern at the minute is that I'm waiting to have a trapeziectomy on my thumb. I've researched this a lot on the net and it gets a pretty bad press, ie long recovery period, 4/5 success - the 1/5 failure sounding horrendous -reduced mobility, and continued pain for a long time. I just wonder why they do it in the first place!

It would be great to get some sort of reassurance from anyone who has had this procedure done.

Also, does anyone know what the procedure is for an arthritic big toe joint?

Many thanks in advance. :wink:
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Comments

  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Hi Susan

    Welcome to the forum, it is a shame you had to find us but we are here to help support and sympathise.

    I am about nine weeks post trapeziectomy and yesterday ditched my light weight splint as my consultant was so pleased with the way my recovery is going. I will admit that I have a bit of numbness up the side of my thumb which can be due to the nerves being stretched to get to the trapezium bone. My consultant has said the feeling may or may not come back. The way I look at it is it is a small price to pay for having less pain(bliss).

    I live on my own and had to do everything for myself and managed from day one and as you can imagine trying to do things one handed can be a bit difficult BUT if you have someone to give you a helping hand all the better.

    Everyone is different Susan and I personally don't believe everything I read on the internet, if you put trapeziectomy into the search at the top of the page you will find a thread with information, especially Michelle who had it done a few months before me.

    My left thumb is on it's way out as well, question: would I go through the same again........answer: I absolutely would.. If there are any questions you would like to ask, please PM me I am only too pleased to help...................Marie x
  • stickywicket
    stickywicket Member Posts: 27,098
    edited 30. Nov -1, 00:00
    Very wise words from villier. Yes, the internet is the Wild West of information. Only research reliable sites, Susan. I've not had hand surgery but have plenty of replaced joints in my legs and I know lot of problems arise because people do either too much or too little post op. I know some on here have had foot surgery. Maybe if you start another thread one of them will see it.
  • As5567
    As5567 Member Posts: 665
    edited 30. Nov -1, 00:00
    I've not had surgery of this kind but wanted to say that you would not be offered the operation if the benefits of it outweighed the risks, you will often find the "bad press" on the Internet because most people who have a positive outcome are less likely to post somewhere and are probably enjoying life compared to those left in the same pain or worse.

    Every operation has its risks and failure rates, statistics are often misleading and confusing to the most of us
  • barbara12
    barbara12 Member Posts: 21,276
    edited 30. Nov -1, 00:00
    Hi Susan
    I am so glad villier has answered your post, it good to have help of some one that has just gone through it.
    I have only put mine off because of other probs..but I do wish you well with it
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Thank you Villier (Marie) and all of you who have responded.

    Marie, it was very reassuring that you've come through this without serious complications and you're well on the road to recovery. Like you, I live alone and I know it's going to be difficult but fortunately (I guess!) it's my left hand that's the problem and I'm right handed so I'm sure I'll muddle through. My right thumb is arthritic too but not bad enough, thank goodness, as yet to need an op.

    Can I ask you what pain killers you were given? I can't tolerate codeine which may be a bit of a problem since most of the strong painkillers contain codeine.

    The sites I used to get info about Trapeziectomy were reliable NHS sites and articles written by consultants and they all said more or less the same thing - chance of serious complications and ongoing pain after the op. This is what scares me. But, as was suggested on this thread, I guess some people fare/recover quicker and better than others.

    Susan.
  • marrianne
    marrianne Member Posts: 1,161
    edited 30. Nov -1, 00:00
    Welcome to the forum Susan ,I cannot add to what has been said just hope it all goes well and your having an ok weekend seems we have had a little bit of sun thank goodness :) ((())) hugs Marrianne
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    Hi, I am now 5 months post op on my right thumb. Initially things were quite tricky and painful but I am so glad I had the op. I have full range of movement and can carry out most tasks. Ironing, washing up, jam jars and heavy doors can be a little tricky but the majority of other tasks are a doddle. I went skiing a month ago with no problems other than a few aches in the back of my hand. I have full sensation but I do know if I overdo things as it will ache and it does suffer with the cold. I have been told that it could be up to 12 months for a complete recovery with 95% of the strength that I had before the arthritis. I have a consultation next Wednesday for the right thumb with X-rays for the right one. Carrying out the physio exercises is crucial to the recovery. Check out the other thread where some of us have reported our experiences. Hope this helps. :D
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    I forgot to mention the pain relief. I had it done under a regional block which was fabulous. They prescribed Paracetamol, Ibuprofen and Oramorph. I regularly used the first two but didn't even need to touch the Oramorph. When I overdo things an ice pack comes in handy to reduce any swelling and conversely when it gets very cold I use a skiing hand warmer. :D
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Hi Susan

    It was Paracetamol I was given, I am prescribed morphine for neurological pain which I did that night as I had a bit of a flare due to the surgery. All the pain killers I had was some that day and a couple the next morning, I was lucky I did not need any more after that. The only pain I get at the moment is an odd shooting pain up my thumb, the surgeon said that is just the nerve settling down and will go away. I am doing most things for myself nine weeks post(even driving) I think the only thing that really causes me pain is cutting with a knife which will come good once the thumb gets stronger or not watching what I am doing now that I have the splint off.

    I am glad Michelle saw the thread and has given her input, as As said you will always hear about the bad press and not so much of the good. Let us know if you decide to go ahead as I said we are all here to support one another, give me a shout as I have a lot of tips I can give you if you wish..............good luck.......Marie x
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Thank you so much Marie, Michelle, and Marrrianne. Everything you have said does help particularly with the bigger picture.

    I am seeing the consultant on 18th February when he will decide when I'm having the op. This problem has been going on for 5 years with the last step being a steroid injection. It was meant to be a course of injections, but I had a very bad reaction to the 1st one which took a month to settle down. This is one of the reasons why I'm worried about the op. Will I be one of the unfortunate ones who get severe complications?

    However, I guess it's a no brainer whether I have the op or not because the problem and the pain are not going to go away and I'm not getting any younger, so as far as I'm concerned the sooner the better before the other thumb kicks in! And one of the fingers on my right hand is pretty bad as well. I don't know if they operate on fingers (as oppossed to thumbs)?

    What does the physio involve and does it mean frequent visits to hospital?

    How long is it recommended before you can drive (particularly with the left thumb) or does this depend on individual recovery rate?

    Thanks all.

    Susan.
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Sorry to hear you had a bad reaction to the injection, I had two and they did absolutely nothing for me.

    After my op my hand was in a cast nearly the size of a rugby ball, I had to cut sleeves to get clothes on, after reporting about the numbness in my thumb the physio saw me that day and took the cast off and made me a therma splint and bound it so the thumb couldn't move. After about four weeks they took the splint off and bathed my hand in I think antiseptic water which was lovely, they made straps for the splint for removal for washing, doing hand exercises and moisturising the wound, which I did a few times a day. About three weeks later the physio was so pleased with the range of movement I had and gave me a light weight splint and two lots of putty a soft and a medium, I really felt the difference after using the putty, result was losing the splint last week, I see the physio in three weeks time and consultant in three months I guess I will then be discharged.

    I was told the recommended time to drive is at least eight weeks post I am nine, although with yours being your left hand(mine was right) it will depend on how the hand is healing so could be a bit longer, also different hospitals have slightly different guide lines, good luck on the 18th let us know how it goes Susan, hope this has helped.................Marie x
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Once again, thank you Marie.

    All sounds a bit horrendous really! :o

    Will let you know what consultant says on 18th.

    Susan.
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    I was driving at about 10 weeks with some trepidation. ( dominant right hand) I didn't feel I had enough grip or control on the steering wheel and it was still quite painful. I have a motorhome which has a right side hand brake. I have only started to drive this in the last couple of weeks because I couldn't operate the handbrake properly, not enough grip or pressure in the thumb. Everyone is so different though so do what you feel you can. Turning the ignition key can be bit tricky when my hand is cold. All said the pain that I had originally had has subsided hugely and the grip strength is returning more every day :D
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Thank you Michelle.

    That's quite disappointing to hear, especially since you had the op 5 months' ago. It really does seem to be a long process. You get over hip and knee replacements quicker than this!

    I don't get paid if I don't work and I need to drive an hour to work. It's my left thumb that's the problem so it sounds like it would be tricky with the gear and hand brake.

    However, apart from the motorhome, it sounds like you're managing everything else ok.

    Has anyone found that, since having one thumb done, the other one is on the blink? My right thumb and finger are playing up now.

    Susan.
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    Yep, consultation tomorrow. :lol:
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Very best wishes for the consultation Michelle. I'd be very interested to hear the outcome.

    I meant to ask. You mentioned having pain relief as a 'regional block'. What does this mean? Also, a question for you and Marie, when you have surgery on one hand, do they keep an eye on the other hand, and what's happening with your other fingers? I have painful joints on some of my fingers, including my right thumb.

    Once again, thank you. It's so good to have this site to 'speak' to people.

    Susan.
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Yes, my left hand is on it's way out but still sufferable at the moment, so will keep my left trapezium bone for a wee while yet :lol:

    Susan I think what Michelle meant was the 'regional block' she had was her whole arm would be numb and she was awake throughout the procedure, whereas I was out of it as my surgeon opts for GA, in a sense I was glad I had the GA as I stay myself and having to go home with a totally numb arm I don't think I would have managed.


    You will have to excuse me as I had my infusion yesterday and not kicked in properly so have got some brain fog at the moment. I don't fully understand what you mean by 'when you have surgery on one hand, do they keep an eye on the other hand, and what's happening with your other fingers?' If you mean when you are actually having the surgery I wouldn't know as I was out of it, but when I had my finger done (finger and surrounding area were numbed) they had my hand lower than the operating table so I couldn't see, or do you mean will the same surgeon look after all the joints that are diseased? I am sure Michelle will be able to give you her experience as she was awake.....................Marie x

    Hope your consultation went ok Michelle xx
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    My regional block was perfect for me. They insert 4 needles into your underarm, virtually pain free. They locate the nerves and administer anaesthetic through the needle totally numbing the whole arm for up to 24 hours. Personally I preferred this method but it depends on many things. My arm was numb for about 12 hours and it was bit tricky in the sling to use but got the hang of things quite quickly. Today's consultation was post op and they were very pleased. I also had an X-ray on the left thumb which confirmed The OA that I already knew I had!!!! I am leaving that one a bit longer if I can manage. :mrgreen:
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Thank you Marie and Michelle.

    Glad to hear the post op consultation went well Michelle and for the clarification of regional block from you and Marie. I really don't like the sound of that. Like Marie, I live alone and I think it would be difficult to manage on top of everything else. I don't know how the consultant I'm seeing on 18th operates but I'll soon find out I guess! He's trying to put off operating for as long as possible, but with the oa in the other hand kicking in now, it may change things.

    It's all very scary all of a sudden, with my back (very much ongoing), knee (already had 2 operations but not a new knee), big toe, left thumb and fingers deciding to play up at once.

    Marie, I meant does the consultant who is dealing with the problem thumb at the minute keep an eye on the other hand when there looks to be potential problems. When I first saw the consultant in October I had both hands xrayed. This confirmed oa in both thumbs, with the left one worse than the right. So it's the left one that I will be seeing him again about on 18th Feb. The right one wasn't causing too much of a problem at the time but has kicked in now. It's very bearable at the minute, but the whole picture now is scary. I'm usually a real optomist!

    I'm reading between the lines in both of your posts that your going to endure whatever is going on in your left thumb until your right one has fully recovered? Have either of you got oa anywhere else?

    The opportunity for these posts is great but wouldn't it be great to just talk?!

    Susan.
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    Yep, have OA in right and left hip, left shoulder, left elbow and right big toe. Not too serious, only had 3 major debilitating flare ups in 20 years for those areas. So not doing too bad really. The weird one though is the big toe, it is generally stiff and painful if pressed but doesn't cause much problems other than that, very odd. My grandmother suffers terribly with osteo too so she has kindly passed it on to me. I also have a sort of poly arthritis too which can flare up if I am ill but that has been quiet of late. The main trick is to keep moving at all costs. I used to be a trampoline and gymnastic coach and gave up a year ago. I have definitely stiffened up since I have not been throwing myself around So I must get back to some exercise. Went swimming last week and really enjoyed it. :mrgreen:
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    The surgeon I am under is actually a plastics, I was sent to her as my fingernail had come in funny which was thought it was a cyst that was causing it but turned out a spur had broken off and lay across the nail bed. While I was there my finger was in a flare and really painful so she suggested doing a DIP finger joint fusion, afterwards at my post consultation she noticed the swelling in my thumb and said she would be more than happy to treat my thumb, why see an orthopaedic and be attending two hand clinics, I am sure if I need any more consultations she would be more than happy to see me.

    My both hands are riddled with OA(shown up on x-rays) and I suspect my right knee, back and recently have been told I have TMJD in my jaw so hoping that it is not OA that is causing it :roll: .

    At least Susan you know you are not alone and we are always here to talk, support and try to help.......................Marie :D
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    I was told right from the start by my GP about the need to keep moving. I can't do any high impact stuff because of the knee and back but I like to walk a lot and just try to avoid hills. The back is ongoing but the knee has just kicked in again (along with everything else it would seem!).Really don't know what is going to happen about the big toes. The OA is definitely there, but I'm hoping, like Michelle, it will only cause intermittent flare ups.

    Michelle, you were clearly a very active person, as was I. This must all be very frustrating for you. I think that's what burnt my knee out and didn't do my back any favours. However, ao is rife in my family, so who knows?

    I've decided from today to think about other tactics. I know I just wouldn't stick to everything that's recommended regarding diet but I'm going to drink cider vinegar and honey mixed with water 3 times a day and black molasses 3 times a day. Also to soak hands and feet in epsom salts (I don't have a bath). I've already cut out citrus and tomatoes and red meat and will ease up on the diary and sugar. Giving up wine may be taking things too far!!!

    I don't know what the protocol is on this site about posting an email address, so that I could communicate on a more personal level. Any ideas Marie and Michelle?

    It's so lovely that you always respond.

    Marie, what is a DIP finger joint fusion?

    Susan.
  • Michelle63
    Michelle63 Member Posts: 63
    edited 30. Nov -1, 00:00
    Susan, feel free to private message me. Sounds like you are doing all the right things. Weirdly tomatoes have an horrific effect on myself. I develop symptoms very soon after eating them even to the extent of the base on pizzas giving me pain. I try to avoid bolognaise dishes etc. I did tey Glucosamine and chondroitin tablets for a while but I was unsure whether to swallow them or insert them !!!!!!!!! I didn't appear to get any relief from them. I haven't really looked into diet very much but perhaps I should. Nothing to do with arthritis but hard cheese leaves me with a cough these days so another item to avoid. I am actually convinced that since turning 50 my body is conspiring against me. :D
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Susan, feel free to PM me also. The DIP joint is the Distal Interphalangeal joint, the joint near the end of your finger( there was no cartilage left). I used to be very active also, I used to run to keep fit until my neurological condition and Arthritis got a lot worse, now I can hardly walk the length of myself :lol: Remember and let us know how your consultation goes................Marie x
  • susan100
    susan100 Member Posts: 14
    edited 30. Nov -1, 00:00
    Marie and Michelle, I have PM'd you both - not knowing this facility existed until you pointed it out! Not sure if it worked though.

    I just want to use it to give personal information as it would be a shame to finish the public posts that may help other people.

    Susan.

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