Elbow Replacement

lindalegs

Hello everyone,

I just wanted to know if any of you have had your elbow replaced?

My right elbow hasn't moved for 28 years and now it's being suggested by my OT that I have a replacement due to a possible operation on my left hand which would be very beneficial (we hope) to me.

A surgeon won't touch my left hand until I can feed myself with my right hand which, at the moment, is impossible because of the position my elbow has fused in. :shock:

My main worry is that I have no muscle support because muscles which haven't moved for 28 years, as we all know, waste away. So, potentially, once moving again the joint will become painful until I've had intensive physio and built the muscles up again. I am right handed so although I can't feed myself I do use this arm for other important tasks.

I'm inclined to think I should 'let sleeping dogs lie' but my left hand does need attention.

I take the first steps in November when I see my Rheumy and discuss it with her and then she'll refer me to a surgeon .....but in preparation I thought I'd ask if anyone on here has had it done already.

I really don't know what to do. :roll:

Luv,

stickywicket

My elbows, like yours, constitute two of the original bits of me still more or less intact. In fact, like yours, they are rather more intact that is useful :roll: I'm fairly confident I couldn't feed myself with my left hand. It will just about reach my mouth but at entirely the wrong angle

Contrary to what my medical history would reveal, I have an ongoing policy of 'if it aint broke, don't fix it'. It seems your elbow only needs fixing because your hand does. (Why am I singing to myself 'There's a hole in my bucket' ) I'd be wondering not so much about the elbow but about the hand. How much does that need fixing and how likely is the potential gain?

I'd also want to check on the success rates of both ops. I guess this thread is one way of doing that but I can't offhand remember any elbow replacements on here. That's possibly because only us aged auto-immuners get into that particular pickle in the first place 8)

Good luck with your research and eventual decision, Legs. And please keep us informed if you go ahead.

lindalegs

Hi Sticky,

Thanks for your reply

My left thumb has no substance because the internal workings have been destroyed by the RA ......picture a rather fat slug with a nail on, that does move and bend (more than it should) but is floppy and I can't grip with it. :roll:
I've been wearing a splint for the last 4 months to hold my slug firm in one position, this is to mimic the operation they want to do which is to fuse the thumb in that position.
I wear the splint in all tasks to see if I can use it when it's immobilised.
I can, its wonderful!
I can pick up a sandwich to eat and the filling doesn't spill,
I can hold and eat an apple whole instead of it being cut up,
I can pick up a cup and drink without using my straw,
I can wash the dishes more easily ..............perhaps that's not such a good thing
I can hold a tea plate in that hand etc
......such tiny tasks, I know, but they count!

So I've come to the conclusion that a thumb fusion would be beneficial. I could continue to wear the splint forever but it's not ideal as it does become sore at the end of the day where it rubs on my arthritic skin, when it's wet after, say, washing the pots it takes ages to dry even when wearing it and the velcro is ruining my clothes! :x

This is why I'm exploring the options of elbow replacement. But I do agree with you about 'if it ain't broke ....etc.' especially as I've adapted to living my life with just one hand which feeds me.

When I talk to my rheumy I'll ask about success rates etc and I'll get her opinion then but in the meantime I'm just seeing if anyone has had it done. Plus I am seeking advice from the members of the forum because we all live with this disease and know better than the specialists IMO.

Luv,

dreamdaisy

Oh crikey, Legs, what a conundrum. Thumbs are very useful things, and it is almost impossible to manage without them; I guess it can be done if every other bone in the arm and hand is OK but you don't have that luxury. I can understand that the splint is not a long-term solution but, like Sticky, I cannot remember anyone on here having an elbow replacement. It may be your time to do the Star Trek thing, yes? DD

PS How's your grandchild getting on?

Starburst

Hello again, I was wondering about you the other day. I recall some time ago, there was a youngish member who had an elbow replacement or was, at least, planning on one as her elbow was locked. I can't remember how long ago it was but it might be worth having a search.

I have no specific advice but wanted to wish you well and send you positive vibes as you make your decision.

stickywicket

Hm. We are similar but different. My pet slugs lie across my palms. The 'joints' (I use the term loosely) nearest to the nails have long gone. Using other fingers, but not will power, I can wiggle those joints any which way. The joints at the base of my thumbs have fused themselves but therefore have some strength plus a little movement which must come from lower down. So, I do have grip but it's between thumbs and palm. The fingers don't come into it. I use both hands to drink. The right one grips the handle between thumb and palm while the left one supports the opposite side of the mug. I only do straws when things are really tough. It's not fun and tea doesn't taste right – even less so, wine and whisky (not togther ). I wish you well in your search. Have you tried the AC search engines?

Starburst

I was right, it was quite a while ago;

http://arthritiscareforum.org.uk/viewtopic.php?f=8&t=31541&hilit=elbow+replacements

There wasn't much info but it might be worth messaging the poster in case she visits but doesn't post?

lindalegs

Hi Dreamdaisy, my grandson is lovely, bright and a joy to be with. He's two now and every Friday when we have him our home is filled with the chatter and laughter that only one so little can bring. Thank you for asking and indeed replying to my post.

Hi Sticky, it sounds as you have your own slugs which is reassuring to hear, though I didn't think I'd be the only one. :roll: We have both adapted to living with these creatures which used to be our fingers .....at least they don't leave slimy trail though, we have to be thankful for small mercies! As for tea/whiskey/wine ....G&T for me where there's a will there is most definitely a way!

Hi Starburst, thank you so much for the link and I shall PM Alicekay in case she's still around and I can ask her how she went on and if I can have a link to the blog she was going to write. (I did try the search engine on here before I started this thread but I'm obviously not as thorough as you.) Thanks again.

I shall let you all know what happens.

Love,

tkachev

I have painful elbows and my left does not move very far. I'd love to have them replaced but nobody medical has ever suggested it, although they have measured the angle on occasions. Its almost as if the elbow joint is not considered important in the bigger picture.

In your case it is very important because they need you to use your hand when the other hand is operated on. If the pain can be controlled while you build up the muscle strength I think it would be worth it but you'd have to do further research to check how successful a operation would be


Elizabeth

lindalegs

Hi Elizabeth,

I think they don't replace elbows very often because they're a very complex joint in that we haven't just got the hinge movement but also turning the hand over.

Have you had yours injected with steroids? I have had my left one done in the past to help it settle down through particularly painful times and it did help. Perhaps you could ask your rheumy about these if you haven't been down that route yet.

If they offer me the operation when I see the surgeon, I will have to think long and hard because I will have to be awake for the procedure due to arthritis in my neck. :roll: I was awake for my knee revision and that was fine but this is a lot more complicated which I won't go into now in case you (or anyone reading) is squeamish. :shock: Plus with any surgical procedure we all know they're not fun but it's the recovery afterwards that takes it out of us.

Anyway thanks for your reply, I hope your elbows settle down very soon as it takes the joy out of eating and drinking when they hurt.

Love,

tkachev

I had a cortisone injection in one elbow, long before I was diagnosed with RA, and it did nothing. I'm not sure if that is the same as a steroid injection? However humira helps a lot and both elbows were much more mobile and almost pain free for a few years, but unfortunately I have to take frequent breaks from humira and the pain has returned.

I'd be tempted to have an operation but, like you say, there are other things to take into consideration. I was awake for my hip and as long as you don't look during the operation I'd like to think you would be okay.

As you say, you have adapted to using one hand and the operation is complex so its not an easy decision.

Enjoy your day with Jack Spratt.

Elizabeth x

barbara12

Hello Linda
Sorry you have this quandary, I haven't heard of anyone having an elbow replaced but things are moving on..suppose you will have to write down the positive and negative,,not easy when there isn't much info..I remember my late Mum having in injections in her elbows many years ago..its one of the y joints that is behaving at the min for me..touching wood..My head :roll: hope someone can help make your mind up..I would think long and hard...xx

lindalegs

Hi Elizabeth and Barbara,

I am tempted by the operation but ......here's the rub. Although my left elbow doesn't move (and therefore only hurts when I flare when every joint hurts :roll:) I do use that arm for important things. e.g. ironing, writing, toileting :oops: and it is my painting arm which is tremendously important to me If it goes wrong or if I get an infection in it because of the op, a painless joint has the potential of becoming painful.

My splint helps me do things things I've lived without for 28 years but I have a window of opportunity and the possibility of doing things I couldn't. I have to weigh up though whether I might lose more than I might gain should it unsuccessful.

My OT also said that my left elbow has been doing the work of both elbows for all these years and if that goes wrong I shall be unable to feed myself or touch my face at all ....... what happens if I get a cold :shock: :?:

If, when I've seen the consultant surgeon, I decide to have my elbow replaced and it all goes well I then have to face having my left thumb fused and they did talk about replacing all my left knuckles ...what if that goes wrong!!!!!!

In an ideal world all this surgery will go right and there will be no complications but in an ideal world I would not have contracted RA in the first place and neither would any ill fall to anyone.

I just wish I had a crystal ball.

(We had a wonderful day with little Jack Spratt, which proves that through all my uncertainty lovely things still happen.)

Take care.

Love,

barbara12

Oh bless Linda..I feel like a wuss having to deciding between hip or spine.. :roll: I really wish I could help, but am scared of sending you one way or another....do you know and trust the surgeon..and does the hospital have a good record with infection :?: ...so glad you had a good day with jack...yes there is plenty to be grateful for hope if you do decide to have the op that its goes really well for you...we are all behind you whatever. xx

stickywicket

I think you've hit on something important, Legs, in that, the more ops we've had and the more we've learned to cope with the disabilities we have, the less attractive surgery becomes. I shall definitely have my other knee revision when it finally breathes its last and, if the THRs go, I'll have more. But, shoulders, elbows and fingers I can live with despite their many limitations. I do wonder about the golf ball under my foot but do I really want surgery on a foot that has a revision and a THR above it :?

lindalegs wrote:

if that goes wrong I shall be unable to feed myself or touch my face at all ....... what happens if I get a cold :shock: :?:

:shock: It's funny and it's not. I, too, have pondered this from time to time. My answer is to exercise and keep the movement I have.

I think we all love OTs but I'm not sure they understand all the implications of yet another op for us who are already extremely surgically enhanced. As for the knuckles – I'd leave well alone as long as you can get by with what you have. I once saw a hand surgeon and he said I did so well with what I had he wouldn't advise it as I have little pain there.

I think we cope OK until someone suggests life could be better – with the emphasis on the conditional tense. Rather you than me.

lindalegs

barbara12 wrote:

Oh bless Linda..I feel like a wuss having to deciding between hip or spine.. :roll: I really wish I could help, but am scared of sending you one way or another....do you know and trust the surgeon..and does the hospital have a good record with infection :?: ...so glad you had a good day with jack...yes there is plenty to be grateful for hope if you do decide to have the op that its goes really well for you...we are all behind you whatever. xx

Dear Barbara,

Don't feel a wuss, your decision is just as difficult as mine

I haven't met the surgeon yet. I see my rheumy in November and I shall discuss it with her first and then she will refer me to a consultant surgeon and then I shall discuss it with them. There is a little time before I have to decide.

I, also, don't expect anyone to decide for me as I know ultimately at the end of the day only I can make that decision.

I bet you're still enjoying your little granddaughter.

Love,

lindalegs

stickywicket wrote:

I think you've hit on something important, Legs, in that, the more ops we've had and the more we've learned to cope with the disabilities we have, the less attractive surgery becomes.

I think we cope OK until someone suggests life could be better – with the emphasis on the conditional tense. Rather you than me.

D'you know Sticky I reckon if I looked in a mirror my reflection would be you!

I can remember the 'excitement' I had before my TKRs and wonder at my naivety now and although I have no regrets and the operation changed my life I just know surgery isn't fun and the recovery is hard work! :roll: We have to sort the chaff from the wheat and decide what's really necessary .............as with you and your golf ball atm. (Golf balls and slugs .....I'm wondering what other affectionate names we have for our lumps and bumps! )

My OT suggested I make an emergency appointment to see my rheumy to get the ball rolling but when you've waited 28 years, what's the rush? :roll:

I shall speak to the surgeon, if my rheumy thinks it's a good idea, and see what he/she has to say and then do some hard thinking. At the moment I'm vying towards if it ain't broke ......etc. (Why are cliches always so wise?)

Anyway off to cook dinner we have friends round for a bite to eat tonight.

Take care.

Love,

barbara12

I bet you're still enjoying your little granddaughter.
We really are Linda.. a bit sad that she has to go to a child minder while mum goes to work , I looked after my two eldest GC..and thoroughly enjoyed it..suppose I was lucky to be able to do that.. she isn't talking yet..but knows how to get our attention... sure you know what I mean with Jack.. xx

stickywicket

lindalegs wrote:

D'you know Sticky I reckon if I looked in a mirror my reflection would be you!

Oh I hope not, for your sake

I usually find surgeons very willing to answer questions and helpful in their advice. One good thing – I've always felt that, being complex cases, we get the best surgeons. They like the challenge whereas the ones who prefer a patient with one single dodgy joint don't want to touch us with a bargepole

lindalegs

barbara12 wrote:

I bet you're still enjoying your little granddaughter.
We really are Linda.. a bit sad that she has to go to a child minder while mum goes to work , I looked after my two eldest GC..and thoroughly enjoyed it..suppose I was lucky to be able to do that.. she isn't talking yet..but knows how to get our attention... sure you know what I mean with Jack.. xx

I understand about the child minder because Jack goes to nursery 2 days a week but Grandpops Legs and I are lucky to have him all day Friday He is talking but then he's a little older than N isn't her. When I gave him his tea of spag bol the other day he said "Jack doesn't eat dog poo NannaLegs!" :shock: We have so many laughs

Love,

lindalegs

stickywicket wrote:

lindalegs wrote:

D'you know Sticky I reckon if I looked in a mirror my reflection would be you!

Oh I hope not, for your sake

I usually find surgeons very willing to answer questions and helpful in their advice. One good thing – I've always felt that, being complex cases, we get the best surgeons. They like the challenge whereas the ones who prefer a patient with one single dodgy joint don't want to touch us with a bargepole

You're so right SW. When they originally offered to replace my left elbow (the working one) 20 years ago they wanted me to travel to Edinburgh from the Midlands for the best elbow man in the UK :shock: I did refuse (a) because I didn't want them meddling with my working elbow and they wouldn't look at this frozen one and (b) you have to have all your appointments in Edinburgh, pre-op, op and post op and that wasn't feasible because our boys were very small.

It seems quite an attractive thought to have one single dodgy joint. :roll:

Love,

barbara12

Jack doesn't eat dog poo NannaLegs!" :shock: We have so many laughs
Don't you just love them.. ..although her mum has spent hours she can now count to ten..but that is it..she does a sort of sign language ..and it works and nothing wrong with her ears they have been checked
Hope you will get there soon with that elbow I do think you will be more clearer your head when you meet the surgeon..xx

lindalegs

barbara12 wrote:

Jack doesn't eat dog poo NannaLegs!" :shock: We have so many laughs
Don't you just love them.. ..although her mum has spent hours she can now count to ten..but that is it..she does a sort of sign language ..and it works and nothing wrong with her ears they have been checked
Hope you will get there soon with that elbow I do think you will be more clearer your head when you meet the surgeon..xx

A type of sign language, what a clever little girl!

You're right Barbara, I need help with making this decision. My rheumy is excellent and I know she will advice me and she's the one who'll refer me, or not, as the case maybe.

When they were considering replacing my working elbow 20 years ago I had a different OT then and I said to her 'if it was your elbow would you have it replaced' And her very honest reply was "No, because I see the ones which go wrong!" That has remained with me ..........in fact, thank you Barbara, you've given me an idea! I have her address as we still exchange Christmas cards so I shall write to her with my dilemma. She'll help!

Love,

barbara12

Hello Linda
I have been doing some googling on your behalf, Im sure you have done some..I have found a good site its Nottingham university hospital..Elbow replacement, its a very clear site and show you the post exercises you would have to do..and tells you the recovery and so on ..hope its helps
Apparently the elbow replacement is just becoming more common , hope the OT can help you, if she is still working in the NHS maybe she will know if things have improved in the last 20 years..xx

lindalegs

barbara12 wrote:

Hello Linda
I have been doing some googling on your behalf, Im sure you have done some..I have found a good site its Nottingham university hospital..Elbow replacement, its a very clear site and show you the post exercises you would have to do..and tells you the recovery and so on ..hope its helps
Apparently the elbow replacement is just becoming more common , hope the OT can help you, if she is still working in the NHS maybe she will know if things have improved in the last 20 years..xx

Barbara, thank you so much. I haven't actually googled it as the forum was my first port of call.

Can you copy the link and put it on here for me please?

Love,

barbara12

lindalegs wrote:

barbara12 wrote:

Hello Linda
I have been doing some googling on your behalf, Im sure you have done some..I have found a good site its Nottingham university hospital..Elbow replacement, its a very clear site and show you the post exercises you would have to do..and tells you the recovery and so on ..hope its helps
Apparently the elbow replacement is just becoming more common , hope the OT can help you, if she is still working in the NHS maybe she will know if things have improved in the last 20 years..xx

Barbara, thank you so much. I haven't actually googled it as the forum was my first port of call.

Can you copy the link and put it on here for me please?

Love,

If you can tell me how to do a link I will... I did try but nothing happened.. :? xx