Trapeziectomy soon and live alone - advice needed.

Drewa

Hi all - so glad you're here! OA in both thumbs started just over a year ago and earlier this year I had them x-rayed. However, though my GP could tell me they showed arthritis he didn't get to see them, so no idea of severity. Apart from telling me not to take too many painkillers (I once had a stomach ulcer) all he said (with reference to "gadgets" I had bought to make my life manageable) "they saw you coming"!!

Eventually, at my suggestion, he referred me to the Occupational Therapy dept. who assessed me over the phone and said they couldn't help me as I didn't need help with "personal care". Following this I decided I would have to go down the steroid injection route, though they had been useless for an OA knee previously, so my GP referred me to a consultant at the hospital.

I turned up thinking "here we go again", expecting the steroid injections, but I got a big surprise as the consultant took one look at my x-rays and said injections would be of no help and I needed a trapeziectomy operation on both thumbs. Although the left thumb looked far worse, I said most of the pain was in my right thumb (dominant hand) so he agreed to do that first.

Next surprise was that he said he had virtually no waiting list and sent me off for my pre-op assessment there then and later his secretary phoned and gave me a date for the operation - 5th November i.e. three weeks from now!

I live alone and have no relatives close by that I can depend on for help though I have a number of friends who have offered to do things (particularly looking after my dog) but I want to be as independent as possible.

About two months ago I took on a woman to help with cleaning and she is marvellous and I'm sure will willingly do some extra hours. This suits me as well as I'm paying for her time, so don't find it too difficult to ask for her help. I already do on-line shopping and can walk to local shops and get a bus into town until I can drive. I have also recently discovered a small company who make and deliver home-made meals at a reasonable price.

I've been reading through the forum and found a few people who had this op and also lived alone, so I would really appreciate any tips they can give me for managing the early weeks. I was going to buy various "aids" (including a bum wiper!) but have now been told that I will be assessed by the Occ. Therapists and "given everything I need to manage at home on my own". However I wasn't given specific details of what this might involve.

So my questions for those who were in a similar position are - what help did you get from the authorities, and what tips can you give me to prepare pre-op and cope post-op?

Sorry this post is so long but I will be grateful for any help you can give me.

villier

Hi Drewa welcome to the forum. I had a Trapieziectomy coming up on two years ago and have never looked back, I live on my own.

I was never referred to O.T. but then again I never asked, I really didn't need to buy very much.

I did a lot of cooking before hand and put it in the freezer so had lots of meals to hand, I see though you have thought about getting ready meals in. I put a selection of plates etc out on a work top so I wouldn't have to struggle one handed to get them out a cupboard.

I wore joggy bottoms to start with as they don't have buttons or zips. The cast I had on was like a rugby ball(hopefully yours wont) so you need tops with loose sleeves, I had an old jacket with knitted sleeves which I had to cut to get it on.

I bought a limbo to put on over the cast for showering the only problem was the cast was so big the limbo didn't fit, not to be beaten I used a bin liner, between my other hand and teeth managed to tie it on, once the cast is off and your splint is on the limbo will go on no problem. I don't know if you will need a 'bum wiper' I managed with my non dominant hand no problem.

It s good you have your woman to help you with your housework the only thing I struggled with was ironing although I mostly wore clothes that didn't need ironed. As for driving I didn't drive for 8 weeks which was a bit of a pain for me as I get treatment in hospital every few weeks for another condition.

I am afraid I have got a pred head on today so brain a bit fuzzed if there are any questions you want to ask feel free and if there is anything else I can think off I will post later....................................Marie x

Drewa

Hello Marie, thanks for replying. I had already seen some of your previous posts and felt very reassured by this one! You sound as if you did amazingly well on your own - did you have no help at all? Do you mind if I ask you how old you are - you sound fitter and less anxious than me!

I could make some meals for the freezer myself and in fact often do so, but this company is so good and even though a meal is around £3.50 I think it's worth it as I don't have to shop for the ingredients, prepare it and then spend money on cooking it and washing up afterwards. Plus it is delivered to your door and put away in your freezer if you want!

I note what you say about having plates etc out which is a good idea as I am also very short (4'9") but as I don't have a dish washer I have decided to largely go down the route of disposable plates, cups and crockery. I am also going to sign several blank cheques and write my Xmas cards!

As for aids, I have a few from having a replacement knee a couple of years ago like a thing to help you put socks on and a number of gadgets I have bought to make life easier before I knew I would be having the operation so soon. My daughter has a limbo which she can lend me and I do need the bottom wiper - my body seems adjusted to wiping with my dominant hand and I can't seem to reach so well the other way! I will bear in mind what you say about clothes generally and today I went out and bought a fashionable poncho I can wear to avoid the coat sleeve problem. Another worry is gloves as I get very cold hands but I suppose the plaster/splint might keep it warm?

Today I tried to do things with just my left hand - what a joke and so frustrating! I did manage to get one of those genie-type bras on which pleased me, but socks were very difficult. Mainly I was thinking about it when I took the dog out. I couldn't fasten or undo his coat with one hand or open the thing to fasten his lead. I couldn't have used my walking stick or walker and hold a lead as well and tying a full poo bag with one hand was also impossible!

I think you just must be a very strong and resourceful woman as indeed I used to be. I shall take you as a shining example of what can be achieved and I keep telling myself that the worst only lasts a couple of months!

On a different note I am glad to be having the surgery because I consider my thumb arthritis to be a "hidden disability". My hand is not misshapen or swollen and looks completely normal, so I'm always having to explain when I don't shake someone's hand or I'm struggling to get tiny coins out of my purse etc. I've often thought I would write a list of all the ways it has affected my life but it's easier to say just about everything! Whatever results I get it must be better than what I have now.

Drewa

Just bumping up as I hope to get more ideas from people who have gone through this and live alone.

barbara12

Hello Drewa and welcome to the forum
I am down to have this but have put it off till I have my second hip replaced..so glad the villier has come along with lots of advice..good luck with the op..

villier

Hi Drewa, no I didn't have any help at all, I was fifty eight when I got it done, I am not in the greatest of health I also have a painful neurological condition but when you've got to manage you manage You will surprise yourself by how much you will manage, you will find ways of doing things, you should have your fingers free on the operated hand which will help, it will also be a bit easier once you get the cast off and the therma splint on.

You sound very well organised and the poncho sounds just the trick, that's good you found a bra you were able to put on I was lucky I had one which was pretty stretchy and was able to pull over my head closed.

Are you having a GA or a nerve block(think that's what its called terrible memory)? I had a GA and was kept in overnight. If there is anything else you need to know please ask...............Marie x

Michelle63

Hi, there is quite a lot of info on the thumb recently fused thread that may be of use to you. I am 2 years post op and doing splendidly. Back at the gym, lifting weights and only experiencing mild problems such as stiff door handles or keys. Pleas feel free to message for any more info. One good tip.....forget spearing a bra for a while.

Drewa

Thanks to all of you who replied.

Michelle - is a "fused thumb" the same as having the trapezium removed? I'm afraid I couldn't find that thread so could you possibly give me a link? Well done on your recovery though. I've been watching some You Tube videos by someone who had the op in the US but I had to stop as she was such a whiner and a wimp, plus she said it's impossible to do this on your own and three days after the operation she hadn't got her make-up on! It'll be more 3 months with me, least of my worries.

Marie - yes, you were 10 years younger than me when you had your op and certainly 10 years ago I was a very different person re what I could manage physically, but still, with your other condition, maybe we are more equal?

Do you know, I had completely not realised that I will have the fingers on my right hand free - but can you use them ok? The woman on the YT video says you can't. If I can use them a bit, even if not immediately, it might help a lot.

I have just ordered a "limbo" though I take on board that I might not be able to get a huge cast into it at first. How long were you in that cast? I have bought some "Bath in Bed" wipes which might be ok for a week or two and already have some shampoo that doesn't need water. At least living alone nobody else has to put up with it if I smell!

One of my problems is that I know virtually nothing about the op and what happens afterwards, or at least not from the consultant. Bar saying I had to have the op and go for a pre-op assessment there and then he said nothing. The nurse I saw likewise just told me that I would have a GA, though not sure why. I'm not bothered either way and in any case the same surgeon might need to do a small procedure on my foot at the same time (but that's another story!). She also said I would be staying in for at least one night. His secretary just said he would come and talk to me about it on the morning of the op but that's cutting it fine IMO!

My biggest worry at the moment is about my dog but I have several irons in the fire on that one and still almost 2 weeks to go. I have also managed to invent something myself to assist with the bottom wiping - maybe I'll go on Dragon's Den with it and demonstrate!

Bye for now.

Michelle63

Hi again. I wish I could remember which thread all the info was on. A fused thumb is different but presents similar problems with everyday tasks. I was surprised at how unable I was to carry out the most simple of tasks at first. My physio was brilliant at telling me exactly what I was allowed or not allowed to do. Some of the most difficult things were getting dressed..pulling things up etc. Also eating one handed was tricky until I go the hang of it but I definitely recommend some non slip matting for underneath plates. I spent many a meal time chasing the plate around the table. The limbo was a great purchase and did a great job.
I didn't suffer a great deal of pain but the limitations in movement did cheese me off and I got quite frustrated. I couldn't drive for 10 weeks as I was still in the plastic splint. Writing was a ridiculously long wait. I reckon it was about 18 months until I felt that my hand was pretty much as good as it was going to be....that said I am very glad I had it done as the previous pain and difficulty in mobility was getting unbearable. Be patient and listen to the physio and definitely buy some Bio oil to massage into wound. You will very surprised how quickly you adapt and change how you do things around the house. XX
Forgot to add I did manage to go skiing 16 weeks post op

villier

Hi Drewa I only had my cast on for few days as my thumb had gone numb(thumb now ok) so physio took if off and put the therma splint on I'm sorry I cant remember how long I should have had it on. I had quite a few physio appointments they will show you exercises to do and I got different types of putty to strengthen the thumb, like Michelle I have never looked back and very glad I got it done the problem I have now is the arthritis is now in my wrist and the consultant mentioned a fusion the last time I saw her although I am not very keen to have that done.

Michelle mentioned plates sliding over the place I just used a damp cloth underneath to combat that. I managed to shower from day one as I said earlier I managed to tie a bin bag on with my good hand and my teeth, the wipes will do the job until you get your splint on. Bio oil is very good for the wound make sure you use it often. I was lucky I had no pain after the first day hopefully you will be the same......................Marie xx

Drewa

Thanks for the replies. Michelle, surely you don't mean it was 18 months until you could write again? But yes, I do think the frustration will be the worst thing for me as I am not the most patient person and I already get very frustrated with the limitations of my thumb now. And I'm already dreading the fact that I will have to have the left thumb operated on next, but at least it won't be my dominant hand and hopefully I'll have learnt what is useful.

Luckily, as I am a very keen gardener, we are out of the growing season and plus I have a good excuse for not sending many Christmas cards! Do you know, I never even thought about how I would manage to eat with my left hand - I wonder how many other things I haven't thought of?

I know what you mean about pulling things up. Before I was offered the op I had been referred to my OTs hoping they might give me some tips on managing everyday tasks etc but they said they only help if you can't manage your personal care. I told him (assessed on the phone) that I couldn't dry between my toes or pull up my pants, but he didn't seem to want to help!

As regards pants, well we'll have to see, but I have a couple of long skirts which I'll wear instead of leggings/trousers and two pairs of slip on shoes/boots. And meant to say before - no way am I going bra-less - I'm even hoping to persuade the surgeon to let me wear one during surgery.

Drewa

Marie - it's very good news about the pain because Michelle also said it wasn't a big problem. My difficulty is that I can't take codeine, so it's paracetamol all the way I expect. Luckily I seem to have a fairly high pain tolerance.

I've got lots of that non-slip matting I can use, especially as I bought some very lightweight plates which are also very slippy but a damp cloth seems like a good alternative.

I've never used bio oil - is it really worth it? I had my knee op done 2 years ago and the scar has almost faded to nothing without using anything.

I keep reading that people have to keep their arm in the air, or at least above their heads, for some time, and some seem to have found very original ways to meet this need. Have you any tips?

As I have said before I think you are a very resourceful person and an inspiration - whenever I get frustrated after the op I shall think "What would Marie do?" :?:

Michelle63

Sorry, poor grammar. Writing took about 14 weeeks for it to be at all comfortable to hold the pen. Fine motor skills take a bit longer to return, tying laces and buttons etc. My left handed writing was actually very good by the end. Intend to type as I think and it all comes out a bit random !! One other thing that was very useful was a dining room chair on the first night home. I sleep on the right so I put the chair back against the bed, arranged some pillows and managed to sleep with my arm elevated, propped up against the chair, which is what they advise. I found that in the internet somewhere, must have googled so many sites for information that I forget which one was which.

Cushytara

Hi. I had my trapeziectomy on 12 Aug 2015 and coped amazingly well mostly alone and with a dog ( I was glad to get out of the house, it took ages to walk her as if I moved too quickly, my arm swelled up in the plaster cast and became uncomfortable!). Very little pain post-op, had a regional block, no sedation so saw bits of the op. It was amazing!

Drewa

Hi Michelle - which thumb did you have done? I assumed it was the right one too as you talk about the writing thing. I too sleep on my right side and couldn't imagine how the chair thing would work as it's my right thumb that's being done.

14 weeks before being able to write at all comfortably/properly! Oh well, like you I expect my left handed writing will improve - was it awkward for you with you for not being able to sign things? Even when I'm wearing my splint and say writing is difficult they still want me to, but I suppose they can't argue with a plaster!

Drewa

Cushytara - welcome to the forum! Why on earth did you have to keep your plaster on for 6 weeks? I don't know how long my surgeon likes patients to wear it for but I hope its not that long!

Re the dog walking - the problem with me is that I need to use a walking aid, at the very least a stick, but preferably a walker, so if I've got the dog lead in one hand I am left with nothing to help me walk! So far a friend has offered to take him a couple of times a week with her dog, so he'll get a good run then and I've also applied to the Cinnamon Trust and someone from there has volunteered as well, though she has to keep him on a lead at all times because of insurance. If I feel as if I want to get out of the house (as I know I will!) I can just go along with them for the walk and if I leave the dog at home and use my walker I can at least get to a few local shops - how exciting will that be?!

Yes, I'm sure I will have to learn patience! I already get very frustrated at things I can't do with my thumbs, so heaven knows how it will go. Only 3 more days - hard to believe - still so much to do!

Cushytara

Not sure why it was 6 weeks, just my surgeon's preference I suppose. My Occ Therapy dept is fantastic. They have given me aids to help me write and use cutlery and this week I got some therapy putty which has really helped. I met a woman who had hers done on the same day and our results have been very different. She has great movement in the thumb but still has pain and an angry scar whereas I've had minimal pain but stiffness and restricted movement. My scar is very beautiful tho'! One thing we both agreed on was that the op and recovery was worse than we thought it would be so you may have to manage your expectations somewhat. That said, I'm having the other one done, I'm giving myself around a year to make a full recovery but I'm determined to get a good result and I'd have it done again in a heartbeat.

Yes, I can see the dog walking may pose a problem. Glad you've got some helpers on hand. You'll be amazed at what you can do and frustrated as hell when you can't do stuff you hadn't even thought of. It drove me batty that I couldn't open a bottle of beer. A quick look on Amazon for a wall mounted bottle opener soon solved that. I lived in pull-on trousers and even when I went back to work 8 wks post-op, I couldn't do my trousers up. Sadly, tights are a step too far right now but then I could barely manage with them before the op. I still step into my bra. It feels like the only way to do it now!

Michelle63

It so hard to describe the chair support. Pity I can't draw a picture. I put the chair facing away from the bed so the back touched the side. I then propped my arm up between some pillows and it sort of stayed up against the chair. I only did it for the first night after that I just rested it on some pillows. I don't know how I managed to not sign anything but I did somehow. Did I mention how good the limbo was at keeping it dry? Best thing I bought. I had my plaster cast on for the first 10 days if I remember rightly then my physio made a beautiful pink plastic cast with purple Velcro. I had to wear this constantly for 6 weeks until she had assessed that I could take it off. I could take it off for bathing. I then had to wear it at night with a compression glove for several more weeks. I also had regular exercises to do 4 times a day, these are crucial for a good recovery. Good luck, keep us informed XX

Drewa

Tara - I'm surely hoping that I don't need to have a plaster on for 6 weeks, but really have no idea - what will be will be. It's also frustrating that I don't know what aids I might get from OTs, so I don't know whether to buy things. One thing I bought today was a one handed tray which is as you might guess, a tray with a handle which I hope will be useful. I have already bought something called TV forks which look like forks but have a cutting edge on both sides so can be used in either hand.

I'm thinking/expecting that the things I buy will be useful when I too have the left thumb done in hopefully a year's time. The surgeon said the x-ray for that one is very bad but agreed to do the right one as it is more painful. Have you noticed a deterioration in your left thumb now it's doing extra work?

I am expecting the op, and especially the recovery, to be absolutely dreadful, so I reckon my expectations are about right, and if it's not so bad well yippee! Some people seem to swear by bio oil for the scar - did you use it? I've put off buying that for now.

I know that despite all my preparation I shall find a thousand things afterwards that I never thought of or considered. You mention tights - no I'm hopeless with them and being retired can dress as I please. But like I said I'm planning on long skirts and a couple of batwing tops, plus the poncho I've bought for now. I have a pair of slip on shoes and a pair of slip on boots, but one thing I've tried with one hand and can't do is put socks on.

Michelle - I will work something out one way or another re sleeping. I have bought a limbo so that's good and also some "bath in bed" wipes for the first couple of days. I would love a pink and purple splint in preference to a cast after the first few days so I'll keep on hoping.

And of course I'll keep you all informed as to how it went as soon as I can!

Drewa

Oh one more thing - how do you butter bread with one hand? I've just tried and it's really nearly impossible - maybe I'll lose weight! :spider: I like spiders!

Cushytara

Ah, yes. Buttering bread. I've only just regained that skill! Cut your toenails, it's impossible left handed! Limbo great but I couldn't get it on til day 10. A Next carrier and hair bulldog clip worked well til then. Showered on day one! Am huge fan of bio oil. Treat yourself, it's worth it. My left hand was pretty bad because I had to use it more but it's calmed down a bit now and my neck and shoulder hurt as a result of keeping the arm elevated. Get loads of pillows for bed they are just fine for elevation. Thing is, Drewa, it's a bit like childbirth; you forget very quickly. I'm sure it won't be as bad as you think. Just do exactly as you are told.

Drewa

Hello again Tara. Ha, ha re the toenails - luckily I have a chiropodist to do that, so one less problemo! Re the bread (sounds like I can't live without it, but I do like a sandwich or a bit of toast. Maybe I could ask my daughter (if she pops in, which isn't guaranteed - full of promises that one) and she could just butter a couple of slices then put them back in the bag.

I am rushing round like a mad thing trying to get my life in order for the next 3 months - total over reaction, you'd think I was having it amputated! Part of me knows I will cope ok and that how I did so will eventually fade. I had a new knee 2 years ago which was a hassle with no driving either but time went by and I don't remember a lot about it now.

What I don't want to forget, even if I'm in a lot of pain afterwards, is the pain I am in daily now and the constrictions and frustrations - today another customer had to help me push a jumper into a carrier bag at S****b**y's for goodness sake! Some days are much worse than others and I don't know why (doesn't seem weather related) but every day the pain in both thumbs is there from the minute I wake up, so whatever else happens it will be great to not have that any more and you saying you will have your other one done has inspired me, so thanks.

Edited for colour/use of company name

Mod JK

Cushytara

Had my Occ Therapy appt today. I'm 12 weeks post op tomorrow and my therapist said this is now the magical time where most people start to regain normal use. That was very reassuring. Today, I touched the tip of my third finger. I was beyond excited!
I did smile at the supermarket thing. OMG, been there! I was fumbling around trying to get money into a ticket machine, dropped it then couldn't pick it up. Some poor young man had to do it for me! I felt so useless and silly. I'm only 52!
So chin up Drewa, it's going to be so worth it! Keep in touch :-)

Drewa

Many congratulations on touching tip of your third finger - yay - high 5 or should that be high 4?

I thought you must be much younger than me as you still work! On the downside 52 is very, very young though to get this problem but on the good side I expect you are stronger and more flexible than I which makes it easier to cope. I am coming up to 69 with mobility problems and certainly know I am a very different person physically than when I was 52 and still working full time as well as being a single parent - seems like a different life now and I can't begin to imagine how I did it all.

I am slightly fed up with the medics who I've read/watched on here who say "Thumb arthritis happens to about a third of post menopausal women but "much less frequently in men, but we don't know why this is"!! Well, I'm no medic but it seems obvious to me that "post menopausal" is the clue - it must have something to do with loss of oestrogen like so many other things. I was taking HRT until persuaded to come off it age 60yrs and I've had various health problems since. I don't hold out much hope but I'm going to try and persuade my GP to let me go back on it.

Oh well, only two more sleeps before the big day! I'll get back on here as soon as I'm able afterwards.

Edited colour...Mod JK

Drewa

Well I hadn't done this before but have now had a quick look at the possible "oestrogen connection" and it seems to be fairly well know and acknowledged so I don't know why doctors play dumb. Here is a couple of interesting links but there are plenty more

http://www.drdach.com/Menopausal_Arthritis.html

http://jeffreydachmd.com/bioidentical-hormones-prevent-arthritis/

but then there's this one http://www.everydayhealth.com/osteoarthritis/osteoarthritis-and-gender.aspx

which, whilst admitting a link claims that HRT doesn't help. Also says other interesting differences between the OA suffered by men and women.

Drewa

And here's another really good one http://www.healthafter50.com/alerts/arthritis/JohnsHopkinsArthritisHealthAlert_1984-1.html
I wonder if there's anything about this on the general forum board and haven't got time to look but if it's not there it should be as it might interest a lot of people.