Hand Surgery

For those of you who keep up with me in ways other than my blog, you probably know I had hand surgery recently. Here is how that all happened:

The Beginning

Saturday, October 12, I knit a purse for a little girl I was babysitting. It was cute and awesome and super fast. The next morning when I woke up my right wrist was hurting. It was not that bad, and I figured I must have slept on it weird or been knitting a bit too much the day before. I went ahead and got a wrist brace to wear just in case I sprained it, in the hopes that it would heal faster. Over the next few days, it started hurting more. I called my doctor so he could check it out, but he was out of town that week. It was getting bad, so I just made an appointment with one of his associates. She told me I had De Quervain's tendinitis. Basically, the tendon that runs along the outside of my right thumb was inflamed. Not a huge deal, I just needed to wear a brace that immobilized my thumb for 2 weeks. I was told to stop wearing the wrist brace, and to wear this one instead. I started wearing it on Thursday, October 17. There is a sock on my hand under the brace because the exposed Velcro was itchy.

The Pain

Halfway through lunch the next day (Friday, October 18,) my wrist started hurting VERY badly. Just suddenly, almost-in-tears pain. First thing I did was call the doctor to see if I could get an "emergency" appointment that afternoon. As I was waiting for a call back, my fingers went numb. That scared me even more than the sudden pain did. I called the doctor back, in tears at that point, asking if I should go to the ER or something because I was afraid my nerves were dying. The doctor called me back shortly after that, and after getting more details told me it was just carpel tunnel and not to be worried about my nerves. I was told to wear BOTH braces, was given painkillers to take when needed, and I got an appointment with a hand "specialist" (actually a surgeon) the following week. During that week, my right hand started getting swollen when it was not raised up high. I kept it up and iced it twice a day. I wore both braces all the time, awake and sleeping. By Tuesday, my left wrist was starting to hurt like the right one did at first. Meanwhile, the right just kept getting more painful. Painkillers were my friend. The only risk to Baby Kylie is/was the risk of her getting addicted to them and then going through withdraw once she is born. As much as that would suck for both of us, it is really not that bad. 

The Shot

I met the hand surgeon on Friday, October 25. He told me that the tendinitis was all better, but the carpel tunnel is/was bad. There are only 3 things they can do for carpel tunnel. 
1. Wear a brace and deal with it. 
2. Steroid shot into the tendon. This works for 1-4 months, then needs to be done again.
3. Surgically cut the tendon to make the tunnel wider.
I had already tried the dealing with it, and it was not working out for me. I opted for the shot. There was no risk for Kylie because it was just a local shot. As soon as I said we should try the shot, he started putting out bottles and a needle. I didn't even have time to prepare myself for a shot! First was the lidocaine to numb it. Pinched a bit, but not too bad. Then the real shot. If you have never had a needle touch your nerves or tendons, you cannot imagine how much it can possibly hurt. I was in tears. I didn't want to be, but sometimes we don't get choices. It was okay though, this was going to make me better!

I was fine leaving the office, and in the elevator, and getting in the car. As George was driving us home, the lidocaine started wearing off. There have been 3 times in my life that I have labeled myself as being a 10 on the pain scale. Once was when I was in the ER for chest pain. The other was later during surgery. This was the second. I took another oxycodone, because IT WAS SO BAD. All to make it better though, right?

The Next Step

Wrong. The immediate pain got better over the next few days, but my wrist never got any better than it was the day I got the shot. I also developed a shooting nerve pain in my index finger, most likely due to the shot touching my nerve. November 1 I started wearing a wrist brace on my left hand as well, because it was getting worse. Friday, November 8, I had a follow-up with the hand surgeon. The shot did not work. At all. Either I have some really weird body chemistry that makes steroid shots ineffective, or my wrist just got worse as it was "getting better" so it ended up feeling the same. Regardless, it was pretty obvious this was becoming a huge problem. Even if I did decide to just tough it out (with painkillers, I am not a super-hero,) it would most likely be back at least with future pregnancies. Given that, he recommended surgery. Both hands needed to be done, as the left was obviously showing carpel tunnel signs as well. One at a time is the best approach, so you can still function at least a little bit without help. The surgery I had was 3 parts. Carpel tunnel release- cutting the tendon sheath to widen the tunnel. De Quervain's release- cutting the tendon sheath to help the thumb tendon. And Synovectomy- removing inflamed tissue.

George and I a few days before my surgery. I got cool arm warmers to wear under/over the braces.
George wore some too =)

Right Hand Surgery

The first surgery was Wednesday, November 13. We were going to have a fetal monitor on, but my OB said it was unnecessary. According to her, there was no more risk from the surgery than any other time. I did have to be awake though, because if I was asleep, Kylie would be asleep too, which did have some risk. All I have to say about that is awake surgery is not for the faint of heart. I did fall asleep for the very beginning of it, and when I woke up I quickly informed the entire room that THERE WAS NOT ENOUGH LIDOCAINE. That was the 3rd time in my life I was a 10 on the pain scale. There was a curtain between me and my arm, so I didn't get to/have to watch it. I had the anesthesiologist on my side of the curtain talking to me. Mostly making idle conversation, trying not to think about all the pressures I could still feel in my hand. When I could feel something I would tell her and she would pass that on to the surgeon who would put more lidocaine there. The sutures were unfortunately, the worst part. I could feel all the tugging going on =/ Kylie was kicking during a lot of the surgery, which made me feel a lot better. This was for her sake, so I can hold her and take care of her when she is born =)

The recovery was extremely long and painful. Actually, it's not all over yet. My right thumb is still numb, and my median nerve is still irritated, so I get sharp pains in it. My fingers are still stiff and it is difficult to squeeze things tightly. I can only bend my wrist maybe 3/4 of what I should be able to, but it is getting better. Even given all of that, it hurts significantly less now than pre-surgery. The surgeon said he was surprised at how much inflamed tissue he had to remove. Given that, it was most likely going to be a problem in the next few years regardless of what I did. Kylie just sped up the process.

Left Hand Surgery

My second surgery was Tuesday, December 3. I was going to wait longer between them, but we are moving to California on Friday and I needed to still be around Boston for my 1-week post-op appointment. (More about the move and why on my next post, hopefully tonight or tomorrow.) To be honest, I was terrified of the second surgery. My right hand was still in pretty terrible shape, and I was worried I ruined it by getting surgery. George said he was there for me, and it really is best for Kylie if I get both done now. As it turns out, I just had really irritated nerves in my right hand for no good reason. I felt like the surgery itself went a lot smoother, and the recovery went WAY better. My left hand is almost stronger and better than my right hand already. I have no numbness or nerve pain. I had almost as much inflamed tissue in my left as my right, so I have no idea what made the difference. Neither does the surgeon. I am happy I had it done though =) My post-op appointment was today, and everything is healing well! 

Aftermath

I can finally type using both hands again, and I just started being able to knit again a few days ago! Things only get better on a day-to-day basis. Is there still pain? Yes, but it feels more like soreness and stiffness than the numbness and burning the carpel tunnel gave me. Do I still take pain meds? Yes, but only once or twice a day. I take them right before intense physical therapy, because it is hard to cause yourself pain even when you know it's for the best in the long run. When I am not using my hands/wrists, they don't really hurt much. According to the surgeon, I should be able to knit all I want without risk of getting carpel tunnel again for at least 20 years =) Even with all the pain, it is totally worth it.

If you wondered why there have not been blog posts lately, that is why. Typing was painful until recently, and a blog post is a lot of typing. I am back though! =)

Rachael