As long as I think I need to, I’m going to keep you guys updated with my progress on my wrist.  I have a lot of readers who love how thorough I am on this subject, so I want to document not only my troubles, but also what it’s like post-op from the wrist arthroscopy.

For those who aren’t in the know, four weeks ago, I underwent a wrist arthroscopy for a torn TFCC ligament in my left wrist.  You can find all my posts on this blog under the “TFCC Tear Treatment” tag.

Okay, now for the update.  Today is the fourth week post-op.  Here is a pic of my scars:

It’s a huge pic, I know, but I want to show you what they look like instead of just some blurry pic from afar.

Okay.  So my scars are still a *little* tender.  And right underneath them are two bumps.  I suspect it’s scar tissue.  When I had my stitches, it looked to me as if the surgeon folded my skin under and stitched it.  But of course, I’m not a surgeon, so I’m not sure what the heck he did.  There are definite bumps, however.  Moreso on the scar closest to my thumb.

Things are still tight in there.  I don’t have my full range of motion back.  Pronation and supination are slightly ouchy.  Bending up and down is the most painful now, actually.  Oh, and side to side hurts more when my hand bends away from my body.  But NOW, it hurts where my radius and scaphoid (sp?) meet in my wrist, whereas before my surgery, it was above my ulna, between my DRUJ joint.

If I press on my hand to make it bend back or bend forward, the pain is on my radius now.  It’s not as “bad” as the TFCC was.  In fact, I’ve only worn my brace one time since my surgery.  And that was because I’d been running around and doing too much.  I know the limits of my wrist now, so I try to baby it when I can.

Certain movements are strange and clicky, and sometimes really hurt if I twist the bones wrong.  Reaching back for the seatbelt, for instance.  Scooting a chair forward while sitting in it.  Washing your hands and flinging water droplets in the sink.  Folding towels or long pants.

Now, I have no idea if this is due to the fact the doc shaved away some of my TFCC ligament and now my wrist is just a little more unstable as a result, or if it’s part of a bigger problem my doc never saw.  Like I said, my pain has lessened considerably.  I have tolerable tenderness throughout the day.  I don’t even take Tylenol or Ibuprofen unless I’m really hurting, which isn’t that often.  So if it’s a “bigger problem”, you’d think there’d be more pain, right?

I have an appointment with my doc in September for my 6 week post-op check up (which is actually more like 7 1/2 weeks because I had to wait 10 days to see him to get my stitches out, and it was 6 weeks AFTER those 10 days…)

He told me to cancel the appointment if I was pain free, but I’m going to go.  I need to know if this pain while flexing is a result of the surgery, something else, or just… the beginning of arthritis.  Joy of joys.  Gah, what a CF, eh?

To all of you who have wrist issues, I feel your pain, I do.   After reading other TFCC websites, I think there’s nothing they can do about the clicking.  Once the ligament is unstable, I think you’re just… SOL.  Maybe *I’M* just SOL.

Sigh.

Well, at least I can still write, right?!?  lol

~~Becka

Well, folks, my wrist is doing MUCH better.  Got my stitches out today.  My scars are still kinda scabby, but here’s a looksee.

Looks like I’ve been impaled by a roasting fork.  Or maybe bitten by a vamp.  Heh, I like that one better.

Overall, my wrist is doing great, about 90% better than before.  It’s still not up to snuff, due to tenderness and some bruising still, but that’s all after effects from the surgery itself.  My range of motion isn’t as good as my right wrist, and it gets very tired and achy if I do too much, like run a bunch of errands, do lots of loads of laundry in a day, that kind of thing.  Thankfully, typing doesn’t tire it out.  Thank the Lord for small favors, eh? 

Doc told me something interesting, though.  He went in there and found my TFCC was frayed from degenerative wear.  Usually, the ligament is smooth, but mine looked like it had tufts coming off of it.  He cleaned it up with his little debridement thingy (I think it’s called an arthroscope), but found no significant tears.  He said he spent a little time looking all around, because my MRI showed the dye clearly leaking in my DRUJ joint.  He didn’t find it.

He did say that puzzled him, but he wouldn’t have sutured a small tear anyhow.  There is no blood flow to the center of the disc, as they only debride central tears, they don’t suture them.

I thought it was odd, too, that he didn’t find an actual, obvious tear, however, he did say he didn’t want to continue poking around with the arthroscope.  Sure, it’s only 2.5 mm wide, but since the bones in the wrist are so compact and it’s such a small space, poking that camera around in there can sometimes do more harm than good to the ligaments.

But the wisps on the TFCC were indeed degenerative, and they were long and obvious, he said, so the surgery was a good move.

I’ve been out of my brace since I took off the splint from my surgery.  The doc said if I do get ouchy a bit, I can wear the brace again for a little while.  I told him my hand was still weak and got very tired after doing some things and he said that’s to be expected from a wrist that’s been in a brace since December of ‘09.  The muscles and ligaments can get deconditioned if they’re not used regularly.

So good news is, I suppose I’m not as bad off as I thought I was.  My hand feels so much better, and you cannot believe how weird it is to be able to do something without my brace that I could barely do before my surgery.  It’s still hard to hold a book or heavy things.  I’m not sure even when the pain of the surgery goes away if I’ll be back to where I was before.  Even though the doc didn’t find any tears, he did cut away pieces of my TFCC, so probably not.  But as long as I’m pain free, I don’t mind not winning any bowling tournaments!  LOL

I’m not left-handed anyway, so that’s a bonus. 

So I’ve still got some owwy bruising, my scars are still tender and scabby, but all in all, I would do it again.  Just gotta work some strength back into my wrist.  But thankfully, doc didn’t think I needed any physical therapy.  YAY!

Made an appointment in 6 weeks to see him one more time.  He said if I’m 100% pain free by then, I can just go ahead and cancel it.  So we’ll see how it goes from here on out.

~~Becka

It’s been a few days since my surgery on July 16th.  I’m still pretty tender.  I can’t quite bend my wrist all the way forward and back, but I can pronate and supinate it (flip my hand palm up and palm down).  Although that’s ouchie as well.  My stitches look pretty gnarly.  Have a gander:

I get them out next week.  Right now, my entire hand has a big ol’ bruise on the back of it that extends down my fingers.  It’s still swollen, but it’s getting better.

So here’s what happened.  The first two days post-op were the worst pain I’ve ever had in my wrist.  Maybe I don’t remember the pain from my childhood, but it seemed like it hurt worse than when I’d broken my wrist as a kid.  I couldn’t go four hours without my trusty Vicodin, and even got high a few times (because I’d needed to take two pills).  I did NOT like how the Vicodin made me feel, so I tried to go as long as I could without taking them.

After the second day, I could wean myself off them.  It hurt, but by the third day, I could take off my post-op bandages.  I think this helped things, because moving my wrist around helped with the pain of stiffness.  Yes, it hurt, but it actually hurt a bit more to have it immobile, I believe.

Right now, I’m on my fifth day post-op, and my surgery site is tender.  Bending my wrist is tender.  BUT, I’m able to type, which is a bonus.  It’s tight inside there, probably due to swelling and the procedure itself.  I’m pretty sure it’s not going to feel like it used to before.  Getting things cleaned out in there is bound to make things feel tighter in there.

The good news?  All the ouchies I’m feeling right now seem to be from the surgery itself.  I’m not feeling the original ouchies I had before my surgery.  I can move my wrist, type, open my hand wide… nothing makes the original pain.  As the days wear on and after I get my stitches out, I believe I’m going to be as good as new, aside from a few cool new scars.

Of course I won’t *know* until the surgery pain completely goes away, but as far as I can tell, my previous pain is no longer there.  This is the longest I’ve been out of my brace since December of ‘09.

So far, I would recommend debridement surgery for anyone who has a TFCC tear.  Know the first few days will be hella pain.  Pain like chop-my-hand-off-that-would-feel-better kind of pain.  BUT, within two – three days, the pain should slack off.  And now, it still hurts, but I’m at that point where some of the pain is actually good stretching pain instead of ouchie pain.

I’ll probably give you another update after my stitches come out to really give this fix a good test drive.  But so far, so good!

~~Becka

Well, I finally had my surgery yesterday.  Here I am, typing one-handed.  It seemed to go just fine, other than starting late.  I was scheduled for 3pm, but I didn’t go into the OR until 5:30pm.  Surgery was two hours long, because when I was wheeled to recovery, the clock said 7:30pm.  Then I needed to sit in a hospital room for another three hours to get over the effects of anesthesia.  UGH

Didn’t get home until 11:30pm.  Not the best day ever.

Today, I’m pretty much in Deep Hurting.  The day started with no pain, but I’d taken a pain med before bed and I’d slept with it elevated.  But throughout the day, it steadily got worse over the course of the day.  Now I’m anxiously awaiting dinner so I can eat to take more Vicodin.

So I have a huge splint and bandages I need to wear for three days.  When I take them off, I can use my hand “as tolerated”, meaning nothing too much too soon.  I see the doc again in ten days for a follow-up.  I’m not in a cast, and I don’t think I will be.  I don’t know how extensive the damage was in there, as my doc peaced out before I had the faculties to put two thoughts together.  I’ll let you know more as I know more.

As for right now, it’s ouchy.  Very ouchy.  I’m thankful I bought my sling when I had my cast a few months ago because even the weight of my own arm hurts.  But I’m so hoping that after the ouchies of the surgery pass, everything will be feeling better.

~~Becka

Got a phone call from my doctor’s office today to tell me the date of my arthroscopy.  I’ll be going in for surgery on July 16th.  Bonus: it’s at my local hospital, just about a mile away from my house!  However, I’ll be going under general anethesia, so DH will have to take the day off work to drive me too/from the surgery as well as watch our kids.

I’m a little excited and apprehensive about it.  I want this to work, I really want to be better.  There are days when my wrist doesn’t hurt much.  I’ll think, hmm… should I be getting this surgery?  And other days when my wrist is on FIRE and I can’t do things with it and think, yup, I am NOT canceling.

Today, I was eating some pistachios.  OUCH.  You cannot believe how much it friggin’ hurts to friggin’ crack open a friggin’ pistachio!!  I had to stop after a few of them.  My wrist doesn’t really hurt bending up and down.  It’s the side to side that hurts.  And opening my hand wide, like if I was to do a huge chord while playing piano, that hurts like a beeyotch too.  Holding heavy things, like a pile of plates from the dishwasher, that’s ouchy.  Transferring laundry from the washer to the dryer (I have front loaders) yeah, that hurts too.  Driving.  Tying my shoes.  Putting in a pony tail.  I’m just thankful it’s not in my dominant hand.

I’ve known people this surgery has done miracles for.  And others who wish they’d never gotten it done.  One woman found me on Facebook and told me she was convinced she’d need pins in her wrist too, but come to find out, she just needed the debridement and now, she’s a million percent better.  I hope my story is the same.

Doc says I’ll only need the brace for maybe 3 to 4 days after the surgery, then get back to my normal activities.  Well… I don’t believe THAT. You were just poking and prodding inside my wrist with cutting tools, a small camera with a light, and fluids, don’t tell me it will only hurt for a “couple of days”.  LOL  *I* thought I’d need a cast.  Perhaps instead of dwelling on the brace I’ll “only” wear for a few days, I should be thankful I don’t have to be in a cast for 6 weeks!!

That is, assuming they don’t need to do anything else while they’re in there.  Guess I’ll know after I wake up from general.  Five weeks and four days until the Big Day.

~~Becka

Saw my hand surgeon yesterday.  Long story short, I’m going to have a wrist arthroscopy.  Yup, I was right all along and I’m getting my surgery.  Told the doc my pain wasn’t any better and if anything it was different, leaning toward the worse side of things.  I can now feel exactly where my pain is, it’s in three places.

In the center of my wrist, on the ulnar side, and on the top, right above my hamate bone.  The doc is confident he’ll go in there and just do a simple debridement.  He thinks my pain is a flair up from when I broke my wrist as a kid because I didn’t have a significant trauma that would make new tears in there.

I think he’s wrong.  I literally felt the twanging of my ligaments in there when I pushed myself up off the couch back in December.  I asked him how often he goes in there and doesn’t find what he thought he’d find.  He told me perhaps one surgery every few years.  I think I will be his once every few years surgery.  Why?  Well, because  it doesn’t feel like inflamed tissue to me.  When I rotate my hand palm up, I can feel my ligaments pulling in there.  And the skin on the outside of my wrist doesn’t look the same as the other side, as if things underneath are fubared.

If it turns out I need more than a quick debridement, then I’ll be waking up from surgery with pins in my wrist to stabilize the ligaments as they heal.  I’d have to have them in for 4-6 weeks as opposed to a splint or brace for 3-4 days with the debridement.

Pfft.  Whatever!  Three to four days are you kidding me?!  I believe my recovery will be longer than that, even if the doc is right!  But we shall see.  I’m not a doctor, but I’ve been right about everything else so far!

I don’t have a surgery date sceduled as they’re moving their office and they aren’t sure which facility to do the procedure in yet, but I should be getting a call in a few days.  I got the impression they’ll need to get approval from my health insurance before they can schedule, and depending on when they get the approval and when they move is when I can get this done (and where). SIGH

Anywho, that’s what’s going on with my wrist these days.  Hope this helps with the pain.  Doc said at this point he can’t heal me, he can only help with pain management.  As long as I’m better, I don’t care.

~~Becka

I got my cortisone shot for my TFCC tear(s) on Friday.  Went in nice and early, to save my hubby from having to take too much of the day off to watch the kids for me.  So, here’s the deets.

They took me to a waiting room, where the doc came in and gave me an anesthetic shot.  I had to wait about 10 minutes while it worked to numb me.  I thought this would be all I would get.  But then the doc started talking to himself about whether to give me the local first or combine it with the cortisone.  Okay…

So, I deduced numb #1 was so I didn’t feel the needle of numb #2.  **shudder**

Doc decided to inject the local with the cortisone for one shot instead of two shots.

I went into the back, where I was ushered into an operating room.  It was weird, only me and the doc in this big ol’ room.  And it was cold in there!  Gah, isn’t that a little cliche there, doc??  I don’t know why those rooms are so cold, but I digress.

So I’m lying on a little gurney-like bed and the doc has me put my arm on this x-ray machine that resembles a microscope, after he draped me with the lovely x-ray-proof gown, of course.  This x-ray machine wasn’t quite as cool as the one at the hospital (this was at a surgery center, not the hosp.)  The one at the hospital showed a real-time x-ray.  This one, he had to take single pictures with a lever by his foot.  I was thankful for the numbing, because I didn’t really feel the cortisone needle, but I could see it going in on the pics.

I told the doc, “Wow, that’s so fascinating!”  He gave me this strange look.  I got the impression most “normal” people freak out at seeing the needle going in.  Me, not so much.  I’ve been poked and prodded so much in my life by giving birth to five babies, having to endure blood tests for diabetes and low thyroid, not to mention the yearly visits to the girly doc, it just doesn’t bother me anymore, if it ever did.

The doc’s response to me was, “Yeah, I really love my job!”  I liked that, because it was candid, and I had a one-on-one with the doc for about 15 minutes.

Twice, he either nicked my bone or went below the numb area, because it hurt a bit and I actually said, “Ow!”  He apologized and repositioned, then began again.  He also didn’t inject me very fast.  He took his time while my wrist inflated like a water balloon.  I was thankful for that–it might have been more painful otherwise.  But as the local anesthetic took over, I didn’t feel anything.  In fact, the injection for my MRI dye was more painful.

I was numb for the rest of the day.  In fact, because the ulnar nerve is right there, it totally paralyzed it, so my ring and pinkie fingers were curled into my palm and I couldn’t extend them to save my life.  I had “The Benediction Claw!”  LOL

I wore my brace to bed that night and was glad I did because my feeling came back sometime during the night.  When I woke up, I was a little achy.  Nothing too bad, though.  I did some light housework without the brace for awhile, then stopped when I began getting achy.  Took some Tylenol and I was okay.

Then today, I was in Deep Hurting.  Doc did say it would get worse before it got better.  In fact, it can take up to 6 weeks before cortisone really kicks in.  Therefore, I don’t see him for another 6 weeks.  He does, however, want me to call his office for an update tomorrow, to see how I’m doing.

So, I’ve survived the shot.  Now it’s another waiting game to see if this works.

If it doesn’t, then arthroscopy is the next step, going in surgically and removing the inflamed tissue.  Anyway, that’s the latest!

~~Becka

I saw the hand surgeon today to discuss the findings of my MRI report.  The doctor informed me the dye that was injected leaked out the central part of my Triangular Fibrocartilage Complex (TFCC for short) right over my distal radioulnar joint, or where the radius and ulna come together at the wrist.  He mentioned that because the TFCC disk is shaped like a Certs breath mint, when there’s a central tear, it won’t ever heal, due to inadequate blood supply.  Therefore, they don’t suture it, because even with help, it won’t heal.

What they can do is go in arthroscopically and debride it, meaning, they insert a small camera and a scalpel device with suction and cut away the inflamed and irritated tissue.  This helps with the swelling and the pain.  It will not heal the TFCC, but it helps.

However, before I get to that point, the doctor wants to inject me with a cortizone shot, just to see if that alone will be enough to bring down the inflammation.  He said it works for some, not for others, and sometimes, it can get worse before it gets better.  The reason is because they’re injecting a liquid right into the joint, pressing against the torn ligaments, and it will probably be uncomfortable for a few days before I can really benefit from it, if I do at all.

Now here’s the kicker.  I had to ask about 5 times in the office for a copy of my MRI report, because I wanted to see for myself what it said.  The receptionists were always busy doing stuff, so they never actually remembered, but I nagged them, and I’m glad I did.  I only skimmed the report until I got home, but that’s when I realized…wait.  My TFCC is torn in TWO places.

Here’s what the report says:

There is contrast seen entering the distal radioulnar joint through the triangular fibrocartilage, compatible with a tear of this structure.  Also, there is a tear of the triangular fibrocartilage from the ulnar attachment site.

What my doc and I discussed was ONLY the central tear.  I didn’t even know there was another tear until I read the report.  Of course, when I noticed it, it was 4:40, and upon calling the office, got the exchange – they go home at 4:30.  BOLLOCKS!!  So, I have to call them tomorrow and ask about it, even though I don’t think the doctor will be there.  I think he does surgeries on Fridays as well as Tuesdays.

I see him again on the 16th, next Friday, for the cortizone shot.  He isn’t going in blind, he’s doing a fluroscopy, which is looking at the joints with a mobile x-ray machine (like what I had when I was injected with the MRI contrast) so that he can see the actual TFCC and inject the cortizone right into the disk itself.  Of course, he’s going to numb me first.

So now, I have to see if this secondary tear means anything, and if he thinks it can all be taken care of with the cortizone.  I knew it ached on the side as well as the middle!

Between you, me, and the fencepost, I don’t think the cortizone will work for me.  I mean, I’ve never had a cortizone shot before, so I could be totally wrong, but nothing else up to this point has worked, why should this?  We shall see.

The really bad news out of all of this is, my central tear will never heal.  There is no blood flow, and once it’s torn, it’s done for.  Doc said it’s possible it’s an old injury that I got when I broke my wrist at 13 and has now degenerated over time.  But there’s no way to know unless he goes in there.  If it’s wispy frays, then it’s an old tear, but if it’s sharp-edged, it’s a newer tear.  I think they’re both newer tears.  When I pushed myself off the couch back in December, I distinctly felt a twang, like someone plucking a guitar string.  The next day, I did it again, and I felt it again.  I think I might have done it one more time.  It didn’t hurt, though, just a plucking, like oh, that’s weird.  Shortly there after is when the aching began.

So… Anyone else out there have two tears on their TFCC?  And if so, how did your doctor handle it?  I believe I’ll need the surgery, I’m just a pessimist that way.  But it looks like I have a few more weeks of red tape before I get it.  And if you’re all said and done, are you all healed, or do you still have to wear a brace?  I’d love to hear some stories.

That’s what I’m worried about the most, if I have two tears and the TFCC never really heals, then… am I stuck in a brace off and on for the rest of my life?

~~Becka

Lately, I’ve been feeling good, my wrist hasn’t been bothering me too much.  Since I’ve stopped taking my Naproxen and Tylenol due to stomach cramping (thank goodness it stopped, last thing I need is an ulcer!), things have been all right.  I wear my brace on and off nowadays.  I wear it when I sleep, because certain positions tweak my wrist.  I wear it doing most chores (except for dishes, I can’t stand a wet brace).  But if I’m on my computer or watching TV, I usually take it off.

I now have pain only doing certain things, most the time I’m all right.

But I realized the other day, it’s not because I’m “getting better”, it’s because I’ve learned what to do and what not to do to keep myself from hurting.  I don’t twist the mop head like I used to.  I hold my hand straight and over-handed doing some things like picking up the laundry basket or a boiling pot of water instead of turning my hand palm-up to do it.  I automatically hold heavy items in my right hand.

The swelling is still there on the ulnar side of my wrist, and when I massage it to relieve the stiffness, it still snaps, crackles, and pops.

While things might be seemingly “better” due to the new behaviors I have adopted, running errands is the sure-fire way to get my wrist aching.  I don’t ever have sharp pain.  It’s always a diffuse throbbing, deep in there.  Pushing a shopping cart is the hardest.  Sure, I have a lot of kids, why don’t they help, right?  But because I have a lot of kids, the shopping trip is epic, and by the end of the trip, I end up pushing the cart anyhow because it’s now too heavy for the kids to do on their own.  Getting my groceries delivered, like from Safeway.com is nice every now and again, but it can get pricey. I like to shop at the cheaper Winco more often than not, and the one by me has nice-quality produce and products.

Sometimes when I’m not wearing my brace, I “forget” about my malady and do things like scootching my chair closer to the table while I’m sitting in it.  Ooo, not good.  Feels like my wrist is being pulled apart like one of those baby toys where you pull on it’s neck and it sings a song for a few seconds.  Of course, the song I sing is usually a string of expletives.

I see the doctor to discuss my MRI results on April 8th, six more days.  Halle-fricken-lujah.  I’m a little miffed, because of course, the doc had the results the DAY AFTER my MRI, but due to being one of the only hand surgeon specialists on this side of Portland, he’s hella busy.

If this saga has taught me anything it’s this.  Whatever I did, I did to myself in early December.  It’s now early April and symptoms are the same, albeit a little easier to manage now that I know what to do and what not to do.  In four months it hasn’t healed.  If something hasn’t healed on it’s own in four months, even a little bit, it’s probably not going to without help.

Now that I’ve learned to live with it a bit, it’s easier for me to wait for the doctor to get around to seeing me.  It’s still annoying, but no longer am I gnashing my teeth.  Like I said in another post, it’s like living with the five stages of grief.  I think I’ve reached acceptance.

At this point, however, if surgery is needed, it will be more long weeks/months of immobilization/physical therapy/pain.  I’m not ashamed to say I’m a bit nervous/scared/apprehensive to find out what the MRI shows.  Be careful what you wish for and all that jazz… 

I do have a high pain tolerance, however, which is actually kind of annoying.  There have been a few doctors I know of who haven’t quite believed things were as “bad” as they were in my past.  So I’m not a good judge to say if my problem is minimal or really bad, because how would I know if the pain doesn’t bother me as much as it might bother someone else?

Anyway, just wanted to give you an update on how I’m doing, since people ask me all the time.  Right now, I’m just kind of slogging through until I see the doctor again.  Nothing has changed.

~~Becka

So, I just got the “This is Not a Bill” statement from the hospital, which gives a breakdown of how much their tests cost.  The MRI cost my insurance company $1470.00.  That’s about $50 for every minute I spent in there.  Wow.  On top of the x-ray fee, which was about $150, and the doctor who did the x-ray in order to inject me (not the radiologist, another guy) was $319.  The funniest thing about all this, was the stuff they injected me with, the anesthetic and the dye, were $7.25 and $5.00 respectively.  With all those high fees, you’d think they’d charge something ridiculous for those as well.  LOL

~~Becka