The Charlottesville hand specialist I’d seen once before, years ago, pulled the x-rays from the envelope and clipped them crisply onto the lightboard on the treatment room wall. He made a noise half nervous chuckle, half groan.
“I’ve got good news and I’ve got bad. Let’s put it this way. We measure this kind of arthritis on a scale of 1 to 4. Four is the worst. Your right hand is maybe 3.5. The left one is a 5.” And we looked in silence for a long moment at the odd angles glaringly apparent on the x-ray, at the lack of cartilage in what used to be joint space, at the source of my lack of strength. And the pain.
“The good news is that no matter where we see the patient in this process, the interventions are still about equally as successful.” Some do well. Some, not so much.
Short term possible fix: an injection and a custom fitted brace. Long term, a surgery that uses a “redundant” tendon in the forearm for two purposes. First, to stabilize the thumb where the ligaments and joint surfaces no long hold things in the right alignment. And second, a bit of tendon is balled up in the joint space to keep bone off bone, and consequently reduce the severe pain with things as simple as buttoning a button.
Yesterday, we implemented the short term option on the left hand. The right one got a shot a few weeks ago during the Super Bowl at my MD friend’s house. I’ll be wearing the braces mostly at night. (I know this has you sitting at the very edge of your seats.)
Weirdness: my particular joint condition is 10 times more common in post-menopausal women than in men. Maybe I should just take some estrogen supplements. Ya think?
So we’ll see how this works out. Some people get more than a year of relief from injection and splinting. It’s a long way to drive up to Charlottesville for a shot. I may just wait until the next Super Bowl.
We waited for the OT next door, a drop-in appointment, and finally by noon, we walked out with two heat-molded fiberglass thumb spica splints. I’m supposed to sleep in those things. This ought to be interesting.