Hands of Time

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.

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7 thoughts on “Hands of Time”

  1. Fred – has your doctor ever mentioned “Rheumicade” infusion treatment? My wife has had rheumatoid arthritis for 15+ years, and these IV-based treatments have done WONDERS. WONDERS! She can paint, type, all kinds of stuff she used to suffer to do. Expensive as heck per treatment, but insurance pays a good chunk. But for her, it has been worth every penny, believe me!

  2. I’ve had patients who have the Remicade treatments. It is used in conjunction with methotrexate for folks with rheumatoid (an auto-immune condition) as a fairly extreme pharmacological intervention, not without considerable immune system side-effects risk.

  3. So sorry to hear that you didn’t get better news. I hope the braces at night help.

    But I’m sure no matter what, you will adjust and keep on typing and taking beautiful photos.

  4. Ugh. Wish your predictions had missed the mark this time, but “thank God for modern medicine,” right? Thanks for the update, and keep us posted…

  5. Go for the surgery, I say. Modern medicine is at its best with its miracle procedures they have invented in recent years. And it won’t involve driving to Charlottesville so much!

  6. I have the same problem as did my mum before me. Both of us are physiotherapists and I guess given the ligament laxity in our joints we chose the wrong profession. I was told about the injections also – haven’t gone down that road yet though. I’ll follow your progress with interest.

  7. I have severe arthritis in my thumb joints complete with bone spurs. “I do feel you pain.” I had some of those hard braces also . I bought some “thumb stabilizer” gloves at the drug store and wear them when I am planning on using my hands a lot.They are comfortable and have 2 metal stays in the thumb area. You can use your hands , but they restrict the movement of your thumb. They would be much more comfortable than the hard ones to sleep in too. I also searched and found different designs of many other products that do not put stress on my thumb joints. I talk about some of them on my blog. http://www.ohmyachyjoints.com

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