2 months post-op

Almost exactly 2 months after my surgery I went back and they took off my splint and pulled out the pins. It's not as bad as you would expect. The first one didn't hurt at all. The second one, which was in at an angle, just felt like a pinch at the site of the skin, and a little bit of pressure. And it was all over in 15 seconds. And yes, I kept the pins. They just put a bandaid over the holes, and they closed up externally at least within 24 hrs. My whole wrist is very tight and somewhat sore. When they first took out the pins I literally had no left to right range of motion, but I've already gained some back in 2 days. They gave me a neoprene brace like you can buy over the counter to wear whenever I might be in a place where it could get knocked around. But they want me to keep it free as much as possible (just be careful) and do my exercises every hour that I'm awake! I'm supposed to go to PT twice a week for 4-6 weeks now. He said there's usually a 1:1 ratio for time immobilized to regaining ROM, and a 1:3 ratio for regaining strength. In my case, I was immobilized for 2 months, so it should be 2 months to regain ROM and 6 months total to regain strength. And yet he said the goal is unrestricted use in 3 months... so we'll see.

The much anticipated video of the removal of the pins...




The 4 spots where they went in with the scope have healed nicely, but I can feel some scar tissue under the one on the bottom right mainly (probably closest to the ligament that was torn/repaired_.


Where the pins came out, already closed up after 24 hrs.

1 Month Post-Op

I went back to the Dr. today. They took more xrays and put on a new splint. He said everything looks great and that my wrist is healing nicely around the pins. I am now allowed to take the splint off up to 6 times/day to move my hand around some to prevent it from getting so stiff (but this involves undoing and redoing the ace wrap every time). It still hurts (I'm still taking 1 -4 aleve per day) and is still pretty swollen just above the site of the ligament repair, but he said this is normal and in comparison to other people, was not very swollen. He said he could give me some stronger pain meds, but I declined. He also asked me to describe the pain, and if it was the same or a different feeling as before the surgery. I told him it was different, that it just aches, and feels like I have a nail in my wrist. This seemed to be good news (that it didn't feel the same as before the surgery). Mainly it's just annoying and uncomfortable, but I've gotten much more used to it, and at times if I hold very still and think about something else I can't even tell that anything's wrong. All in all the 4 weeks have gone by more quickly than I thought they would. Half way there! I go back in 4 weeks, at which time they'll take out the pins.

10 days Post-op

Friday afternoon I noticed a tiny spot on my thumb that was numb. I took off the outermost ace wrap, thinking maybe it was too tight, even though nothing felt too tight. But by Friday night the numb area had gotten much bigger, so I paged the on call nurse and she told me to come in monday morning (today). 24hrs later, by the time I went to bed Sat night, my thumb was basically back to normal, but I went ahead and went in this morning. The doctor didn't really say what could have been going on, and when I asked he said that something was probably too tight. My speculation was that since I'd had more mobility in my thumb and had been using that hand more, something became inflamed and was pressing against a nerve, or when I moved my thumb the pins were rubbing something the wrong way. So they put me in a bigger, more normal splint, and my thumb is back to being immobilized. While I was there they went ahead and took out the stitches, and told me to come back in about 2 weeks.



"Short-arm thumb spica splint"

1 Week Post-Op

I went back to the Dr for my follow up today. They took the bandage off, had me move my fingers around some, took some xrays, put a splint back on, and told me to come back next week to get the stitches taken out. He said everything looks good. The swelling has gone down a lot and this time the splint is a much lighter weight/smaller splint, and my fingers and thumb have more freedom. So thats's nice. I might actually be able to use 2 hands to type soon. But it also kinda freaks me out because my wrist feels much more exposed, and like I could mess something up. But the Dr basically said my bones aren't going anywhere (due to the pins), even if it hurts or feels awkward. They also made a sort of trap door in the splint, with one part that is removable, with velcro. So if I happen to go for a walk or something and get sweaty, I can access the pins and gently swab the area around them with some peroxide. Very cool. Apparently there is a whole associates degree for learning how to design and make such things... "orthopedic technology". Who knew! I also found out that the pins will stay in the whole 8 weeks (7 more), not 4 weeks like I thought he originally told me. And of course I will need PT after everything is said and done. He said I'll prob only regain 66 - 75% range of motion even after PT. I guess fortunately I don't play a sport or instrument competitively where that might matter more. Oh, and for the grand finale... in answer to everyone's questions of how they remove the pins at the end: they just yank them out.

Seeing the pins for the first time...



4 stiches that will come out next week, one for each spot that they inserted the scope . And of course the 2 pins. (the purple line is from a marker, not bruising, and some of the yellowish-orange discoloration is from the iodine? that they scrubbed my arm with before surgery).




2nd splint: my fingers and thumb have more freedom now, and the swelling has gone down a lot since day3.

3 Days Post-Op

look ma', no knuckles!



2 days after the surgery I switched to just taking Aleve because I decided I would rather be in a little more pain than be dizzy and tired all the time. I think the day after the surgery was the worst in terms of the pain, and the day after that was pretty bad too. But 3 days post-op I put on real clothes for the first time and I left the house to get lunch (I was starting to go stir crazy not being able to do anything!). 4 days post op was the first day I woke up truly feeling better (though still in pain), and the next day I went back to school/work. However, I think I tried to do too much too quickly. I was exhausted that night, and my shoulder/upper bicep started cramping because it was so tired.

Day of the surgery

I got to the hospital at 7am, filled out the paperwork, and was called in by 7:45am. They had me put on a hospital gown and hair net, and wheeled me into the pre-op room. I spoke with my doctor before his other surgery that began at 8am, and then the anesthesiologist came in to describe everything on his end. I was getting a general anesthesia, which I had just learned the day before. Then there was almost an hour of waiting around in the pre-op room, repeatedly answering the all important questions ("on a scale of 1 to 10, how much pain are you in?", "when was the last time you had anything to eat or drink?", and "which wrist is it that we're doing the surgery on?"), and doing little things like going to the bathroom, starting an IV, and signing my life away. Around 9:20am they put something in the IV to sedate me, and wheeled me into the OR. In less than 5 minutes I could feel the effects. It was really surreal. The sedation combined with not having my glasses on made everything very hazy. They hooked up all my tubes and monitors, put an oxygen mask on me, I took a few breaths, and don't remember anything else. Next thing I know, I was waking up in post-op at 11:15am. They asked me to move my fingers, rate my pain again, and gave me some morphine in my IV. I was very alert and asking questions and felt great (my hand was numb for several hours). I think I was unconscious a total of about 1.5 hrs, with the surgery itself taking just over an hour. I lay around there for about 30-45 min eating ice chips (which have never tasted so good!). Then they took me to another room where I got to see my parents, and was upgraded to apple juice and saltines (which were nearly impossible to eat due to dry mouth/throat from being entubated and not having had anything to drink in over 12 hrs). They gave me some oral pain meds, and were about to send me home. All that remained was using the restroom, and getting dressed. I accomplished 1 of those 2 before I threw up. They said this was common from the anesthesia. So I collected myself for a few minutes, and they brought a wheelchair for me, and we left. I was home by about 2pm, and just lay around watching tv the rest of the day. I was still quite naseated, and threw up again around 8pm. So we paged the Dr and he prescribed me a different type of pain med, which wasn't quite as strong. It still made me kinda dizzy and unable to concentrate, but at least I wasn't sick to my stomach and could eat something.

Xray taken just after the surgery, while I was still unconscious:

How it happened

I fell ice skating in early December and tried to catch myself on my wrists. They both hurt for a week or two, but then got better. It never really swelled or bruised, so I didn't think much of it. Then in January, I played in a slow pitch softball tournament. Our first game was in the morning and it was really cold, and I remember the first time I hit the ball it kinda stung more than usual. Again, it hurt for about a week, but then got better. Then one random weekend laying around the house, sitting up off the couch, my left one really started bothering me, and it didn't get better. My grip strength was terrible, and it hurt if I put any pressure on it at all with my hand cocked back. So I went to my general practitioner, who took x-rays. He didn't see any broken bones, but he thought something was still going on, so he referred me to a hand specialist, who took more xrays at different angles. There were two bones (the scaphoid and the lunate) that looked farther apart on the xray than they should have been. A ligament (the scapholunate ligament) is supposed to be holding the 2 bones closer together, so he had me get an MRI to see if the ligament was torn. Nothing showed up on the MRI, but he still thought I had a very small partial tear, and that I needed arthroscopic surgery to fix it. Otherwise, I would for sure reinjure it, possible tearing the ligament completely, which would require open surgery instead of arthroscopic, and/or I could have arthritis within 5 years. He gave me the alternative option of just putting a cast on it for 8 weeks, and seeing if it healed correctly. However if it didn't heal, or healed incorrectly then he'd have to do surgery anyways, and again not arthroscopically. I'd read online that surgery is most successful and you get the most range of motion back if you do the surgery within 4 months of the injury. I'm wasn't too thrilled about the idea of surgery, especially since I'm trying to finish my thesis by April. But, I guess there's really no good time for these things. By the time of the surgery I would have already been wearing a brace for 5 weeks, and I had probably injured my wrist a month before that. So I decided to just get it over with. The specialist/surgeon (James B. Stafford, IV, M.D.) was very nice, seemed to know what he was talking about, and works at top notch hospitals in the Houston Medical Center, and I trusted him. After sleeping on it for a night and discussing with my family and friends, I called him back and scheduled the surgery for a week later.