Some lady from a newspaper in Washington DC asked me about my hand surgery. I posted that picture that I linked yesterday to the IMGUR community and sent me a private message asking me about it. This is the story that I told.
About a year ago I noticed a nodule on the palm of my left hand about an inch below the base of my ring finger. It started out as a bit of a dent in my hand. Almost like the fascia in my hand had been pushed to the side. The nodule was sore to the touch but did not affect my day to day activities. No big whoop.
As time went on the nodule increased in size and started to become painful even at a state of rest. The nodule continued to grow in length, width and height. It became visibly noticeable on my hand. Once in a while people would as me about it because they could see it. I of course would tell them to touch it and sick them right out.
As it grew, it became more painful and my ring finger began to lose mobility. It was able to curl it in to make a fist, but I wasn’t able to hyper extend the finger backwards. Doing so would cause a significant amount of pain. It got to the point where I was unable to extend my fingers in an open hand formation. Preventing me from doing cool activities like push ups and giving sweet high fives.
Being a stubborn male, I didn’t go and see a doctor for a while. When I did, my doctor knew what it was immediately and sent me to a plastic surgeon. The surgeon talked to me about options to remedy the problem. He explained to me that I had a disease called Dupuytrens disease. That it's a hereditary disease that has the unfortunate side effect of coming back. It was explained to me that within 5 years there is a 50% chance of a reoccurrence. I spoke to my mother and she is not aware of anyone on her side of the family who has it. My investigation found that another name of this disease is “Viking Hand” and is something that people of Scandinavian decent get. I am Danish, so.. the makes sense. This is my fathers fault!
The options that were offered to me to remediate the problem were surgery or injections. With the surgery they open up the hand, remove the tissue, stitch up back up and you endure a 6 week recovery time. This solution was covered by Heath Care (I am Canadian).
The other option was to do an collagenase injection of an enzyme which breaks down the excess tissue. The recovery for this treatment was about the same as the surgery. This would have been a cost of $1500 dollars. As the recovery was explained to me to be about the same, including risks and reoccurrence (As you have seen from my picture) I chose the former solution.
As I waited for the surgery, the fascia tissue continued to grow. In fact it seemed to pick up speed. It knew that it’s time was limited to it would wreak as much havoc as possible. By the time of the surgery the excess tissue now extended about quarter inch from the base of my ring finger to an inch above where my wrist starts. The pain was constant and significant. Though I could use my hand, I definitely knew that there was something going on in there. I would often over extend my finger and I would have to stop, endure the pain, relax, rub it then continue.
The surgery took place on Feb 16th 2016 in an out patient clinic in a hospital. I was given block freezing of the hand and was awake for the procedure. (no, I didn’t look...gross, Sara)
Laying on my hand with my left hand extended out, my hand was frozen, and all the blood was pushed out of my hand. It was rather uncomfortable because of the tunicate that they put on my arm was increasingly tight to prevent blood flowing back into the hand.
The picture that you saw has about 20 dissolvable stitches in it. The procedure, once they started lasted only about 20-30min. My hand was wrapped in combo soft/hard cast. The hard part held my pinky and ring finger stationary but the soft part allowing my thumb, middle and pointer fingers some mobility. This cast was to stay on, dressings unchanged for 10 days. I would be set up with an appointment with a physiotherapist who would remove it. I was perscribed 325mg of Toradol and was told “don’t be a hero. This is going to hurt. Take the pain meds”. I went home and my hand was frozen for about 6 hours… then the pain started to creep in. I took 2 of the Toradols and hoped for the best. I wasn’t a huge fan of taking opiates if didn’t need them, though I had no interest in being a hero. I consulted with my paramedic sister and nurse friend about some pain therapy. It was suggest that I take 1000mg of acetaminophen and 400mg of Ibuprofen every 6 hours. I started this regiment and it worked so incredibly well. I was virtually pain free and still had all of my mental faculties. So with tat being said, the pain wasn’t that bad at all. Just annoying.
I took this combination of pain medication for 3 days. After that, the pain was very low. Just the every once in a while bump or movement. Still, once in a while now, as it heals, I take 500mg of acetaminophen but certainly not daily.
10 days after the surgery I met with the physiotherapist. She removed the cast and I got to look at my poor hand. Swollen, bruised, red… but clean, wounds sealed. She said that it looked really good. I looked at her like she was crazy. It looked like a dog got a hold of it. Anyway, she gave me some soap and got me to clean off the dried blood and to wash my hand. That was one of the most amazing feelings ever. I have to tell you. Heaven. Imagine scratching an itch that has been taunting you for 10 days.
The therapist and I talked about exercises that I would have to do for the next number of weeks. My hand had become very stiff from being immobilized for 10 days and on top of that, the fascia that was removed was right on top of the tendons that go to my ring and pinky finger. The exercises are pretty standard. Range of motion, stretching, things like that. I was also asked to begin gently massaging the wound to begin the break down of the scar tissue in the hand. So, every 2-3 hours I go through my exercises which takes about 10 min or so.
I was also given a splint to wear at night which extends my ring and pinky finger straight out, to prevent them from curling and having the tendons shorten. Still every morning they are very tight and sore, but that is in part of the wound still being tender and there being a rather significant scab on the palm of my hand.
So here we are. 23 days after the surgery and I’m working just fine, doing my exercises, irritated once in a while as the skin dries out and cracks on its way to falling off. All in all, it’s doing pretty well. I have a follow up with my therapist next week and also the surgeon the week afterwards. After all this typing I definitely need to do my exercises now!
If you have any more questions, I would be happy to answer them.
—adam
No comments:
Post a Comment