18-Months Follow-up

I cannot believe that 18-months has past since I walked out of the hospital with fingers the size of a gorilla’s and pain that would not subside without prescription drugs. I took the train yesterday to Toronto for a follow-up visit this morning with my surgeon Dr. Steve McCabe and his team at the Toronto Western Hospital Hand Clinic. The result is that I am better than most but not as good as many. This is not a very scientific description so let me explain.

The real point of a PRC is to get the patient back to some sort of normality so that he/she can deal with their life and do most of the things they want to do. A PRC is not like setting a broken bone whereas you heal to almost normality. A PRC is when they remove the row of bones that are causing the most trouble and hope that the remaining bones will eventually find their place together in the left over space in such a way as to function. Let the chips fall as they may you might say. That is why the survey shows some very satisfied while others very dissatisfied and finally a group in the middle.

I put 12,000 kilometers on my motorcycle this summer. That’s a lot for a normal person. Most people up in the north are lucky to get 6,000 kilometers on their motorcycle. I moved into a new house and did much work with my hands. I cook, clean and push the lawn mower.

The doctor measured my grip strength today and found it was 55% of my good hand. Enough to stop my bike, hurt my wife’s hand in a hand shake, and so on. Based on this it seems I should be 100 % satisfied. I suppose considering the alternative (fusion or just swollen with pain) I should be 100 % satisfied. But I still have stiffness (swelling) and inflammation issues that I control quite effectively with diet. There are times that I over work my hand and I must give it a days rest by wearing my brace all day. I can count those days on my two hands since the last year.

I do not have pain in the sense that I need a pain killer or Advil but I am always aware of my fingers and I seem to continually open and close my fist to keep stretching them. There is not a moment in any day that I am not completely aware of my fingers and the condition or level of stiffness. The swelling is not a lot and visually it could go unnoticed except for the slight stiffness I feel. I always wear my brace at night while I sleep.

I think I would say that to be 100 % satisfied would be if I would simply not notice or think about that hand at all. So to put it on a more accurate scale, I guess I would be about 75 % satisfied.

I know for a fact that my diet controls the inflammation and stiffness since when I go out to a special event (such as my wife’s office Christmas party last week) and just enjoy myself by eating what I will and drinking wine my fingers are always much more swollen for the following two days.

Riding also causes swelling a bit but the enjoyment I get out of riding just makes me forget about my wrist while I m on the bike. I do have to wear the brace afterwards sometimes, depending on the road conditions.

The stiffness or swelling is most likely caused by a small bone spur at the base of my thumb and the surgeon feels like the risk to remove it is to great. It may fix the problem or make it worse. So this is as good as it gets. I function fine although I am always aware of my fingers.

Other minor issues is the blood flow to the fingers, especially the tips is less than normal so the cold is far more cold and I am better to wear mittens instead of gloves in the winter. I wear heated gloves on my motorcycle.

All that is left to do is to smile and move on with my life. Enjoy what I have and ignore what I am missing.

This is my X-Ray after 18- Months: