Wrist Operation August 2022


Wrist Operation August 2022

On Thursday, August 11, 2022, I had an operation to eliminate the pain in my left-hand wrist.  Finding effective treatment was quite a journey, taking a long time.

In February 2017 I saw a doctor about pain in my left-hand wrist.  It appeared to start at the pisiform bone and travel up my arm.  The doctor recommended physical therapy.  I will admit the young therapist who treated me was very capable and competent, but the treatment was not a cure, so I stopped spending money on her treatment.  Over time the pain appeared to concentrate or localize at or near the pisiform bone and surrounding wrist area.

Jumping to more recent times, during March 2021, I saw wrist orthopedic specialists about the pain that was waking me a few times at night.  It hurt during the day, occasionally, but naturally that did not disturb my sleep.  I started self-medicating.  I bought a small bean bag that I heated in the microwave oven and rested my wrist on it until the pain subsided.  When I felt heat emanating from the area, especially at night, I used an ice block to address that symptom by resting my wrist on the ice pad.  I bought CBD (cannabidiol) cream, applied it to the general wrist pain area, affixed a Kleenex tissue so as not to dirty the bandage, wrapped a bandage around my wrist, and used a soft material wrist brace to bind and hold everything together.  In general, the pain would disappear within ten to fifteen minutes.  I am extremely fortunate in that I can get back to sleep very quickly once the pain subsides.

The orthopedic specialist requested an x-ray that was performed in early March 2021.  After my next appointment in early April 2021, he recommended that we keep monitoring the situation, which led to another visit in late November 2021.  On that visit I was given a lidocaine injection into the pain area that provided 24-hour relief.  I saw the same orthopedic specialist in early March 2022 at which time I he told me that it was arthritis and would need to learn to live with it.

In May 2022 Linda and I spent a month in Italy.  In early June I contacted the orthopedic specialist again but could only get an appointment 71-days later in late August.  A friend recommended that I see Dr. David Siverhus, a hand to shoulder specialist who had treated her efficiently and effectively.  I called for an appointment, and he saw me within a few days.  He reviewed my X-rays, CT scans, and MRI records from previous doctor visits.  He did not believe the tests revealed anything meaningful and had me get a fresh MRI.  Here I must compare experiences.  Back in 2017, the MRI technician made me lay on my back with my arms extended above my head.  Each time during the 40-minute procedure, the tech would shout at me to lay still because my movements spoilt the images.  With these new tests, I lay on my stomach, and my left hand was secured in a clamp delivering significantly better results.

Dr. Siverhus, in consultation with the MRI doctor, did not believe the MRI results were what they required, and recommended that I have an ultrasound.  In mid-July I met with the ultrasound specialist doctor.  Those results were not helpful in isolating the source of the pain.  Later in July Dr. Siverhus requested another MRI, but this time using a color-contrast.  It required an intravenous drip into my right arm.  Finally, we had a breakthrough.  The doctors found the source of the pain, a palmar mass within my wrist near the pisiform bone.  I met with Dr. Adam Wooldridge, a musculoskeletal and orthopedic oncology specialist through a referral by Dr. Siverhus.  Three days prior to surgery, on August 8, I had a pre-operation visit requiring a few tests and a PCR Covid test the same day.  My covid test was negative.

In preparation for the procedure, I had to shower the night before and wipe down my body with six disinfectant cloths to rid me of any germs.  We had to wash our bedding sheets, blankets, and pillowcases, to ensure that it too was germ free.  I was not allowed to eat or drink after dinner until the time of the procedure the next day.  The next morning, I had to go through the wipe down of my body with the disinfectant cloths again and to dress in clean clothes without using any deodorant or hair gel.  I was restricted from taking some of my regular daily medications that might conflict with drugs used for the procedure, or ones that may have hindered the healing process. Since I climbed into bed the night before with the sticky disinfectant on me, on the day of my procedure we had to launder the sheets and pillows again.

I arrived at the hospital at 8:00 am August 11, 2022, and was shown to Bay 14, a preparation area for surgery.  Here I had to strip, place my belongings in a bag for safe keeping.  The nurses began a series of tests with many questions to learn of allergies, etc.  I am not sure how strongly and positively I can make this statement, but with a succession of nurses and doctors taking time to verify my fitness and preparedness for the procedure, which assured me that I was in great hands.  The teamwork was a joy to behold.

From what I can recall, the nurses checked my blood pressure, checked my oxygen levels, my heart rate, performed a mini-EKG that took only a moment, made me bend my head to my chest, and look up to the ceiling, and reported that I was in great shape for surgery.  I was fitted with white compression stockings and a pair of cute yellow socks.  A nurse inserted an IV into my right hand, in preparation for surgery.  I was covered with a “blanket” more like a thermal blanket where warm air was pumped to keep me at an ideal temperature.  I was lying down, and given the option to watch TV, but I chose peace and quiet. 

The anesthesiologist paid me a visit and informed me of how a general anesthetic process would take place and verified my information.  Dr. Adam Wooldridge, had seen me a few days prior to this operation, informed me what would take place during the procedure, and this time before surgery, showed me where the cyst was within my wrist, and marked it on my wrist with a marker showing where the incision would be made.  Just before I was to be transported from Bay 14 to the surgical ward, nurse Jesse met with me.  I doubt anyone can find a more personable individual.  Not only did he introduce himself and explain his credentials but spoke of his siblings who are all nurses.  In many ways I wondered if his calling should not be as a stand-up comedian, because he was so funny.  Jesse was the greatest tonic putting me at ease prior to surgery.

The person responsible for transport wheeled me on my bed to the surgery ward, where I met a different team of doctors and nurses.  Naturally, Jesse was there, humor and all.  After I was moved to the bed where the surgery was to be performed, I was made comfortable with arm rests left and right, and a blanket to cover me.  More 5-star luxury.  I do not remember much else as I was out for the count.  I woke up in Bay 4, a recovery area.  During the four hours I was in hospital, the nurses kept sending text messages to Linda to keep her informed of my progress.  I was handed a packet of written instructions of what to do, and not do, over the next few days.  I was not permitted to drive, so Linda was duly appointed my chauffeur.  The hospital prescribed strong pain medication that I was to collect at the hospital pharmacy before leaving, but I declined to get those drugs. 

The transport orderly arrived at Bay 4 with a wheelchair to take me from the third floor to the hospital entrance.  I declined the chair but used his service to guide me to the entrance.  To me, walking was preferable.  If you have ever visited this hospital, and I have on numerous occasions, to be treated in several different departments, I can assure you it is not easy to find your way around.  There is an app you can download to your iPhone that will provide detailed directions to any department you need to visit.  As it so happens, the nurses called Linda to meet me and drive me home and arrived at the entrance at precisely the same moment that the orderly got me to the main door.

When I arrived home, my left hand was bandaged, and I was told to keep the bandage on for two weeks.  At that time, I would have a post operative inspection when the gauze would be removed, and the scar inspected to verify that there were no healing issues that needed to be addressed. I was permitted to remove the outer bandage to shower in the morning provided I had a plastic bag to cover my hand and protect the bandage from getting wet where the incision was made.  I am right-handed but I found some tasks a challenge such as washing my face with only my right hand, when all my life I used two hands to do a thorough cleaning.  Washing my hair was no easier.

Part of my instructions was to use my trusty ice pad to help reduce swelling.  On waking the next morning, I had a few surprises.  The main one is that I was able to sleep through the night without wrist pain.  That proved that the operation was an overwhelming success.  Thank you doctors David Siverhus and Adam Wooldridge and supporting team members.  The sad news is that overnight I put on four pounds (1.8 kilograms) weight.  I spoke to a nurse who informed me that during the procedure I was pumped full of liquid.  I certainly noticed that I had significantly more frequent bathroom visits, twenty-two in all in a single day—a new record.  On returning home after the procedure, I was quite dehydrated and took many sips of water throughout the afternoon and evening.  I can return to a normal life, except I must carefully guard the area where the incision was made, keeping it covered with gauze and bandage, a challenge when showering.  Here I remove the outer bandage and wear a plastic glove to keep water away from the area where the incision was made.

Alas the saga does not end here. Next month the cure on my right hand starts with a Dupuytren’s contracture condition. At this age and stage in life, we keep the medical industry funded. That includes hospitals, clinics, doctors, nurses, and pharmacies.  We are fortunate to get financial help through payments for insurance through Medicare and supplemental insurance that helps offset the bills. To repeat, I am so fortunate to have the best available medical care from dedicated doctors and nurses.

Oh, and my nights and daytime hours are now pain free.

Update August 24, 2021.  I saw Physician Assistant Lori Hollingsworth-Burds for a post operation checkup.  She gave me a clean bill of health and recommended I cancel my next checkup with Dr. Adam Woolridge in October because I am in great shape.  She also provided me with telephone numbers should my situation change.  Again, what wonderful care.

Update August 29, 2022.  I have now learned that what I had was an angioleiomyoma.  Angioleiomyoma is a rare, benign, smooth muscle tumor arising from the tunica media of veins and is seldom diagnosed before surgery. Angioleiomyoma can be found throughout the body but occurs most frequently in the lower extremities. It commonly arises in the dermis or subcutaneous tissue.  A majority of these tumors are quite small, generally less than 2 cm in diameter, which is consistent with our results.

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