The Peculiar Pin Protectors and Other Adventures With An Ex Fix: Part 2

5 days after surgery - no turning yet

5 days after surgery – no turning yet

So my surgery was on Tuesday and tomorrow I’m jetting off to St. Louis to fend for myself with a broken dominant hand. This week after my surgery has just flown by even though all I’ve done is run errands, watch tv, and sleep. I don’t know what it is, but having surgery is just so exhausting. I’m hoping once I’m all on my own I’ll get some energy back. That or I’ll be falling asleep at my desk.

So my surgery was pretty similar to the first, except for being on the other side. This time I decided we could leave for the city a little bit later than we did last time and we still managed to get there 15 minutes before we were told to arrive. At least they were actually open this time. I signed in and did the crossword until they took me back to the pre-op area. They sat me in a chair in the corner this time instead of a bed, I guess because they were short on space. This did not please me.
Nobody puts baby in the corner.They also had me strip down completely and gave me hospital boxers to wear which was different from last time. In case you were wondering , I do not recommend those hospital boxers.

The one benefit of being in the corner at the beginning was I got to memorize several people’s medical histories, birthdays, heights, weights and full spelling of their names. However no social security numbers were mentioned so I quickly lost interest. They switched me to a bed and finally gave me an I.V. I tried to convince the murse he had already given me one (only because he asked if he had yet, which seemed like an odd question with a very visibly obvious answer), but he quickly caught on. I met with some more nurses, physician assistants, Dr. R, the same anesthesiologist as before, and my parents. I was feeling pretty popular. I discussed with the anesthesiologist about staying awake during the procedure and he said I could if I wanted to.

Like I did before with the last two surgeries I walked into the OR and got on the bed. Those rooms are cold, but luckily I was tucked in with lots of blankets. The anesthesiologist gave me the block and the feeling in my fingers slowly tingled away. I kept wiggling my fingers until I couldn’t because I knew it would be a long time before my hand didn’t feel stiff again 😦 Once my block kicked in they scrubbed and sterilized my arm and that’s where the fun ended. They put up a curtain between me and my arm and wouldn’t let me see anything. I quickly lost interest and asked to be knocked out.

Waking up afterwards, it was less of a shock to not be able to feel my arm although I was still loopy. I did an E.T. impression, ate some snacks, read a book and refused to use a bed pan. Like before the block began wearing off while still in the hospital. This time I was prescribed pure oxycodone instead of Percocet, so my dad was nice and went to the hospital pharmacy to get some before leaving the city to avoid another horrible Walgreens incident. All in all the experience was pretty similar to the one in July, just chillier. I did have to sign some papers before leaving the hospital, but I just initialed them with my left hand.

Getting by with just my left hand at first was annoying, but because it was just a couple days before I could start attempting to use my right hand it wasn’t too devestating. I just avoided food that needed to be cut and neglected personal hygiene more than I would like. On Thursday we went to New York to see the doctor and get my bandages taken off. Since then, my right hand has been a reluctant participant in taking care of me. I’m hoping that by using it more my right hand will require less drastic PT overall. It’s still really hard to completely bend any of the fingers. I’m not sure if it hurts less than before or the pain is just relative and I know it could hurt a lot more, but I’ve been using my hand for a lot more. At first I could barely lift a glass of water, but after some getting used to it and drinking some of the water, things have gotten a little better in a few short days. Still not sure what working, or driving, or grocery shopping will be like, but I can get dressed on my own now. I even am feeling confident enough to plan on missing only a day of work for my next appointment. I hope once I start turning tomorrow I still feel that way!

The Peculiar Pin Protectors

The Peculiar Pin Protectors

My doctor mentioned before my surgery that no two surgeries on different patients is the same and no two surgeries on different sides but on the same patient is the same. He then made some profound comparison between surgery and the Four Questions on Passover. So far
the major difference I discovered was this time around Dr. R did nor cut the pins as close to the fixator. I know this because last time I found the perfect width and height beads to go over each pin and protect the pins from getting caught on things. This time the beads are too short. Dr. R also provided me with these yellow rubber pin tips. Some may think this would negate the need for the bead solution, but in addition to finding the goldenrod color incredibly hard to work with, the covers have a very unsettling familiarity with a certain body part. Once again I was forced to improvise my own pin cover. My mom was nice enough to find a bead shop still open in NJ and I was able to make up the pin height difference with a second bead. I went with purple this time to match the awesome gloves she knit me. This solution was much simpler than using a dremel to smooth down the pins, like snowboardervstree did, especially because I don’t own a dremel!

One of a kind glove made by my mom!

One of a kind glove made by my mom!

 

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New Year, New Hand

Well I definitely enjoyed my time without a fixator. For the past couple of months I’ve been fixator free and it’s been so nice I’ve almost forgotten all the troubles and pains associated with having an external fixator in your hand, especially early on. Not to worry though, because I’ll have my memory refreshed tomorrow for Surgery Number 2 (or is it Number 3, does the external fixator removal really count?). That’s right, the time has come to lengthen the fourth metacarpal on my right hand.

I’m not sure if knowing what to expect makes it better or worse. I know what I’m not looking forward to, but I also know that I can get through it and figure out how to do things and in the end I’ll be happy with the results. Here’s how the left hand’s doing:

About 10 weeks after fixator was removed

About 10 weeks after fixator was removed

Everyone is telling me the scar is looking much better. Wonder what it will look like in a year from now. I guess it’s still the unknown that still makes me the most nervous. Since this is my dominant hand this time, it’s bound to be more challenging. Will I even be able to write? For the first few days my right hand will be bandaged and in a sling, but I’m hoping that once it’s released I’ll figure out how to do things with that hand still. For one thing, I don’t want to lose flexibility to the extent that I did with my left hand. Getting it back was not fun. I already have physical therapy appointments lined up for the second and third week after my surgery. We’ll also be working on my left hand strenght. My physical therapist made fun of me for having a weak left hand grip so I’ve been bulking up with this:

Set to 30 lbs currently!

Set to 30 lbs currently!

As much as I claimed to miss my fixator when they took it off, I got over it. I definitely enjoyed my time off over the holidays. I managed to go ice skating, get a few work out classes in, and even went bowling last night. Bowled a 116 even! At least this time around I won’t be missing out on beautiful weather and by the time it starts getting nice the fixator should be coming off. I’m really hoping by my 25th birthday in May I’ll be done with it all, but I’m not sure if I’ll make the deadline. Based on my left hand it will be right around then.

Well here’s a picture of my right hand before the surgery. My mom took me in for a manicure so that I wouldn’t have to deal with trimming my nails for a little bit. She also knit me fixator gloves! I’ll model  them for you after the surgery.

Before the surgery

Before the surgery

I’m debating whether I should stay awake for the surgery. It certainly would make for an interesting blog entry, but do I have the stomach for it? I might just be too tired to want to stay awake. The surgery’s scheduled at 8:45 with a be-at-the-hospital-time of 6:45. I’m hoping it’s the same anesthesiologist and everything so I know what to expect. Not sure when I’ll be writing again, but I’ll check back in with post-op pictures and details of whether I stayed awake for the surgery when I figure out how to type again. Maybe Dr. R will let me hold a scalpel. I was a candy striper once after all.

Loose Ends

Shiny and "new"

Shiny and “new”

I got lazy about following up on my last doctor’s visit and now I’m flying for a visit non-hand related: Thanksgiving! Went through security with no hand accessories to give me trouble, although I did miss the pre-boarding to which I’ve grown accustomed.

Here’s my update, better late than never:

I flew into LGA for a one-night trip mid November. Being in New York City by myself was a little lonely. Had I arrived earlier than 11 PM I would have called up a friend, but instead I watched TV in bed, got room service breakfast in the morning, worked out in the hotel gym and walked the 10 blocks to my doctor’s office.

The waiting room was full as usual. There was a girl there who was really upset. I think it was her first appointment and she was concerned about the bill. It also seemed she didn’t have use of her right arm. Most of the patients are there for leg or ankle problems so I was super curious about her, but never solved the mystery. In all my six appointments I don’t think I’ve seen the same patient there twice.

After I finally got x-rays I was moved to an examining room and Dr. R came in fairly quickly with a resident I had met once before. He said the x-rays looked good and I could stop wearing the splint, except when doing dangerous things. Asides from my flight back and a grocery store trip during which I didn’t want to accidentally carry the bags in that hand, I’ve been pretty much splint free.

It’s been great. I’ve really appreciated being able to hand wash dishes and clothing without worrying about getting anything wet and being able to French braid my hair. I’m still accustomed to not washing my left hand as thoroughly as my right, which is slightly gross. Perhaps writing it down will make me more aware of fixing that issue. I also am working up my ability to applause again. Those are just a couple little things the fixator made challenging that I never would have thought would be so hard. It was quite disappointing to go to a Broadway play a couple days after I got the fixator on and not be able to clap at the end. However, my hand looks awesome and no one besides my family knew I didn’t applaud at the end of Wicked until just now, so well worth it. I also tried playing the saxophone to see how my new finger handled that and I’m not quite amazing at playing it. I think that’s because I still haven’t fixed my right hand, and not that it’s been 3 years since I had a lesson.

Here’s the x-ray of my left hand taken 2 weeks ago:

Can still see the pin holes a bit

Can still see the pin holes a bit

When Dr. R came into my exam room, he caught me reading a book on algorithms I was brushing up on and he made fun of me for being a nerd. When he examined my x-rays he commented that the new bone looked nice and straight, but to me it looked a little crooked. I mentioned this, qualifying that as a mathematician those bones were not straight lines;  as a bone doctor he insisted they were straight. All in all I’m very happy with my “new” hand and excited and nervous about doing the right one in January.

I went back to PT last week. It had been so long since I’d seen my physical therapist so I was excited to be back. Plus, asides from my scar massage, the session was pain-free! I got to play with silly putty or as I call it when I use it at work and don’t want to share “serious putty”. It was medically prescribed to me after all. The exercises are challenging, but I think I’m making progress. In addition to putty, my physical therapist gave me an itty bitty splint to wear on my middle finger. Apparently the buddy tape I wore on my fingers for 3 months made my middle finger crooked. Why are my hands so strange and malleable? That was probably why I was a little concerned about the other bone maybe being crooked. Even though I’ve forgotten to wear the splint a couple nights I think it’s helped. Now I just have to work on that scar and enjoy having 2 hands for the next month and a half. I hope I’ll have lots of things to clap for in that time. Happy holidays!

Missing My Ex

Disaster struck the very night I got back into St. Louis. The Cardinals lost the World Series and I managed to get my cast all wet again by merely rinsing off a dish before putting it in the dishwasher. I called the doctor’s office and explained to the operator what had happened in hopes he could give me more advice as to whether I needed to rush off to the ER. He didn’t know and only asked me if my case was an emergency because only emergency calls would be passed onto the doctor until the morning. A bit impatient with his lack of knowledge, I told him that if neither one of us knew if it was an emergency I guess he better assume it was. Either the doctor determined it wasn’t or never got the message that night.

The next day at work my cast still felt damp and I was a grumpy pants even though I was wearing my candy corn socks. Plus it was raining all day, banishing me indoors for fear another raindrop might reach my cast. I e-mailed Dr. R. about the night before. It took a while to hear back. Finally the nurse called to say they were waiting for Dr. R’s decision since I obviously could not come into their office for a new one. At the end of the day he said I should get an orthosplint at the physical therapist. I was able to make an appointment for early the next day which was good news but I was nervous the prescription wouldn’t reach their office in time, because now everyone in New York had left for the day. After a lot of back and forth e-mails the nurse confirmed she faxed it through.

Getting the plaster off was such a relief. I got to wash and dry my hand which still had the doctor’s initials on it and even see my scars. Not sure if I should start treating them. Best of all no plastic bags while showering. Not that the splint is problem free. My wrist sometimes gets irritated since I’m constantly trying to use it despite its restraints, especially while typing, and it still gets sweaty. By the end of the 3 months, the external fixator definitely seemed less cumbersome than the whole spint ordeal.

Thumbs up for orthosplint!

Thumbs up for orthosplint!

I was looking forward to seeing the doctor on Thursday and I hoped I’d be hearing that I only need the splint for very risky behavior like  participating in fight clubs and that I could resume PT. Instead, I got a call today that Dr. R had a family emergency and my appointment had to be rescheduled to the following Thursday. This was a confusing phone call to me, because Dr. R is supposed to fix any emergencies I might have, not have his own. Back when they tried to reschedule my initial meeting with the doctor to an different day I simply refused to allow it. In that case both my parents and I were coming in just for that and it was only rescheduled due to another patient’s surgery. This time it seemed an objection would be pointless and at least it was just me flying in (my parents decided to stay down in the Sunshine State for something so unimportant as a first check up after surgery ) so I told the secretary I would make sure I could rebook my flight and hotel and then confirm the new appointment. I since e-mailed the doctor to see if I have to now stay in my orthosplint for a whole extra week and suggested I might get x-rays taken here, but have yet to hear back.

I’m anxious to start PT. My regular therapist called me today to see how I was doing since I had to cancel on her last week and a different therapist made my splint. It was very sweet! I haven’t gone this long without trying to bend my finger since the infection and hope that not doing any bending of the mcp joint isn’t costing me all the hard work I put in. Plus I want to know if I can start treating the scar. I hope whatever the emergency was isn’t too serious. I hate to nag him with these questions without even knowing what’s going on, but this extra week does change some things. So glad I’m not in a plaster splint right now or I’d be freaking out.

Sneak preview of the new hand in the flesh

Sneak preview of the new hand               in the flesh!

To cope with the culmination of the treatment of my left and upcoming break from the world of orthopedic surgery for a couple months, I picked up Hot Lights Cold Steel, which is a memoir about an orthopedic resident. So far I can’t put it down.

Goodbye ExFix, Hello Cast

Monday was the big day. The hospital called the Friday before with the time of my surgery. Up until then it didn’t seem very real that I would be getting the external fixator off.

I flew in Sunday this time so I could celebrate “Halloween” in St. Louis on Saturday. I had a very early flight Sunday morning and between the World Series, the St. Louis Marathon, and my alma mater’s parents’ weekend, I had quite a challenge getting to the airport and on my plane.

A word to the wise, even if you book the night before with St. Louis County and Yellow Cab, don’t expect them to actually come pick you up. Half an hour after the time I requested to be picked up, they still hadn’t dispatched a cab for me. Luckily Laclede Cab  came within a reasonable time and got me to the airport.

I had never seen Lambert International so swamped! And now running half an hour later than I hoped, I was anxious about making my flight. I requested assistance because of my hand in the hopes I might get past the behemoth of a security line a little quicker. Southwest insisted that they could only assist me if I went through on a wheelchair. I swallowed my pride, hid my face, and slithered past all the proud Wash U moms and dads.

When I made it home, I took it easy with a nap and dinner with the family. I didn’t think to take advantage of all the mobility I had slowly regained while externally fixated as I had done before my first surgery. I thought better days were just around the corner, not another 10 days away!

On Monday morning we woke up early to drive into the city. My surgery wasn’t scheduled until noon, but everyone is always so much more cheerful when they are exhausted so we decided to leave at 7 AM. We once again got to the hospital an hour earlier than instructed.

Having gone through the whole ordeal 3 months earlier I was less anxious than the last time. Eventually they took me to a bed, I peed in a cup, put on a gown and read a book until they gave me an IV and brought my parents back in. I like my nurse. She commented on my Cardinals shirt and said she hoped they won. Not because she was a fan, but because she hated the Red Sox, but I’ll take what I can get. Then a PA came in and talked about what I was having done. She mentioned in addition to the removal of the ex fix there would be the application of a plaster splint. That’s just a sugar coated way of saying a cast you can’t get wet. At the last appointment there was mention that there would probably be some sort of support for my hand while it continued to heal, but the implications seemed to be that a cast was a worst case scenario, not a definite before they even x-rayed.

Dr. R’s fellow came in and told me more about the process and the horrible terrible cast. I begged and pleaded for a different option. A med student named Remy came by to introduce himself. I appealed to him,”please don’t let them put a cast on me.” Dr. R himself finally stopped by right before the surgery and I told him something horrible would happen if they put me in a cast, I just knew it. But did any of them listen? No, and guess what the Cardinals lost game 5.

Sometime in between all the futile negotiations not to be bound in plaster the nurse also stabbed my right hand with a needle and brought in my parents. The anesthesiologist came by too. It was the same doctor as before. I told him I wanted to stay awake this time in a last ditch attempt to make Dr. R see that wrapping my hand in bubble wrap and caution tape was also a viable option. The anesthesiologist told me that I wouldn’t have a block this time so if I stayed awake it would be very painful. In the end, I was awake for a lot of it, which meant I probably hit on Remy and revealed several incriminating secrets. Yesterday I suddenly remembered asking Dr. R if we could make a youtube video together. I think he said we could for the next hand. Earlier I had suggested I wouldn’t do my right hand if he put me in a cast, but maybe I’ll reconsider if I have a chance to become a youtube star. Orthopedic surgery videos are the ones that go viral, right?

Because I was alert, it felt even worse that I ended up in a cast. My sweet talking in the OR had no effect and I willingly posed my hand for the fitting of the plaster splint. One second they were unscrewing the fixator and asking if I wanted to keep it, another second I was being x-rayed and then, before I knew it, they were wrapping up my splint in an ace bandage. And I thought I still had the pins in my hand! What a cheap trick. What was most disappointing was that I didn’t even get to steal a peak of my hand before they wrapped it up. Now I’ll have to wait til next Thursday unless I find a way to slip in and out of my cast. It’s already so gross, but if I wiggle enough maybe I can slip it off and back on without Dr. R ever knowing. After surgery I immediately identified that the plaster was digging into the back of my fingers, but the nurses couldn’t do a thing so I had to wait another hour for Dr. R’s PA to come back just to bend the plaster back a bit.

Yesterday after showering with an umbrella bag elephant condom on my arm, the cloth part of the cast got a little wet. The nurse said I could come in in a couple hours for a new cast, but it was such a hassle that we dried it with a hairdryer. Today’s shower went better, but I’m terrified something will happen when I’m back in St. Louis and I’ll be stuck waiting in the ER. I wrote that I was worried about my hand being fragile, but this solution does not calm my nerves. I was hoping for a splint like the one my physical therapist gave me. What’s even worse is I had to cancel my PT appointment tomorrow and with my hand stuck in a cast I have no clue what my flexibility is like sans ex fix. By next Thursday I’ll probably be stiff as a board or at least I’ll pretend to be when I see Dr. R.

Thumbs down for plaster splint

Thumbs down for plaster splint

Stockholm Syndrome

The external fixator is set to come off a week from Monday, 99 days after I got it. This is exciting news, but at this point I’ve gotten so used to it that it doesn’t bother me. Sometimes I only remember it when someone asks me about it and then I have a conversation that goes something like this:

Other person: What’s that?

Me, (looks to see if there is something strange they are asking about, everything appears normal, it must just be my external fixator): Oh this is just an external fixator. I had surgery and this is holding the bone together until it heals.

Other person: Oh, what’d you do to your hand?

Me:  Nothing, I had surgery to lengthen one of the bones.

Other person: Why’d you have to do that?

Me: Because the bone was too short (rolls eyes)

Okay, most of the time it doesn’t go like that and if they are cute, I’m definitely friendlier. But at this point I’m so used to the fixator that I accidentally sat on it once. The only times I think about it are when I have to clean the pins and when someone asks me about it. One time a couple eating dinner outside literally flagged me down as I walked by to ask me about it.

Sometimes I enjoy the attention, it’s an easy conversation piece. Other times I just want to go on my day and not talk to strangers. I’m from the east coast after all. One time a lady asked me if it was a step counter. I’m not sure what type of step counters get drilled into your hand. Perhaps they would be really accurate that way. A lot of people tell me it looks like a laser and that I should attach one. These people are less original than the step counter lady.

But despite it all, I’m a little nervous to get the fixator off in a week. I think I’m worried that without the fixator people won’t be able to tell that my hand is hurt but it still will take a little time to heal. There are going to be 4 new holes in my bone after all and I’m still not completely flexible. My physical therapist cut me down to every 2 weeks instead of once a week. I think that was more because my improvement has plateaued until the fixator is off than because I’m doing so well. I’m trying really hard to not loose flexibility now that I see her less, but I’m nervous that has happened. So without the fixator what if people just heave heavy items at me and expect me to do several sets of push ups right away? Gosh it’s been so long since I did a push up. I’ll miss not having a good excuse not to do one.

Ex Fix & the City

ImageWe spend our lives waiting, in lines, on hold, in waiting rooms. As I spent another three hours waiting to see my doctor today I couldn’t help but wonder, what are we really waiting for it and is it worth it?

Okay that’s my horrible Carrie Bradshaw impression to go with the corny blog title today. But to answer her ponders, the wait was definitely worth it! It’s been nine weeks with the external fixator and I had another appointment in New York today. It was another long wait at the doctor’s office, but more of it was spent in an exam room than the waiting room and I caught my plane at the end of the day so it all worked out fine.

New bone shown on the left vs. giant gap from last month on the right

New bone shown on the left vs. giant gap from last month on the right

I was nervous for this appointment, because I haven’t had an x-ray since a couple days before I stopped turning. Back then there was just a giant gap in my hand so it seemed hard to comprehend how my body was going to fill it in. I’m not sure if it’s the bone stimulator or that I have super bones or that age 24 is still early enough to heal well but that gap is now filled in with the beginnings of bone! I was so happy to hear that and to actually see it, too. I’m right on schedule to get the external fixator off in the end of October, right before Halloween. Guess I won’t have to go as a robot anymore.

Plus Dr. R was really happy to see the range of motion I’ve regained in my finger. He showed me off to a couple colleagues and interns. He said I wouldn’t need to have my tendons released and to just keep working hard at PT. I’m excited to tell my physical therapist tomorrow. I didn’t have time to bring her back a cupcake for her birthday, which is tomorrow, so the good news first thing 7:30 AM will have to suffice as my birthday present to her.

And most importantly I finally made my modeling debut. Dr. R complimented my personal style choices for my external fixator and took pictures of my hand. Glad I decided to get that manicure beforehand so that I was camera-ready! The manicurist was so terrified she was going to hurt me, but she was really gentle and it turned out great. It actually was probably less painful for her to file my nails then when I tried to do it, because she could use her other hand to steady the finger and keep it from being bumped uncomfortably.

Well, back to PT and work tomorrow. I can’t wait to wrap up in my cozy orange sweatshirt at work.