Monday 5 August 2013

Gwen's Hand

I mentioned several months ago that my fingers were not really straightening properly. The issue is only affecting my left hand and means that my fingers can curl up to make a fist but cannot come up straight to make a flat hand (to give a high five, for example).

My fingers showing how well they can bend.
Their attempt at straight.

 


In addition to the lack of movement, my knuckle joints were getting sore more often and especially in cold weather. The pain was the main motivation for me to try and address the problem, although the lack of movement was also getting pretty annoying (being unable to put on gloves easily, for example).

I mentioned the problem to my rheumatologist last year and it resulted in several referrals. I saw an occupational therapist, a physiotherapist and a surgeon. The OT offered me some generic hand exercises and some advice on carrying things carefully to not hurt my hand. I didn't find it especially useful to be honest but they did say they could make me some splints if I felt I needed them in the future. The physio appointments were slightly more fruitful. The therapists looked carefully at my hands and the movements I was able to make and gave me some specific exercises for those precise joints. He measured the range of motion I had and compared this with new measurements at each appointment. Following some promising progress initially, the overall outcome was that the exercises weren't going to be able to get my full range of movement back and so the appointments stopped. The physio did recommend that the next option to look at would be surgery and that worked out pretty well as I had already had my appointment come through to meet the surgeon.

When I went for the first appointment with the surgeon, I was straight away sent for X-rays. Unfortunately, they didn't quite show clearly enough and I had to go for an ultrasound. After I had had that and returned for the second appointment with the surgeon, he told us that I would be a good candidate for knuckle replacement. The surgeon explained that the tendons were not damaged so would be able to be realigned once the knuckles had been replaced. He recommended that we think about whether we want to go ahead with the surgery before we made a decision. I decided quite quickly that I would like to go ahead with the surgery and so the operation was scheduled for 1st August.  
 
The surgeon explained that after surgery I would be in a cast for a fortnight and following that would need to wear two different splints, one during the day and one resting splint for night time. I was also told there would be quite a lot of physiotherapy to regain full movement of my hand. The surgeon seemed unsure as to whether I would be able to return to work, expressing concern about the complexity of the daytime splint and how I would get on teaching wearing it. However, I decided to try not to worry too much about exactly what would happen after the surgery and be more open to go along with whatever happened when it happened. I did speak to my headteacher and he said we would have to discuss it when we knew more about the splint, how I felt and whether I would be able to acquire a fit note from my GP or the surgeon. I went through periods of feeling quite eager for the surgery and confident that it would be really manageable compared to my feet and also periods of feeling really apprehensive and thinking I didn't want to have it done! Luckily the apprehensive thoughts were outweighed by the ones telling me it would be a good idea!

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