Let me preface this by saying that I wrote this while very very tired and that I will be editing for content and flow and doing some fact-checking and linking… also, I am by no means a doctor or medical professional. Just a gal who had surgery and is recollecting that experience.

I’ve gotten quite a few pieces of email from people around the world in response to my posts about the proximal row carpectomy I underwent (the surgery I had to remove three bones from my wrist) to rid me of the pain I was experiencing due to Kienbock’s disease.

I’ve tried to be good about tagging and categorizing those related posts, but I realize that not many of them dwell on how I feel about having had that surgery and how it affects my life (which is often a concern from people who’ve been diagnosed, been informed that a PRC is the solution for them and are considering it/worrying about it).

So - to start, here are all the posts thus categorized.

In a nutshell - Kienbock’s disease is a rare disorder in which there is no supply of blood reaching the lunate bone in your wrist - avascular necrosis of the lunate. Lack of blood leads to bone death (necrosis) and once the bone is dead, it starts fragmenting, turning to mush and being absorbed back into your body. Prior to the mush stage, you can have a prosthetic lunate put in place; by the time I received the correct diagnosis, I was at stage 3b of this 4-stage disease. My only option was the PRC since waiting any longer would’ve meant having my wrist bones fused together and the loss of all flexibility in that wrist. I opted for the surgery.

[and this I pasted from an email I just sent] Essentially, what it boiled down to was this: at the age of 28, I was unwilling to allow for the likelihood of a total wrist fusion that would leave me with a far less-than-functional wrist for the rest of my life. I figured I could still get a few good years out of it and that it was worth it, since the longer I waited, the more the bone death and mushiness would progress. And arthritis would develop. While the procedure seems radical (”Removing three bones from the wrist? And that’s it? They’re gone?” Yes.), there aren’t (at least to my knowledge at this point) many other options by the time you get to the stage where the doctor is recommending a PRC (of course, that would also depend upon your doctor).

From what I remember from my research and conversations with the surgeon, the radial or ulnar shortening works better in earlier stages (and I was pretty far along in the stages of the disease), but even that isn’t guaranteed to help since it removes some pressure, but they’re not certain it’s the CAUSE of the necrosis. For me, PRC was the way to go - I researched, I asked questions, I thought about it - and the benefits outweighed the risks and the fear. And now I’m typing and cooking and driving and eating and folding laundry… and rock-climbing and learning to play the guitar and opening jars on my own again.

And now, a bit of an update in general. I had my PRC in October of 2006, so almost two years ago. I was diagnosed several months before that after having spent years thinking it was carpal tunnel. While I was pretty torn up about my lack of choices initially, since the alternatives (inaction and pain, or wrist fusion) weren’t really choices. I researched, I read, I talked to my surgeon several times. He gave me his home number so I could call him outside of office hours with any questions that might hit me over the weekend while I was determining if surgery was the right choice for me.

As you might guess from that, my orthopedic surgeon is a good egg and a good surgeon; he was the third one I went to, and the third time was the charm for me. Very much a Goldilocks scenario. I made the decision, a date was set, and I talked to him several times about what exactly the surgery would involve, what he would be doing, and what I should expect. For some people, this is terrifying. For me, knowledge is power and I wanted to have as clear an understanding as possible.

I had the surgery bright and early on a weekday morning in late October, just a few days before Halloween. I sort of planned it that way since it would be the perfect excuse to not have to come up with a Halloween costume; I’d be in bed on painkillers. When I woke up after the surgery, there was some pain… mostly from the swelling. I was in a soft cast so that there would be plenty of room for the swelling. My fingers were slightly bruised (just spreading from the wrist area) and swollen so they resembled Vienna sausages made from slightly yellowed tofu. Just picture it… yes, precisely that attractive.

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So, after having been deprived of rock-climbing for a solid month, I managed to find a friend to belay and got back to the gym last Wednesday as well as tonight. Last week, I tore the shite out of the skin on my left hand, since my protective callouses had disappeared. My hands were pretty much healed by Sunday, but still looking a bit raw. I didn’t tear them up tonight, but they’re mightily sore and dry… and I’ve actually been doing better at the gym than I expected to after that much time away from climbing.

My biggest problems (what with my gimpy left wrist) have been overhangs. These are precisely what they sound like - parts of the (typically) vertical wall that jut out somewhat horizontally (on an angle, in any event) and “hang over” your head. That might be a poor explanation - a Google image search should help.

So, in order to get past an overhang, at one point or another, I either a) have to hang from the more horizontal portion of the wall by my gimpy wrist and reach up over the overhang with the good wrist, or vice versa (both of which result in some discomfort or unpleasantness) or b) have to pull my entire body up and over through sheer inertia. There’s some major defying of gravity involved; that’s not as easy when you have a butt and hips and not a tremendous amount of upper body strength.

Anyway, I felt pretty good tonight since I got past an overhang that I wasn’t able to get over last week. I could even say I got over it multiple times since once I passed the crucial point of the climb, my hands were so tired they kept giving out with the next move and I kept dropping. And kept returning to that point and trying again. I’m tenacious.

I kept at it and finally just asked my belayer to give me a moment to rest, hung there, shook out my arms and shoulders and hands, exhaled deeply (for some reason, this really works and untenses tension that I sometimes didn’t even know existed until that moment) and just mustered up my last bit of energy to fire through the last two moves and finish the damn thing. And it worked. And I was done. And it was good.

As long as I get to keep going and trying and working at it, there will come a time when these baby steps will become one bigger step, and it won’t be long before it will come naturally. I mean, it was only 11 months ago that I started climbing, and while my progress hasn’t been as speedy as some people’s, it’s been good for someone who’s not innately athletic, who’s missing a bunch of bones and who was struggling to lift a half-pound weight with her left hand 18 months ago.

Just call me Pollyanna.

(Except that’s not exactly what I’m doing. “Pollyanna” has become symbolic of being optimistic, but that wasn’t really her deal - I remember from the book that her attitude was more, “Oh - the mission sent us crutches for Christmas instead of a doll or toy. I guess I should be happy anyway because I’m fortunate that I don’t need those crutches like some other poor child.” I would probably just get angry at the ineptitude of the service organization for leaving some poor crutch-dependent child without crutches because they couldn’t get their gift distribution list together. And I’d want to help them by creating a spreadsheet and a series of checks and balances. But that’s just me.)

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I had my wrist surgery a year and a half ago. I went to occupational therapy for almost five months. I’ve been doing well, I think. I’ve been rock-climbing since September and my wrist has gotten a lot stronger from that; I’m able to grab onto holds with strength I most certainly did NOT have even three months ago, much less last September.

Despite all those advancements, it’s still something that impacts my day-to-day activities. When I was shopping in Princeton yesterday, I had a bag of about eight CDs. After carrying that for about 45 minutes, my left wrist was experiencing sharp pains shooting up into my forearm - I thought about asking one of my friends to carry them for me, but I would’ve felt like a helpless weakling (definitely NOT a feeling I enjoy). So I switched carrying hands for a bit, but I’m right-handed so I needed my right hand to reach into my purse, open doors, get money out of my wallet, sign my name, and other such things.

Yes, I can feel changes in barometric pressure in that wrist; the weather will affect it for the rest of my life, according to my surgeon.

Today, though, it’s really bringing me down. I did some light cleaning and then took a break to do my new Pilates DVD so I would have some kind of exercise today. Since my friend LJ is out in California, responsive and regular climbing buddies are a rare treat (commodity?). I’ve been able to go climbing once every two weeks, basically, down from twice or three times a week. Last time I went (Tuesday night), I sucked. Before getting back from vacation, I’d been climbing 5.9s (not easily, but I was finishing them) and trying 5.10s, but I was struggling with a 5.7 on Tuesday. Maybe it was just a bad night or I was tired from a long day of work; those happen - but it was pretty demoralizing. I didn’t cry, but it was close.

However, in a change from the Eva of Olde, I’m not going to give it up or give up on it. I’m trying to enlist my brother since he has the gear but just hasn’t been climbing in several years. I’ll keep contacting friends at the rock gym to latch onto their climbing nights. This has been such a good thing for me in so many ways, it would be stupid to toss it without trying every possible method for retaining its presence in my life. I can hope that my steadfast friend returns soon and brings with him the promise of regular intensive climbing, but I can’t count on that. In the meantime, even once a week is something.

So my substitution is more Pilates; both Pilates and climbing work your core muscles, so they dovetail nicely (some of my best climbing has been after doing a Pilates work-out beforehand). On this new DVD, I got through the first 17 minutes; broke a sweat, felt good about doing a more challenging workout… but then it got to the portion where the mat exercises required me to rest my entire weight on my hands (a la downward dog) while lifting my legs or stretching. It also called for me to rest my weight on my hands and wrists behind me while I balace on my tailbone and lift my legs into the air.

I couldn’t bend my left wrist enough in either direction to complete the exercises. The range of motion (ROM) in my left wrist is limited and while I can increase strength with exercise, my ROM is as good as its going to get because my anatomy is different; it’s not a matter of stretching or exercising. I have missing bones. Bones that aren’t supposed to be located in the active portion of my wrist have moved into that space; that’s how I was supposed to heal. It’s never going to be the same.

There are other things it will impact as well, but as a currently single gal, I have the luxury of waiting to cross that bridge.

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Too much food, too much of everything.

Family drama wasn’t as high as in previous years, though still higher than average.

Note: we do basically ALL of our Christmas celebrating on Christmas Eve. The big dinner, the breaking of the bread and wishes for the new year, the opening of gifts, etc.

My father was grumpy because he got gifts after specifically saying (though I never heard it) that he didn’t want anything. He got several bottles of wine and a few other things, so it’s not like we went all-out. He just likes being grumpy.

My sister was feeling guilty over getting so much stuff - and commented that this Christmas left her feeling empty. I welcomed her to her 20s and told her that this is part of the existential dilemma we all face as adults… the realization that most things are meaningless, but that it shouldn’t keep her from enjoying the gifts we got for her.

Dinner was good, but I ate too much starch - rye bread, potato and cheese pierogi, Polish mushroom soup with egg noodles, a biscuit, a small piece of breaded flounder (with lemon juice) and then dessert (Polish cake, orange slices and various chocolates truffles.) I didn’t eat a LOT of food overall (a slice of bread, 3 pierogi - not a huge quantity) but it was a goodly amount of very filling things. Glutenous things. Floury, starchy things. My tummy is like a pot of paste or papier mache right now.

As for me, I was quite satisfied with my Christmas, despite the drama. There was some laughter (which is uncommon) and that was valuable. There was only one problem with some snow boots I got (a half size too small) so my mom called the company - tonight - and they’re sending out a new pair on Tuesday, and we can return the ones I have here now.

Now if we’d only get some snow. I’ll be very upset if I got these waterproof suede snow boots and we don’t get any snow this winter, thanks to global warming. It was 60 degrees today. SIXTY! My mom commented that it was a beautiful day; I replied, “Yeah, for APRIL.” Not for winter and certainly not for December 24/25th.

It doesn’t look promising for New Year’s either. Oh, well.

To those of you celebrating, merry happy. Enjoy the rampant consumerism and all the feelings of goodwill it generates between/among family members.

I hope your celebration is peaceful and drama-free!

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Sniff. Sniff.

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… the present your friend gets you for Christmas is something you just bought for yourself. I mean, that’s impressive. Even my family can’t get that accurate!

I had my second occupational therapy session tonight and I have improved a lot even since Tuesday’s session; my range of motion before was 15/25 and now it’s 25/40 (those numbers represent the corresponding angle to which I can bend my wrist back and forth… that is, if I bend my wrist forward, it’s not the angle that’s formed between my palm and my forearm, but 180 degrees minus that number).

There’s a magical machine there that I want to own. It’s got a proper name*, but I am calling it the corn-husk machine. It looks like a giant two-slice toaster with a hole in one end which has a canvas tube coming out of it. It’s filled with ground corn husk particles, which feel like really soft sand. The “toast slots” are protected with netting so the corn husk doesn’t fly out. I stuck my hand into the canvas tube and the therapist velcroed the tube around my upper arm so the corn husks wouldn’t fly out. She turned on the machine; extremely warm (but comfortably so) air started puffing up through the corn husk particles in a staggered fashion, making it seem like a massage. Meanwhile, a metal plate hidden under the vast quantities of corn husk started to warm it all up from underneath. Between the soft, warm, dry sensation (like running your fingers through really soft and fluffy sand on a beach) and the soft drone of the machine, I was basically lulled to sleep… but I managed to stay upright and kept doing my hand exercises in the machine. I love the corn husk machine.

*Proper name = fluidotherapy: a dry heat treatment where the hand is placed in a unit filled with a particulate similar to sawdust (ground corn husk). The machine forces warmed air through the particulate to decease joint stiffness, reduce hypersensitivity, and improve circulation.

SO today was my errand-running day off. It was action-packed and now I need to get to bed since I DO have work tomorrow. A half-day, but still…

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I am wearing an elastic hand stocking. It’s actually an elastic compression stocking my occupational therapist gave me today which I must wear all the time to help the swelling go down. But at one point, she referred to it as the “elastic stocking.”

I also have at-home exercises to perform. I have a handout.
And another appointment on Thursday. And then Tuesday. And then Thursday.

Currently, two Christmas presents are sitting in my bathroom drying. It’s not as gross as it sounds; the bathroom has both a window and a ventilation fan, so it’s the perfect place to spray something that has toxic vapors (”known in the state of California to cause cancer.”)

Great. I didn’t notice that when I bought it. Oh, well. All the more reason for very good ventilation.

My sister will be home soon and wants to decorate the Christmas tree. It looks like she and I will be the sole decorators. The rest of the family is in a state of uncivil war. Or passive-aggressive resistance. Whatever stupid phrase applies.

I guess this quality time with my sister is my reward for videotaping “Gilmore Girls” for her. It hurts. Oh, it hurts.

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The answer to that question in our family seems to be, “pointless arguments that ruin the day.”

I take some comfort in the fact that mine is not the only family with this particular flavor of dysfunction. I recall that last year, we had a departmental dinner for work at a restaurant where the dishes were served “family style.” My co-worker asked, “Served family style? What does that mean?” to which I replied, “Perhaps it means they serve the food along with a disparaging remark?”

He laughed heartily and reassured me that this is not an isolated experience.

Anyway, there was petty bitchiness all day and I ended up getting lectured about “showing respect” - which I was too angry to respond to then, but I wish I’d said, “Don’t talk to me about respect until I can get through one day with this family WITHOUT someone calling me a bitch.”

If it comes up tomorrow, though, I will. It’s bullshit. I prepared this dinner today and only asked for help with things I really could not do with this weak and aching left hand. I mean, here’s the site of the incision:

It’s still swollen and I have very little range of motion since the tendons and muscles are really tight from the surgery and from being stuck in a cast for a month. The skin on my left forearm is dry and peeling and I keep slathering it in Kiehl’s Ultimate Strength Hand Salve. It’s good stuff.

Anyway, I was so upset after dinner/dessert, I went to bed at 8:30 and then woke up at midnight, did my first bit of holiday shopping online and just now turned on “The Lady from Shanghai” with Orson Welles and Rita Hayworth (trivia: the movie was made towards the end of their marriage . According to trivia on IMDb.com, “they were constantly fighting at the time and (some say as a comeuppance to Hayworth) he made her cut off most of her long, luxurious red hair and dye it bright platinum blonde.”)

Oh, and why does it have to suck to live in the United States sometimes?? Penguin UK is publishing six classics with “pure white, art-quality covers for people to design their own book jackets.” I read about it on BoingBoing.

Maybe I’ll place an order with a UK bookseller. It’s just annoying, though, that I can’t get them here (yet, anyway.)

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THE CAST CAME OFF TODAY!!!

I sat there, looking at my hand. It was sort of yellowish and misshapen (from the cast squishing my hand) and the skin was/is SUPER dry. So much so that I was able to peel layers off of the back of my hand and my palm. Ewwwww. It truly looks like those mummies preserved in ice or marshes that they show on the Discovery Channel.

The incision actually looks OK. My doctor had his technician take some new X-rays; the doc said that the bone healing is “excellent” and that the wound is healing very well indeed.

I am allowed to move my fingers and start small motions like making a fist (though I can’t just yet) and practice wiggling them. For the next two weeks, I have to wear a regular old brace, and I have another visit on Dec. 7th. Then we’ll talk about physical therapy.

Tomorrow is preparation day. I will need help, but it will be a lot easier to bear since I can use my elbow.
_____

R.I.P. Robert Altman.

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Had my post-surgery checkup yesterday and am stuck in this same cast for another two weeks. However, the doctor had some X-rays done in the office and I’m healing very well - for just a week after surgery. The doctor actually thanked me for healing well; I don’t know if that’s just a thing he does or if he was thanking me for listening to his instructions and doing the exercises with my fingers and keeping my arm elevated, etc.

I’m getting a little better/faster at typing with one hand, but I don’t like it. One bit. It’s still slow and annoying.

I’ve added more of my library to LibraryThing.com; it’s easy to add ISBNs with one hand since I can just use the number portion of my keyboard. I’m up to almost 850 titles. I commemorated the event by posting something to the book portion of this blog - here.

Time to wash my hair. It’s a whole f***ing production. Since I can’t shower, I have to run a bath and tie my casted arm up in a plastic bag, then pull down the shower head (since I have one of those with a hand-held sprayer) so I can wet and rinse my hair without getting the plastic bag arm too wet.

My hand and wrist are hurting a good deal today. I haven’t taken any Motrin or anything today, so that might be it. I’d best do that soon, too. Ugh.

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