Oooooh. My hands are raw from climbing. RAW. I didn’t climb very well tonight. I felt heavy like lead and stiff like wood. Still, I’ve been going with some regularity. And that comes with battle scars.

And allow me to gross you out with a close-up of… cracked skin!!!

(I’m sort of proud of it actually. Especially that it’s my left hand. That’s the hand attached to the gimpy wrist. This means I’ve been USING that wrist and getting somewhere with it. Truly.)

(Also, it’s hard to belay when your torn skin keeps catching on the rope. I used tape to cover the ickiest bits.)

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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