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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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.