Knuckle Replacement Surgery

I started this blog post about 6 weeks ago. I knew I wanted to journal and document the process of this journey, but each time I’ve come here to update, the outline of this post changed. I purposefully did not know what I was getting into. I did not want fear to talk me out of doing what needed to be done. There have been more challenges along the way than I ever anticipated (that’s so hard for me to admit), but every single bit of this is/ will be 100 % worth it!

Before and After

Most people know that I suffer from Rheumatoid Arthritis. Only those who are around me often really know the struggles I have. While I face numerous challenges due to my RA, I often try to conceal the pain and symptoms, but those who spend considerable time with me know. I took this picture at my 2 week, post-op appointment. This picture has now become the thing I show everyone, even strangers, where they can see what I can’t explain in words. This is why.

Stress makes my RA worse. The last few years have been hard. Everyone faces different hardships, so we just kept going. What I didn’t realize was that the damage to my joints would be irreversible without surgery. I truly tried to power through and use my hands the best I could the way they were.

Throughout this period, my hands suffered the most damage. I’ve known for 15 months that I had two options: undergo surgery or let the disease continue its progression. However, the news of my grandbaby on the way compelled me to make a decision. Consequently, I scheduled my surgery for August 19th. I had knuckle replacement surgery on my left hand. My left hand is the most contorted, but my right hand has the most arthritis. Since I’m right-handed, I decided to try my left hand first. I have very limited usage of it, so if the surgery is a bust, then I won’t notice much of a difference.

Video of “before” left hand

I made this video on the way to surgery. I wanted a reminder of what my hand was like, before.

Post Surgery

Surgery Information

We arrived at the TOC surgery center in Huntsville at 1 PM. I can’t say enough wonderful things about our experience with my doctor and with everyone involved with the surgery center. Just ask Jonathan and he will give you all the details. For me, I was mostly medicated or unconscious. Just as it should be. 🙂 I do remember coming to in recovery and I just kept asking if Dr. Licht was able to get my hand flat. She had warned me that it would be a challenge to do so and did not make any promises. Just shows how bad my hand was.

My surgery took about 2 1/2 hours. Dr. Licht said “You made me work for it”, at my post-op where she shared her side of the surgery details. I’m telling you, this lady is amazing! I’m so glad I chose her for my surgery. She was persistent and managed to get all 4 knuckles replaced with silicon knuckles and stuck with it until my hand was flat. I’m so thankful.

Jonathan brought me home at about 7:30 PM. I don’t remember a lot. My arm was in a sling from the nerve block and I was struggling to wake up enough to go back to sleep. I can’t say enough good things about how wonderful Jonathan has been. Bless him. He’s had such a load and just continues to show up and provide whatever any of us needs.

I’m not going into all of the details, but I will say this, coming off the nerve block was the absolute worst pain I have ever experienced. Everyone said, “stay in front of the pain”. We tried. We didn’t. My PSA is to remember you don’t have to hurt, call the doctor because there’s more information available than what they give you at dismissal.

Day 4

This was the first moment where I realized, this surgery was a big deal. Side note, when I showed up at TOC Athens for therapy, I realized I would be in great hands with my former student, Dani Hughes. The cast was removed and Dani started her process. She made me 2 splints, an activity splint and a sleeping splint. I discovered that I could not drive for about 2 weeks and that my recovery process would be 6-9 months.

The slideshow contains a few pictures of the first few days and includes the sleeping splint.

Rehab

I’ve previously mentioned how enjoyable it is for me to have my occupational therapist be a former student. Additionally, I now have the pleasure of having Hannah Grace as a new student in occupational therapy, who is interested in hand specialties. I’ve been actively capturing pictures and videos to share with both my journal and Hannah Grace. These visual records not only serve as a way to track and share my hand’s progress but also provide me with a tangible reminder of how far I’ve come in my journey.

Splint #3- Stretching my finger joints

Unexpected Challenges

I won’t delve into all the unexpected challenges I’ve faced in detail, but after a week of taking Bactrim, dealing with a Shingles outbreak, and various other issues, I can confidently say that after four weeks, I’m beginning to regain my sense of self post-surgery. Well, except for my Go Go Gadget hand, of course! 😄 It’s difficult to put into words just how supported and loved I’ve felt as I reflect on the past four weeks. While much of it has been a blur, I’ve somehow managed to work almost every day. How? I honestly don’t know. I’m surrounded by amazing co-workers who make it easy to be vulnerable and still show up.

Jonathan has become quite the expert at helping me dress. I’ve resigned myself to The Land of Headbands. Elastic waist pants have become my new obsession. I’ve humbly learned to lean on others and ask for help when needed. Pushing forward is all I know. With RA, staying still only leads to more pain. My goal is to return to the gym this week, focusing on every part of my body except for my left arm and hand. As they say, “el movimiento es vida” – movement is life.

My Why

Mary Elaine is expected to arrive in January. My primary aspiration is to be able to hold her with both hands, move her without any pain, and never worry about my hands spasming and endangering her. Initially, my plan was to address the issues with my left hand, undergo rehabilitation, address the right hand, go through rehabilitation again, and then prepare for Mary Elaine’s birth. However, I’ve come to realize that this plan is no longer feasible.

The positive news is that I will have one hand operating at 100% capacity by the time Mary Elaine is born, and the other hand will be functioning at around 80% capacity. This is a far better situation than I would have had without surgery. I’m uncertain about when I’ll be able to schedule the surgery for my right hand, but I’m confident that the recovery process will be much smoother, Lord willing.

This post is as of September 16, 2023. I will update this post as my progress updates. Here I am in my favorite elastic pants work set, headband, and Go Go Gadget hand. 🙂

3 months

November 19, 2023 updates

I started this update at 2 months, but didn’t finish so I’m updating at 3 months post-op.

People have been so kind to ask for updates. I officially got to remove my activity splint around the 6-week mark. I’m not going to lie, I had great anxiety walking around without protection, worried someone would bump my hand. I continue to use my stretching splint and I sleep in a different splint. This last month I’ve really become so unaware that is impressing even me.

I started back to the gym on Nov 1. I could’ve started back sooner, but honestly, the medicine I was still on from the Shingles did a number on me. Once I was officially off of it, I felt so much better physically. I continue to say the worst part of my journey was the Shingles and the recovery from it. The first day that I did arms I was nervous, but felt very eager to see what I could do. I was stronger on all of the machines, even the ones that needed my hand strength. I decided to try dumbells and I did not have any 5 lbs around (I could only use 3 lbs before) so I used the 7.5 lbs available. Guess what? I was able to do 3 sets of 10 bicep curls! I couldn’t believe it. I was looking around the gym to see if Jonathan could see me. :). Not gonna lie, I was a little disappointed he didn’t want to take my picture. Ha ha!

It’s really the little things that mean the most to me. Thanksgiving cooking was a joy. I didn’t run into any task that I couldn’t do. That’s huge for me because I’ve truly lost the joy of cooking, just because I hated asking for so much help, and I couldn’t do so much of the work without help. I feel like I’ve found a new energy. I can bounce around the house and get all sorts of things done in no time.

This morning I was looking for a picture for something else. It literally stopped me in my tracks. I don’t know if anyone else ever noticed my hands in pictures, but I always did. I love a good comparison photo, so I compared a picture from yesterday to one from this summer. What a difference it makes!

And look at how good my scar is looking! I think my surgeon might be the best EVER!

I go back to the doctor mid December to see what we can plan for my right hand. I’ll be sure to update you once I know.