Sorehand by Topics- Post Op Advice

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Date:    Fri, 22 Dec 2000 17:06:23 -0500

Subject: surgery tips, please?

Hi, all,

Well, I do not know if I am taking the step that may bring some relief
from the flaming pain in my right wrist or I have made a deal with the devil,
but it looks like I will be having surgery in the 3rd week of January.

I shall have not one, but *two*, incisions, in my right wrist and distal
volar forearm.  I will be having a classical open carpal tunnel release,
as an EMG 2 years ago indicated "mild carpal" tunnel and things are much
worse than they were when that test was done.  I will also have another
incision just proximal (behind, if you will) the wrist to extract what my
surgeon thinks is a small ganglion cyst under my palmaris longus
tendon that could be irritating the median nerve
(strange that both an MRI and sonography did not pick up the cyst which I
found myself months ago poking around in my wrist - it's readily palpable
not only by me but also by my co-workers, let alone doctors).

I live alone in a neighborhood that empties out completely as everyone
goes to work/school.  I might be able to get a little help from neighbors
but cannot count on much, and have no family in the area.
The nearest close friend I have lives at least 10 miles away so I'm
trying to figure out how I am going to function post surgery.
I hate this but I imagine I will be out of work for several weeks
at a mimimum.

Here's my current list of things to do prior to surgery as I anticipate
a problonged recovery:

pay all bills and sign *lots* of blank checks
get a lot of cash
cut off my long hair (many tears here)
get toothpaste that dispenses from a pump
get an electric toothbrush
get a few pairs of fleecy sweatpants (I live in Rhode Island, it's cold)
print the local bus schedule - no driving for awhile
arrange for my 2 cats to be boarded for a couple weeks (sob)
buy frozen and canned food and paper plates/plastic silverware
do all laundry
hire someone to shovel snow

Socks - they are tough now.  I am going to get a few pairs of polarfleece ones
because they are easier to get on, though expensive.  Any other ideas?

Any ideas about shoes?  I cannot imagine putting snow boots on and I will
probably need to as a snowier winter is predicted for us here.

I figure forget wearing a brassiere - even an underwire front-loader like I
wear now will be impossible.  I did not burn mine in 1970 so now is the time.

Any other tips?  Permit me to tell you all that I am scared, scared, but
I cannot see any other way out of this hellhole of constant pain.
I have around 50 work days of banked sick and vacation time and I hope that
I will recover sufficiently in that time to return to work - otherwise
I may lose my job of almost 20 years.

Oh, yes, how did people who went through this pass the time?

Regards and stay warm, everybody,

Nan 

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Date:    Fri, 22 Dec 2000 18:40:38 -0700
Subject: Re: surgery tips, please?

It is not a fait accompli that the recovery will be devastating or
particularly prolonged.  For one, I don't think I would cut my hair if that
was something I liked about myself.  Absolutely avoid shedding things that
are important to you at all possible costs.

Take some precautions as you have suggested, make sure you will be all set
up to see a competent hand physical therapist right after the surgery and
prepare yourself to do well coming out of the surgery.  Some people do
remarkably well and recover very quickly, you may find your pain
dramatically reduced.

Anyway, best wishes and reconsider the hair thing!!

Best of luck,

Greg 

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Date:    Fri, 22 Dec 2000 20:39:22 -0500
Subject: Re: surgery tips, please?

Hi Nan,

Maybe I'm missing something, but you'll still have your left hand, won't
you?  If you're having both sides done at once, you might want to reconsider
and do one at a time.

I can tell you've given this a lot of thought, but if you have one good hand
it seems as though you could manage some of the things all right.  It's no
fun, but I can do one-handed laundry, put on Socks, and manage my hair well
enough as long as I don't have to go out in public.  You could try a little
practice run by wrapping your right hand in a towel or something.

A friend of mine returned to work as a clerk typist a week after her carpal
tunnel surgery.  True, this was an incredibly stupid thing to do (and I
think she'd agree with me now), but she did it and survived.  She lived
alone at the time and I didn't get the impression that she had much help at
home.

Also, even if you do use up your vacation and sick time (and I'm in absolute
awe of your accumulation), you should be eligible for unpaid leave under the
family medical leave act.

I apologize if there's something I don't understand, but maybe this won't be
as bad as you think it will be.  Perhaps some deep breathing is in order? :)
I hope your surgery helps.

Best wishes,
Diana
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Date:    Fri, 22 Dec 2000 20:58:15 -0500
Subject: Re: surgery tips, please?

Dear Nan:
I haven't had surgery but here are a couple of thoughts:
Do you have an electric can-opener?
Also, perhaps you can contact your local social service agency (anybody have
more specific info?) and see if someone can come by and give you a hand.
It's so hard to ask for help, I do know that, but it sounds like you're
going to need some and that's OK; we all do sometimes.
I searched the archive for post-op tips but couldn't find them. Several
people have posted some great stuff in the months since I joined. Anyone
have them? Penney?
As for passing the time, I watch a lot of comedy -- movies, Frasier and That
Girl! reruns, whatever makes you laugh and feel good. Do you have a book
weight so perhaps you can read. I loved the Harry Potter books, good
positive escapist stuff.
Regarding footwear: I have some great clogs -- several pair including wool,
Splogs, lined suede, etc., all with traction soles -- and I find they are
just fine unless there is lots of snow. As for snow boots, try something you
can slide your foot into that doesn't have laces, like apres ski boots or
lounge boots.
Mostly though I am sorry you are frightened. I don't blame you at all. Have
faith and take good care of yourself. Know that lots of us will be sending
you kind thoughts and well wishes.
Namaste, Susanne

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Date:    Fri, 22 Dec 2000 21:05:25 -0700
Ann  wrote:
  Saw a request for some post surgery tips - here is a
list I put
 together.
  Here are some helpful hints for post surgery:
  If you wear contacts, learn how to put them in with
one hand.  I wish that I had made myself learn to do it.  I love
wearing contacts (and the blue eyes they gave me) - one of the things I missed
was being able to wear my contacts.
 If you live alone, plan to take the day off
before your surgery. Use this time to do all the things you won't be able
to do after surgery.  Like getting rid of all possible trash, doing all your
laundry, doing your cleaning, and doing a big shopping trip.
  Do yourself a favor, buy paper plates, paper
cups, and plastic silverware.  Even if you have a dishwasher, it's much
easier on yourself to use disposables.  Try not to use real dishes.
  Save the plastic bag from a  big loaf of bread.
Put this in your  bathroom with a rubber band.  It will come in very
handy for taking a  shower  without getting your hand/arm wet.  It has the
advantage of being thin -  no need  to worry about all the excess plastic from using
trash bags.  *OR*
  If you don't live alone like I do - this might
be a good idea.  I  thought it would be smart to go to a medical supply
store and buy a  rubber sleeve  that's designed to go over casts and bandages.  It is
a good idea, IF  you live  with someone who can help you put it on.  I wasn't
able to get it on one   handed.
  If you don't already have one, buy an electric
can opener.  I recommend Black and Deckers cordless model.  You
don't  have to hold the  can up
 and it is very easy to work.  It can fit easily in a
kitchen drawer  because it"s  not much bigger than a manual can opener.
  Anyone think of any other good tips to add?
  ------------------------------

Date:    Fri, 22 Dec 2000 21:06:27 -0700

I keep scissors in each room, from kitchen to bathroom.
It really helps to open up packages, also I found clothes pins to be very
useful.I use them to reclose packages.Makes it very easy to reopen with one
hand.I also went to import store and got some cheap baskets,[WITH GOOD
HANDLES} and have found this to be a very good way to carry things with one
hand.Hopes this helps
post-op, D.J.

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Date:    Fri, 22 Dec 2000 21:39:39 -0700
Subject: for Nan

Hi Nan;
Sounds like your doctor has failed to give you info
about what to expect. Have you discussed what "classic"
open surgery involves? Seems to me that incisions &
consequently scars have gotten much, much smaller in
recent years. If you're anticipating the older style
incision the length of your forearm, my question is,
why go that route? If you're looking at a more modern
CT release, with a shorter incision, then probably you
can work around most of the inconveniences. Many
patients start physiotherapy within a week of surgery,
from what I hear, so it's not like the whole arm stops
working. If the pressure on your median nerve has been
severe, you might even find that some of your fine
motor skills improve post-op, at least temporarily.

Have you contacted your local Arthritis Society? They
consider CTS a form of arthritis & in Canada the
society organizes volunteers to help arthritis
patients. The US website does not indicate that any
such help is available, but there seem to be a lot of
local chapters and probably some are more active than
others. 

www.arthritis.org

Non, I'm feeling a little guilty here b/c I'm one of
the people on this list who argue against surgery
except as a last resort. That's partly b/c so many
doctors seem to tell every woman with hand pain that
she needs to get her palmar ligament cut and mostly b/c
of the mounting evidence that the great majority of
cases actually originate in the shoulders & neck. It's
not b/c the surgery is inherently dangerous, just that
I think it's usually the wrong move.

Most CT releases today are considered "minor" surgery,
done on an outpatient basis. Usually the bandages cover
the wrist and in your case, maybe part of the forearm.
You _are_ doing only the one arm? People who have both
hands done at the same time, do run into trouble. For
one hand, it's awkward coping afterwards, but it's a
temporary awkwardness. You're not likely to starve and
even if your long hair gets snarled, (not necessarily a
sure thing) eventually the day will come when you can
pour olive oil or mayonnaise over it -- or Johnson &
Johnson No More Tangles --  and comb those snarls out.
You can probably get a mostly-elastic bra and pull it
on over your head. 

Get your cats used to dry food, or
those pouches of moist food, and get clumping litter
that you can scoop out with a slotted spoon, even
left-handed. 

Pass the time with books or videos or
music that lifts your spirits -- or if you have the
energy, volunteer to answer a hotline phone (you can
usually have calls forwarded to your home).

As Zero Mostel used to say, "Expect the worst, hope for
the best." Your contingency planning sounds good, but
as with Y2K, the preparation itself makes the disaster
less likely.
cheers, Penney
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Date:    Sat, 23 Dec 2000 04:02:42 -0800
Subject: Re: surgery tips, please?

Nancy,hi.I'm just getting home from  another "vacation " in the hospital. I
would say I'm most likely queen of one handiness on this list from the
number of surgeries I've had done on my wrist, and all my time in casts.
Its not as bad as it may sound to you now if you get things ready for your
self now.  I would rethink about your pets, I have 3 Lhasa, and now I do
have to keep them clip as I'm unable to take care of there coats daily
myself, but they was a great comfort to me everytime  after surgery. Pets
seem to know when we are ill, or hurt, my dogs would lay next to hand and
arm and were so gentle and caring. If feeding them is a worry to you, start
getting them use to pouch food now, or dry. 

I've had 3 carpal tunnel releases to date, 1 on the right 2 on the left 18 months apart. 
The right
hand was done 6-7 years ago, and have never had a problem since. On the left
I still have CTS,and also Cupital tunnel now also . The longest time I've
spent in a cast at one time was 6 months, the shortest 5 weeks.At this time
try doing things with one  hand, this will show you where you will have
problems, and most things you can find an answer. 

As for the bra, I would
wear sports bra, not as much support as my others, but I didn't feel so
naked in public. Also if you have no small children around, get your pain
pills and any over the counter pills in easy open bottles. Nothing worst
then having pain pills and not being able to get to them. Keep a note pad,
and clock near your pills, you willn't believe how easy it is to forget if
you took your pill or not. Myself, I wore sweat pants and extra large tee
shirts, easy to get in to, easy to laundry, and you feel so comfortable. 

I have long hair, still do, I just would wear it in pony tails.Start doing it
now with one hand, it doesn't have to be perfect, and after all this is over
you will be glad you still have your hair, trust me please on this one. If
you can freeze a few home made T.V. dinners you can nuke in the mirco wave.
My husband would cook for us after I broke my wrist and started this
nightmare, but I got tried of frozen and can food fast. Agood meal can do
wonders for your mood and out look. I really like salads, so I  get
everything cut up and put in containers before going in for surgery, it was
really easy to make me up a salad  for the next few days. 

Also have someone
{even if its long distance} call you once or twice a day, just to check up
on you. For socks I wore those little booties ,very easy to slip on. As I
said earlier, I'm just getting home again from the hospital, but if I can
help you any more please feel free to e-mail personal and I will answer you
as soon as I can . best of luck D.J.

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Date:    Sat, 23 Dec 2000 09:28:17 -0500
Subject: surgery tips, please?

Nan, et al:

Despite my anti-surgery bias, if I felt a cyst-like bump within my wrist,
I'd be optimistic about surgery, and you should too if you've exhausted the
other remedies you've read on Sorehand and found a highly recommended
surgeon.

As for coping, I got tho following book from my library, and it had the best
"coping" info I've seen among 6 books I've read, about 75 pgs from a female
sufferer, down to the most intimate details.

The Repetitive Strain Injury Handbook :
An 8-Step Recovery and Prevention


Good luck, Jack
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Date:    Sat, 23 Dec 2000 09:41:17 -0500
Subject: Re: surgery tips, please?

Penny has already reposted my surgery tips post, but I thought
of something this morning in regards to your hair.
    Instead of cutting it off, how about having it braided the
day before your surgery?  Then about a week later - when you will
start feeling up to going out - go to a salon and have them
wash it and rebraid it for you.  Then you'll be able to keep
your long hair and still have it neat.
     My hair wasn't long enough to braid, but after a week and
a half of using all in one shampoo, I went to get my hair trimmed
so that I could have a real wash and condition done.
    Ann

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Date:    Sat, 23 Dec 2000 17:55:14 EST
Subject: Re: surgery tips, please?

Go to the library and get all those books, (or books on tape) that you have
always wanted to read. I know someone once mentioned a good book holder...

You may want to stop at the local video store the day before surgery and pick
up some videos. There probably are some 5 day rentals out there. (Returning
them could be a problem, though, huh?)

That's all I can think of now....
Anne
PS- GOOD LUCK! I'll be thinking of you!
------------------------------

Date:    Sat, 23 Dec 2000 17:57:10 EST
Subject: Re: surgery tips, please?

Oh, try and get your pain meds BEFORE the surgery. Nothing worse than
standing at the pharmacy post-op.

Anne
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Date:    Sun, 24 Dec 2000 02:07:58 -0800
Subject: More surgery tips

Nan, I hope it goes well, that you've found a reliable treatment
professional who has ruled out other factors that may be causing your
problems, and that this is indeed what you need. Your preparations are good
and so are others' responses. (Like signing checks in advance.) I'd like to
add a couple:

1. The electric can-opener I have does not have to be held, a strong magnet
on top holds the cans, and the can opener adjusts to accommodate
larger-than-standard cans. I find that preferable to having to hold
something, especially when that something vibrates.

2. RE the electric toothbrush, because of the vibration -- to which you may
be extremely sensitive because of median-nerve injury -- I recommend
finding some thin, high-density foam (packing stores may have it; I tend to
save bits that are sent in packages -- and it's usually dark blue) to wrap
around the brush, as it will absorb some of the vibration. Without doing
that, the vibration would have made me unable to use the toothbrush.

3. If you don't have thick pens and pencils, wrap some of that same foam
around a couple of pens and attach it with rubber bands. It's a lot easier
to write when you're holding something thick.

4. Laundry: if you have to do your own, put soap for individual loads in
empty yogurt containers or something easy to open. (And don't try to do
more than one load at a time.)

5. Food: I can't bear most prepared foods and couldn't cut anything for
more than a year, so I used to buy plain frozen "stir fry" (cut) vegetables
and do my own stir-fry with different spices or jars of Chinese sauces and
condiments (like pickled radish), so I was able to get variety and be in
control of what I was eating. If you can't find these in local markets,
enlist some friends to cut up and freeze some mixed veggies for you prior
to surgery. If you eat meats, you can also do this with other things --
e.g., bone some chicken breasts and freeze them individually, freeze fish
filets, etc. If you want help with simple recipes, let us know!

6. Jar opener: get a good jar-opener or have a friend come over and loosen
all your jars before surgery, and ask cashiers in shops to open new ones
for you. One option, if one hand isn't bad, is to get a thin piece of
rubber (there are special rubber circles to open jars, or squares of the
material used under carpet runners to keep them from slipping, or under
glassware in earthquake country).

7. Opening doors: if you have the typical door handles that have to be
turned (rather than levers), you might want to put rubber bands around the
handles, or use the same kind of rubber I mentioned above. I also carry a
thick rubber band in my fanny pack so I can open bottles of water when
necessary.

8. Re showering, I've never found the plastic bags and rubber bands to be
helpful; the latter were hard to get on and off and also hurt, and the
plastic bags usually aren't large enough or strong enough to keep water
from getting in. I don't remember if I got my arm cover from the PT clinic
or the hospital where I had the surgery, but I did get a special heavy
plastic cover with an attached velcro strap, it was easy to put on and
strap on, and did exactly what it was supposed to do. I think I must have
given it to someone, or I'd send it to you!

9. Definitely practice with your other hand the daily and monthly hygiene
routines that you are accustomed to doing with your primary hand. It's
quite amazing how much we take for granted all those little things, which
are a source of incredible frustration when we can't do them with the other
hand!

10. If it is not too cold and icy to get out and walk -- and assuming
you're able to cover your feet with warm things easily enough -- do take
walks. *But make sure you don't walk with your hands hanging down by your
side,* which can cause your hands to swell and put a lot of pressure on you
injured median nerve. No one told me that until after I took a 3-mile walk
one day, and suffered for at least the next week.  Eagle Creek and L.L.
Bean both make combination purse/fanny packs (Bean's is a little larger),
which enable you to carry essentials like wallet, keys, and water bottle,
and you can rest your hands on the pack while you're walking. (BTW, I got
some low-cost $30-something almost knee-high rubber boots from Vermont
Country Trader or some catalog like that, which I can wear with warm socks
and slip into virtually hands-free. They're great for trudging through rain
and snow, and a lot less expensive than leather. I get them off by pushing
at the heel with my other foot.)

The only other thing I can think of at the moment is a reminder that people
are often quite happy to be asked for help, contrary to our reluctance to
ask (out of embarrassment or helplessness) as well as our expectations. So,
for example,if you have neighbors, ask if they'll call you before they go
shopping to see if they can pick up a few things for you. (Some shop keeprs
have been very good about opening water bottles for me, and others have
looked at me as if I'm nuts; after all, this is a hidden disability. My
usual response then -- if I'm not wearing my "hand impaired" pin -- is to
ask, "Would I have asked you for help if I hadn't needed it?" That usually
does the trick, and someone has learned a lesson in the process.)

Oh, and one more thing: as I said to another subscriber off-list recently,
I had arranged a barter for housecleaning when I wasn't able to do any of
it. A local paper used to have a Trade/Barter section in its classified
ads, and it was free or set at a pretty nominal rate. I said I would trade
tutoring in writing or editing or WordPerfect, or international cooking and
breadmaking, in exchange for housecleaning and gardening. I got seven phone
calls, and several would have worked out. I did a barter with only one of
the respondents because I couldn't handle so many things and people at
once. It worked out really well, and we became friends -- so that even
after the woman no longer needed my help she would come over and clean
sometimes, or would borrow my car (when I had one) and then clean in exchange.

We all have skills someone else wants, and we have to be creative about
meeting our needs. For example, most of our communities have a lot of
immigrants, and a good many of them work on jobs with other immigrants,
where they speak their native languages and have few opportunities to learn
English. You may be able to find someone who would jump at the chance to
speak conversational English in exchange for some housework.

Again, best wishes to you. Enjoy the holidays. Ask your family and friends
for videos (and to take you out for movies after you've had the surgery!
You'll want the company.), and do what you can to make sure that your
problems and pain are only a part of your life, they don't define it or
define you. Do something every day that gives you joy.

And, as Susanne always says, have a wonder-full year!

Cheers!

Joan

------------------------------

Date:    Sun, 24 Dec 2000 18:07:53 -0800
Subject: Re: Surgery Tips

Nan,

I use an electric bottle opener.  It  can be attached under a kitchen
cubboard. It opens small bottles like water or soft drink up to wide mouth
jars and costs around $45.00,   (It was introduced at Fred Myers for $25.00,
until the medical supply people got a hold it, and doubled the price).  To
me it is a pain saver and worth the $45, and I don't have to call on outside
help so often.  It is called "Open-Up Electric Jar & Bottle Opener," both
electric and battery operated.  I am sorry I don't have the Medical Supply
name, I loanded the Medical Supply catalog to someone and forgot who it was.
Your local medical supply might know; I do remember it took some
investigation to find it, my local Medical Supply stores had never heard of
it.  It might be easier now!!

I hope your surgery is successful, my left ulnar nerve improved about 75% in
a few months, so it does happen.

Peggy
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