Contemplating hand surgery

Raymond Richard

Raymond Richard

Joined
Jun 17, 2001
Messages
5,705
My right hand has suffered a lot of abuse starting from my late teens to the present. Well over 40 years worth of abuse. I met with a surgeon not quite a month ago and was given two options. I was told flat out the first option wouldn't work because of what I do. The other option is having several of the joints fused together that would involve the right thumb and the joints connecting it to the wrist. I was told I would just lose a little movement in that part of the hand. If I did have it done I will not be able to do any knife work including hand forging for at least 4 months. I'd like to hear from someone that has had some bones fused or knows someone that has had it done. Does it work and does the pain go away. I know bone fusion has been done with backs and I've heard good and bad both. I did some forging yesterday and it reminded me why I went to see the surgeon.

Thanks!
 
Hello Raymond.
I for one would sure miss the beautiful work you do. Hey are you sure that is what is needed ? Could it be a carpal tunnel sindrom problem? I had the surgery - minor - for me on both hands at the same time. I was over it in two weeks although for some it can be a lot longer. What happens is the nerves get pinched and you get a feeling that your fingers are falling asleep. It gets worse as time goes on. The less you move your hand the longer it stays "asleep." I hope this is all it is. Frank
 
Frank Niro said:
Hello Raymond.
I for one would sure miss the beautiful work you do. Hey are you sure that is what is needed ? Could it be a carpal tunnel sindrom problem? I had the surgery - minor - for me on both hands at the same time. I was over it in two weeks although for some it can be a lot longer. What happens is the nerves get pinched and you get a feeling that your fingers are falling asleep. It gets worse as time goes on. The less you move your hand the longer it stays "asleep." I hope this is all it is. Frank
Click to expand...

Frank, Its not carpal tunnel. I do have tendinitis I deal from time to time. I had x rays taken of both hands a few months back thinking I would get treated for arthritis and I met with a specialist that deals with that. Then I went to a hand therapist who suggested I see a surgeon after saying the damage in my right had was not from normal wear and tear. I asked the surgeon how they tell if the joints are ok and she said there would be a line between the joints. She pointed out at least 6 joints where it was just bone on bone.
 
That bone on bone could easily be the angle the pictures are taken. Personally if your hand still works I wouldnt have it done. But thats easy for me to say.

Maybe you should make left hand knives.
 
With a carpal fusion you potentially could lose considerable motion in the wrist. I would definitely go over your potential motion loss with the hand surgeon again to verify that you would be able to do what you would like afterwards. I would make sure the surgeon knows the extent of the activity that you perform. I am a physical therapist, and by no means a hand surgeon, but the potential motion loss is there. It is also dependent on how many joints he is looking at fusing.

Tad Lynch
 
Ray, I am saddened to hear this!:(

Has your doctor discussed what effects the fusions will have on the joints adjacent to them if you continue your typical pursuits after the surgery/healing? I know in the case of backs, at least, the fusion frequently causes the adjacent disc(s) to go bad quickly because of shifting the stress point, and can lead to more surgeries.

Good luck with this.
 
Bruce Bump said:
That bone on bone could easily be the angle the pictures are taken. Personally if your hand still works I wouldnt have it done. But thats easy for me to say.

Maybe you should make left hand knives.
Click to expand...

Well, I'd leave the diagnosis to the experts, but that being said, it sure couldn't hurt to get someone else to look at the images...
 
I don't know anything about these issues but I'm so sorry for your situation, your work is always an inspiration for most of us. Take care...
 
Bruce Bump said:
That bone on bone could easily be the angle the pictures are taken. Personally if your hand still works I wouldnt have it done. But thats easy for me to say.

Maybe you should make left hand knives.
Click to expand...

They took 3 shots of each hand so it wasn't an angle issue. Between playing high school football and a fight or two the right hand was toast before I even got drafted by Uncle Sam. It was put in a cast back then but didn't do any good. I tried to use it to get out of the army but as long as I could make a fist the army still liked me. Its more of a pain issue now. They have me on one pain pill that helps most the time but not when I over exert it like when I forge. The next step with the pain pills would be a narcotics and that I don't need. I'd be crazy and constipated at the same time. About the only thing I can do with the left hand is comb my hair and you know what a joke that is. Its really not in much better shape than the right.
 
Mr Richard
Two things
1) For something as possibly life changing as carpal and metacarpal fusing
I would get a second heck maybe a third opinion, by Hand Surgeons not Gen Orthopedic surgeons
2) I have seen dozens of bone to bone joints repaired with hinged silicone implants.The implants may not be able to handle the pounding of forging though. Most were older sedentary adults
The technology of implants should be much advanced since I left the O.R. 5 or 6 years age
Tom
So.Ga.
 
That's sad new to hear Ray. I hope that you make the right decision with your situation. I pray that you can make knives for a long time down the road. It would be sad if you had to stop creating them beauties. I hope to see many more from you. Good luck and keep us posted. :thumbup:

Terry
 
Bruce Bump said:
That bone on bone could easily be the angle the pictures are taken. Personally if your hand still works I wouldnt have it done. But thats easy for me to say.

Maybe you should make left hand knives.
Click to expand...

Thanks for pointing that out, Bruce.
I tried to call you Ray.
Without sounding condescending, if you go to a "surgeon", that's what he's going to recommend - surgery.
That wouldn't be my NEXT step, that would be my LAST step.
You can't un-do surgery.
I would see every nutritionist, chiropractor, orthopedist, sports medicine specialist, etc. before I would go under the knife.
I know you've dealt with this a long time Ray. You told me a dozen times how much your hand bothers you.
But it's the only right hand you've got.
Hang in there a little longer, Friend.
Get a few more opinions first.
Then check back in with us here.
You lift us up.
 
You can still forge again, right? It doesnt take much of a grip to hammer a blade really. The loss of motion may not be much of a problem. Maybe they can cast your hand with a hammer handle in your grip? That way rehab wont be very long.
 
I guess what I was hoping to hear is, have the surgery and don't look back. I don't have health insurance but I did qualify for VA Health Care and so far I've been more than satisfied with the care I have received not to mention Portland has one of the top VA Hospitals in the country. Actually I was surprised that they even offered to do the surgery on my hand. One of the last things the surgeon told me when I said I'd think about it was. If it keeps you awake at night its time to have it done. I sleep pretty good and always have. Thanks for your input and concern!
 
+1 on surgery being the last resort unless you have a degenerative condition that needs arresting NOW, or have tried every other option and it's getting worse (or not getting better).

I had surgery on both of my shoulders to relieve impingements. I tried PT, targeted exercises, NSAIDs, and direct steroid injections. Not to mention just sitting around and doing nothing. I talked to multiple surgeons and decided on the one who actually took the time to explain things to me and approached it from an engineering perspective instead of just blowing me off.

Invariably the surgeons I've seen have recommended surgery. They usually don't consider other alternatives (plus it's how they make payments on the Porsche).

Please, get multiple opinions before you have any cutting done. Mine was a success story but many are not.
 
I don't know anything about the medical stuff Ray. But which ever way you decide to go I hope your still able to do your knives. Everyone of them have been an inspiration to me. Hope it all gets better.
 
Ray.
I've had several surgeries done including a life saving one I wasn't even aware of that needed doing.The thing is I've got a super G.P. he gets me to the specialists when necessary but always comes back with the same attitude. " I'm not going to let them do anything unless it's absolutely essential." Frank
 
Hi Ray. I haven't had to deal with surgery yet though I have struggled with tendonitis, and I actually have a somewhat similar issue with my thumb due to a bike accident. I've been exploring something that might be helpful weather you decide on surgery or not. Of course you may already be doing this....
Anyway, there is a blacksmith named Uri Hofi who has put a lot of study into ergonomics and designed a very well balanced hammer and way of swinging it that might make a difference for you. I recently got a knock off of one of his hammers (20.00 vs 100.00), and his DVD on ergonomic hammering.
It takes a bit of getting used to, but I noticed a difference with my tendonitis right away. The main difference is that the handle is rectangular rather than oval (and fairly short) so you can have better control, and you hold it loosely with the palm of your hand facing the face of the anvil (rather than the edge of your hand facing the anvil face).
This method seems to transmit less shock to that thumb/hand joint, and less shock up your arm to give you tendonitis. His DVD sells on ebay for about 35 bucks and might be worth checking out. You can see a sample of it on u-tube. I got the hammer from blacksmith depot.
Hope this is helpful. I wish you the best. I know its a pain in the arse to have to pay for your forging with days of pain. I hope you get some relief however you get it. You've been a great inspiration to me everyone else here.
Good luck,
Ed
 
Big-un,

I have constant trouble with my wrist. Starts in the wrist, then moves to the thumb, then the fingers go dead. Usually last for about 3 days, then its good to go for about 5 weeks.

A former co-worker told me it could be "gout". I always thought gout was in your toes, (which I have on a regular basis), however, a guy who suffers from gout said his doctor told him that it can also be in your hands, (especially in the thumbs) and that is what he has, in addition to his toes.

It is just another area to explore with your doctor prior to going under the knife.
 
Boy Ray leave you alone for a couple of days and your going to get cut on.... Seriously though, I had my back done in 96 and it just made things worse. I have had several surgeons want to cut again and as long as I am walking and can sleep some of the time I will live with the pain (with help from pain pills at night). If you can stand the pain then I say wait. If it is preventing you from doing everyday tasks or making knives then you might need to try it. If for some reason you do go ahead with it, then this might be the time to look into some sort of mechanical forging assistance, ie hammer or press. I know you had a press or most of one before the fire. This would cut down greatly on the pounding and deterioration of the hand and tendons. Heck you might be able to live with it if you tried a hammer or press rather than the op. As far as the VA in Portland goes, Great bunch of DOCS. I have been treated better there than at any other Hospital. I even have Dr's calling me to talk about my test results and wondering how I am doing. Not bad for Govt Health Care. Hope you fell better.
 
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