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Had fasciectomy on Wednesday
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11/02/2018 09:49
dupynz 
11/02/2018 09:49
dupynz 
Had fasciectomy on Wednesday

Typing awkwardly with my non-dominant right hand. Left hand in a plaster cast with thumb and forefinger free. My little finger was at 90 degrees and ring finger at 45 degrees. Nodules cut out of palm but didn't need a skin graft. Surgeon said it went well and got my fingers straight. Had a general anaesthetic but day surgery only.

I am coping at home alone and it is tricky!! But I made a lot of preparations beforehand and prefer to be alone. I have help readily available and transport whenever needed and of course I do need some help.

I do not have much pain at all - very little in fact. My guess is that when the cast comes off next Wed. there will be more pain and more again as I get into hand therapy. Stitches out 12 days post-op.

Would others who have had this surgery say the pain got worse in the way I predict?

11/02/2018 10:33
Luciferette 
11/02/2018 10:33
Luciferette 
Re: Had fasciectomy on Wednesday

I had a fasciectomy on my right (dominant) hand last year, to correct a 90 degree contracture at my pinky pip joint. They didn't leave any fingers free of the cast, which made life tricky! I also live alone, but I went to stay with my mum for a couple of days straight after the op. I had some initial pain after the nerve block wore off, especially when getting dressed, due to some tight stitches at the lower knuckle joint. In my experience, having the stitches out was a bit unpleasant but the worst pain came from the physiotherapy afterwards! You just have to grit your teeth and get on with it, it soon improves -- in fact, the more you keep up with the exercises (don't push it, little and often I found was the best way) the faster it improves. I had full use of the hand re grip etc after about three months, which sounds a long time but it soon passed.
I'm due a dermofasciectomy for the same problem with my left hand early next year...can't say I'm looking forward to it (skin grafts!), but in all honesty the right hand is much better now than pre-op (about 30 degree contracture as opposed to 90), and knowing what's involved means I'm much less nervous this time round. It was scheduled for last month but my parents were away, and it does make life easier if you have someone you can call on you're struggling with everyday tasks. You manage, though (I even found a way to fill a hot water bottle with one hand lol). Good luck with your recovery :)

11/02/2018 19:33
dupynz 
11/02/2018 19:33
dupynz 
Re: Had fasciectomy on Wednesday

Thank you so much for sharing your experience! I am cheered to have some idea what to expect and how to cope. I will do what I have to with the hand therapy and any pain associated! To be honest I can't wait to get this cast off what with itching skin on wrist underneath!

It really is wise not to be alone from day 1, but I have coped partly from all sorts of tips I got off the internet beforehand on how to manage with one hand. My worst experience was having a shower and the preparation involved with plastic bags (x2) and parcel tape layers to hold the bags completely closed against water entry. So darned hard to shower and wash hair in shower with non dominant hand only.

My brother lives close by and is taking me to the supermarket shortly. I have some jobs lined up for him while he is here. He is only a phone call away at all times and I have 3 very close neighbours who are only too happy to help.

By and large I feel very lucky so far. Brilliant hospital experience also.

I also have Dupytrens in my right hand - middle finger at about 45 degrees - but will ask about Xiaflex for that. In New Zealand where I am, that is not available through the public health system - yet - so I'd have to pay for Xiaflex and have it done privately which I will if it is the best option.

All the best for your future treatments!

11/03/2018 06:09
wach 

Administrator

11/03/2018 06:09
wach 

Administrator

Re: Had fasciectomy on Wednesday

Hi dupynz,

if xiaflex is too expensive you might consider NA (= needle fasciotomy https://www.dupuytren-online.info/needle_aponeurotomy.html) . Dr. Yoon in NZ is doing that https://www.dupuytren-online.info/NA_lis..._countries.html .

Wolfgang

11/04/2018 01:11
Scarlettnova 
11/04/2018 01:11
Scarlettnova 
Re: Had fasciectomy on Wednesday

Hi, I had right surgery on my dominant right hand the June 26. I had no bent fingers. Just nodules and a beginning cord going to pinky. Palm and three fingers involved. Dr. recommended surgery saying the sooner, the better as nodules were active. We had watched them for a year. In hindsight, RT should have been the recommended treatment, but surgeon never mentioned it. Of course, I would have had to travel to another province to get treatment, but it would have been better than the surgery. Lesson learned!

Here are some tips I can give you. As for pain, I really havent had any. Took a pill when I first came home and that was that. Didn’t use the sling unless leaving the house. Kept it elevated a lot the first week. I flexed my fingers in the half cast as much as I could to make sure I could feel everything. Went back 17 days later and had 1/2 stitches removed. That hurt a bit, but nothing dreadful. The first view of the surgery stitches was rather shocking. Didn’t think it would look so terrible. Dr. refused to let me take a photo of it while it was uncovered. Hand was rewrapped without the half cast. The next day, the wrap lost the tape and started coming undone. My daughter, a nurse, came over to rewrap it and at that point we decided as long as it was loose, let’s take a photo. She agreed it looked dreadful, but said everything looked like it was healing well. We nicknamed it the Frankenhand. I can post a photo if you are interested. I was now able to drive myself. Husband was out of town. The next week I returned and had the other half of the stitches removed. Beware that he missed a couple of stitches and I went to duty dr a few days later and he got them out. I returned the next week for final look see and started physio. I did start moving my fingers a bit after the cast came off. This involved using my thumb across my palm to touch each of base of each finger. As soon as possible, I started soaking my hand to get the dead skin off. It felt so good! It took a while. I started touching the scars too. Physio said you need to get your brain back in touch with your hand. I went to occupational therapy for a splint and wear it at night still. Might get the Foxx glove.Your skin is so sensitive I wore a cotton glove on it for a little protection. The Michael Jackson look. For showers, you can buy a cast cover at the drugstore. It was a life saver! Covered hand to above elbow. No leakage. I was able to take it on and off by myself. Used it for several weeks. Get any meds with easy open top. Child proof was impossible to get off. I had no grip strength in my weaker left hand, so jars and things I needed to open were left looser. Had to wear elastic waist pants. Couldn’t do a zipper. No button anything. Learned to hook up bra and pull it over my head. Skipped makeup. I would have looked like the Joker! Slip on shoes. Fortunately it was summer! Learned to eat with other hand. Felt spastic. Can’t cut my meat as couldn’t hold the knife. Couldn’t use scissors. I learned to make do and my husband was back after a couple of weeks. I used the dictation feature on the iPhone and iPad. It’s the little microphone next to the space bar. Just hit it and the screen goes wiggly and start talking. You can tell it to put in Punctuation too. Just proofread before sending!
Research your physio therapist. My first private one was terrible. I think he had never seen this surgery. He told me to do some exercises. I came back the next week and he measured angles and said keep doing them. He never really touched my hand to check things. I returned to dr and he was unhappy with my hand. Sent me to hospital therapy and they were wonderful. I’m still seeing them once a week. It’s been four months! Fingers still a little swollen. Dr. put me on Celebrex for swelling and arthritis. My fingers are flexible, but stiff. I play clarinet and I can do so again. Can’t make a fist yet which means I still don’t have any grip strength. Can’t really lift heavy things with just this hand. While I was healing, I would heat up a little mitt with beads in the microwave to make my hand feel better. Heat felt good. Then later I would use an ice pack to help with the swelling. It went back and forth for weeks. My hand has healed nicely. Scars aren’t too bad. Just gets very stiff. Lots of stretching throughout the day. One of the things really helpful was having my husband massage my scars. It kept the tissue separate. Nothing healed weird. It hurt at the time, but made a difference! Go to a massage place or ask someone to do it for you. The physio did say I was lucky it was my dominant hand as it forces me to use it more. I didn’t think so at the time! Supposedly, healing takes 4-6 months. Heading into 5th month now. Hang in there! If you have any questions, feel free to ask. I’m praying DD doesn’t return. Dr. said he feels a little something in the left hand. I’m already researching RT in another province! I will travel!

11/04/2018 01:55
dupynz 
11/04/2018 01:55
dupynz 
Re: Had fasciectomy on Wednesday

Sigh!!

Your experience, for what was a lesser surgery than mine, or should I say, mine being at a more advanced stage, makes me feel a bit depressed!

Not that I have been under any illusions about the length of time it will take to get the full use of my hand back, but if you took 4-5 months, I guess I'll take longer. People's experiences on this forum were more enlightening than anything I have been told by the medical profession about the time it will take to recover, though the surgeon did of course point out the likelihood of recurrence, possible nerve damage etc.

I am a bit impatient about it all, even knowing what I did before "going under the knife", because I live alone and I'm ferociously independent. Want to be able to drive as soon as possible, do vacuuming etc and mow the lawn but those things will be quite a way off. It's late spring here so the garden beckons! I found I could do hand-held hose watering with one hand OK and a bit of weeding.
Wiggling my fingers a little in the full cast (thumb and forefinger free) I reckon I might have lost a little sensation in the little finger. Peering down the top end of the cast I can just make out that fingertip (plus the others) so at least it's upright for the time being! My job will be to make it stay there!

Cast comes off on Wednesday (we are a day ahead of the US, if that's where you are, so right now is Sunday 4 pm), so I go back to the Plastics Surgery Dept for that.

I will expect to see an ugly sight. Before I ever went down this track I did look at a lot of Google images of hands operated on - with dermofasciectomies included - so I don't think I will be too surprised.

Other therapies could have been used if I'd got it seen to at an earlier stage - well, one guy had a go at NA on my worse (left) hand a year ago without much success - but that is largely my fault, not being proactive enough. I will get my right hand dealt to by non-surgical means as soon as my left hand is able to function well enough.

By the way, I found I could do up the hooks of a bra with one hand by having them at the front, then pulling them to the back before putting arms through the straps. Can unscrew jars if I hold them between my knees and unscrew with my free hand, but only for dry goods - not liquid contents or they would be all over the floor.
Dealing with toothpaste is tricky - it goes everywhere, and cleaning my teeth with the "wrong" hand is hard. I use dental brushes instead of floss (which I had anyway).
I found I could do up shoelaces, sort of. Can only wear things that I can get my cast through the sleeves of which is quite limiting. Being at home much of the time it doesn't matter what I look like. Can't put in stud-type earrings, can put on some makeup.
I cannot write a legible word with my right hand Most people can write a lot better with their other hand than I can. Wish I'd practiced years ago at being ambidextrous.

Edited 11/04/18 04:10

11/04/2018 13:13
Scarlettnova 
11/04/2018 13:13
Scarlettnova 
Re: Had fasciectomy on Wednesday

Sounds like you are doing okay. I had the same issues with the tooth brushing! Yes, our cast doesn’t fit into every sleeve. Ha! My husband put in my earrings. That was a learning experience for him! I missed most of the gardening this summer. Could pull some weeds with the weak hand, but that’s about it. When the cast comes off, you’ll see what more you can do. I think the swelling is a big factor in the recovery. If your fingers are swollen, you cannot bend your fingers. Rub your scars to keep them flexible and smooth them out. My physio showed me how to massage those scars using a small hard ball from the Dollar Store. Get it in the Birthday treat section, not toys. Several in a package. Put in on a hard surface, cover with your hand and start rolling. It gets right in the scar tissue. You control the pressure. I did it standing. As for massage cream, I ordered Free-up professional massage cream. “A lubricant for soft mobilization and massage. Enhances tissue perception and provides effortless glide without being slippery.” It was much nicer than Vaseline! Not greasy. Non scented. 8 oz. I still put some on my hand if it is feeling dry. Doesn’t take much. Look for a little cotton glove to wear. I even wear it with the overnite splint. There are some kind of silicone sheets with infused oils that the occupational therapist put on my splint. Supposedly it works its way into your scars at night. I used them for a week or so. Not sure it did anything, but I was game for anything. Get a good physio. I didn’t think I would need one this long... getting that cast off is such a relief. Hang in there!

11/04/2018 22:45
dupynz 
11/04/2018 22:45
dupynz 
Re: Had fasciectomy on Wednesday

Scarlettnova, many thanks for your encouragement - it's what I need most at the moment because a fair bit of what I read here depresses me or makes me anxious! But at the same time, I know it's best not to naive about this and expect a quick fix. My pinkie was well down into my palm but fortunately it hadn't been there so long that there was a knuckle issue that prevented it being straightened. (There is terminology for this situation that others on this knowledgable forum would know for that... but I can't recall!)

When the plastic surgeon saw my hand she said "Oooh, that's a challenge!" (with a smile) but "I love a challenge!". and afterwards she was pleased with the result. All will be revealed on Wednesday! This was not the surgeon I expected because he had some emergency that called him away, but I wasn't going to let the surgery date go by so close to Christmas, because with the public health system here, you cancel something and you wait all over again! But for free (well, paid for by taxpayers like me!), and great care from all involved so not complaining, and the surgeon is a proper plastic surgeon who has done a heap of these ops..... so I'm still hopeful it went as well as she said!! She is an American, BTW, judging by her accent, and I can tell Americans apart from Canadians, which most NZers can't!!

Most sensible people would have taken action sooner than I did but I have learned my lesson and will not let my right hand get that bad!

The products and shops you mention may exist in New Zealand under different names/places but I am sure I can get similar aids, just a matter of asking and researching.

I am now very belatedly going to Google that surgeon!!

Thanks again for your tips and helpfulness!

11/05/2018 07:44
spanishbuddha 

Administrator

11/05/2018 07:44
spanishbuddha 

Administrator

Re: Had fasciectomy on Wednesday

There are some hints, tips and exercises for post surgery here http://dupuytrens-society.org.uk/treatme...-fasciectomy-2/ but the advice of your surgeon or physio should be first.

11/05/2018 11:28
dupynz 
11/05/2018 11:28
dupynz 
Re: Had fasciectomy on Wednesday

Thank you Spanishbuddha for the link to all that info. I sometimes forget all the stuff on this forum apart from people's personal experiences!

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