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Request from Patients who have had Dupuytren Surgery
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11/10/18 23:43
Melly 
11/10/18 23:43
Melly 
Re: Request from Patients who have had Dupuytren Surgery

spanishbuddha:
I would ask your physio/OT, they, and nurses, are trained in recovery more than surgeons. It’s true that they will often push patients gently into a pain zone but they also know how much and when to stop so things are not worse. It would be helpful to understand what the restriction is, scar tissue, swelling, blood supply, joints, tendons and flexibility? Tackle these if they exist.

Did you see the helpful exercises posted by the BDS http://dupuytrens-society.org.uk/treatme...-fasciectomy-2/ ?

Thanks for your reply Spanish Buddha. Yes, my PT is getting me to do most of those exercises, except my results are different, hand cant fist, it can only make a "C" shape. I agree it would be useful to know what the restriction is, scar tissue, swelling, blood supply, joints, tendons and flexibility. When I asked the doc about the severe scar tissue...the size of two five cent pieces to the right of the incision and the swelling, he told me that it makes no difference, that it would not stop me from making a fist. But I no longer trust my doctor. I will have another talk to the PT.

Mel

11/10/18 23:51
Melly 
11/10/18 23:51
Melly 
Re: Request from Patients who have had Dupuytren Surgery

wach:
Hi Mel,
personally I would not do such painful exercises every hour. Moderate exercises several times a day might make sense and helped me to recover my hand function after surgery. I am just a patient myself but what you are describing sounds to me excessive and wrong. Would it be possible to consult another experienced hand surgeon, maybe from another Hospital or clinic, what he would recommend for PT?

Wolfgang
Melly:

..., he told me that I need to be pushing as hard at home for ten minutes every hour. i mean, how is that even possible? It goes against the grain to push yourself to excruciating pain. Anyway, my PT had warned me to take pain killers when I saw him because she knows what he's like. I am going once a fortnight or so for PT, sometimes more if she can fit me in. She does push me to pain but not nearly as eye watering hard. So I do feel I am doing everything pretty well correctly and diligently. Soaking my hand in warm water for five minutes, pushing into all exercises for about ten. And this is EVERY HOUR. By late afternoon I just cant bear to do anymore but I do them at least 8 times a day. That's around two hours a day I'm devoting to my hand. Plus all those moments during the day when Im massaging my hand.
...


Thanks for your opinion Wolfgang, Yes, am beginning to see what you mean. Since I've stepped up the exercises to ten minutes every hour, the swelling has gotten worse, even with anti inflammatories.

11/13/18 15:33
GailSusan 
11/13/18 15:33
GailSusan 
Re: Request from Patients who have had Dupuytren Surgery

Melly:
Thanks for your opinion Wolfgang, Yes, am beginning to see what you mean. Since I've stepped up the exercises to ten minutes every hour, the swelling has gotten worse, even with anti inflammatories.
Melly, Have you considered getting a second opinion? You had much more extensive hand surgery than I have had in either hand. I have one incision in my right hand that goes up my little finger and two in my left hand, one of which goes up my little finger. Three incisions and three fingers is a lot of trauma for one hand. Have you considered meeting with another hand surgeon and a hand therapist that he/she recommends, just to confirm that your doctor and hand therapist are on the right path for your recovery?

01/15/19 20:31
Sunbeam 
01/15/19 20:31
Sunbeam 
Re: Request from Patients who have had Dupuytren Surgery

I’m really interested to find this post, I had a fasiectomy 11 weeks ago I have zig zag scar in my palm and up my two middle fingers, at my 6 week check the surgeon diagnosed Complex regional pain syndrome, my fingers that were bent at a right angle were straightened with surgery but I’ve never seen them straight, the scar took a long time to heal and when the dressings finally came off my fingers were bent not as bad as before but definately not straight...my hand was so swollen, numb and painful Physio was almost impossible...my fingers are now less numb, I no longer need pain killers but have Amitriptyline at night for nerve pain... I have seen the OT every week and have been doing the exercises but maybe not as forcefully as I have read some of you are doing, the surgeon says I still have a chance with a lot of work, of getting them straight, I can tell by the OT’s face she doesn’t agree I am heartened a little by reading that it has taken some of you a long time to make a fist, I can still only manage a C, I’ll persevere... it’s my right hand and I’m right handed, I paint watercolours, well I did! My enjoyment in life was sewing and cooking too, I can’t do anything, hardly hold a pencil, and I can’t grip the steering wheel....Please can anyone cheer me up!!!!

01/16/19 08:31
spanishbuddha 

Administrator

01/16/19 08:31
spanishbuddha 

Administrator

Re: Request from Patients who have had Dupuytren Surgery

Sunbeam:
I’m really interested to find this post, I had a fasiectomy 11 weeks ago I have zig zag scar in my palm and up my two middle fingers, at my 6 week check the surgeon diagnosed Complex regional pain syndrome, my fingers that were bent at a right angle were straightened with surgery but I’ve never seen them straight, the scar took a long time to heal and when the dressings finally came off my fingers were bent not as bad as before but definately not straight...my hand was so swollen, numb and painful Physio was almost impossible...my fingers are now less numb, I no longer need pain killers but have Amitriptyline at night for nerve pain... I have seen the OT every week and have been doing the exercises but maybe not as forcefully as I have read some of you are doing, the surgeon says I still have a chance with a lot of work, of getting them straight, I can tell by the OT’s face she doesn’t agree I am heartened a little by reading that it has taken some of you a long time to make a fist, I can still only manage a C, I’ll persevere... it’s my right hand and I’m right handed, I paint watercolours, well I did! My enjoyment in life was sewing and cooking too, I can’t do anything, hardly hold a pencil, and I can’t grip the steering wheel....Please can anyone cheer me up!!!!
Sorry to hear your story Sunbeam. I can’t offer much more advice than has been previously posted. Keep doing exercises, gentle but often rather than forcing the hand. If there’s still swelling keep the hand up when resting in a chair or at night. CRPS too can be a difficult to treat side effect, maybe ask about a nurse specialist for help with treating that. There are techniques for improving touch sensitive nerve pain that might help. It’s not clear how long since the surgery but hopefully you will get there eventually, recovery for some can be slow, several months. Are you able to splint at night, even loosely, to help keep the fingers straight?

01/16/19 10:02
Sunbeam 
01/16/19 10:02
Sunbeam 
Re: Request from Patients who have had Dupuytren Surgery

Thank you for your reply spanishbudda, I’ve worn a splint at night since my surgery 11 weeks ago, I also have to apply silicone strips on the scar and bind my fingers with compression bandages...I’d understood when I was given the splint that it would be adjusted as my fingers straightened but that hasn’t happened...The Occupational therapist I see gave me de sensitisation exercises that have helped the numbness and nerve pain, I feel resistance pushing my fingers towards making a fist but think, hope, they are very slowly moving, however trying to straighten my fingers they feel as locked as they were before the surgery...

01/16/19 10:29
spanishbuddha 

Administrator

01/16/19 10:29
spanishbuddha 

Administrator

Re: Request from Patients who have had Dupuytren Surgery

Sunbeam:
Thank you for your reply spanishbudda, I’ve worn a splint at night since my surgery 11 weeks ago, I also have to apply silicone strips on the scar and bind my fingers with compression bandages...I’d understood when I was given the splint that it would be adjusted as my fingers straightened but that hasn’t happened...The Occupational therapist I see gave me de sensitisation exercises that have helped the numbness and nerve pain, I feel resistance pushing my fingers towards making a fist but think, hope, they are very slowly moving, however trying to straighten my fingers they feel as locked as they were before the surgery...
For some, 3 months can be early in the healing and recovery process. It sounds like you have good support. Maybe ask your OT about warm/hot soaks with gentle stretches or massage to see if they are appropriate for you. I hope you’re back on this forum in a further 3 months to tell us about improvements.

01/16/19 13:07
dupynz 
01/16/19 13:07
dupynz 
Re: Request from Patients who have had Dupuytren Surgery

Hello Sunbeam!
I had a fasciectomy about the same time as you, same fingers, and in my dominant (left) hand. My little finger was at 90 degrees for several months and it will probably never be really straight (my hand therapist reckons) but I do find the thermoplastic splint she made me (which I wear every night) does straighten it out quite considerably. It doesn't stay that way but gradually "heads south" a bit during the day.
I have quite lumpy scar tissue at the base of my little finger which has not reduced, but the scar tissue in my palm looks a bit less so. I wear a silicone strip under the splint at night.
I can almost make a fist.
I'm luckier than you in that I have no swelling!
However, about the 2 month post-op mark just after Christmas, I was having a few days' annual leave over summer (in New Zealand) and did quite a lot of gardening, pruning, and other odd jobs around the house. I used a power drill to drill some tiny holes in the back of some picture frames for the hooks - BIG mistake!! Since that moment the fingers in my left hand have been numb! I've read somewhere that you shouldn't use a vibrating tool after this surgery, but I'd have thought 2 months would be OK.
My hand therapist told me to STOP doing the exercises she had given me and to try and rest the hand (not really possible!) and be careful to keep the wrist straight when keyboarding. I find my hand goes really numb when holding a toothbrush or a pen. My hand therapist made me a new thermoplastic splint which immobilises my wrist as well as my fingers to wear at night but this hasn't helped.
So - for me the numbness in my fingers is my biggest bugbear because my fingers were NOT numb for the first 2 months
One thing we both know - recovery from this surgery is not straightforward, and everyone's therapist gives out different advice from other people's therapists. Who knows if it is the right advice?? My therapist says she will refer me back to the Plastic Surgery Dept if my numbness doesn't go away in the next fortnight.
I hope things improve for you, Sunbeam! You seem to have had a bad time so far.

Edited 01/16/19 13:09

01/16/19 14:05
Sunbeam 
01/16/19 14:05
Sunbeam 
Re: Request from Patients who have had Dupuytren Surgery

dupynz:
Hello Sunbeam!
I had a fasciectomy about the same time as you, same fingers, and in my dominant (left) hand. My little finger was at 90 degrees for several months and it will probably never be really straight (my hand therapist reckons) but I do find the thermoplastic splint she made me (which I wear every night) does straighten it out quite considerably. It doesn't stay that way but gradually "heads south" a bit during the day.
I have quite lumpy scar tissue at the base of my little finger which has not reduced, but the scar tissue in my palm looks a bit less so. I wear a silicone strip under the splint at night.
I can almost make a fist.
I'm luckier than you in that I have no swelling!
However, about the 2 month post-op mark just after Christmas, I was having a few days' annual leave over summer (in New Zealand) and did quite a lot of gardening, pruning, and other odd jobs around the house. I used a power drill to drill some tiny holes in the back of some picture frames for the hooks - BIG mistake!! Since that moment the fingers in my left hand have been numb! I've read somewhere that you shouldn't use a vibrating tool after this surgery, but I'd have thought 2 months would be OK.
My hand therapist told me to STOP doing the exercises she had given me and to try and rest the hand (not really possible!) and be careful to keep the wrist straight when keyboarding. I find my hand goes really numb when holding a toothbrush or a pen. My hand therapist made me a new thermoplastic splint which immobilises my wrist as well as my fingers to wear at night but this hasn't helped.
So - for me the numbness in my fingers is my biggest bugbear because my fingers were NOT numb for the first 2 months
One thing we both know - recovery from this surgery is not straightforward, and everyone's therapist gives out different advice from other people's therapists. Who knows if it is the right advice?? My therapist says she will refer me back to the Plastic Surgery Dept if my numbness doesn't go away in the next fortnight.
I hope things improve for you, Sunbeam! You seem to have had a bad time so far.
Thank you for replying dupynz interesting to hear what stage you are at having had surgery about the same time..I saw my GP this week hoping for advice but I think the treatment is too specialist, all he could say was that injured hands can take up to a year to become functional, tbh if I knew after a year my hand would be right that would be OK...the negativity of the OT isn’t helpful, I can’t knock the treatment I am seeing them most weeks, they’ve supplied me with sponge blocks, rubber balls, various compression bandages but at the end of the day the message is I have to work hard at the physio, it’s difficult to assess if I’m heading in the right direction my end knuckles still seem locked...good luck with your treatment I’ll be interested to hear how you progress...

01/16/19 14:15
spanishbuddha 

Administrator

01/16/19 14:15
spanishbuddha 

Administrator

Re: Request from Patients who have had Dupuytren Surgery

Not to override your OT's advice but want to make sure you have seen these exercises on the BDS website http://dupuytrens-society.org.uk/treatme...-fasciectomy-2/, includes a link to an app if that's something you like.

Edited 01/16/19 14:16

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