Anybody had hand surgery?

[Gary75]

Im facing hand surgery on my right index finger, does anyone have experience of surgery on the hands?. Recovery times etc?. My flexor tendon on that finger has become stuck, tendon problems are quite common in people with Type 1 diabetes apparently. Im quite scared of the recovery process and if it will pose any further problems to me. First thing on a morning I can't close that finger until I get moved around and heat gets into it. I tried Ibuprofen gels but they are not working so the only other option is surgery to release it.

 

Im presuming that because there is so little skin thickness in the palm of your hand that healing will be pretty quick. I don't feel it's affecting my playing too much as it tends to come into play at a point below the key depth of a keyboard, but it is annoying to say the least.

 

 

[BluesKeys]

First let me say I am currently going to school in massage therapy. There can be several things going on to create the problem you are having.

1. Cubital tunnel syndrome. This is where the two heads of the flexor carpi Ulnaris muscle come together just off your elbow. They form a canal where the Ulnar nerve comes through. Pressure on this nerve could have the same or similar effect on your fingers.

 

2.Overuse and that would be less than average for someone with T1 diabetes.

 

3. A fall or leaning on the elbow

 

Soft tissue manipulation can offer relief for this symptom.

 

I suggest consulting with your doctor about this. If he agrees he may also know of a massage therapist in your area who can help. If he can't recommend someone just ask other musicians in your area since most of us have had some sort of forearm problems.

 

I would exhaust all the alternatives before surgery.

[StanC]

I had surgery twice on my left 5th finger due to a condition called Dupuytren's Contracture. Then tendons in the finger become involved with tissue growth and draws the finger in towards the palm. The recovery was about 5 weeks, however the surgery was unsuccessful leaving me with 4 usable fingers on my left hand. A few years later the same condition appeared on the 5 the finger of my right. I have not attempted any corrective surgery. I am now one of the few (or maybe the only) keyboard players with 8 fingers!

[Gary75]

Well I had an ultrasound, and it seems the problem is localised to the bony part about 1cm below the bottom of the index finger palm. This is where the stiffness is at. I have had steroid injections which alieviated trigger finger issues but this is no longer a triggering issue and more of a stiffness issue on the index finger. Apparently instead of the tendon sliding through the sheath, it is actually stuck to the sheath and the whole thing is bending instead of sliding. I'd love to try massage therapy, but I can't see it being able to detach a tendon from it's sheath.

 

[Gary75]

Stan, my father has that condition. He has not had it treated yet, but his fingers are turning towards the palm. He worked with his hands a lot, he has Type 2 diabetes. Im expecting my hands to deteriorate as I get older, but hoping that future medical advances will allow me to keep playing to a certain level.

[Joe Muscara]

I would exhaust all the alternatives before surgery.

+1,000,000

[marino]

I never had any hand surgery, or serious hand problems even when I played with less than correct technique as an adolescent. A student of mine who plays double bass had a tendon which went slightly out of place; the operation lasted 15 minutes, and he recovered totally in a few weeks.

 

Now, get ready for an horror story: When I was about 15, a fellow piano student who was about my age had an accident, and completely cut all tendons on the back of his right hand.

The happy ending: After surgery, followed by about 18/24 months of careful phisiotherapy, he started playing again. I suppose his young age helped a fast and strong tissue reconstruction.

[Tonysounds]

About 15 years ago, I had surgery to remove a pretty decent size tumor from right pinky. Short story: while I was told 6 weeks before I could start playing again, I was playing pain free in two weeks. Good luck with everything.

[nmcq]

If they've called it "trigger finger" (which it sounds a lot like) my understanding is that it's pretty simple surgery HOWEVER some doctors will start with a cortisone shot or two to see if they can dissolve the nodule that's preventing movement first.

 

You might want to consult with a physiatrist (that's an MD who specialized in physical ways to treat conditions, as opposed to other orthopod docs who like to start with a scalpel)

 

If's it not trigger finger, never mind but good luck.

 

Neil

 

[SK]

b3boy, I can't comment on your specific problem or the capability of your doctor, but as general advice - it's far better (and cheaper) to get the opinion of the very best hand surgeon you can find than opting for surgery as first choice.

 

A lot of surgeons have an itchy scalpel finger and often recommend surgery. Surgery will probably fix it, but it should be last resort. A second opinion couldn't hurt, and then you won't wonder if you're making the right choice.

[BluesKeys]

Well I had an ultrasound, and it seems the problem is localised to the bony part about 1cm below the bottom of the index finger palm. This is where the stiffness is at. I have had steroid injections which alieviated trigger finger issues but this is no longer a triggering issue and more of a stiffness issue on the index finger. Apparently instead of the tendon sliding through the sheath, it is actually stuck to the sheath and the whole thing is bending instead of sliding. I'd love to try massage therapy, but I can't see it being able to detach a tendon from it's sheath.

 

B3er, one of the things massage therapy does is break up soft tissue adheasions. I would certainly give it a try and if after 2-4 sessions there is no progress then maybe take SK's advice on a specialist.

[Gary75]

Thank you for the advice everyone. This massage therapy does seem to be worth a shot. Im currently under the NHS here in the UK but I do have a private healthcare scheme so should have fairly instant access to this if their is a long wait NHS wise. Im just fed up with trying things and getting no where. In the last two years I have had trigger finger on 2 or 3 fingers, and it's coming back on my fourth on my left hand. Im not too bothered about it at the moment, it's the index causing me the most pain.

 

Thank you all for your advice, maybe I'll hang inthere and try this before I let them dig the scalpel in.

[Griffinator]

Any doctor worth his salt will have you explore every possible alternative to the knife before he puts you under one. If your doc is all hopped up to cut your wrist open, find another doc.

[timwat]

I had surgery on my left pinkie about 20 years ago, due to an injury suffered while working at UPS (loading boxes). The knuckle had gotten pulled open and tendons got caught in the opening.

 

Surgery was relatively straightforward and recovery time as described by the docs (although I don't remember how long that was - it was two decades ago). However, the surgeon warned me that it was likely it would NOT heal as pre-injury, and indeed it has not. The finger will not lay flat, there is always a minor arch in the knuckle, and it does effect finger strength for playing.

 

Of course, being right handed my left pinky was one of my weakest fingers to begin with, so this doesn't help. Agreed unless you have a severe injury that cannot be repaired any other way (such was the case with mine), I'd pursue viable alternatives before going under the knife.

 

Best to you, hope this all works out for you.

[steinwaym]

I would also try "Active Release Therapy" It is sort of a "deep tissue massage" technique that is primarily practiced throughout Canada, but also in the U.S. I was virtually unable to play piano, and went through many traditional doctors who all suggested surgery, until I found a "miracle worker." In Anchorage, Alaska no less....

[Moonglow]

.....A lot of surgeons have an itchy scalpel finger and often recommend surgery. Surgery will probably fix it, but it should be last resort.....

I think this is excellent advice. Regarding the orientation of a surgeon, as a doctor friend once told me: "A carpenter has a hammer which he uses to hit nails. Surgeons have scalpels with which they operate."

 

Also, here are some questions I always ask a doctor regarding any diagnosis they render:

 

1. What would you have to see that would rule out your diagnosis?

 

2. Is there any alternate explanation?

 

3. Do you see anything at all that works against your diagnosis?

 

These questions are subtly different, and I've had a doctor or two become offended when I ask them (especially the ones with a "god complex"), but I feel they are important, nonetheless. If a doctor is unwilling to acknowledge other potentially contributing factors or alternate treatments, this may tell you something about him/her.

 

[Marzzz]

A surgeon once told me, "the most important thing for a surgeon to know is when not to operate." While there are instances where you should proceed with surgery (we REALLY need to take out that inflamed, about to perforate appendix) generally it is always best to exhaust all conservative treatment options first.

[SK]

A last point (sure, this is overkill here) but it's not simply that some surgeons will unnecessarily recommend surgery. Those same doctors are often more concerned with making money with a quick fix, than they are about the best, humane treatment of the problem. The point is surgery can occasionally lead to more complications, which the doctor will say "no problem, we'll just do another surgery."

 

Most of the time surgery is safe, but there's always a low risk.

 

I was fortunate to have had a world class hand doctor who fixed my tendon problem without surgery, when other doctors I'd seen were calling for major invasion.

 

Always get the best doctor and save the guessing game.

[eric]

Another thing about knife happy docs is they can sometimes get their patients hooked on all these unnecessary procedures. I have a friend whose mom has literally had dozens of surgeries and it all seems overkill. She uses the surgeries to plot out her year, just like this..."well I had my pinkies done last month and he's gonna do my elbows next week and then my shoulders after that." Talk to her in 6 more month and it is the same story, often covering the same body parts OVER AND OVER. I have probed a little bit without trying to be nosy and this lady seems to be addicted to surgery.

[Jode]

I'd also suggest trying acupuncture. It will definitely get some lubricant flowing in your soft tissues. But add me to those who say to try anything and everything short of being sliced open. No matter how good your surgeon is, once a body part is cut open, it does not go back together the same way again. Best to not cut on things unless you really have to.

[Gary75]

Im going to give this a go. It's a while until my follow up apointment in a few months so I will explore some less invasive treatments.

 

http://www.amazon.co.uk/Zen-Lifestyles-Physio-Massager-Infrared/dp/B000WE1UIK

 

 

[echo44]

I had hand surgery for cut tendons. I was moving to a new house and put a lock

blade in my pocket to open some boxes. The blade unlocked and stabbed my leg while i was carrying a box. I had forgot about the knife and with out looking

thought i was being stung by a bee. I tried to kill the bee with my hand 3 time before i bothered looking why it was still stinging me. I looked down and saw blood streaming from my hand. I lacerated my tendons. Had surgery by a world expert and my recovery was 100%. In fact I don't have any loss of function and no difference from my other hand.

[GregH]

B3Boy - Very sorry to hear about your finger problems. However, I want to also encourage you to seek the best medical attention possible, and if the doctors agree, to try non-surgical treatments first. Once all is said and done, even if you never get back to 100% physically, it need not impact your playing, your passion for music or the satisfaction you derive from it.

 

I also had an injury to my left hand that rendered my 2nd, 3rd and 4th digits useless for an extended period of time, and while it was disheartening and painful (and leaving me with a shorter middle finger), it may have been one of the best things that ever happened to me in terms of my playing with a band.

 

As a pianist and former accompanist, this injury made me really have to think about and be more selective about which notes to play with only 2 fingers available, rather than doing what pianists often do (e.g. playing lots of notes, big cluster chords, etc.). Less actually IS more...

 

After my injury/surgery had healed, it was wonderful to be able to gradually introduce my somewhat atrophied fingers back into my playing (although, I hope that I never revert to the bad habits that I had prior to the injury). Within several weeks, the fingers had become more flexible, the pain was gradually going away, and I was able to use them on the keys again (although I had to adjust for the shorter middle finger). Plus, I was able to learn several things, like 1. Don't mess with lawn-mowers when they're running, 2. Some of the best musicians have overcome huge physical limitations to expresss themselves via their instruments (think Django Reinhardt), and 3. One's attitude about a physical limitation is WAY more limiting than the actual physical issue.

 

Take care, and hang in there!!!

 

Greg

 

[Gary75]

Thanks Greg for your story and words of encouragement, I had my final course of steroid a couple of months ago, it's not really working, I'm also using a deep tissue massager which does help. I'll have to go private, the NHS doctor I got said not much could be done with my right hand but could do surgery on the left. She looked straight out of med school and I didn't listen much to what she said, which was very little. It's not like I'm asking for brain surgery! I'm not stressing too much because the tendon problems come into play beyond the physical keydip of a piano. Still, it may get worse so I need to do something specialist wise. My responsiveness in my right index finger is slow.with tissue thickening. All diabetes related. I really feel for Keith Emerson right now.