Had my first PT appt today
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wrote on 23 Sept 2020, 19:55 last edited by Horace
Yesterday my surgeon called me to chat, check up on me, and let me know how fragile the repair is on the thumb side. Since this is a tendon graft, there are two sides to the repair, but the side in the forearm is not so fragile since he wrapped one long tendon around another. The thumb part, though, that is held by a tiny anchor and a single thread. It is a raw tendon being held against a raw bone. He scraped the bone before placing the tendon against it, to promote the healing response. So I am to be super careful. Duly noted.
This morning I went to PT and got my cast off and my splint on. In the therapist's manipulations of my thumb, she would grab the top part, pressing directly onto the repair site, then bend. She did that so many times. I'll just bet in retrospect she didn't even know where the repair site was. I'm trying so hard to fight my natural impulse to tell my expert health practitioners that they are doing it wrong. I didn't say anything and let her press into the repair multiple times. She knows what she's doing, right?
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wrote on 23 Sept 2020, 19:57 last edited by
Wrong. It's your hand. When you see a concern bring it up there and then. The surgeon's word would carry more weight than the PT with me, although that is not always correct.
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wrote on 23 Sept 2020, 20:09 last edited by
What Mik said. If the therapist has any questions, s/he should call the doc for advice.
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Yesterday my surgeon called me to chat, check up on me, and let me know how fragile the repair is on the thumb side. Since this is a tendon graft, there are two sides to the repair, but the side in the forearm is not so fragile since he wrapped one long tendon around another. The thumb part, though, that is held by a tiny anchor and a single thread. It is a raw tendon being held against a raw bone. He scraped the bone before placing the tendon against it, to promote the healing response. So I am to be super careful. Duly noted.
This morning I went to PT and got my cast off and my splint on. In the therapist's manipulations of my thumb, she would grab the top part, pressing directly onto the repair site, then bend. She did that so many times. I'll just bet in retrospect she didn't even know where the repair site was. I'm trying so hard to fight my natural impulse to tell my expert health practitioners that they are doing it wrong. I didn't say anything and let her press into the repair multiple times. She knows what she's doing, right?
wrote on 23 Sept 2020, 20:10 last edited by@Horace said in Had my first PT appt today:
She knows what she's doing, right?
If she does, she is one of the few.
People are no darned good.
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wrote on 23 Sept 2020, 20:47 last edited by jon-nyc
From your tone it’s obvious you don’t believe she received that communication from your surgeon. Why would you just let her do that? Honestly Horace that post made it sound like you’d be willing to lose use of your hand just prove a point.
Be a little less dedicated in your cynicism.
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wrote on 23 Sept 2020, 20:52 last edited by
You consistently misinterpret me jon. I did not at the time consider there to be any important communication she should have received from the surgeon. I considered the injury and the repair to be the basic information she would know. I gave essentially zero credence to the notion that she needed to be told by me the basics of my injury and its repair. I was not attempting to prove a point, you imbecile. I was trying to avoid insulting her by patronizingly mansplaining what she should be assumed to know.
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wrote on 23 Sept 2020, 20:53 last edited by
@George-K said in Had my first PT appt today:
What Mik said. If the therapist has any questions, s/he should call the doc for advice.
Hard to pre-judge who is actually correct but the surgeon is the most accountable and is the captain of your thumb. Agree with George.
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wrote on 23 Sept 2020, 20:55 last edited by Jolly
Listen to the doc.
I have seen PT's screw up.
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wrote on 23 Sept 2020, 20:57 last edited by
Anyway this post was about my own reflections on what I chose to do in the moment (not say anything). Maybe she was aware of where the repair was, and was correctly assuming that it was not fragile enough to worry about pressing against it. In retrospect, I doubt it, but I do try to respect people in the moment.
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wrote on 28 Sept 2020, 15:03 last edited by
Update, please?
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wrote on 28 Sept 2020, 18:03 last edited by
I think I can twitch it... I have the surgery followup with the doctor early tomorrow and I'll probably know one way or the other. I'm still paranoid to try very hard but I think I was able to produce flexing tension on the thumb ring on the brace.
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wrote on 28 Sept 2020, 18:36 last edited by
Really hoping for good news on the thumb post-surgery evaluation. It can take a (long) while for recovery.
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Really hoping for good news on the thumb post-surgery evaluation. It can take a (long) while for recovery.
wrote on 28 Sept 2020, 19:06 last edited by@kluurs said in Had my first PT appt today:
Really hoping for good news on the thumb post-surgery evaluation. It can take a (long) while for recovery.
+1 on both points
It's surprising how long it can take for the swelling to go away, and it impedes movement until it does go away. -
wrote on 28 Sept 2020, 22:47 last edited by
Thanks George, kluurs and Brenda.
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wrote on 28 Sept 2020, 23:11 last edited by
Best wishes tomorrow.
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wrote on 29 Sept 2020, 00:37 last edited by
Hope you get good news...
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wrote on 29 Sept 2020, 00:38 last edited by
What Jolly said.
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wrote on 29 Sept 2020, 00:56 last edited by
What everybody else said!!!
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wrote on 30 Sept 2020, 17:26 last edited by
Nah, something is wrong again. I can pinpoint it to what the PT did but that is never going to be accepted so I'm just going to shrug with ignorance as it ever so slowly dawns on everybody that there must be another tendon discontinuity. I really like this surgeon and he does want this to work. But he's not going to conflict too strongly with his PT team and there can never be any proof of anything anyway. I can't twitch the thumb anymore. That got a shrug and a positive thoughts reaction from the surgeon yesterday. It will take time before the fact that the joint is non functional is accepted. I am familiar with this process from last time. Maybe there will be another procedure. I have three months of free medical care, so there's at least that.
Education is extremely important.
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Nah, something is wrong again. I can pinpoint it to what the PT did but that is never going to be accepted so I'm just going to shrug with ignorance as it ever so slowly dawns on everybody that there must be another tendon discontinuity. I really like this surgeon and he does want this to work. But he's not going to conflict too strongly with his PT team and there can never be any proof of anything anyway. I can't twitch the thumb anymore. That got a shrug and a positive thoughts reaction from the surgeon yesterday. It will take time before the fact that the joint is non functional is accepted. I am familiar with this process from last time. Maybe there will be another procedure. I have three months of free medical care, so there's at least that.
wrote on 30 Sept 2020, 17:41 last edited by@Horace said in Had my first PT appt today:
I can pinpoint it to what the PT did but that is never going to be accepted so I'm just going to shrug with ignorance as it ever so slowly dawns on everybody that there must be another tendon discontinuity
The surgeon MUST be made aware of this. If the PT did damage, he should stop referring patients to that organization, or that therapist's qualifications/abilities should be re-examined.
Also, does the surgeon say "Wait, and see how it goes?"
The problem with tendon injuries is that if they're not repaired, the tendon can atrophy and become useless for further repair. That's the physiology of rotator cuff arthropathy. If the rotator cuff repair is delayed, the tendons turn to mush, and won't hold a suture. I'd see him again ASAP.
