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George K · M Mik 25 Jan 2022, 00:58

@mik the high dose acetaminophen is amazing for acute pain. One gram every 6 hours. Mrs. George has had dental extractions and (!) a joint replacement using little more than that for analgesia.

Don't exceed the dose, supplement with opioids and anti-inflammatories (which acetaminophen is not!) as needed.

As I've said before, I was impressed with the intravenous route for this drug, and now, it seems that the oral is just as effective.

If you can take it prophylactically, all the better.

George K · wrote on 24 Jan 2024, 01:13

So, about 8 months ago, I started having symptoms on the ring finger of my RIGHT hand. Pain and "catching." I had it injected in June, and got a good response.

Then, about 3 months ago, it started catching again. Not bad enough to require intervention, but just annoying enough. 6 weeks ago, my right thumb started to trigger. This was accompanied by pain, and, in the last few weeks interfered with my trying to play piano.

I saw the hand guy yesterday and he injected both fingers.

"So, you've done the ring finger twice now. What happens when/if this recurs?"

"Chop chop." (He actually said that)

"Fuck (I actually said that). If you operate on the ring finger, and my thumb acts up again, as I expect it will, do you have to do a second injection, or can you do both fingers at once, just to save me the extra trip to the OR?"

"Yeah, we can do both. See you in the fall. I'll have them wipe the blood and rust off the scalpels. I'll be waiting for you."

taiwan_girl · wrote on 24 Jan 2024, 02:13

LOL Hope that the injections work for a long time!!

Copper · 24 Jan 2024, 06:45

I have arthritis.
Just over 6 months ago I got a cortisone shot in the left thumb metacarpal. It worked ok.
Now the pain is coming back.
They said I could get 3 shots separated by about 6 months. If it is still hurting, then they'll remove the Trapezium and toss it in the trash.
Then they'll rebuild the lost support by rearranging some tendons.

I haven't investigated exactly how this surgery works yet; I was hoping the cortisone would last longer.

89th · wrote on 24 Jan 2024, 03:17

How does this impact your (cheap) scotch drinking motions?

Copper · wrote on 24 Jan 2024, 03:27

You get a cast on one hand for a few weeks, but the other hand is ok to pour.

If that is a problem, just drink straight from the bottle.

kluurs · C Copper 24 Jan 2024, 03:10

@Copper said in Triggered:

I have arthritis.
Just over 6 months ago I got a cortisone shot in the left thumb metacarpal. It worked ok.
Now the pain is coming back.
They said I could get 3 shots separated by about 6 months. If it is still hurting, then they'll remove the Trapezium and toss it in the trash.
Then they'll rebuild the lost support by rearranging some tendons.

I haven't investigated exactly how this surgery works yet; I was hoping the cortisone would last longer.

I have arthriitis in the same joint (thumb). At one point, I thought I'd have to give up the piano completely. My ortho doc asked what I'd done to mess up the joint so badly - beyond the arthritis.

I'm playing the piano as badly as ever but I'm playing - and it came from using a splint at night to completely restrict movement along with the liberal use of Arnicare on the joint just prior to putting on the splint. I've given the splint/arnicare combo to a few folks who have had a good measure of success. You might want to give it a try.

Jolly · 24 Jan 2024, 12:57

Splints helped the wife at one time. Hers were custom fitted out of a foam that became rigid after molding.
Steroids are a temporary fix, in most cases. When you get them, they're like money in the bank. Spend wisely.

George K · J Jolly 24 Jan 2024, 12:04

@Jolly said in Triggered:

Steroids are a temporary fix

Yup. I am resigned to the fact that I'll need surgery on both fingers by the end of the year.

Interestingly, the injections helped the pain, but both joints are still triggering a bit almost 48 hours later. Hopefully it'll continue to improve.

I got almost immediate relief on the other hand, so I don't know what to make of it.

Renauda · wrote on 24 Jan 2024, 14:52

Sorry to hear this George. It’s sounds to be mire than just the PITA you described a couple of years back.

George K · wrote on 6 May 2024, 23:37

The ring finger continues to deteriorate. Painful for any activity (like piano) and I've really restricted my playing. I was hoping that the thumb would act up again as well, so that the surgeon could do both at the same time.

However, the thumb is fine for now.

So, the ring finger has had two failed injections - surgery is the next step.

I emailed Dave (the surgeon) and asked, "PLEASE, can we do another injection and hope the thumb acts up so you can operate on both at the same time? If the ring finger fails, and the thumb is OK, I guess I'm doomed to another operation."

He said, "Sure. One more injection we can do."

Bullet dodged - for a while, at least.

Mik · 7 May 2024, 00:54

Good. Most people I would not follow that lead, but with you I would.

George K · 7 May 2024, 15:50

@Mik said in Triggered:

Good. Most people I would not follow that lead, but with you I would.

I have very little confidence that it won't recur. Surgery was a nothing, basically, but it stopped my playing for about 4 months. I would just love to get both fingers fixed at the same sitting. But, if the thumb's OK, I'm sure Dave won't touch it.

taiwan_girl · 7 May 2024, 01:43

@George-K how long does the affect of the injection last for?

George K · wrote on 7 May 2024, 01:43

@taiwan_girl said in Triggered:

@George-K how long does the affect of the injection last for?

Variable. I only got about 3 months last time. I imagine the next will be the same.

Jolly · wrote on 7 May 2024, 02:19

Hell to get old.

Copper · wrote on 7 May 2024, 14:18

I'm in the same boat.

Now about 9 months since the shot in left thumb metacarpal, it hurts full time.

I'll be calling today to schedule a second shot. They said I could have maybe 3 shots and then surgery.

I assume surgery will shut down the golf game for a while, I don't like that.

Copper · 7 May 2024, 17:06

@George-K said in Triggered:

it stopped my playing for about 4 months

Have you seen this?

I'm not sure if it applies.

SUTURE BUTTON SUSPENSIONPLASTY (SBS) FOR BASAL JOINT ARTHRITIS

Patients remain in a splint for about five days, after which their dressing comes off. They can begin therapy and start using their hand again immediately.

With traditional thumb arthritis surgeries, patients can be in a cast for one month or longer. The majority of Dr. Yao’s patients get back to normal activity by the three-month mark, if not sooner. Other surgical methods can have double the recovery time, up to six months in some cases.

https://stanfordhealthcare.org/stanford-health-care-now/2021/outpatient-SBS-procedure-for-thumb-arthritis-shortens-recovery-time.html#:~:text=One of these advancements%2C suture,for its rapid recovery time.

George K · C Copper 7 May 2024, 15:50

@Copper it's not arthritis. It's a trigger finger.

George K · wrote on 10 May 2024, 01:10

Finger injected yesterday...

Surgeon said that there is evidence that after a steroid injection, if surgery is performed less than three months after the injection, risk of infection is higher. Statistically significant, but probably not clinically significant.

But, pain is gone.

The finger is still triggering, but he said this might last a few days.

The good thing is that, even though triggering, playing the piano (I tried today) is not painful.

The plan is to see what happens. If triggering recurs, I'll ignore it, as long as it doesn't REALLY affect function. If it causes pain, that's a different thing, of course.

Hopefully (?) the thumb will start acting up as well, and I can get both of them done at the same time.

The New Coffee Room

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