Left Wrist Replacement:

After years of suffering from left wrist pain, it got to the point where I was avoiding using my left hand at all. I couldn't type more than 100 or so words a day without causing extreme wrist pain. I was wearing a splint most of the time. Surgery was not my first choice, but steroid injections had done nothing. Even while splinted, my wrist would still give me spikes of pain that would have me clutching my hand and unable to speak.

Wrist replacements are more common now than they used to be, though they are still pretty rare. I was only able to find one surgeon in the state of Maryland who performed them. The research online I did prior to meeting the surgeon was not optimistic. Most of the sites said that wrist replacements only lasted 1-3 years, on average; and that there wasn't much that could be done after that. Most sites described the "ideal" wrist replacement candidate as someone in their 80s who would use the wrist minimally (and the implication being the person wouldn't live long enough to really see it fail). I'm not in my 80s and, with my right wrist fused, I rely on my left wrist to do things my right wrist can't.

The surgeon, though, offered me different information. He explained that, if the person respected the weight limits for the wrist, a wrist replacement could last as long as 10-12 years before needing another surgery to fix it. Hardly ideal for someone who was 26, like I was, but still better than the internet led me to believe. He warned me that I would lose some range of motion permanently, but as I wasn't able to use the range of motion I had, it was a price I was more than willing to pay.

In preparation for the surgery, I stopped taking Enbrel 2 weeks before the surgery and switched to Prednisone. The day of the surgery, I showed up at the Baltimre hospital, 45 minutes from home, at 6 AM. After the nurse finally hit a vein, I met with the anesthesiologist to discuss options. Because I have limited jaw opening, we decided to use sedation and nerve blocks instead of general anesthesia. In retrospect, I know that was the wrong choice.

After being wheeled into the operating room, I fell unconscious, as expected. But suddenly, I felt like I couldn't breathe. Knowing my left arm should not move, I tried to focus my energies on moving my right arm and legs. I woke up to pulsating pain in my left elbow and the sensation of not being able to breathe. The nurse put a pillow behind my neck. I coughed and finally felt like I could breathe again. I asked if my left elbow could be bent just a little. The surgeon said, "No." Then, I asked how long the surgery had been going on. The nurse answered, "15 minutes."

At this point, I began to freak out. 15 minutes??? I'd assumed I'd woken up for the last 15 minutes of the surgery, not the first! The nurse must have slipped some anti-anxiety medication into my IV, because I suddenly started feeling much more relaxed. I eventually fell back unconscious.

After the surgery, I was wheeled into a private room. Because of my IgA immune deficiency, I was being kept overnight to receive extra antibiotics. Unfortunately, though the nurse and medical staff had been told of my allergy to morphine, I was given an IV morphine-derivative for pain relief. Instead of changing the drug, I was given more and more benadryl, which worked less and less effectively. I kept waking my husband, who was sleeping in a chair next to me, to scratch my back. The one upside to this was that we got to watch the sunrise over Baltimore: especially moving for me, as I'd never watched the sunrise before.

I was released the morning after the surgery with a prescription for another morphine-derived pain-killer, although it took a few days to figure that out. I stopped taking the pain-killer two days after the surgery and switched to Tylenol #3s, which I had on hand. I'd been warned that the pain would increase once the nerve block wore off (which usually happens within 48 hours), but felt confident the worst was over. I was wrong. Thursday night, three days after surgery, the pain became excrutiating. Knowing I couldn't go back to the morphine-derived pain-killer, I took pain-killers left over from the surgery I'd had done the year before. Unfortunately, I only had 4 of these pills.

To complicate matters, it was now the Friday of Fourth of July weekend. Pharmacies also require written, not faxed, prescriptions for strong pain-killers. To drive to Baltimore on the Friday of Fourth of July weekend, leaving me home alone for hours, was something my husband was very reluctant to do. After playing phone tag with the surgeon on call all morning, I finally got a new prescription at 2:30, just as my last pain-killer was beginning to wear off.

After months of occupational therapy, my new wrist settled. I now have 15 degrees of motion up and around 40 down. This was less than I expected, but, overall, the surgery was a success. I'm able to type without difficulty, though the weight limit (I'm restricted to 10 pounds or less, forever, on my left hand) can be difficult. I've found that my left arm has weakened significantly since the surgery, while my right arm has grown noticeably stronger.

Even with all the complications and disappointments, the surgery was successful and definitely the right choice.