Leslie Runs

My journey as a long distance runner who started the sport later in life.

Second Opinion (#justfingers #running #accident #injury)

I had a follow up appointment with my surgeon today. He told me that I am the patient that keeps him awake at night. He told me that if I didn’t indicate to him otherwise that he would believe I have had no physiotherapy since my surgery. After 30 plus PT appointments and feeling like few gains have been made it is nice to be corroborated, even if it is extremely bad news. I knew I was resenting all that time I had spent in PT for a reason.

He is always so tender and gentle at these appointments. I told him to go ahead and do his worst with the fingers to see what he thought; he couldn’t cause me any more pain than PT does. We were there for quite a while, so long, in fact, that I had to call and cancel tonight’s PT appointment. After going without supper and nearly getting into a serious car accident trying to race across town to a different hospital the last time, this time I figured canceling was the smarter move.

So here we are. Where are we? He was all about tenolysis, a surgical procedure that has a very bad success rate, that is very dangerous, and that scares the living daylights out of me. It is what he said we were trying to avoid, but somehow we wound up there anyway. I do not get the notion that he is self-serving and manipulative, but how did it come to this if he’s not in some way those very things? I already know some of what we all did wrong. No point in dwelling on it here. I told him he could get an article published in a medical journal based on my case. This did not seem to be his primary interest.

He does want my fingers to work, but his tried and tested methods for early movement did not work in my particular case. The reason for installing titanium plates is to get early movement to reduce stiffness and pain, but the installation of titanium plates requires an incision. An incision can lead to fusion of tendon with skin at the incision site, and than can gravely restrict movement. Significantly, it’s a permanent condition.

In the end it is likely that the pinky finger, while stiff now, will enjoy a better recovery than the other two fingers, simply because it had no incision, and therefore no potential for fusion. He told me as much tonight. My spidey senses tingled on the day of the surgery when he said titanium, and I asked him to do something else instead, but he said that it had to be titanium. It might be the right answer for most cases, but I think that my instincts at the time were correct. Cutting someone open, even a smaller incision, should be a last resort. Sure, metal wires in all three fingers would have been a pain, and it would have delayed PT, but isn’t the short term pain worth the long term gain of restored range of motion? Even in the face of evidence in support of this contention he stood by his titanium decision. It has worked for others. That’s nice, but it hasn’t worked for me. I will now seek a second opinion. I think it’s time.

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This entry was posted on March 26, 2014 by in Broken Fingers, Physiotherapy, Surgery and tagged , , , , , , , , .
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