Dorsal Wrist Synovectomy

Second day post surgery

It's almost four months now since my wrist surgery on 1st September 2015. I can now do anything with no more pain except heavy lifting. After ten sessions of occupational therapy, recovery was speedy and range of motion regained. I was already back to work full force one month post surgery and even worked on weekends.

Looking Back

A year ago, I was suffering from De Quervain's Tendinosis until the last steroid injections I had in November last year,  I stopped all medications and started taking Purtier. After three months, I had less pain and left with a slight bony bump on the dorsal right wrist. After MRI, it was diagnosed as Synovitis. My hand surgeon strongly recommended surgery for pain relief and improve hand function. Of course, it was not fun living in pain. For me, surgery was the only solution. Whether or not it's gonna be only temporary relief, I had to get it resolved.

One hour after surgery

Wrist Synovectomy

Wrist Synovectomy is the surgical removal of the membrane lining a synovial joint (diarthrosis) capsule (synovium) and debridement of inflammed tissues to prevent further degeneration and arthritic proliferation that may lead to cartilage destruction and rheumatoid arthritis.

The Surgery

With the administration of general anaesthesia, I fell asleep soon before the surgery began and awoke after a nice dream. The surgery lasted one and a half hours. Due to the diffuse proliferation on the extensor surface of the wrist involving several areas in close proximity: the extensor tendons and the radiocarpal or intercarpal joints, an open surgery debridement was done in placed of the earlier plan of arthroscopy/key-hole surgery. One hour was spent at the recovery room after the surgery for morphine injections and pain monitoring. My head was floating, feeling high and mighty the next few hours until dinner, I went downstairs. The side effects of the morphine acted up as I was strolling and puffing along the road of cars and pollution. I puted twice.

That night at the hospital was the beginning of a nightmare for the next few weeks of inconvenience using one arm. It was tough falling asleep with my arm lifted. Finally the nurse let it down but I had to keep it in a upright position to reduce swelling. As you could see from the pictures of my arm was bandaged to the size of a leg, lifted upright.

Post Surgery

The bandage must not get wet for the fear that getting an infection on the wound could be disastrous. Before shower, I had to wrap three quarter of the arm with a plastic bag (NTUC) and kept it lifted until I finish. The most tiring part is the shampooing and rinsing of hair using one hand. It was made easier to rub the body using a long handled sponge than using just one hand as it's impossible to reach the other side of the body. It took me almost thirty minutes to take every shower.

Brushing teeth and washing up before bedtime is another chore using the my non-dominant left hand. As my arm had a stiff bandage or the hard splint. There was not enough space to do it at the sink so it had to be done at the bath tub. The other household chores and dressing up were done using my left hand. The different size of my arms had gone noticeably ugly. The bandage was removed after 4 days and waterproofing for 2 weeks before removing the sutures. 

Taking the public transport with a arm sling did not proof much advantage nor any passionate humanity uncovered in this stressful and selfish society. I did not use any handbag but kept my belongings inside the sling so I still have one hand to hold on to the rails except on days when I had more things to carry. A few times out of the two months with the sling/splint on, I was offered a seat on the MRT/bus.

Using my left hand at the computer, mousing was not fun at all. After a week or two, the nerves on my left arm were "pinched" or trapped. The ulna nerve on the cubital tunnel was compressed due to prolonged activity on the computer. Several sessions of acupuncture and "tui-na" did the trick and saved the time going back to the doctor. After all, I felt much relief before the appointment for the nerve conduction test. It could only be another costly stinct of multiple tests/investigations and finally occupational therapy. 

Using the chopsticks for noodle meals was tough but challenging. For a month, I was only eating with my left hand, even with spoon and training myself to be ambidextrous and believe that I could still use my left hand without a problem.

Having the splint on most of the time has its efficacy of reduction in swelling and speeds recovery. However, it also causes stiffness and prevents regaining range of motion and strength. I could not even carry anything more than a kilogram at two months post surgery. Finally the therapist allowed me to stop using it on the tenth week.