Busted Wrist

In the last chapter of my Busted Wrist, I wrote about how I was going to get a second opinion from another doctor. I was probably still upset/frustrated when I wrote that, and not at her.

Instead I decided to give her a 'second chance' and saw her on December 17th.

She was very professional (as always) when we met again and I explained I didn't think tendinitis was the primary problem, and that any therapy would likely worsen things. We talked about other things that could be done, went through the MRI & X-Ray imaging, discussed what aggravates my wrist... A bone-scan was ordered, and she maintained her recommendation to see a hand-therapist.

The bone-scan was booked for January 6th, but finding a Hand-Therapist (which is a specialization of Occupational Therapy) was proving rather difficult. I had a list of a dozen therapists, but it was from 2006 and most of practitioners on there had moved or changed fields... Then when I managed to get a hold of someone, they seemed to only accept two types of cases: Post MVA (Motor-Vehicle-Accident) Insured recovery, or workplace assessments. Confusing, and further frustrating!

Out of the blue, Danielle W., sent me a message saying there was an OT at the physio clinic I'd been to, and that I could call there to book an appointment. Done - January 12th.
(Danielle also recently injured her wrist, and she is Chris's housemate - Chris being my biz partner in Server North... so he's dealing with two one-armed people in his life!)

Christmas happened, New Years... K and I went to Upper Canada Village to check out their Alight At Night event... and I'd had a few good days, decided not to wear my splint/cast/brace-thing/"VacoHAND" while driving - and paid for that for several days. So much so, that when the 6th rolled around, my hand was quite angry and the lunate was visibly dislocated (Jesus-Hole!)

So what's a bone-scan all about? Well, unlike an X-Ray, where they beam X-Rays through you and an image is developed on a film, for a bone-scan you're injected with a radioisotope Technetium-99 - bound to a phosphate. You come back 3 hours later when any bone activity will have gobbled up the phosphates, and they point a Gamma-Camera at the parts of you they're interested in, and wait 5 minutes for you to irradiate the camera's sensors enough to generate an image of bone reformation.

It's actually a neat concept: Instead of blasting a source of radiation through you, they inject it into you and see where it builds up, and use you as the radiation source for the detector.

(Of note, kidneys filter phosphates... so I had radioactive pee after this test!)

And that's all fine and dandy, until a somewhat baffled radiologist walks into the suite and starts asking you questions about where you hurt, and your entire case history. It seems I lit up light a belated Christmas tree, and not just in my left wrist (they looked at both wrists/hands and elbows also), so he wanted to figure out what was going on... unfortunately I had no idea and couldn't tell him much. He pondered arthritis, asked if I had back pain or any other problems. He got me a little worried, especially since I've had a lot of medical imaging done to me over the years, and I've never even met a radiologist, so that was a pretty significant event alone.

The next day I saw my knee doc for my MRI results (ligaments still intact, as useless as they are, lots of minor secondary damage, some minor arthritic changes, an unknown mass between my tibia and fibula, but nothing really exciting) and mentioned the surprising experience with the scan the previous day... so they (my knee doc and I guess a student) pulled up the images on the computer and were quite surprised by the brightness too. So the bloodwork was ordered, but I didn't get it taken right away since I'd had both of my flu shots right after the bone scan, and I theorized that since they're checking for autoimmune response, getting a sample less than 24 hours after getting 2 shots, one adjuvanted (H1N1), probably wouldn't be the most useful course of action.

Fast forward a week to the appointment with the OT. She's actually a certified hand-therapist, so, pardon the pun, I was in good hands. Could this be the beginning of the end of this saga? Back to having 2 useful hands? Could it?

No.

Damnit.

She was very concerned about the stability of my wrist, surprised I hadn't yet had a surgical consult and very strongly felt I should be doing nothing to load my wrist. Keep wearing the big hardware and protect & immobilize the arm-wrist-hand. Could I do basic things like squeezing a foam ball or something to keep up my strength? NO!

Sigh. Fail.

Then she started talking about how she thought I've got a 'positive ulnar variance' and how they might want to actually break the bone, shorten it, then screw it back together. (my knee doc had actually mused about the same thing when she saw the big ulnar hook on the X-Rays.) The OT was also concerned about Keinbocks, where the lunate bone dies from the damaged ligaments... Oh happy times! She offered to make me a smaller, custom thermoplastic splint that I could use if I wanted to wear gloves, or a winter jacket... so I took her up on that, but she said to keep wearing the big badass hardware too; this little one was just for practicality and reprieve.

She wrote up about a page of notes for me, recommended I go back to my doctor and request a surgical consult, possibly do some physio, but cautioned it might not actually help.
On the upside, she was actually a favourite hand-therapist for one of the local rock-star wrist surgeons, and suggested that when the request for consult was called in, to drop her name... maybe that'd help get me further up the priority list. No follow up, because there was nothing to do.

Got my blood sample taken a couple days ago. And I'll mention here, because I haven't anywhere above, there's been zero improvement. Nothing is any better. Nothing has changed.

Which brings us to today. Met with my wrist doc again, a fairly short & sweet discussion: I reported back what the OT said, discussed the Bone-scan report (rather vague, not really conclusive of anything other than "wow! That's bright.") told her about the blood-tests in progress, and then we talked about next steps...

Or rather, the only step: Surgical Consult.

Referral being sent within the next 48 hours. Hopefully with all the testing and therapists I'll get prioritized a bit closer to the top.

Just before I left, she says to me, quite candidly, "You know, when I saw you on the schedule today, I was really hoping you were coming in to tell me that you were getting better. :(" - I swear she almost verbalized the sad face.

Oh, and by the way, it's been 5 months to the day that I sustained the original injury.