It’s a double header when I visit Addenbrookes again two weeks after my op. First it’s back to the plastic surgery unit for Sophia to remove my cast and tell me it’s no longer needed. Hallelujah! It seems like I can now begin to use my right hand again.
Then I’m seen by Julia in physiotherapy who gives me a splint (see photo above) to wear in bed. That doesn’t seem quite as bad as the cast but who knows. She also give me my first set of exercises with which to get started and clears me for driving, but carefully.
Post op there seem to be two priorities. The first is to retain the ability of the fingers to bend and that seems to be the objective of the exercises. The second is to get my little finger to straighten and that’s why I wear the splint overnight.
This means that when I wake up my finger is quite straight and slowly curls during the day.
The splint is indeed better than the cast for sleeping. I’m pretty much free now to sleep in any position but after the first few nights I’m aware that there’s a tension as my little finger is straightened just a little more than it would like. It’s not a pain a such, more of an ache, but it’s another manifestation of there being no such thing as a free lunch.
I’m quite surprised how weak my right hand is after just two weeks of inactivity compounded of course by the trauma of surgery. Some things, like shaving, using a mouse and fastening shoe laces I can do again quite quickly, but others which call on a little more strength or effort take time. You try but then pull back in response to some sense that it can’t be done yet. I persist.
It seems that that’s the nature of recovering from a fasciectomy. It takes time. My notes from Addenbrookes talk of wearing the brace overnight for up to 12 months. Do the exercises, be patient, it takes time!
In the second week after I lost the cast I’m doing finger exercises diligently and imagine that there is some progress. However when I’m doing a fist I can feel the scar tissue acting as a substantial obstacle. Will this dissipate or will I always be aware of its existence?
As I’ve been doing more with my right hand, even though it’s still not very much, I’ve had a few nights of disturbed sleep from muscle pain with which for some reason paracetamol doesn’t seem to help.
These night time difficulties continue but change. Most recently it seems like micro spasms which are really uncomfortable. But then I persist and last night was largely OK. However I compensate by wearing the brace a little in the daytime as well.
Two weeks later, actually a couple of days more, and I’ve got a video appo with Julia. It’s not an ideal format but I give her the positives viz no pain and a wound that’s 98% (there’s still a couple of small scabs to go) healed, and the negatives viz an adverse night time reaction to the brace, lots of scar tissue limiting movement and some swelling. I also suggest that my brace might usefully be straightened. Although she can view my hand over the video link and she can take a photo, off-line with her phone (!), it’s really not very satisfactory.
We agree that an in person appo is needed but the best Julia can offer me is three weeks hence. That’s when I grumble a little more given that good physio follow-up is key to getting the best long term outcome. Delaying it is surely counter productive. She agrees and sympathises and after much studying of calendars she finally agrees to one within two weeks and provides a contact with a private provider who might be able to respond sooner.
In the meantime Julia has shown me a few more exercises and advised that I begin massaging the wound and will send me a parcel of goodies including a pressure glove, a cotton sleeve for my finger (to help with my adverse reaction to the brace) and foam inserts which will act to ‘straighten’ the brace. She also gives me the name of a private physiotherapist whom she thinks I might wish to contact.
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