Wrist MRI Results: Options and Decisions
So a brief update on my wrist. After my MRI last week, I went back today to meet with Dr. Wiedrich to discuss the MRI images.
Reviewing the results, there’s definitely a tear… and a lot of fluid built up. Other than that, everything else looks fine. But the fluid build-up may be part of what’s causing my wrist pain, and basically… I have a few options.
First – I do nothing. According to him, lots of folks end up with cartilage tears and don’t end up having surgery. It comes down to pain, and whether or not it’s affecting your ability to function.
Second – I get cortisone injections. From all accounts, everyone who has had this or knows of someone who’s had this has told me how much it hurts, how painful it is. Even the receptionists at the doctor’s office winced when I told them, and said “it’s painful.”
About 30% of folks who get the injections end up feeling better, and require nothing more. The downside to the injections is that it ups the chance for infection, if surgery is the next step. If I were to get the injections… I’d have to wait about 6-8 weeks before I could pursue the surgical option.
Third – a 2-hour outpatient surgery to repair the damage. Basically, a suture would be inserted and would help the wrist heal properly. As a result of this procedure, I would spend about 2 weeks with my right arm in a restraint, with my lower arm at a 90 degree angle and my palm up. When I asked if I could use my right arm at all, Dr. Wiedrich replied “not for anything more than receiving change.”
The recovery time would be about 8-10 weeks. Because these sutures tend to loosen with time, the typical approach is to make them tighter than necessary… figuring on them loosening a bit, afterwards. There is a slight danger the suture is too made too loose/tight, but for the most part… the body ends up adjusting.
Liz has been telling me to see a doctor for ages now. Today, Dr. Wiedrich told me that had I come in earlier… he would have been able to give me a splint, and my wrist might have healed on its own. But he also followed this with the fact that usually only 1 in about 20 cases ever come in in the first week. He said that most people (95%) would do what I did – assume it was a sprain, wait, and figure on the injury getting better.
Most would, like me, see some slight improvement over time… but the injury would never quite get over the hump and fully heal.
So I’ve got a few options to consider. The logical part of me says cortisone… see what happens… then the surgery. But another part of me thinks that the cortisone won’t help the fact that I will end up needing surgery to get full mobility back to my right hand. The cortisone might help with any pain/discomfort I feel… but it won’t fully heal my wrist.
Right now, there’s no time limit on any of this. These options, as I understand them, are open to me from now until I’m 100. So I have a few calls to make, to figure out how expensive the surgery will be, whether I want to be immobilized for 2 weeks, etc. Last I heard, the ballpark for the surgery was about $5,000; the injections would be about $500.
Decisions, decisions.
I know people who have had cortisone injections. Different people had problems with different joints (hip, knee, wrist, etc.). They all said the injection experience was painful. It was a mixed bag about whether the cortisone helped. For one person, it helped but then wore off. Another person had to go back to have more, and then she wound up having to get surgery anyway. From what I observed, if the damage/pain is more extensive, the cortisone will be a temporary stopgap. But I don’t think there’s a guarantee that it will have a lasting effect even if the damage/pain is relatively minimal. I think it’s pretty much a crapshoot.This has some general information. See the links at the bottom of the page, too.http://orthopedics.about.com/cs/paindrugs/a/cortisone.htmI hope, whatever you decide, that it works and you get your wrist back!
juliet (May 30, 2008 at 12:31 am)Always so good with the resources. Thanks, Juliet!
avoision (June 1, 2008 at 8:12 am)Another possible option to ease the pain/get some of the fluid out is to visit a massage therapist. I have had carpal tunnel for the last two years or so and there’s a lot of liquid in both of my wrists even though i’ve been using splints. Went to a massage therapist and after a few appointments, it felt much better, there was less swelling, and I didn’t have much pain for about a year or so. It got me off of daily ibuprofin at least.At this point, i’d actually suggest surgery even if it’s more expensive since it’s more likely to fix the wrist than than the injections.
Yreka (June 2, 2008 at 11:22 am)Try electro acupuncture.
Anonymous (August 31, 2010 at 10:25 pm)