Immobilized Thumb

BY BOB SMITH

When I retired in October, I resolved to do everything I hadn’t had time to do while working – including studying guitar so I’d become a better hack guitarist than I am now. I started lessons in mid-December and was practicing for an hour every day. It was great – my skills improved steadily.

But after a month I developed persistent pain at the base of my left thumb, and my doctor prescribed an analgesic cream. Three times a day for weeks, as directed, I applied the cream religiously (every time I put it on I muttered “this Goddamn stuff better work”), but to no avail – the pain remained. Next stop – the hand specialist.

He examined my x rays and promptly diagnosed arthritis, which means there’s no more cartilage in the joint between my thumb and my wrist. He said he could give me a cortisone shot to relieve the pain, and if necessary do surgery to replace the cartilage. I said I’d heard repeated cortisone shots could damage the joint.

“That’s why we’re going to start conservatively – wear a brace for six weeks and then we’ll see where we are,” he recited, scribbling indecipherable notes.

He told the nurse to get me a wrist brace and schedule a follow-up. Then he leaned in with his best dead-on empathetic look (do they teach that in medical school?), firmly shook my hand (the right, which isn’t hurting yet), and left. Examination over.

As the nurse showed me how to wrap the brace around my thumb and wrist, she explained that it should reduce the inflammation and pain by immobilizing the joint. I should wear it all day, every day, if possible.

“What happens when I take the brace off and start moving the joint around?” I asked. “If it’s arthritis and there’s no cartilage there, won’t it just start hurting all over again?”

“Let’s see where we are after the six weeks, okay?” she said, followed by the nurse version of the sincere sign-off: she handed me my file, told me to pay any copay at the desk, and scurried away.

Both she and the doctor had given me the same sketchy prognosis: “wait and see.” In other words, they didn’t know if the brace would help, but felt it was worth a try before they started jabbing me with painful needles of dubious long-term efficacy, or slicing into and reconstructing the joint itself. Let’s face it – the doctor’s office is called “Hand Surgery Associates,” so I’ve got some inkling of what the ultimate recommendation is likely to be. Reducing inflammation is probably the normal first step in the process.

I’ve been wearing the brace every day, with the same religious fervor I brought to the analgesic cream routine, and the pain’s been reduced – no surprise, because with the brace on you can’t rotate your thumb at all. But it isn’t gone, and I’m sure it’ll return in full force once I stop wearing the damn thing. And because of the pain, I haven’t played guitar for five months and counting.

Remember the nerdy bookworm played by Burgess Meredith in that old Twilight Zone episode? He was a ravenous reader, but his dead end job as a bank clerk and his overbearing wife had combined to prevent him from curling up with all the great books he wanted to read. Then the world ends in a mass cataclysm, and he finds himself the sole survivor in a ruined city.

He comes upon mountains of books in the rubble that was once the public library, and settles down to finally read to his heart’s content – for days; weeks; the rest of his life – he’s thrilled. But he falters as he bends down to pick up the first book and his Coke-bottle glasses fall off, shattering on the hard concrete. He can’t see his hand in front of him, much less read a book.

The episode ends with him sitting amid a sea of books, moaning miserably.
“That’s not fair. That’s not fair at all. There was time now. There was all the time I needed! That’s not fair!”

I know just how he feels.