25 years later...
Recently I was worried that I might have a ruptured tendon so I saw an orthopedic surgeon. His opinion was that I had to have my wrist fused before any other hand surgery occurred. He said a replacement wrist joint was not an option for me, given the spotty success rate. Since there was only about 10 degrees of movement in my wrist it sounded as though I would not lose much dexterity and my hand would be in a more functional position.
This is one view of how it looked before the surgery:
You can see that my hand above has an ulnar deviation. The whole hand is no longer straight. More often in RA it is the fingers that sway to the side. This is the way it looks now:
Much better than before. Very strange how you don't really notice as things change over the years. Finger deformities have always seemed more obvious than the orientation of the hand.
My operation was 5 weeks ago. It was done as day surgery and it took 2 1/2 hours to complete. I had a nerve block that numbed my whole arm. When I saw my arm raised in the air and could not feel it I thought it belonged to someone else.
After the operation they put a cast on from below the knuckles to above the elbow that left me able to bend my arm a little. You can't tell that from the picture because the cast is wrapped in a tensor bandage. There is an open gap down the whole cast to accommodate swelling. That purple arrow on my shoulder marks the correct arm for the surgery. There were more markings under the cast.
The nerve block was very effective and I have moderate regrets I did not stay conscious through the operation to hear the surgeon talk his surgeon assistant through the process. However my curiosity wilted once they started. I have heard the noise level in the OR is high and I know surgeons use power tools in their work. Remembering the noises was not on my bucket list.
Now that my wrist is fused it is supposed to be a pain free joint and stronger than it was. It's early to say how that will work out but my fingers still move well. They were very bruised and swollen but that's normal after surgery. Anything the surgeon touches seems to bruise and swell more dramatically now than when I was younger.
I am told that the incision is healing well and it is meticulously stitched - it will probably be unobtrusive. In the following picture you can barely see it.
I was glad to see this blog before my surgery. Reading someone's actual story of the process is more illuminating than reading the technical sites like Wheeless. I had read enough that there were no surprises after the surgery.
All in all my hand looks better in profile and straight on. After the cast was removed my elbow range of motion was diminished but with rehab exercise from the Occupational Therapist (OT) I have regained most of it.
There is still some pain in my wrist as it heals, and I must wear a splint for the next month. The OT custom-makes them for each hand surgery patient. The splint can be removed for washing and exercise.
I am doing a follow up post showing how it looks 4 months after, and also the X-rays of the hardware they actually use for the fusion. I can hardly believe what is under my skin. You can see it here.