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04-26-2011 07:38 PM  10 years ago
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rnkasp

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Pottstown, PA USA

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Medical question pertaining to flying
It seems that an injury I had sustained some 25 years ago has over the years caused my left thumb to loose all of the cartilage at its base. I have developed rather severe arthritis in it which I have been struggling with for the last few years. I was told back then it needed to be fused but I have held out as long as I can. I know that I now need to go ahead with the surgery in order to, hopefully, get rid of this constant debilitating pain. My question is has any RC pilots out there experienced the same surgery? I'm wondering how it may impact my ability to fly as well as will I be pain free. It is getting to the point that after even short flying sessions I really pay the price in pain. I'm planning on sticking it out until the end of the season but it really looks to be my only alternative. Any serious input would be greatly appreciated.

Thanks

Ron
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04-26-2011 09:47 PM  10 years ago
Justin Stuart (RIP)

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Plano, Texas

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Instead of fusing the joint, I believe they have implants now (similar to hip implants) which allow a full range of motion in a saddle joint such as your thumb. Depending on how bad the osteoarthritis is, it may be possible to restore full range of pain-free motion to the joint (if you go to the right orthopedic surgeon). Fusions are typically a surgery of last resort.

It might also be possible for Curtis Youngblood's dad or RadioSouth to make you a single stick TX so you won't have to use your left thumb as much.

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04-26-2011 11:47 PM  10 years ago
wc_wickedclown (RIP)

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long beach calif

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hope you get better and i recommend a transmitter tray until you get better.

practice with it on a sim if you can
Insha Allah made in america
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04-27-2011 02:22 AM  10 years ago
Weng

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Norfolk, MA

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I am 58 years young and have the same condition in both thumbs. Justin Stuart is correct that there is an implant that is a piece of plastic that is put in the joint and cartilage forms on it. The plastic dissolves over time and the cartilage replaces it. I will be having it done in the next couple of years and if I were you I would look into it. PM me if you have any questions.

JW
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04-27-2011 02:22 AM  10 years ago
Rogman88

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West Monroe, LA

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Do you fly with your thumb or pinch? The movement at the thumb carpo-metacarpal joint (saddle joint) is much less with pinch verses thumb only, thus may cause less pain when you fly this season and may help you continue to fly after the fusion. I trained my left hand to use pinch in a matter of a couple of hours on the sim which is where I recommend you start if you fly thumbs only.High Voltage just works better
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04-27-2011 02:34 AM  10 years ago
JOLT

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Baltimore, MD

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There are many other ways to fly if you can't use what's become "standard". Example, placing the stick between your index and middle finger...and using a board to place the radio on for stability.

I think whatever decision you make regarding surgery, you will find a way and get accustomed to it very quickly.

Watch at YouTube

Obviously, not to the same extent, but a good example of a hobbyist overcoming an obstacle to persue his passion.
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04-27-2011 06:56 PM  10 years ago
rnkasp

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Pottstown, PA USA

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Thanks for everyone's input. I do fly thumbs only. I had messed around with pinch but it didn't go very well. I admit that I didn't put forth a serious effort in teaching myself either. The reason my Orthopedic has suggested I go with fusion is mainly because of my activity level. With being involved in other sports such as Tae Kwon-do, weight lifting, and mountain biking he had concerns that the "plastic ball" prosthesis would not hold up. From what he explained if the prosthesis would fail my only option would then be an excision. From what I understand at that point most of my recreational activities would be over or severely hindered. From that stand point fusion looks to be my best option. This is something I have been dealing with for many years and I hoped that I could just suck it up and deal with the pain until technology advanced to the point of offering a solid replacement joint.
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04-27-2011 08:23 PM  10 years ago
CalmAir

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Camarillo, Ca.

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Good luck. Living with pain sucks...Hope you find some long term relief.
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04-27-2011 08:40 PM  10 years ago
Justin Stuart (RIP)

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Plano, Texas

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I'm almost certain I've seen a titanium implant for the thumb joint.

Before you have a joint fusion done, get a second opinion from another orthopod. If you by chance have a teaching hospital near where you live, talk to their orthopedic department to learn about the very latest treatments.

Oftentimes a specific surgeon has a specific procedure he is allowed to perform at the hospital where he has privileges, and as a result he will try and convince you that his particular procedure is the very best procedure available and that you should not consider any other surgeon or any other procedure. But osteoarthritis is a very common disease and with the relatively high reimbursements that come from performing orthopedic surgeries, there should be many options available. Usually the teaching hospitals have surgeons who are testing new implants for the medical manufacturers, so you might be able to get involved with an implant study and as a result get something done which is really cutting edge.

Roger, you're an orthopod, right? Are you aware of any options other than a plastic implant or a joint fusion for the thumb joint?
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04-27-2011 09:04 PM  10 years ago
Weng

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Norfolk, MA

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What the doctor I saw (one in a long line of doctors)told me that it was not a "plastic ball" prosthesis but a dissolvable insert that promotes cartilage growth. I had to see several doctors before I found the right one that can do this procedure.
Before him I was told fusion was my only option as well because of my activity level. So if I were you I would keep looking for the right doctor.

JW
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04-27-2011 09:36 PM  10 years ago
steve9534

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yakima, wa.

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Orthopedic surgery
I'm an orthopedic surgeon and would have to say that joint replacement surgery in young active people still has some serious pitfalls. None of the CMC replacements have a long track record to go on and the common final pathway is often wear, loosening, and failure. I'm not familar with the implants that Weng has mentioned and would be curious to know exactly what the brand and device name are and who is recommending it. There have been dozens of gadgets which supposedly promote cartilage growth and restore normal joint surfaces. None of them are being widely used and the failure rate has been high. I would be very interested to know what the success rate has been in trials with surgeons other than the one promoting the product before I'd be in a hurry to have such a device implanted in me.
I've not got an ax to grind here and am something of an outlier among orthopedists in that I do joint replacements for younger people, but with the understanding that they will fail and at some point will need to be redone. I don't do any CMC joints and it's not entirely clear from your description if that's what you need, or it's the MP joint? If it's the MP joint, a fusion is not a disabling surgery, and my own bias is that you'd be foolish to have it replaced. The CMC replacements are problematic in that there's not much bone to connect to on the proximal end. If mine were wearing out, I'd wait as long as I possibly could before having it fused. Hope this helps. steve.
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04-27-2011 10:07 PM  10 years ago
Justin Stuart (RIP)

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Plano, Texas

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Steve, is there any substance which can be injected into the joint capsule? Teflon or silicone?Avant RC
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04-27-2011 10:32 PM  10 years ago
Dood

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You could use the heli chair!

On second thought, maybe you don't want to use the helichair. It is the 3rd stupidest invention of all time, behind the Slap Chop (you're gonna love my nuts) and this thing:
  ▲
▲ ▲
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04-27-2011 10:52 PM  10 years ago
Rogman88

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West Monroe, LA

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There are joint lubes made from chicken cartilege that are injected into knees with mixed results. I don't know if there's been any trials on smaller joints such as CMC's and MCP's. I assumed that it was your CMC as that's what I've seen mostly wear out in the thumb verses the MCP. Steve makes a good point that it may be your MCP (joint at base of thumb and not as the metacarpal meets the wrist). The MCP fusion may be more conducive to thumb flying than pincer as I sit here with my transmitter and analize the movements.High Voltage just works better
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04-28-2011 01:32 AM  10 years ago
rnkasp

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Pottstown, PA USA

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Thanks so much for all of you input. It is the CMC. I'm being told that the joint deterioration has been a result of a bad fracture of my Trapezium which resulted in multiple bone grafts in an attempt to repair the bone. My Orthopedic Surgeon is a University of Penn. hand specialist and his advice was exactally that of Steve's. I have been holding out now for close to 10 years with the last few being very trying. My Orthopedic told me to hold out as long as I can and that when the time came that I would know. Originally I didn't even consider it an option but I have been thinking more and more about it lately. I guess that is a sign that it may be time.

Steve, If I were to get it fused would that end the pain? Also would it at all hinder my radio operation as well as any of the other activities I have mentioned. I find the biggest problem now is that I cannot use my left hand for much as I have almost zero grip strength. Would fusion allow me to regain my hand strength?

Thanks again guys

Ron
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04-28-2011 02:27 AM  10 years ago
Rogman88

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West Monroe, LA

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Ron, I was an Occupational Therapist for an ortho for many years before I went back to PA school and currently work in industrial medicine (injured workers). I did therapy on many folks who had CMC fusions. Sometimes the pain would drag on for a while during the fusion process, but usually once fused the pain would subside. The problem would be sometimes that the MP and IP joints would get tight because the patients wouldn't move their unaffected joints enough. That's where I came in Sometimes reflex sympathetic dystrophy would compound pain problems and I had to address that as well with desensitization techniques.

Have you tried the thumb radial spica splint yet? As an OT I would custom fabricate low profile splints for my patients as they can be big and bulky otherwise. Patient compliance becomes an issue then. It may be worth a try to immobilize the CMC and give you an idea about what your limitations will be. In any case you will want to switch to pinch grip on the sim. Down the road, you will thank me...

Roger
High Voltage just works better
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04-28-2011 02:52 AM  10 years ago
Justin Stuart (RIP)

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Plano, Texas

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I put rubber Trex 500 skid nuts on my transmitter sticks to make switching from thumbs (which I flew for at least 25 years) to pinch easier. The larger stick ends make it much easier to grip.

I need to use the transmitter strap to hold the TX, but now I lean the TX against my belly and can fly pinch. It took awhile to learn, but now it feels second nature.

So if you want to learn pinch, it is possible.
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04-28-2011 03:05 AM  10 years ago
Rogman88

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West Monroe, LA

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Good point made by Justin. I started using a neck strap when I went to pinch. Pinch also allows you to keep your middle finger rested against the throttle hold in case you need it quick.High Voltage just works better
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