So, the bump didn't go away. It still maintained a square shape, not something abundant in nature. And it had become, literally, a "hot spot." All the rest of the bruising had disappeared by now, one of the things I was told to be patient and wait for. My bump hadn't obliged by doing the same. And during the evening when Steve and I were sitting watching TV, the house warm enough for short sleeves and the ceiling fan going, while both my arm above the wrist and all my fingers on that hand were cool to the touch, my square bump was warm to the touch. Not neutral warm, but warmer than the hand touching it. Even without the fan it stayed that way.
I wasn't waiting for a referral. My insurance doesn't say I have to, thank goodness, because I'd already been waiting too long. I made a phone call and got an appointment with a hand specialist at an orthopedic clinic, with a Dr. Aundrea Rainville, in Stillwater. They scheduled me for the next afternoon. It was nearly an hour's drive away, but I took it.
Happily.
I showed up with all my medical info and my photocopy of the original x-ray showing no bone damage. They got a new set of x-rays, making sure nothing had changed in the meantime. While waiting for my doctor to show up after reading the new one, I entertained myself with the view of a large pond out the 2nd floor window, and several very red mature maples scattered across the mostly green landscape. It was very relaxing, something I returned to during subsequent waiting periods.
When the doctor showed up, the x-ray still showed no bone problem. She carefully felt the edges and height, asked how far out the painful area was and where, and explained it was in fact a hematoma. We were exactly where I'd been with two other doctors at this point. But instead of dismissing me, she took it further.
Why was it square? The blood was trapped in between layers in the hand, and could only push up at this point. Being clotted, it retained some shape.
How long might it be this way? Several months, was the discouraging answer. Not "a bit" or "a while" like the other docs had said, but it might easily last through next spring. She added we could just leave it alone - not what I wanted to hear- but continued that this buildup of blood would attract bacteria in the body to the site, resulting in an infection. It may already be happening as it was becoming a hot spot.
Then, she offered a solution, music to my ears! She could open it up, suction and flush all the built up blood out, and stitch it back up. It would have to be bandaged with gentle pressure to keep a new hematoma from forming in the same location.
Was I interested? Oh you bet!
When would I like to have it done? I seriously replied that yesterday would have been good. She informed me that her surgery schedule for today was full... (DAMN! I mentally reviewed my schedule for the next few days) ...but if I were willing to wait around until she found a space between patients this afternoon she would fit me in before she left for the day.
YES! Yes-yes-yes! Did she want me to head out to the waiting area? Nope, she'd keep me right here. Now, did I want a local anesthetic or... I stopped her right there. I had no back-up driver. It would be a local, I'd be driving home. Knowing it was a long drive, she agreed it was the only choice.
Now the flurry of activity started. Two women brought in trays of instruments, stacks of gauze pads, large sterile square drapes to cover the table my arm would rest on, and bunches of stuff I could neither name nor wished to know the function of. One spread the first drape over the table, asked me to put my hand on top of it, and got to work with a couple cleaning pads with a bottle of sterilizing solution fed into them from behind to cover every bit of my hand twice. When my hand was done I was required to keep it in the air. A new drape was set on top of that just used one, with some gauze added where my hand would rest again... but I still had to keep it in the air.
Now the doc came back, checked the progress, and opened up a syringe full of anesthetic. I was allowed to put my hand down again, and she asked if I wanted to watch?
NO! I mean, it would have been fascinating if it weren't happening to me, but watching might make me react by flinching, or tell myself I could feel it just because I could see it. She slowly gave me three injections, which I could count only from the first fraction of a second for each, plus by feeling her gloved hands move around mine, touching areas not needing to be numbed. When finished half the syringe's contents remained and it was set on the table holding all the other supplies. I joked that we'd better not throw it away yet: we might need more! (We didn't)
She then left the room for a while, giving the anesthetic time to fully work. (Why can't dentists get that right?????) The two women who'd hauled in the supplies stayed, further organizing them to how and where the doc liked them to be for surgery. I could see my hand, which now had a very tall bump rising from over the square, presumably full of the fluid just pumped in with nowhere else to go. I wondered that there was enough loose skin in the area to stretch over all that. Weird as it looked, it was doing its job fantastically well. For the first time in weeks the ache was gone.
Several minutes later the doc popped back in, looked around at where everything was, regloved, and sat down. Several times she asked if I could feel something, and I rather flippantly asked in return whether she was doing anything? Yes, she'd been pinching, rather hard, and was testing if I was properly numb. Yes! I could feel my hand being moved, occasional pushing against it, and as she got down to business, hear something liquid go into a metal pan, feel cool liquid running over my fingers after they'd been set inside a kidney shaped metal pan along with the rest of my hand. When no more liquid ran down my fingers, I felt it lifted, set back flat on the draped table. The palm side all had normal sensation.
I knew more was happening, and sneaked a peek. Stitches were going in. Still no feeling at all, so I actually watched them get tied. There are three. The hand around the area was flat for the first time in weeks, except now for the ridge the stitches make.
It was conversation time again. Stitches have to stay in for a full two weeks. I could make an appointment with them to come in to get them removed. Or I could see my local doc and save a long trip to get them removed. I thought I might give it a go myself. I'd already told her that I'd self treated my previous break in that hand. So part of my take home supplies included a sterile pack of tools to remove stitched, and she interrupted wrapping the hand to show me where to pull and what to cut, because these were blanket stitches, not going where I might have assumed where they went, and if I were to do it I need to know that. (Pretty cool doc!)
After giving instructions that no water touch the hand for two days, the pressure dressing stays on those same full two days, and can be replaced after removing for washing to keep swelling down for the full 2 week, she left for her next patient. One of the assistants remaining bandaged the hand, first with a multi-folded gauze pad, then winding a stretchy/sticky breathable wrap around the hand until the spool it came from was used up. It looks like what some vets are using on pets these days.
I'd mentioned I had ibuprofin in the car, so no further pain meds were suggested. I took them once I got in, even though I was still feeling nothing in that hand. That started to change once I started driving, but then the ibuprofin kicked in... and after picking Steve up some requested milk, it kicked off for most of the drive home. I'll definitely have a full dose before bed, and start again first thing in the morning, I expect. It's no worse than the ache before surgery, and I expect it will diminish steadily with time.
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