Surgery helps woman with rheumatoid arthritis regain use of hand
Michelle Zyvert is one of the 2 million Americans who live with rheumatoid arthritis (RA). The disease attacks the joint lining and destroys cartilage. Eventually, the joints become enlarged, and ligaments and tendons weaken, causing bones to become misaligned.
About 10 years ago, Michelle noticed her RA was affecting the function of her right hand – her dominant hand. Her fingers were gradually curving to the right.
“The deformity started about 2007, but it didn’t happen overnight,” she said.
It wasn’t painful, but it was definitely affecting her daily life. She had difficulty using scissors and putting on gloves. The issues got progressively worse, to the point where she couldn’t write or pick up a coin. For months, she tried splints and braces to keep her fingers straight, but those didn’t work.
She dreaded the thought of surgery but knew that was probably what she needed to fix the problem.
Michelle’s rheumatologist suggested OrthoIllinois and gave her the names of surgeons who might be able to help. She also talked to another RA sufferer who had surgery at OrthoIllinois.
“His surgery was long ago but he had nothing but glowing reports,” she noted.
Taking the leap
Michelle made an appointment with Dr. Brian Bear, an orthopedic surgeon specializing in hand, wrist, elbow and shoulder surgery. His credentials were impressive. He had specialized orthopedic training at Mayo Clinic and serves as a faculty member at the Orthopedic Learning Center, where he teaches other surgeons the latest techniques of hand, elbow and shoulder surgery.
“I met him and he was very forthright,” Michelle said. “He gave me tons of information, told me what was wrong with my hand and what he could do.”
He also told her he hadn’t seen a case that bad in more than three years.
Dr. Bear said Michelle had severe hand deformities secondary to RA.
“When I first started practice in 1997, I would see over 20 patients a year with similar severe deformities like Michelle has. Over the past 15 years, there has been a dramatic improvement in the types of medicines used to treat RA. With the newer medicines available, the disease is more controlled and we don’t see as many patients with such severe deformities.”
He also noted that surgeons typically will wait for patients to tell them when they are ready to have surgery.
Finally, Michelle had found someone who could help her, but she soon discovered she would have to have heart surgery.
“I waited a whole year for hand surgery,” she said. “But as soon as I was finished with rehab for the heart surgery, I was ready to do it.”
In 2017, she had surgery to straighten her hands. Dr. Bear performed a total knuckle replacement on all four fingers – a technically challenging procedure that takes three hours to complete, which is nearly twice as long as a typical hip or knee replacement.
“The tendons, bones and ligaments have to be realigned and perfectly balanced to correct the deformities,” Dr. Bear explained. “The hand and fingers are very complicated. Over-tightening or misaligning things a few millimeters (less than one-eighth of an inch) can result in crooked, nonfunctioning fingers.”
Following surgery, Michelle had rehabilitative therapy twice a week for four months. What impressed her most is that whenever she was there, Dr. Bear or his Physician Assistant Joe Steiner would make a point of stopping to see her.
“They really made the effort,” she said. “They would check my hand to make sure everything was going well and always asked me if I had any questions.”
“Rehabilitation for this procedure is just as critical as the surgery,” Dr. Bear noted.
Michelle had to wear a special dynamic splint during the day for six weeks. For six months, she wore a protective split that spanned her forearm to the tips of her fingers while she slept.
By the time Michelle had completed rehab, she was amazed by how much function surgery had restored to her hand. She could write, use scissors and pick up small objects. Best of all, she can put gloves on.
Michelle said she would absolutely recommend Dr. Bear, especially for those like her who have RA.
“I can’t tell you how happy I am,” she said. “Dr. Bear was fabulous. He gave me the use of my hand back.”
Dr. Bear said Michelle is an “amazing person and worked diligently with our therapists to achieve a fantastic outcome.”
“Michelle did phenomenal with her rehabilitation,” he said. “I was very pleased with her outcome. Her pre-surgery pain was eliminated. Her hand function and severe deformities were corrected.”