"Problems with intended hand surgery, (trapeziectomy)"

Some 7 or 8  years ago I started to experience pain in my lower left thumb joint which was treated by my practice doctor at Stockbridge Health Centre (Green Practice), Stockbridge, Edinburgh, with "un-steered"  cortisone injections on, as I recall three occasions over a period of 2-3 years which, regretfully, were unsuccessful in mitigating the problem.  I was then referred to the Hand Unit at St.Johns Hospital, Livingston, where I was seen by Mrs. Davidson, Head Surgeon, who suggested the use of a thumb support.  As this also proved unsuccessful I was further referred to Mr. Geary who, over a period of approximately 18 months, administered three "steered" injections under X-ray.  I was also to attend a Physiotherapy course at the Western General.  Unfortunately there was an error made in the  original  booking which was only revealed when I attended an appointment with Mr. Geary for him to ask how it had gone and I had to advise that I had NOT received an appointment - rather a wasted day !  However a session was then arranged shortly afterwards but the assessment was that the condition of my thumb joint was beyond help and required surgery.  

After a period of months I was advised of an appointment for surgery to take place In November 2018 at the Jubilee Hospital in Glasgow, not the most convenient of locations as I would have to travel there by train the previous day, stay overnight in the hotel linked to the Hospital, and then on the day of the surgery stay overnight in the Hospital, as I would have been unaccompanied, before returning to Edinburgh by train.  However, I received a telephone call late afternoon a few days before the surgery advising that the appointment was cancelled - no reason was given.  After pursuing enquiries in a series of telephone calls, I found that the reason for the cancellation was that no arrangements had been made for "follow-up" physiotherapy. Frankly this did not appear to me to be valid as the hand would have been encased in plaster for 5-6 weeks following the procedure which I would have thought might have been sufficient  time in which to make the necessary arrangements or, had I been made aware of the problem in advance, I could have arranged for physiotherapy  near my home, to be paid for privately if necessary.   I then requested another date which was advised as just after Christmas at Livingston- not the most convenient but nevertheless accepted.  I then received a telephone call to attend the Heart Clinic at the Western General 2 days before this planned operation for an ECG which I did and underwent the procedure. accordingly.

On the day of my planned surgery I travelled to St. Johns by taxi, as the only practical means of getting there in time for the appointment.  Having been shown to a side room I completed a set of confirmatory questions with a nurse, was introduced to the Surgeon and then waited for approximately 20-30 minutes when the Anaesthetist arrived to tell me that he had studied the results of the ECG taken a few days earlier and had concluded that I would be "at risk" from being under anaesthesia for the period required, approximately 90 mins. and that consequently he would not wish to continue with the procedure.  Somewhat shaken by this news, I therefore returned home by taxi.   I was aware that I had a relatively minor heart irregularity which is controlled by daily doses of Losartan and Amplodipine.  I monitor my heart daily and give the results to my practice Doctor each month who pronounces them to be well within acceptable limits. I am also on a yearly examination rota with a Consultant at the Western

As a consequence of the unexpected rejection for surgery for the reason given, I therefore arranged a private consultation with with my consultant who examined me and also studied my daily "home recordings" for the preceding month and pronounced himself satisfied of my ability to withstand the operation and subsequently wrote to St. Johns accordingly.  

As a consequence I was returned to the Waiting List and subsequently received another appointment for surgery in mid February 2019. I also received a telephone call some days prior to advise on a SPECIFIC dosage of my prescription heart tablets which I did.   I travelled by taxi as before (it was another early morning appointment ), and was interviewed and details checked as usual.  Shortly thereafter the Surgeon introduced herself and a further 20 minutes later TWO anaesthesists arrived and again raised the question of my heart condition. I referred them to the letter from my Heart Consultant which they acknowledged BUT continued to press me VERY strongly on the possible deadly outcome of such a lengthy procedure to such an extent that I literally "took fright", accepted their warnings, and once again taxied home, feeling I was lucky to be alive and recognising that I would continue to suffer increasing pain in my left hand and thus even more conscious of early signs of the same problem starting to arise with my right hand, which, in the circumstances, I am unsure what to do about !

No doubt the concern expressed about the possible (almost likely !) effect of anaesthesia was genuine but I do feel that the whole exercise of injections, physiotherapy etc. over a period of some years was such a total waste of everyone's time and effort.  As an incidental I might add, referring back to original operation in Glasgow in November, no queries were made beforehand regarding my general health or heart condition, not to say it might have arisen in discussion before the procedure actually took place.

As a side issue, I incurred the costs by car of the visits to St. Johns over a period of approx. 2 years, unfortunately to no good effect and, insofar as the two declined operations were concerned, specific travel expenses (taxis x 4) of £154  plus the private visit to the Heart Consultant costing £140.  I only raise these points as a further illustration of my frustration at the futility of the whole exercise over such a lengthy period with, unfortunately, such a disappointing outcome.  Of course, looking on the bright side, although in pain, now in both hands, I am still alive - praise the Lord !

Yours faithfully.