SLAC wrist surgery

[sourdough]

Anyone had surgery as treatment? Proximal Row Carpectomy(PRC) or Midcarpel Fusion with Scaphoid Bone Excision

[sourdough]

3 years ago I used pain medication 24/7 and was diagnosed with slac wrists(both). I modified my activities, mostly due to retirement from hand intensive work. My activity level is now based on how much of a pain hit I whish to endure. I now seem to be maintaining a low level of pain and use very few pain meds weekly, maybe Aleve twice.
Can I have the expectation of this continued low level pain or will my wrists degenerate further and the intense pain return. I am 59 years old BTW.
FYI, 3 years ago surgery and total wrist fusion were recommended as salvage option. At that time I was miserable, I would have had the surgery but had no insurance or money for it. Today because of a L&I settlement, surgery is back on the table for a short time period. Is it prudent to have it done now. I will not have the funds later.

[mtomaino]

First--thanks for posts. This is exactly why I included a Forums section on this web site.
Several meta-analyses of level 3 and 4 studies comparing PRC and Midcarpal fusion with scaphoid excision have shown equivalence. Range of motion and grip strength may decrease 30 percent or so, but one can generally expect pain relief except with the most strenuous of activity. This is pretty much the only downside of a "motion-preserving" alternative----as compared to a full wrist fusion, for example. And, neither option burns the bridge of complete fusion in the future.

Regarding your question of whether to have surgery now-----there is no Evidence to accurately support an answer. I would prpbably not have surgery now if your wrists are tolerable---however, as a hedge in the future, it may make sense to invest what funds you have avalable today, in a Health Savings Account. When the "red warning light" goes on in your car, you don't monkey around. When and if your wrists become intolerable, you need to be positioned to receive the approriate care. If you have the surgery before you feel you need it, and it does not fully meet your expectations--you will be disappointed, potentially.

[sourdough]

Thank you for your thoughts. I don't think I can ever give you enough "Evidence to accurately support an answer". I'd like to make an appointment. Meet you at the clubhouse http://www.cdaresort.com/golf I don't play of course but I will chauffeur your cart for a round.
Short of an appointment with you, do you have any wrist specialists referrals on the West Coast. I'm in Spokane, Wa. Any recommendations in a 1,000 miles or so will do. The surgeons(none have wrist surgery certificates) I've seen so far haven't performed many wrist procedures and just aren't giving me confidence in a positive out come. All of them threw in total wrist fussion as a possability once they open up my wrists. I'm thinking if they don't know what they are going to due going in, they shouldn't be.
I do need to get past this surgery quandary. I've been running with a piece of tape over the "check engine light". But I don't like the idea counting on "Lotto " luck in securing a healthy "health savings account" for the future. Which is what it will take if I elect not to do surgery now because I don't believe Medicare will cover it later. Thanks for the forum and again for your time.

[mtomaino]

There are a number of skilled hand surgeons in Seattle, including Dr Tom Trumble. Best to you.