Unfortunately no printed review/summery by the University of Pennsylvania medical team was offered as to the operations I believed I and the surgeon had agreed upon. Perhaps that would have prevented the incomplete discussion and resulting continued discomfort from the second group of surgery procedures.
The first procedure went without a hitch. It corrected my `locked' elbow and allowed my right arm to hang loosely at my side (so much so that now it gets caught in my sleeping position-- and drags on the floor when I stoop to pick up something).
However the second set of procedures were unfortunately also not discussed correctly: It was explained to me (and one of my adult nieces who was present with me in the doctors examining room). The briefing stated that my right hand finger tendons would be extended. Also in order to perform this extension the nerves of the fingers would need to be severed. It was clearly stated that no increased function would result, nor was I under the illusion that the hand would ever function usefully again.
No mention of my wrist being fused!
After a lifetime of questioning Doctors and following my own mature health choices. I actually found the Doctor reassuring, apparently thorough, as befits her stature in a major teaching medical institution. Unfortunately, hindsight has provided an tragic explanation for the gross oversight of Dr Keenan. She was preparing to retire in a great hurry and I got lost in the shuffle. I did not realize it then but there was actually No One in charge of explaining to me what the operation that Dr Keenan had planned for me. Her nurse on her staff was supposed to update me and also promised me some printed documentation. Nothing was provided me.
However the lack of full discussion or supplied documentation as to the two scheduled operations on my arm and hand was quite unfortunate. I believe most of these problems could easily be avoided by documentation or full disclosure of what the surgery entailed.
In fact there was documentation for a surgery on a planned leg procedure, and much of the single meeting discussion was concerning this possible future correction.
The first I heard of the wrist fusion was in the hospital room when the surgeon visited my the day after the operation and I was just conscious enough to say "What did you do." It was then the surgeon stated that my wrist was fused.
To this day it remains swollen and often aches and the wrist is often uncomfortable and with pain. I seem to have traded one type of discomfort for another. My fingers are in a state I have termed "permanent boxtox extension." Note: I did try botox injections after my stroke and found that lengthening was not to my liking. I told that to Dr. Keenan well before the surgery.
From the recent surgery my right pinky gets caught on fabrics in sweaters and shirt arms, coat sleeves etc. This pinky finger seems to jut out quite annoyingly and unnaturally.
After my stroke I had pursued on the web to see if there was any possible help for my affliction, and I came across a news report on a discussion by the a surgeon in Philadelphia on a series of operations on stroke affected limbs. Unfortunately in regard to the arm correction only the finger tendons extensions was named in the news report.
The Physiatrist in NYC I was seeing at the time had noted my difficulties with my locked in place right arm and the resultant skin irritation under my right armpit. My internist at this time misdiagnosed it as a fungous, and sent me home with a script for an anti-fungous cream which (of course) did nothing.
A year later with a different internist, I diagnosed myself and told him that the itching was due to the weight of my upper arm pressing against my torso. He agreed to refer me to a dermatologist. This specialist wrote me a script for a steroid which relieved my immediate discomfort. However the problem has re-occurred with discouraging frequency. In fact the soreness and itching persists to this day in a different form; and also affect my right breast area -- I can only assume that my shoulder sublimation and weight of the inert arm adds to the problem.
The amount of cramped muscles on my right side I assume is certainly related to my post paralysis attempts to walk and exercise. I stretch as much as my spaticity and tightness allow me. My main stretching is cross leg on my bed in a "pseudo yoga position." I now do this twice a day since the first arm operation. I have yet to find an affective release for my neck cramps and right shoulder pain.