Thumbs up for Dr. Atkinson!
I had a chance to see Dr. Atkinson yesterday, for a 2nd opinion. He was so different from Dr. Blum, and I am sticking with Atkinson from now on. Here are some of the differences between what the two doctors had to say / did:
Dr. Atkinson measured the range of motion my thumb when held in the upwards position (hitchhiker-style), as well as my range of motion pointing the thumb downwards. He moved my thumb and wrist around and applied pressure to different spots and asked if I had any pain. I had none during the whole physical examination.
Dr. Blum, would examine me by physically applying enough pressure to the already sore joint, grinding the bones together. While doing this, he would apologize for the pain he was causing, and then tell me I have grinding in there. He did this three out of three office visits. This last time, it ached for two days afterwards since no cortisone injection was given this last time.
Stance on Surgery:
Dr. Blum was quick to prescribe surgery. He mentioned it back in January as the first line of treatment after looking at my x-ray, which showed no issues in the bones, and then he proceeded to give me the physical examination where he grinded bone against bone. It was only at my request, we decided to try a cortisone injection wear a thumb splint before jumping into surgery. During my second visit he backed off surgery since the cortisone took me through the entire spring semester, but then during my third visit, he seemed to think surgery was the way to go again since the cortisone shots were wearing off faster and I said I had some pain. He felt I could develop arthritis down the line if I didn’t do the surgery now.
Dr. Atkinson did his physical examination, and consulted the x-rays and notes from Dr. Blum. After asking me some questions, and moving my thumb around, he said he really wouldn’t do surgery on the thumb at this point. That it just isn’t bad enough for him to recommend it. He said maybe years down the line I’d need it. When I asked if he foresaw me needing it when I got older, he said it’s possible I wouldn’t ever need it if I learned to manage the pain and if it doesn’t progress beyond what it is.
Dr. Blum gave me cortisone shots my first two visits and his nurse asked me if I wore the splint at all times. Aside from the physical examination and shots, and splint recommendation, no other treatment was given.
Dr. Atkinson told me exercises would not help my situation. (I asked the question). He drew a picture explaining what was happening and it reminded me a little of my runner’s knee. The trapezeium, and the metatarsal of my thumb have some friction when certain activities are being done. He told me to wear the splint he gave me today while doing chores or heavier tasks, but not to wear it when I was doing things that don’t hurt me. He said my range of motion is good, and there was only a little subluxation. He said I could take NSAIDs for pain management if I had to do tasks that were gonna possibly hurt it. He felt no more cortisone should be given since it can cause damage with overuse. He said to return in the event the pain gets worse or unmanageable.
Dr. Blum has a nice smile, and seemed caring at my first and second appointments, but was usually running late and a bit frazzled two out of three times I saw him. His nurse seemed overworked, and was kind of friendly, yet not. I felt like a name on a piece of paper there even after 3 visits. He sort of brushed off my question during my last visit where I asked if I’d be able to write a week after surgery since fall semester would be starting. His reply was, “You’ll figure it out.” It prompted me to start doing online research, and seek a second opinion.
Dr. Atkinson took the time to literally draw me a picture. He also had a resident shadowing him and explained things well to me and the resident at the same time. His bedside manner was friendly, and even though the exam was quick, I didn’t feel like it was rushed. He has more experience and it shows in his calm demeanor.
As a result of Dr. Atkinson’s exam, I feel so much relief. I also am not going back to Dr. Blum. I have some pain, but it’s getting better as I am beginning to adjust my hand and movements to accommodate my bad thumb. Today it felt pretty good just about all day. I’m satisfied and relieved I didn’t go through with the surgery.