Trigger thumb surgery on LE side

I'm so glad to hear all went well with the surgery! It sounds like the surgeon is well informed and takes LE concerns seriously, which is quite reassuring. Hope your recovery continues with no drama and great results.

Faced with choices that feel like, 'do nothing = bad; do surgery = maybe bad,' I think you are spot on that it ends up being a gut decision. Hooray that your gut was so accurate for you this time!

Thanks to Doxie for sharing her experience. The aromatase inhibitors are known to contribute to trigger finger development. Luckily for me, mine resolved earlier this year with a single steroid injection and was on my non-dominant "good" side. (I was able to continue light violin playing despite the condition but was worried about progression to a surgical solution if relief was not realized).

My hand surgeon thought this may be a class effect with AI therapy so I have cautiously resumed medication after a 3 month drug holiday...

Doxie.....I, guess I had not choice....but to have the surgery......I am sure others will be put in that position....Liz

vlnrph - No, I had the first skin cancer at 35, 20 years prior to my diagnosis of breast cancer, and I have had more than 25 of them - all basal cell carcinomas.  I am a blue eyed, fair-skinned, blonde who grew up in California prior to the advent of sunscreen, and I was out in the sun all the time. My derm is well aware of my breast cancer history and does not link the two.  I think there is more of a connection between melanoma and breast cancer, but usually basal cell are sun exposure related. I have been very careful about sun exposure for the last 20 years but I have noticed an uptick in the surfacing of the skin cancers after breast cancer treatment that did not include radiation.

Back in 2007 I had painless trigger thumb on my left hand, which prevented me from gripping a guitar neck, so I had a cortisone shot. The swelling from the shot was down enough that I could resume playing two days afterward. It recurred painfully with a vengeance in 2010, and this time the shot was a temporary fix until my touring schedule had a long enough hole in it for surgery & recovery. But all that was pre-bc, and I had and have never had arthritis in my hands.

I have been on letrozole four months now and developed mild right arm LE after losing four nodes via SNB. Yesterday I awoke with painless triggering in my right thumb--my picking hand. Like it was on the left, it's in the knuckle joint. To my relief, I was able to pick up a guitar and found that when I play, I move only the joint at the base of the thumb, which is not the joint that "triggers" (though I learned enough anatomy the last time out to know that's where the tendon nodule that hangs up on the sheath and causes distal triggering is located). If I play for a minute or two, the triggering mostly abates.

So I have no plans yet to get a shot or surgery. But back when I posed the hypothetical to my LE therapist, she said that for all surgeries in the LE arm, the therapist is usually in the OR to do immediate wrapping. She also said that with the shot, not only infection control but wearing compression till the swelling goes down and the infection danger has passed is key. I'm hoping that I can get by for awhile without treating the triggering (aka tenosynovitis). But if it gets worse, I hope I have a long enough window between gigs to recover, especially since after surgery I am not allowed to play till the sutures are out.

Just when I thought I'd dodged all the bullets of successfully treating this early Luminal A tumor, now I am threatened with possible loss of my performing career....or quitting AIs and risking metastasis. Gee thanks, cancer.

chisandy - I have had triggering in many spots - thumb of dominant hand, ring finger and thumb of non-dominant hand, both ankles, one toe. Also had knee swelling after that was not in proportion to the mild twist injury I sustained - required a cortisone injection, which solved the problem. I found that initially switching from Femara to Arimidex after six months when the first trigger developed kept the triggers at bay for the next 18 months, then when they resurfaced I switched back to Femara and was trigger free for two years, until a couple of months ago. I also got relief with the thumbs by wrapping with training tape (Coban-type) for immobilization. I have bi-lat LE, worse on the ALND side - also my dominant hand side - but no hand swelling specifically.

Glennie, I am SO fortunate to have a hospital (NorthShore University Evanston) that not only has several LANA-certified LE OT/PT therapists but also probably the national authority on LE (and LANA’s founder), Dr. Joseph Feldman, on staff of its Physical/Rehab Medicine dept. The surgeon who did my L trigger thumb years ago is out south in Oak Lawn, who operates in his own surgicenter though he has privileges at Advocate Christ (where my husband is a cardiologist and my friend just had her BMX). Advocate Christ is excellent for breast cancer (its bc surgeon Barbara Kruger is terrific) but its attitude towards post-SNB LE is somewhat laxer than Evanston’s, at least re: LE prevention. Not only doesn’t my original hand surgeon have an LE therapist on his staff (and I’m not sure there are any at Advocate Christ), but were I to get my trigger thumb “released” at a NorthShore hospital (be it Evanston, Skokie or Glenview) one of my own two LE therapists would be the one wrapping me in the OR or at least the Recovery room. I have no reason to believe that the hand surgeons at the NorthShore hospitals are any less than excellent.