MedStar Washington Hospital Center patient regains thumb use, giving her back countless abilities.
Chopping vegetables, squeezing a sponge, buttoning a shirt, zipping a zipper, locking a door with a key, writing with a pen – these are all activities that are made easier, or even possible, with the full use of a thumb, that many take for granted. For Linda Briggs, it was washing and brushing her hair, using the sprayer to water her garden, stringing beads to make jewelry, and dozens of other activities that she struggled with and missed when she started to have pain in both thumbs, and they froze in place. “I was thumbless,” said Linda. “And you use your thumbs for everything.”
This was a second blow in a short period of time for Linda, who was in a severe car accident in 2023 that temporarily left her with injuries restricting use of her arm and left side of her body. After months of physical therapy, she was on the road to recovery when she noticed pain and reduced function in her thumbs. “I was getting better,” said Linda. “Then this happened, and it was so limiting and frustrating.”
Linda worked for MedStar Health for 30 years and knew her way around the health system. She spent her career at MedStar National Rehabilitation Hospital, and during that time learned much about navigating the system. Through her network of connections, she was referred to Dr. Kevin O’Malley, Chief of Orthopedic Hand Surgery at MedStar Washington Hospital Center. “Linda had all of the symptoms of trigger finger in both thumbs – stiffness, pain, a clicking noise, and swelling where the thumb connects to the hand,” said Dr. O’Malley. “I always pursue non-surgical options first. Trigger finger is a form of tendonitis, and with steroid injections, typically 50 percent of patients experience relief and symptoms of trigger finger will go away.”
“Dr. O’Malley listened to my concerns and didn’t rush to cut. In fact, he said that surgery should be a last resort,” added Linda. But after two rounds of injections, Linda was still suffering from pain and inability to mobilize her thumbs to perform most of her daily life functions. “I still couldn’t open a jar or even a ketchup bottle,” said Linda. “I was upset that I couldn’t enjoy life like I had before, and I was ready to try whatever was needed to get function back and eliminate the pain.”
Dr. O’Malley presented Linda with two options for trigger release surgery. The first option was surgery under general anesthesia at MedStar Washington during which Linda would be unconscious and would need to be sent to recovery to monitor her following the procedure. The second option was an outpatient procedure under local anesthesia, with less prep, less recovery, and Linda fully awake.
“The local anesthesia option has many benefits,” shared Dr. O’Malley. “Patients don’t need to fast in advance, the procedure itself takes about half or even a quarter of the time compared to the general anesthesia route because less prepping the patient is involved, and they also need less time in the recovery room before going home. I can also ask the patient to move their fingers during the procedure to ensure that the tendons are functioning properly before closing the incision. Afterward, the patient can leave the office and begin using their hand immediately with the only restriction being to avoid getting their hand wet.”
Dr. O’Malley does like to reassure patients who opt for the local anesthesia option that they are fully draped and will not actually see the procedure happening even though they are awake, unless they ask to watch.
“I asked Dr. O’Malley his advice and he was wonderful at explaining everything in a way I understood. I really respected his manner of educating me,” said Linda, who has a Ph.D. in adult education. “He has such a calming demeanor and alleviated any anxiety and addressed every question.” Her decision was to have the local anesthesia procedure on her non-dominant hand first, followed later by the same local anesthesia procedure on her dominant hand. “I didn’t want to go through all the extra prep and recovery, or run the risk of my procedure being bumped by an emergency procedure at the hospital,” shared Linda.
On the day of the surgery, Linda didn’t fast and was able to drive herself. “Once I was given local anesthesia, it was only about 15 minutes until the procedure began,” shared Linda. “They asked me, ‘what kind of music would you like?’ and we talked the entire time. After a certain point, Dr. O’Malley asked me to move my thumb to test function and I could move my thumb! It was so fast - I arrived at 7:30 a.m., stopped at the hospital cafe for coffee, and drove myself home by 10:00 a.m.”
A few weeks later, the process was repeated on Linda’s dominant hand. “I realized I was able to carry my tray when I stopped at the hospital cafe. It was all so easy, and I don’t know why more people don’t choose the local anesthesia option. I took one Tylenol after the procedure, and I never needed anything else to address pain.”
Now that both procedures have been completed, Linda has a list of activities she’s thrilled to be back to, including holding the leash to walk her six-pound chihuahua, and new hobbies she plans to try. “I might even try pickleball now that I have my thumbs back,” she shared.” I had the right surgeon and the right procedure. Dr. O’Malley is the one that you want to see. I really appreciate the time he took to educate me on my condition, provide non-surgical options as a start, and then talked me through the options for surgery. He is a wonderful person and doctor.”