@sueinmn Thank you Sue! I am very fortunate and have a very respected hand surgeon and a rheumatologist. We live in a remote small town in NE Ontario Canada but they are at the hospital about 100 km from us. There is just mt husband and myself at home and other resources are mostly available by video conference. I have had a few hand surgeries, broken bones, trigger fingers and giant cell tumors performed by my surgeon. I am thinking one hand at a time for surgery, possibly the or which ever is in worse shape, I guess my biggest concern is I have been told the fractures are common after surgery and can be complicated. Is just accepting the condition without surgery and living with the pain a better option as I am 78. My GP will just prescribe pain meds. Thank you