If I remember correctly you are in Northern MN? I have a friend in the Bemidji area, I'll try to find out who she sees if you wish. Like you, she is very proactive about her health care, and selective about providers.

As for the thumb, all I can say is "you will know" - just don't wait until the joint begins to visibly collapse, or to "lock up" (indicates it is fusing on its own) - then fusion becomes the only option. And be sure to have a hand surgeon do it - it can be done well or not so well, and experience really matters.
Sue