Wednesday, November 10, 2010

THE LIGHT AT THE END OF MY CARPAL TUNNEL...


This blog has been a long time coming.  You see...around about February of this year...I started noticing some numbness and tingling in my left hand... my first thought was, that I had just slept on it.  It continued to get worse...actually starting in my right hand as well.

In April...I had my annual physical with my PCP...and he did a little test.  He had me put my 2 hands together in an upside down position for approximately 60 seconds.  Guess what?  The numbness and tingling instantly returned.  He felt...that I had the start of carpal tunnel syndrome.
 
Like I had mentioned in a previous blog...why must everything be a syndrome?  Sounds so ominous.

Just so happened that very afternoon...I had an appointment with my rheumatologist...so he told me to be sure and mention this to him.  I got to my appointment...and he did the exact same test as my PCP did...and lo and behold, the numbness and tingling began just like that.

The next step was to have an EMG...or what they usually refer to them, as a nerve conduction study.  I had one of these back in 1984 on my legs...when I was suspected of having a herniated disc...which actually turned out to be an ovarian cyst...but that is another long and agonizing story.  Anyway...I would have to wait another month for this test.  Remember...I have already been dealing with this since February.

So I had the test...they have you lie down and actually send electrical currents to your hands or wrists...and you feel these shocks.  I hate shocks..as sometimes...mine, even give off sparks.  It must be my magnetic personality...hahaha.

The test was considered normal...because as my neurologist who did the test..said..."It Come And Go."  Yes...you heard that right.  This is the same neurologist I had prior to my brain surgery...so I knew I wouldn't get very far with him. He said not enough to warrant intervention.  I was not giving up!
 
He also said that maybe I would need another EMG from time to time.  Insert...RED FLAG HERE! 
He also said it was because of my rheumatoid arthritis.  Now I have known of people who have had carpal tunnel without the RA...and this was just not sitting right with me.

My next step was to see my rheumatologist to at least try to get some relief..I wanted to have my wrists injected...not really...but my job is a scanner..and that requires a lot of computer work and using of my wrists and hands.

I arrived at my appointment...which btw...was made in a lunch line at our cafe at the hospital.  Honest!  He is just that awesome...he really wanted to help me and this specialist was going to be there to demonstrate on a machine, that would be a guide for them, so they would know exactly where to inject.
 
It was awesome!  This is what was found.  "On ultrasonographic evaluation there was a suggestion of entrapment median neuropathy at the level of the carpal tunnel, more so on the left side.  On the right side I had a bifid median nerve with an accessory median artery next to it."  Really sounds like carpal tunnel to me. Another side note...that extra accessory median artery that I have is usually gone...when you get to be somebody my age.  Well...this is me we are talking about. It's not uncommon...but nevertheless rare.

The next step was to see a specialist...well Brenda just thought she was so smart here...and jumped in and said that I wanted to see my neurosurgeon.  Sometimes..in life there are disappointments...this turned out to be a great BIG one.

He said there was no way it could be carpal tunnel...because it always involves the first 3 digits...not the ring finger or the pinkie...I just so happened to experience this in all five...so I was told to basically see another neurologist and to maybe have another EMG...which btw...they couldn't find that day on the computer. Another RED FLAG!

I immediately called my rheumatologist's office practically in tears...because I just could not believe what was happening.  I'm going to stop right here and say...only *YOU* know what is going on with your body.  Do not stop pushing, begging or whatever you have to do to get a doctor to listen to you.
 
I had to wait another month...but this time I was assured that my wrists would get injected. I saw him and asked him right off, if I could get a second opinion?  He said yes...and he now was so good with that machine...that he was able to inject using the guide.  It was a pretty pleasant experience.  I have had rheumatoid arthritis for over 19 years...so believe me when I tell you...I have been through *HELL* and *BACK* many times.

He gave me the name of a specialist and I went home and called their office and I only had to wait a couple of weeks.  I was really starting to feel, like I was getting somewhere.  Thanks in part to my wonderful rheumatologist..who I trust with all my heart.

I went to my appointment.  They did a finger prick test...where you can't look and they ask you each time how many pokes...one or two.. in each individual finger.

I saw the doctor...was very impressed with his bedside manner and he definitely told me I had something going on.  He wanted to be absolutely sure it was carpal tunnel, so he injected into the carpal tunnel in both wrists..wanted to see me back in 6 weeks, if there was any improvement, then surgery could possibly be an option.
 
I ended up with 90% improvement...so full steam ahead.  The surgeries were scheduled for October 29TH and December 10TH...as they have to be 6 weeks apart.  He also recommended taking it nice and easy...so after the surgery...I was to only work half days for the 1ST 2 weeks and then remain on my restriction for the next 4 weeks.  Also...no pushing, pulling or lifting of greater than 1 to 2 lbs.

I had my first surgery on Friday afternoon October 29TH.  Being that I was not going to be put out entirely...it was decided that no anti-nausea drug would be put in my IV.  Well...let me tell you folks...I am a veteran when it comes to surgeries...this being my 11TH & 12TH coming up...and I always get sick.  You're never going to believe this...after I came out of recovery...I was sicker than a dog.  I was also very angry because...I was not taken seriously about the anti-nausea drug.
 
They had to try 4 different times...before I finally started to feel somewhat human...where I was sent home with a Scopolamine patch behind my ear.  They usually give these for motion sickness on cruises, etc. I was told the next time to be sure and mention my problems with nausea.  You think?

Oh...the surgery went well...they had to go in deep...but he was confident, this would help.  I went home icing and elevating my hand, for the first couple of days.  I started exercises the very next day to keep from getting stiff.  I was send home with strong pain meds and anti-nausea...but have used neither.  I am a tough cookie...as you will find out...as you get to know me better.

I went back to work that next Monday...to start my half days.  I have taken a nap so far in the afternoon every day.  I am just so exhausted.
 
To top everything off...on the day of my surgery...it was discovered, that I had a flood in my apartment bathroom and that the ceiling was starting to cave in over the shower.  There was an overflow upstairs...something with a stopper...don't understand all that stuff.

So I am camping out at my Mom's...which was really the plan anyway...at least for the 1ST few weeks...but it looks like it may be longer.  She has been taking great care of me.
 
I had my 1ST post-op appointment and met with the OT.  I only had 2 stitches...so it didn't hurt too much...when she pulled them out.  She gave me some more homework.  Massaging the scar 4 times a day for 5 minutes.  Light gripping with Play-doh for 2 minutes 2 times a day.  Contrast baths for my hand, twice a day...this is where you start out with warm water and then go to cool for 30 seconds....5 to 10 minutes twice a day.  You have to be sure and start and end with the warm water.  This prevents swelling.  I also have to continue my tendon gliding exercises every hour to keep everything from getting stiff.
 
Another side note...because of the fact that they were so concerned about me developing an infection...I had to go off my injections for my RA...one week prior to surgery and 2 weeks after.  That's a total of 3 weeks without my injections.  I have started to get pretty stiff...especially my right ankle...where I recently had a flare.  I finally was able to get back on my injections and hopefully things will start to get better.  We do all this again for the December 10TH surgery...which I am planning not to get sick from...because you can bet your bottom dollar...I will ask for that anti-nausea drug to be put into my IV.
 
This sure has been quite the learning experience for me.  I understand, that you have to keep mobile to prevent stiffness and swelling.  I do not have to return to OT...as I can do everything required at home.  I am doing pretty well for the most part...the pain has sure lessened.
   
I never thought that day would come when...the light at the end of my carpal tunnel was finally opened.

Sometimes in life...things don't always work out.  Well this happened in the case of what was to be my surgery on December 10TH.  I went there all prepared to have the procedure...when I suddenly became very sick from the medicine that they put in my IV...which was to prevent nausea...but instead, it backfired big time.  I ended up not having the surgery that day.

My surgeon even came in to visit me and and expressed great concern.  He said several times...that if I didn't feel better later...that I should consider going to the ER or a walk in clinic.

I just went home and tried to rest...but it was very difficult...because I felt so rotten.  I knew at this point that I needed to get this rescheduled as soon as possible. 

I was able to get another date for December 30TH...nothing like cutting it thin.  I am to go in at 1:30 p.m. on Thursday and if everything goes well...I should be home by dinnertime.

Let's hope my light at the end of my right carpal tunnel finally becomes opened and closed.  This has been quite the experience.

Just a note regarding my surgeon.  He was so concerned that the next week...his office called to see how I was doing.  Now...that was *NICE*  Good to know...that you have a great surgeon in your corner.