Wednesday, August 26, 2009

The road to surgery...

So what's new with Karin? I'm having surgery! Not super-serious-could-cause-death-surgery but still it's the first (and hopefully only) time I've had surgery and it's my right arm so I'm nervous about the recovery afterwards and the long term results.

I've had wrist pain off and on for the past 8 years and my family doctor diagnosed Carpal Tunnel Syndrome and told me to wear a wrist brace. When the pain would flare up, I'd wear the brace until it seemed better and then forget about it until it flared up again. Then in mid-July, I suddenly experienced severe pain from my right elbow down through my pinkie and ring fingers. My husband, Jeff, the wonderful Physical Therapist, said it was my ulnar nerve being pinched. After a week of it not getting any better, I went to my family doctor and he confirmed diagnosis, saying that the ulnar nerve is "trapped" in the Cubital Tunnel space in my elbow. He prescribed steroids and naproxen and told me to come back in 2 weeks when that didn't work.

That's right, he said it wouldn't work and that when I came back, he'd send me to the surgeon. 2 weeks later, I went back when the medicine didn't work like he said. By now, I was also having a recurring muscle spasm in the heel of my thumb. This time, the doctor sent me off for an EMG and then on to the surgeon.

Having an EMG is horrible. They strapped electrodes to my arm and sent electical shocks through my arm in varying degrees of intensity. It was like being shocked over and over again, harder and harder. Some of the shocks really hurt and some made my arm jump. Then, the doctor stabbed (and I mean STABBED) a needle into my arm and hand in various places to see if the nerve was conducting impulses all the way down my arm. Holy cow, that really hurt. Especially when he stabbed the needle in the skin between my thumb and first finger. The results confirmed evidence of Cubital Tunnel (entrapment of ulnar nerve in elbow) and Carpal Tunnel (entrapment of median nerve in hand/wrist) Syndromes.

Carpal Tunnel and Cubital Tunnel can apparently become pretty serious. You can end up with permanent numbness, tingling, weakness and "clawing" of your fingers. There are times that I feel like my pinkie finger is being pulled down towards my palm. I get flashes of pain down my arm like I hit my funny bone, which is the ulnar nerve being pinched. The ulnar nerve runs to the pinkie and ring fingers and the median nerve runs to the thumb, first and middle fingers.

After that, I was off to see the orthopaedic surgeon. Jeff had strong beliefs about who he'd allow me to see and he insisted on Dr. Gary Millard, a hand and arm specialist who treats the Columbus Bluejackets among others. I met with a resident, Dr. John Buschman, first. He asked some questions and did a quick exam. Then Dr. Millard came in and they talked and he asked a few more questions. I basically confirmed that I'd used wrist splints and elbow braces and tried meds but was still having problems. Much to Jeff's surprise, Dr. Millard suggested surgery. He doesn't see any point in waiting since it's not likely the symptoms will ever disappear on their own or for good.

I wasn't surprised despite Jeff's belief that Dr. Millard would recommend physical therapy before surgery but I was surprised when Dr. Millard said he was not only going to operate on the Cubital and Carpal Tunnels, but he was also going to go ahead and decompress the Guyon Canal as well. That's also the ulnar nerve, but in the side of the wrist. From what I've read, Carpal and Cubital Tunnel surgeries are pretty common but not the Guyon Canal surgery.

So surgery is scheduled for October 5th at 9:00 am. Dr. Millard will move the ulnar nerve out of the Cubital Tunnel and relocate it to under the skin and fatty layer in my arm. That's called a Subcutaneous Ulnar Nerve Transposition. He'll decompress the ulnar nerve in the Guyon Canal and the median nerve in the Carpal Tunnel by cutting the ligaments over the nerve and then close the incisions, allowing the ligament to close with scar tissue. Surgery will be out-patient and only take 1-2 hours. I'll be wrapped from above the elbow all the way to my hand for 2 weeks. Sutures will be removed after 2 weeks and then I'll be in a wrist splint for another 4 weeks.

On average, it takes a nerve about 1 inch per month to heal. So if I'm measure my arm from my elbow to the tips of my fingers, that's about how long until the nerve should be fully healed. And as fun as all that sounds, during the middle of all of this, I began to experience the same symptoms in my left arm as well. I haven't told the doctor yet about that arm since there's nothing they can do until the right arm is healing but I'm nervous that I'll have to have the surgery on that arm as well.

I'll keep everyone posted with how things are going once I'm up from surgery. But that's it in a nut shell for now.

3 comments:

  1. Thanx 4 your post, I think.. u must try some Orthopaedic Products India 4 your happy and safe life. Tmtmedsource is Indis'a largest orthoic product manufacturer. Tmtmedsource Provide Cervical Aids ,Shoulder Clavicle Supports,Wrist elbow splints and lots of more product.

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  2. Holy&*$@n crap Karin! I was searching the internet for what it would look like for me to have surgery on my wrist. I have the rare treat of having my ulnar nerve trapped in the Guyons Canal area. My pinky and ring finger have been numb for two months now. I finally went for the EMG test, wasn't that fun? Fine thing for torture that machine would be in the wrong hands...shudder! My tech was nicer than yours though, more careful with the needles and more gentle. The few days after were rough for me as the muscles and nerves recovered from being stimulated like that,the pain that keeps on giving, ouch! The best thing about the test is that it did zero in on where the compression was. Dr. kept thinking it was in my elbow, I felt it was in my wrist. Ha, a small victory for me. I had hoped therapy would sort it out, but it seems from your post that the advice I was given matches up with your experience. I am amazed to see we have the same surgery date, Oct 5th! Whoa. I feel claustrophobic about having my wrist and hand immobile, but after seeing what you went through, good grief, if you can do survive all that perhaps I will be just fine. My other arm is twitchy too, the Doc said it would be rare to get it in the other hand too, but I am worried. Did you have to have surgery on the other side? Thanks for posting, your pictures and description actually helps me in a weird way.

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  3. p.s. Did the awful numbness and pain in your hands and arm go away after the surgery? How long did it take? This also worries me. I sincerely hope you are better now.

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