Tuesday, March 30, 2010

Buy One, Get One...Well...for Double the Cost

Today I went back to see my favorite South African Ortho surgeon to discuss the results of my NCS and EMG tests. Since the tests only showed a mild recurrence of Carpal Tunnel Syndrome (which I'm told never completely goes away) in my right arm, Dr. Millard advised me to give the nerve more time to heal and to do some nerve stretches. Nerves can take months if not years to heal so I'm stuck dealing with the recurring pain in my right arm.

I also asked Dr. Millard about the mystery bump which had appeared just on the outside of the bony tip on the right elbow. He said it was likely a slipped tendon but he hadn't done any work on that side of the elbow at all so it wasn't related to the surgery. I also told him that most people who have a Subcutaneous Transposition report 3-6 inch scars and the pics look pretty ugly but he somehow managed to give me this really faint 2 inch scar. His response was that he always thought he should have been a plastic surgeon!

Anyway, the tests had also confirmed Carpal Tunnel and Guyon Canal Syndromes in my left arm which was previously undiagnosed. At this point, Dr. Millard said the way to proceed was up to me. But given the history I had with my right arm, he suggested that I'd eventually end up having surgery but he couldn't advise when. So I can wait until the arm gets worse or go ahead with surgery now while it's still not that bad. My feeling on it is that it will be easier to recovery if the damage is less severe and I'd also rather get it over with.

The good news is that since this is my left arm and there's no indication of Cubital Tunnel Syndrome in my elbow, I'll only have to miss a few days of work and then I should be okay to return and just take things slow with one hand. I can also work from home if needed. So my second surgery is scheduled for April 26th, a little over 6 months after the first one. I'll have to withdraw from school for the Spring quarter but I should be pretty well healed by the Summer session.

Wednesday, March 24, 2010

Hey, I'm Bilateral!

So I finally sucked it up and decided to go back to see Dr. Millard. The big clencher was that I'm coming up on the end of my quarter at school and on the very slim chance he says I need to go back in for more surgery, I will have to withdraw from school again so I need to know sooner rather than later.

When Dr. Millard came in, he immediately said "So which arm are you here for this time?" which I thought was pretty amusing since I'd spent a very uncomfortable night the night before with BOTH arms hurting. I'd had a few symptoms off and on in my left arm since the summer but nothing major so I'd never brought it up. But I suppose now is as good a time as any. I told him that the pain in my right arm had been consistent over the past few weeks and I had some similar symptoms in my left as well. And much to my chagrin and totally expected, he said he was sending me back for another EMG and NCS but this time in both arms for the ulnar nerve in the elbow as well as the Guyon Canal and Carpal Tunnel in the wrist. I was really not looking forward to the needles and electric shocks again.

My second experience with an EMG and NCS was no more fun than the first one, in fact it was definitely worse. Mostly because it was doubled since this time I was tested in both arms. The tests were done this time by Dr. Rossi, a colleague of Dr. Millard's. First he did the Nerve Conduction Study (NCS) which isn't really fun but not horrible. The shocks can really make you jump and some hurt a little. Next came the Electromyography (EMG) test. This one is not fun! He took a small needle and poked it in various muscles of my arm and hand. Each time he placed it in a muscle, he dug it around and then would have me flex the muscle so he could listen and see the electrical activity of my arm. Flexing against a needle is quite painful. The worst places were when the needle was in my hand.

Afterwards, my hands hurt a lot and my arms just felt overall sore as if they had been worked really hard or were bruised. Dr. Rossi said that based on what he saw, I still had mild Carpal Tunnel Syndrome in my right hand and mild Carpal and Guyon Canal Syndromes in my left, which was previously undiagnosed. I'm officially bilateral. So based on his results, there's no reason for me to have pain in my right pinkie finger or elbow, something I don't buy. So basically, the torture tests are inconclusive in my book. He can't tell me that I don't have pain when I do. Now I just have to wait to see what Dr. Millard says.

Sunday, March 14, 2010

The Pain Returns...

So it's mid March and suddenly I'm having issues again. My little finger and sometimes my ring finger are aching and sometimes my elbow feels sore and tender. I still get random feelings of being stabbed in the elbow with needles. I'm not sure if it's a result of more work being thrown at me since I switched jobs or if it's the result of something else.

On February 15th, I was at the movies with Rhys when I hit my elbow really hard on the arm rest. I very nearly let loose with some pretty bad words right in the middle of the movie but managed to hold my tongue which was a really good thing since it was a kids movie and the place was full of kids and their parents. Afterwards, my elbow was pretty tender for a couple of days.

Then last week, I was checking out my scar on my elbow (which is fading really well) in the bathroom mirror. I had my arm bent all the way back so my hand was touching my shoulder and I noticed a raised white line on the outside of my epicondyle (the boney bump of your elbow). Now, I've checked out me elbow a lot over the past few months and I've NEVER seen this raised line before. And there's no matching raised area on my other elbow either. When I run a finger over it, it's numb like novacaine. The area is about a centimeter long.

I'm pretty sure that it's not normal to be able to see a ligament or tendon or something suddenly appear where it wasn't visible before. It seems awfully unprotected from injury if I can see it with the naked eye just by bending my arm. I can't even imagine hitting it at this point. The thought makes me sick to my stomach.

So now I'm playing a waiting game. I'm hoping the pain that seems to have come at the same time as this suspicious raised bump is just the added stress of more work and will resolve itself. If not, I'll have to consult back with Dr. Millard and I really don't want to do that. I really don't think there's much else he can do on my right arm. Here's hoping that it all works itself out!

Tuesday, February 2, 2010

Wow, 4 Months!

I can't believe that in a few days it will have been 4 months since I had surgery. In general, things are going well. I'm not really sure what I expected to feel like 4 months out so I can't say that I'm better or worse than expected. I still have some numbness in my elbow and some of that may never go away. But it doesn't really bother me per se, it's just kind of weird - like novacaine from the dentist or something. Most of the time, I don't notice it unless I touch my elbow or I try to lean on it which is still uncomfortable. I also still get random nerve firings in my elbow which feel like some evil invisible elf suddenly stabbed me with a needle in my elbow. The feeling generally last for a few seconds and then goes away.

I'd say my chief and only real complaint, is that my little finger is still hurting. From what I can tell, this is primarily a result of the cold as it doesn't seem to really ache when my hands are warm. So I've taken to wearing a fingerless glove at work when it starts to hurt or shove my hand in a pocket to try to warm it up. Dr. Millard had said to come back in a couple of months if I was still having pain but I think I will wait until warmer weather to see if the pain goes away. I'm not really sure that he could do anything else at this point anyway except maybe cortisone shots and after having stitches pulled out of my palm, I'm not so keen on the idea of a shot in my hand!

Tuesday, November 17, 2009

Six Weeks Post-Op

It's now been six weeks since my surgery. Today I met with Dr. Millard for hopefully the last time and I'm now wrist brace free for the first time in about 4 months. It actually feels weird! I'm wearing an ace bandage around my hand/wrist for some support and because my hand incision is still really tender. Pressing on the incision is painful so typing on a computer actually hurts because my hand rests right on the incision. The ace bandage gives me some padding.

My hand is slowly getting better. I can curl my fingers into a fist, I just can't tighten them. I have no grip strength yet. I can't break the seal on a bottle so I have to ask others to do it for me. But I have all the dexterity back. I can type and do just about anything, I just don't have any strength. It will take time for me to regain the muscle that I lost after surgery. I'm sure Jeff will have lots of ideas on how to get that back.

There's still some swelling in the heel of my palm and apparently the scar tissue has built up pretty good. Dr. Millard told me to do deep tissue massage over the incision and when he pressed on it, it was quite painful. Pretty quickly he realized that I wasn't likely to press hard enough on my own hand because I'm really not into self-inflicted pain so he said I'd have to make Jeff do it. He said it was too bad Jeff wasn't there so he could tell him how hard to push and I just laughed and told him not to worry because Jeff had no problem causing me pain.

I did discuss the fact that I still have pain in my pinkie and ring fingers and asked how long I should give the pain to go away before I get concerned about it. He said if it's still painful in 2 months, then come back. Hopefully I don't have to see him again. I'm not sure what options would still be left to me after having surgery and I'd rather not have to find out.

My elbow is doing okay. I still can't straighten my arm all the way, but it's pretty close. The area around the incision is numb in some places and extremely tender in others. The back of my arm above my elbow is very sensitive to touch. Just having my hand or clothing rub across it can be uncomfortable. I also occasionally get a feeling like needles stabbing into my elbow which is always loads of fun! I expect all of this to get better over the next few months as the nerves continue to heal. My main concern is the pain in my fingers not going away and getting my functionality in my hand back.

Tuesday, October 27, 2009

Waking Up Is Hard To Do

The next thing I knew, I was waking up in post-op with someone asking me to wiggle my fingers. I did and said my arm hurt. The voice asked me to rate my pain and I gave it a 7. She put some meds in my IV and asked me again about 15 minutes later how my pain was. The pain was still bad so she gave me another injection. After 4 injections, some anti-nausea meds and a percoset, the pain finally went down to a 4. By now, I'd been in post-op for 2 hours and apparently Jeff was starting to get worried because they called up asking about me. After a bout of losing my stomach because of all the drugs, they finally took be back down to recovery.

Once back in recovery, they finally let Jeff back to see me. He helped me get dressed but I was still nauseous so they wouldn't let me leave yet. I kept my arm elevated and tried not to puke when I sat up. Finally, after a couple more hours, they went ahead and let me leave even though I was still sick to my stomach. I was wheeled to the car and off we went, vomit bag tightly in hand.

Once we got home, I crashed on the bed I'd created the night before on the couch, keeping my arm elevated. After that, I just slept, waking only to take Percosets every 4 hours whether I hurt or not. Staying on top of the pain was one of the best pieces of advice I received and I even set my cell phone to wake me in the middle of the night to take more pain meds. I also used ice packs on my elbow which helped too. My hand was very swollen and I really couldn't move my fingers much at all.

After my first night, my husband had to go back to work but my 7 year old son, Rhys, was home with me. Mostly I dozed on the sofa or watched really bad daytime television. Lunch was difficult with just one arm but Rhys helped out and we managed to get fed. That night, my mother picked up Devyn from pre-school and brought over dinner since Jeff had to work late. But all in all, the first day wasn't too bad. Wednesday was pretty much the same.

I really didn't have any bad experiences until the Thurday after surgery. I went to sleep on the sofa at around 10:00 after taking a percocet. Around 11:30, I woke from a dead sleep and was nauseous and faint. Weird to wake from a dead sleep just to feel faint...I mean what's the point? I managed to get to the bathroom and called for Jeff who luckily was still awake upstairs (there's no way he would have heard me if he was asleep). He came barralling down the steps and found me laying on the bathroom floor, ready to pass out. After a few minutes, I felt able to get back to the sofa and Jeff sat with me. I was in a lot of pain at this point, the pinkie side of my wrist burning really bad. I took another percocet at midnight but it didn't really help. I was starting to wonder if I needed to go to the emergency room which would have been a real pain since we live about 30 minutes from the nearest hospital and we would have had to take our 7 year old and 4 year old with us.

Jeff sat up with me watching television while I writhed in pain on the sofa. Finally at about 2:00 in the morning, Jeff decided to go back to bed and I took yet another percocet. At around 2:30, I finally fell back asleep. The next morning, Jeff called off work and stayed home with me because we weren't sure if I'd need to go into see the doctor. At 8:00, I called the doctor and talked to his assistant. By now, I was feeling better and since I didn't have a fever, I was advised to just monitor how I was feeling and call back if the same scary symptoms returned. Basically, what probably happened was that my body suddenly caught up with itself and went into a mini shock. It was very scary but only lasted a few hours and was the only really bad time I had until the sutures were removed 12 days later.

Living in the arm splint for 15 days wasn't really so bad. I did pretty well at most tasks on my own. At first I asked for help with my socks but after a week, I was able to manage them on my own. I very wisely tied my running shoes very loosely in advance so I could just slip them on and off without untying or tying them again and threatened my husband with grave injury if he untied them. I pretty much lived in track pants or pajama bottoms and t-shirts the whole time so I didn't have to deal with buttons or zippers. Showering required assistance with tying a trash bag over the splint with a spare shoe lace and then Jeff stood outside the curtain and would squirt shampoo, conditioner or body wash when I thrust my hand out the curtain at him. Drying was a bit hard but managable.

Preparing food was difficult. With the Guyon and Carpal surgeries, my hand was completely useless. I couldn't open a jar or spread or cut anything. Trying to make eggs was laughable. I had to have the waitress at Bob Evans cut Rhys's pancakes for him. Driving was managable but probably not recommended. I had to reach through the passenger side to start the engine with my left hand and used a pillow on the middle console to prop up my elbow when driving.

I went back for my first post-op check at 15 days. By then, the splint was getting uncomfortable because the swelling in my elbow had gone down and it was rubbing and just didn't fit right anymore. The resident who'd assisted in my surgery, Dr. Mickelson, was the one to remove the splint and man did it feel weird! I get light-headed really easy anyway so when it came time to remove the sutures, I laid down. The elbow sutures burned but the hand hurt like hell! WOW, did having those suckers out ever hurt! And I was completely shocked to see only one incision in my palm. I had expected another incision for the Guyon Canal decompression but I assume they were able to do both the Carpal and the Guyon through the same incision. Dr. Mickelson kindly told me that he had been the one to do my hand and it only took him like 7 minutes. That didn't really make me feel better.

Dr. Millard inspected my incisions, put my wrist in a hard splint and told me not to lift anything heavy and to come back in 4 weeks before sending me on my merry way. I was amazed at how completely useless my hand was at this point. My elbow felt sore, like the muscles had been really badly bruised and the area around the elbow felt numb like novacaine.

Six days later, I returned to my job. My hand still felt pretty useless so I spent most of the first week using it sparingly and mostly typing left handed. By the second week back, my hand was improving and after the 4 weeks it was feeling fairly good. All in all, at the 6 week point, I felt pretty healed although I know it can take months or years for nerves to heal.

Friday, October 9, 2009

Surgery

I've already figured out that typing left handed is hard to do!

Surgery was Monday and now it's Friday evening. My husband, Jeff, and I arrived at Grant Hospital at 7:30 am. The nurses had called me the Thursday before and said my surgery was being pushed from 9:00 to 9:30. When we got to the hospital, we pulled right up to valet parking which was free for surgery patients. We went upto the second floor and right to a reception desk. The receptionist verified who I was, put on my hospital bracelet, and gave Jeff a card that had an ID number on it. When they were done with my surgery, they'd flash a message up on a tv in the waiting room to let him know I was done. The receptionist then callled back to the nurses and sent me right back.

The pre-op area was super nice. They weighed me and had me pee in a cup and then put me in a little room. I changed into my gown and footies and lay down on the gurney. The nurse asked me all sorts of questions and took my blood pressure. Another woman came in and took my ID and insurance card and then the on-call doctor came in. He listened to my lungs and asked me about my medical history since he'd be the doctor in charge of me after I got out of surgery. There was a struggle to get my IV started and eventually a second nurse had to put it in the back of my hand. While I was signing my consent forms, Dr. Millard and his resident, Dr. Mickelsen, came in. Dr. Millard asked me again if I knew what they were going to do to me and then nicely initialed my right arm. I guess he was claiming me as his own.

Dr. Millard left to go get changed and Dr. Mickelsen asked me some more questions about my history of symptoms. Then I was joined by the anastesiologist who asked me more questions. Jeff left at this point, taking my glasses with him so I was blind. Finally, I was left with the surgical nurse who was going to wheel me upstairs to the OR. All in all, I think I saw about 10 different people leading up to surgery time.

The trip to the OR was surreal. It was like on TV. The halls were empty and we just went up a surgical elevator and then right into the big brightly lit OR. There were a couple people waiting and they had me scoot over onto the operating table. As I was doing so, the nurse put something that burned into my IV. I lay back on the table and they put the mask over my face and someone asked me where my favorite vacation spot was. Then I was gone. Nothing.