The Third Arm is Free!

Today I had my stitches from my Carpal Tunnel Release and Decompression of Guyon's Canal on my left hand removed. Lucky for me, Dr. Millard does both procedures through a single incision because I was not looking forward to having the stitches removed. I really wanted the splint off since it was starting to get funky and was itchy but when I had the stitches out of my right hand, it hurt like crazy. This time, a different resident removed the stitches and it wasn't nearly as painful. He made quick work of the stitches and said that the better they are put in, the easier they come out. Since the last resident told me that he'd done my Carpal/Guyon on the right hand and I'm pretty sure Dr. Millard alone did the left, maybe that's true. Dr. Millard seems to be pretty damn good with sutures since my elbow incision is tiny and you can barely see the scar.

I did notice that the side of my hand below my pinkie is numb, a result of the ulnar nerve being disrupted in the Decompression of Guyon's Canal. Since I'm no newcomer to the slowness of nerves healing, I'm sure it will come back in time. I just hope it's not too long. The numbness in my elbow still creeps me out...I don't really know how I'd feel about long term or permanent numbness in my hand.

15 days post-op and there's still faint bruising in my palm, and pretty nasty bruising on my wrist a good inch to three inches below the incision. The incision site itself is still pretty swollen, the heel of my palm pretty puffy and raised compared to my other hand. The incision itself is about an inch long and nice and scabby. You can see the purple marker Dr. Millard used to mark the site as well as his lovely G.M. initials on my arm from our pre-surgery consult. I'll have to scrub that puppy off!

Dr. Millard didn't say much other than look at the hand real quick, tell me not to lift anything heavy or do too much for a while. Told me to give it a few days and then start massaging the incision to break down the scar tissue (not my favorite) and then told me he'd see me in 4 weeks. I did ask him if he'd give me a discount on the third arm but he either didn't get it or the doctor in him just heard "discount" and immediately said no. Oh well, I guess surgeons don't have much sense of humor!

So it's back to wearing a wrist brace for 4 weeks but I won't complain. At least I can type better now and I won't have to wear a trash bag in the shower anymore!

Uh, chopsticks weren't meant for that sweetie...

Just a quick update eight days post surgery. Things are going well. I went back to work two days after surgery, working from home one day and then heading back into the office. I haven't had any pain meds aside from Tylenol since Wednesday night, three days after surgery. Overall, I'm feeling good aside from some moments of very minor irritation. It seems like the side of my hand beneath my pinkie may be numb but I can't really tell at this point. Working has been less difficult than I anticipated and compared to going back to work 3 weeks after surgery on my right arm. I can actually use my fingers really well and really my only inhibitor is the bulk of the splint in the area of my palm preventing my fingers from really stretching out when typing.

My chief and only real complaint....the insane itching! I really want this splint off! I don't remember the itching being this bad with my right arm and that splint went all the way up over my elbow. I've even taken to shoving a chopstick under the splint in an effort to scratch and relieve the itching. I don't get the splint off for another 7 days and I can't wait (although, I'm not looking forward to getting the stitches removed....YOWZAH!!!)

Hey, are these things actually attached to my hand?

Yesterday I had my Carpal Tunnel Release and Decompression of Guyon's Canal on my left hand. Things went a little smoother this time since they only used a local nerve block in my hand instead of knocking me out with anaesthesia.

The whole routine was pretty familiar when we arrived at 6:45 am. Last time Dr. Millard's first surgery had gotten cancelled so they were able to move me up and we really didn't have to wait long. This time we didn't have the same luck and we had to sit around and wait for a little over 2 hours before they took me back to the operating room. This time, I told the anaesthesiologist about my problems with nausea and they loaded me up on anti-nausea meds along with a transdermal patch.

Once they wheeled me down to the operating room, I was awake for a while longer than I had been the first time. They strapped this big black cuff to my upper arm and then wrapped the arm super tight to put the block in. They put me into a twilight sleep and I didn't feel or hear anything until I started to wake up after it was over and they were bandaging up my arm. I was able to get myself over to the gurney on my own and they took me right back to the pre-op floor where I'd been before surgery. I felt pretty good at that point, no nausea and really no pain since the block was still working. The nurse gave me some crackers and water so I could take a percoset. Jeff came right back and I said I felt okay enough to get dressed and go to the bathroom. After that, the nurse said I could leave and I was able to walk down to the car. All in all, surgery started a little after 9:00, I was back in recovery by 9:45 or so and left by 10:30 am. What a huge difference from October when I was in recovery for 4 hours because I was so sick!

We stopped at the pharmacy on the way home to get my prescription for percoset and then headed home. Aside from feeling groggy, I've felt pretty good. I'm taking percosets every 4 hours to stay on top of any pain but I hope to be off of it in a couple of days. My hand is still extremely numb with only some severe tingling when I touch my fingers. They said the block should wear off pretty quickly but that doesn't appear to be the case. It's now been about 24 hours. I guess if its not wearing off by tomorrow, I'll call Dr. Millard just to check in to see if he has any concerns.

The plan is to work from home tomorrow and then go back to work Thursday as long as everything looks good. I'm really hoping to get a lot more feeling back in my fingers today.

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.

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.

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!

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!