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    Cubital Tunnel Syndrome, Part 2

    image of hands showing fingers affected by the ulnar nerve

    image from OrthoBullets 

    Follow-up to my blog of Oct 24, 2017, "What the Hell is Cubital Tunnel Syndrome"

    Some days it is better, some days not so much. Overall, there seems to be improvement, but it is not ‘all better’. In response to the question, “At the end of all this will I be able to go back to doing things the way I used to?” the short answer might be, “No”. I will need to adopt some accommodating behavior as a life style change, or have surgery. Since this involves my right hand and arm, it is pretty important. Surgery requires about 6 weeks of recovery time, and that recovery time is CRITICAL to 100% back-to-normal. I am seriously thinking about it, but not until after a one person show I  am having in January. I have also pushed back my expect-to-be-all-better deadline to Dec 31, because all my accommodations seem to be working, just very slowing. Many days my left arm feels perfectly fine (it had only begun to have the slightest of symptoms when I saw the doctor), and the numbness in my right arm is definitely less pronounced (although it fluctuates as my activity during the day changes).  

    Since I have no pain (well, sometimes after an activity), I don’t get reminded that I shouldn’t be carrying/pushing/pulling/twisting/typing-too-long/lifting until there is an increase in numbness, mostly felt in the tip of my little finger, and occasional pain that is short-lived.

    My plan of action:

    1) keep my arms in a straightened position for longer periods of time
    2) continue sleeping with arms straight at my sides
    3) get a collapsible dolly for moving my artwork
    4) use shoulder strapped bags for carrying smaller items
    5) get a SMALL drill for putting together paintings into frames, or don’t frame certain work

    And keep my blogs short...
    6) don’t use my phone so much, unless on speaker phone (I keep FORGETTING!)
    7) ask for assistance (just shoot me now)

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    What the Hell is Cubital Tunnel Syndrome?

    elbow pads and gel packsMy elbow pads (cut so they won't press on the nerve at night), and my gel packs

    The last few weeks have been part of the year I have called “The Year of New Normals”. 

    To make a long story short, numbness I have been feeling in my little finger and the side of my ring finger in my right hand for over a month was diagnosed as cubital tunnel syndrome. This means that the nerve going through my elbow in the area we call the funnybone has been irritated; it's similar to carpal tunnel syndrome, except that this involves the ulnar nerve, rather than the median nerve (which controls the rest of the fingers). With cubital tunnel syndrome the ulnar nerve is irritated; untreated (for years) it can actually lead to muscle weakness and nerve death. That got my attention. (This is not the case with Carpal Tunnel Syndrome)

    There was an official diagnosis made after tests, and then physical therapy prescribed to try to avoid surgery. It is a fairly simple surgery, but that is something I always want to avoid if I can. Fortunately (I know, I define ‘fortune’ differently from others), I started having similar symptoms in my left hand before I met with the hand specialist, so we were able to do all tests for both arms at the same time, and do all therapy for both. The tests go all the way to the neck, since problems in the hands can start there. 

    What does this mean for me? 

    My Therapy

    I have a stretching exercise for my arms that I do 4 times a day. Ideally, I should not bend my elbows more than 60 degrees most of the time. I should not carry heavy items, lift heavy items, or grip hard with my hands. The most important thing is to keep my arms stretched out at night instead of bent. While there are rigid splints for this, right now I am using elbow pads with the pads on the INSIDE of my elbows to remind me not to bend my arms (but they can still bend). That seems to be working, because I will wake and adjust my arms if they are bent. I am also sleeping 100% of the time on my back, which is not working so much, but it is getting easier. A new normal.

    Ice on the elbows is good, and I have gel packs that I keep in the freezer so when I am typing (like now), I can rest my elbows on them. I am also to keep padding under my forearms when stretched out on the table (like now), so there is no undue pressure on the nerve along the arm. When working on the computer, or painting, I must try to keep my elbows more open than closed, as much as possible, take frequent breaks, and should not carry things in the crook of my arms (how is that even possible? Shoulder bags, I guess). I am supposed to work 20 minutes, then rest 30. Who even does that? That is the worst; it almost completely prevents me from getting ‘in the zone’. 

    The good news is, this gives me a great excuse not to do housework. Indeed, I wonder if vacuuming is not partially responsible for my problem. I choose to think it is.  

    Taking vitamin B-6 is also good, which means the entire B complex of vitamins, since they work best together. 

    Using the speaker on my cell phone to reduce the time I hold it to my ear is helpful. Not in public (someone did that in restaurant last weekend and I was appalled). 

    Reducing/breaking up time on the computer/tablet/phone.

    Standing with my arms at my sides, sitting with my arms in my lap, and NOT LEANING MY ELBOWS ON THE TABLE. Turns out, our mothers were right.

    Basically, unlearning habits of many years, and replacing them with new, healthier habits. 

    This may or may not prevent the need for surgery, but I will never know if I don’t try. I avoided surgery on my vocal cords THREE TIMES during my teaching career by not talking at all for two weeks (each time). 

    I got this. 

    The reason I am sharing this with you is that numbness ANYWHERE should not be ignored. Even though I have what has been designated as a ‘mild’ case, it must still be treated. This early on, therapy is still an option. Within the next stage it might not be. Some things can be left alone, others cannot.

    I am experimenting with some voice recognition programs, like Dragon Dictation. It works, but dictating thoughts is not ANYTHING like writing/typing your thoughts. NOT at all. I don’t know how my father used a dictaphone for his business letters. Well, it was a different type of writing. 

    Interestingly enough, for some time before this happened I had been thinking about experimenting with a voice-to-text program, just because I am getting older and things happen. Now I can appreciate what a challenge that will be. Not for text messages or business correspondence, but writing like this. 

    As for painting, I had done some (a demo last week, which was more than 20 minutes, but I did stop off and on). I have finished up some work, and just cut back for now. Fortunately, I have quite a bit of  work in reserve for the small shows that are coming up. Whew!

    What has been the MOST difficult is asking for assistance, even when offered. I am fortunate to work in an art gallery where others can do the heavier work for now, and with my studio move coming up the building staff is helping me move things around (bless them!). Still, it just doesn’t feel quite right…

    Well, nothing this year has. 

    The good news is that I BELIEVE the therapy is helping. I have had to think carefully about how I do things, and that is all to the good. AND, this may force me to branch out into a new style, or at least experiment. That is ALWAYS good.

    Just so you know, I did start this blog with Dragon Dictation on my iPad, but finished most of it on my computer—with cold packs under my elbows, a sweater on because they make me cold, my computer farther away from me so I can stretch out my arms, and using 14 pt type so I can read the text from that distance. All trying to still up straight.

    Now, where did I put those elbow pads….

    Postscript:

    I went to the therapist for my last visit yesterday afternoon. I have been ‘angsting’ over every little twinge, tingle, and prickling sensation. Bottom line, I just need to relax and continue with the changes I have made. When I wake up in the morning it feels better, as I go through the day sensations fluctuate, and I just need to stop thinking about it EVERY STUPID MINUTE. Rather, take stock every week or so, and in 5 weeks decide if it is better, or if I need to go back to the doctor. I can do that. 

     

    Yes, I am resting on my elbow pads.