Sunday, January 4, 2015

Carpal Tunnel and the Trike

The medical bits

It all started with being woken up in the middle of the night with a numb hand. Night after night. And not a usual numb hand either. Before this all started if I woke up with a hand that had also gone to sleep then I would just move and the feeling would go away while I dropped off again. However this was different. The feeling wouldn't leave the hand, usually requiring me to get up and walk about for a while before it would let me get back to the land of nod. Sometimes it would wake me more than once.

As it went on I did some www research. The symptoms seemed to point to carpal tunnel syndrome. But last time I'd thought I'd got something similar I didn't and some physio sorted something out in my back relieving the symptoms. So I went back to my physio. But, while the manipulations and stretches helped, the symptoms didn't recede. So, off to the docs I went.

And one appointment with a specialist later and I was diagnosed with suspected Carpal Tunnel Syndrome. And sleeping with a splint on my right hand. It certainly helped with the night time symptoms but the odd numb hand on the bike, when typing at work and random other times didn't go away. It's a very odd feeling when your hand just goes all pins and needles for no apparent reason. The really odd thing is the feeling of pins and needles on one side of a finger and not the other. CTS is caused by an impingement of the median nerve and, as I know now, this serves the thumb, forefinger, middle finger and one side of the ring finger. The un-affected ulnar nerve serves the little finger and the other side of the ring finger.

The really odd thing for me was that it had always been my left hand that had gone numb on the bike but that hand appeared to be ok. Well, it was. Until one day on Skye, after a long tandem ride. And then the same thing started with it. I couldn't find a splint on Skye but I did manage to fashion one with a Buff and a teaspoon.  This amused the specialist!

Ah, yes, him again. This time he was convinced enough to send me for nerve conduction tests. Another specialist, another hospital and a diagnosis. CTS for sure. The tests were interesting though. Essentially a series of electric shock used to measure the speed of the nerve signals in my hands. And because the speed is slower from the thumbs than the pinkie CTS is a good call. Moderate in the left, slight to moderate in the right.

And then another trip to the first specialist. And a decision to go for surgery, carpal tunnel release. I'm going to have it done in the left hand first. If that goes well then we will consider doing it to the other hand too.

Riding

For the most part bike riding has been ok. Rough surfaces, routes with heavy braking and the tandem in general have given me problems. One or other hand going to sleep. Changing gear is a bit of a lottery when you can't really feel your fingers. Braking isn't quite so bad, but I'm not sure I'm able to modulate it well with dodgy hands. The odd sharp stop has been entertaining! Getting a drink or food has been fun on occasion too.

I'm sure cycling has had some part in the development of the problem but I'm also sure that 27 years of typing, loads of goal keeping and golf have played their part.

General

One of the strangest things is the display of symptoms. At night I realise is because a lot of us sleep with our hands and wrists curled up. That puts pressure on the nerve and makes the hand go to sleep. Fair enough. But it's the other times that surprise me. Holding a coffee cup, hand goes numb. Typing, hand goes numb. Holding a mobile phone, hand goes numb. Doing nothing, hand goes numb. It's just odd.

Although may be not as odd as one of the specialist's tests. He took my arm and tapped down the inside of the arm from the elbow to the hand. Bingo, the hand goes numb!

Then I found clapping also set it off. Hard to enjoy a pantomime if you can't clap along... :-(

Looking forward

I can't say I'm looking forward to the surgery even if it is only a 20 minute procedure. I'm also not looking forward to the recovery either. No work until the stitches are out (minimal typing), no riding obviously. I'm just hoping TV will be good.
Then, once the stithes are away, I need to be careful. Cycling will need to be introduced very slowly to build it up again. And, of course, the right hand is still affected.

And, now, one reason for the trike will be much clearer.  I'm hoping it will allow me to keep my legs strong while I keep the weight off my wrists. And that might keep the Stoker happy. I can do upright riding on the tandem.

Well, that's the plan. Hopefully it will all work out just fine.

2 comments:

  1. I understand how you feel, as I have carpal tunnel in my right hand. I would drop things for no reason, simply because I could no longer feel what I was holding. It's funny that you mentioned a coffee mug, I've dropped two so far, both filled with coffee. I hope your surgery goes well.

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    Replies
    1. Jacqueline, thanks for your comment.

      I had the surgery done on my left hand at the end of January 2015. I'm not going to call it a 100% success because the scar has left a little tight spot in my palm. Just some collateral damage I guess. However my night time symptoms in that hand have completely disappeared and did right from recovery time.

      Although the blog is not as up to date as it should be, I'm riding upright bikes again relatively happily although the tandem still gives me the most bother.

      I haven't had my right hand done, and won't until I really need to. I do still sleep with a splint on the that hand but sometimes even manage without, so I think it is still moderate on that side.

      I am also still riding the trike when I feel I need to and also trying to learn to ride a two wheeled recumbent. Now that is fun.


      What I would say, is that if surgery is offered to you consider it seriously. I don't get a numb hand holding a cup of coffee now, and there's still plenty of grip power there when I need it. Obviously that's my experience and your's might be different. But I wouldn't shy away from it.

      I hope you work it out.

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