Date: Fri, 2 Dec 1994 12:17:59 -0600 From: Norma Gonzales Subject: VERY LONG STORY - CARPAL DIAGNOSIS, TREATMENT AND RECOVERY To: Multiple recipients of list SOREHAND Sorry for the length, it's 3 1/2 years worth of stuff. I thought maybe one person will see themselves and be able to try what has worked for me. After 8 years in programming and 2 as a manager, I was diagnosed in 1991 with early stage bilateral carpal tunnel after numbness and heaviness in my left hand and loss of strength in my right (I did not know anything about repetive stress injury so I had no idea what to expect, I now believe the PC keyboard and mouse did me in, 8 years on a terminal didn't give me any problems). An EMG did not confirm the diagnosis, but worker's comp accepted the claim. Nine months of physical therapy (hot wax, ultrasound, electrical, ice, etc), TENS unit, NAPROSYN, RELEFEN, and umpteen pain killers (my body couldn't tolerate, so I went without, and by the way I didn't even used to take aspirin unless I was practically dying), and yes, wrist splints almost 24 hours a day (I couldn't stand the pain without them). The RELEFEN anti- inflam medication worked best for me but it would only work for a month or so (I now have an ulcer induced by medication). Therapy increased my strength and allowed me to functions somewhat, but it increased the pain tenfold. I continued working the entire time, with light duty and a lot of frustration and pain (and threats from my Dr. he would make me stop working if I continued working under the same conditions and deadlines as before). My pain was in my forearms, it was a burning ache and constant pain, no one would listen, and looking back I don't know how I survived for over a year and half like that. I couldn't write much at work or home (check writing time was horrible and was done over the course of a week!), my house was a constant mess, squeezing out shampoo or cutting my meat was extemely difficult, I couldn't even clap my hands, coming to work each day in pain was a chore in itself, and my kids had to learn to live with my many limitations (taking a walk but saying don't pull on my hand at all whey you hold it, sorry I can't lift you to drink from the water fountain). In June 1992, thank God, another EMG (more modern and not as painful) was done when W/C decided I'd had enough therapy. It showed entrapments in both arms, wrist to shoulder in one, wrist to elbow in the other (ulnar, radial, etc though they still have me down as carpal). I think therapy aggravated my other nerves, it was not the correct therapy for what I actually had. I was told I needed up to five surgeries, so I started looking into leaving my job. My Dr. tried trigger point injections (not fun, non-steroidal, 3-4 weeks apart at first, 2-3 months after that and I'm looking into doing my own trigger point therapy that the list talks about) as a last resort, and after 4 months of treatment, my pain began to be a little more tolerable. I also started on ELAVIL at night. I got Dragon Dictate (for DOS, use it with all kinds of PC and mainframe software) and it allowed me to at least feel somewhat productive. It's been about a year since I've been in intense pain, and I attribute most of the relief to the trigger point injections (the last EMG showed the entrapments are minimal and some gone). In March 1994 they determined I was at Maximum Medical Improvement and I got a disability whole body rating of 11%. Under new Texas law, I got impairment income for 33 weeks (should have been 33 weeks of my income but with limitations, it was less than half my pay per week) and medical for life. They are now denying claims for therapy, injections etc., as not medically necessary. Under 16% disability, not too many benefits exist. I never took a day off that I claimed W/C, so I wasn't entitled to supplemental income. They are saying they will not pay for surgery or time off in the future, but I will fight them on that if I have to because surgery was not recommended at the time (reflex sympathetic dystrophy according to one doc). I really don't understand how I have 11% disability, because that may be at my best, but without therapy, or medication, I can deterioriate to how I was before and I was practically useless, definitely not 11% disabled. The good news: I feel closer to normal than I ever thought I would, I actually have pain free days more often. I take Elavil, B6, B complex 100mg, cod liver oil pills ( I started the B this year and it has helped, especially with the cod) and ulcer medication (no more anti-inflam for me), trigger points are on appeal tho I paid for one session myself, I wear splints to sleep or when I feel I need to, drive an automatic car, and have done some water excercises off and on. This combination has done wonders finally! I still have bad days or even a couple of weeks at a time, and I can't do many things, but I am thankful to have this much freedom again. I feel productive again, I felt worthless at some times throughout this. I keyboard a little (trying to do it with ergonomics in mind), use the DRAGON, and can write again for a while. I can peel a potato, lift a pan, things that most people take for granted. Final thoughts: consult a lawyer (I sure wish I had, I didn't because I was getting good cooperation from my boss and my adjuster back then), take time off if it's recommended, (trying to do things "right", without rocking the boat, was a mistake for a workaholic and perfectionest like me), surgery is not the only answer, keep hammering away if something is not working for you (each case is different, find what works for you). There is so much information available now, no one should have to suffer for so long, but I run into people who are hurting and are still in the dark. So if anyone has questions, please feel free to mail directly to me. Norma Gonzales Manager, Information Technology El Paso Community College Normago@laguna.epcc.edu