Gimped

So, a bunch of you have been asking this past week what’s the deal with the sling and my operation. I wasn’t really going to go into all the gruesome details, but then I figured, sure, why not? I mean, it’s no secret; whenever anyone stops me to ask, I tell them. Plus, it’s been kind of an upsetting time because while I’ll probably get a little better, in terms of the longer haul, the jury’s still out.

For the past couple of years, I’ve been having increasing problems with my left arm. Specifically, the ulnar nerve–that big honking sucker that gives you that awful, spazzy, tingling that runs all the way down your arm and into your hand–has been getting increasingly compressed and constricted. It tends to happen to athletic people, particularly those who do a lot of biking (that’d be me) and/or those who do a lot of repetitive motions, such as typing. (Again, guilty as charged.)  In my case, I’ve also got something called a double crush syndrome:that is, that particular nerve is getting squeezed in both my elbow and my neck because I broke a couple vertebrae years ago.  They operated, and those vertebrae were fused, but like any system under pressure and susceptible to torque–that’d be your neck–if a portion (in my case, on the right) is fused and immobile, that means pressure isn’t distributed evenly and there’s greater stress transmitted up and down the column on the left. Really, it’s simple mechanics. Imagine trying to twist a licorice stick, only a portion on the right is much stiffer.

ANYWAY… it was getting to the point where I couldn’t type without a lot of pain in my left hand.  Also, the muscles were starting to get involved. If you look at my right hand,

you can see there’s nice juicy muscle just beneath my thumb and along the outer aspect of the hand; all the fingers are nice and plump.

By contrast, my left hand shows definite atrophy.

My thumb looks relatively okay (but not great), and you can see all the muscle along the pinky and fourth finger, which is all directly ennervated by the ulnar nerve, is wasted and scrawny.  The whole hand looks bonier and what muscles are there aren’t all that strong.

Now, as I said, this is been going on for several years, and I’m the worst kind of patient because I tend to just try and muscle through and beat things back through force of will.  But this last book–THE DICKENS MIRROR–was torture and I hated having to slow down, period.  I simply couldn’t type as fast or for as long without having to take breaks.

So I decided that it was time.  About a week ago, the surgeon unzipped my arm at the elbow in a simple decompression, similar to what happens with carpal tunnel surgery (which I’ve also had).  Except, of course, with me, it wasn’t so simple. When the surgeon bent my elbow in the operating theater, the nerve kept popping out of place (fancy name is subluxing) and wouldn’t stay in its groove. That makes sense if you, the surgeon, have cut away the bands holding the nerve in place. So that meant that he had to take the nerve and transpose it from where it usually runs in my elbow by pulling it around to the other side of my arm where he buried the nerve under skin and muscle to protect it. This works great if you’re a little meaty or a biggish person, but I’m not. There really wasn’t much choice, though, because the only other option would involve cutting away bone–and we’re not there yet.

It’s going to take  a while for the inflammation to subside and swelling to go down and see what remains. Nerves aren’t like other tissues; they don’t readily heal. So the chances that I’ll get back to a time when I had no pain are small. The hope is that you keep a bad situation from getting worse–worse being that I lose a lot of function in the hand altogether. In the meantime, the nerve is going crazy; the arm aches; and I hurt a lot. It’s hard to sleep and I really can’t use the left arm at all, which means I can’t type. So this, for example, is being written with a combination of dictation and hunt-n-peck with my right hand. Still, the bruising’s better.  This week, I’m more green and yellow:

and the swelling’s way down. Last week, my hand looked like it belonged to a black and blue Pillsbury Dough Boy, but I do believe those are tendons I see.

At the end of next week. I get to ditch the sling.  Then…we wait. I get to try using the arm and hand again.  I don’t think I’ll be doing miles in the pool anytime soon, and I’ll bet strength training’s out for a while.  But we’ll see.

I’ll keep you posted.