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arm & hand pain/numbness


Guest ~Aurelie~

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Guest ~Aurelie~

i don't know if this is the proper place for this and i realize this is an MI board and i have plenty of that, but now i also have this and of course i'm scared because i've never had it so severe before.

if any of you have experienced the following, please help...

pain in both arms but way way worse in left. pain is from shoulder to fingers. arm and hand feels cold and numb and tingly with pain most severe in forearm through wrist and hand to fingers. very very bad tonight. worse than ever.

not sure if this is related somehow, but lately, usually upon waking, i get a rash all over my arms and legs that is not itchy or bothersome at all except that it's very red. it lasts for about half an hour and then it is gone. it always comes on with a sensation of heat. very very strange. i do nothing to make it go away. it just does after a certain amount of time.

i know you can't diagnose me and i plan to go to doc tomorrow, but i'm looking for some ideas in the interim to keep me from getting overly anxious about this. i'm really worried actually.

thanks for any help you can give.

aurelie

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Heya Aurelie,

Yah I wouldn't even try to dx you without examining you.

You know all about "if it gets worse or persists, go to the emerg or clinic TONIGHT" but I have to say it!

Things to think about before you see your doc tomorrow:

How long has this been a problem?

Did it start somewhere and then expand from there?

Made worse by activity?  Cold?  Stress?

Any similar feelings in your legs or feet?

How's your health otherwise?

Recent med changes?

How long since you had a checkup?

Don't be scared, you can freak yourself out with the list of things you'll come up with, and I'm NOT going to give you my own exhaustive list.

Just be cautious and don't hesitate to have someone lay eyes on you, okay?

--ncc--

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Guest ~Aurelie~

hi ncc. hey are you a doctor? either way you've given me a good idea-- to answer your questions and write them down for the doctor tomorrow.

do you think it's possible these mysterious rashes have anything to do with the arm pain (which my suspicion is nerve pain)? i mean really, what in the world is a rash that doesn't itch or irritate?

thanks for responding!

aurelie

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Heya Aurelie,

Not on CB but out in real life I'm a family doc.

The rash might be related, nerves can do weird things.  Make sure you mention it to your doc as well, and try to come up with a timeline -- what started first, etc.

Again, don't worry, but don't hesitate to have someone lay eyes on you, ok?

--ncc--

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~Aurelie~:

My goodness.  I had nerve problems with my legs.  I just had lower spine surgery (l4) fusion.  Before the surgery I had similar feelings in my legs, and pain in my back.  I'm about 7 weeks out of surgery and thankfully getting better.  I'm guessing that you may have nerve impingement in one or more of the nerves in your neck or upper back.  I hope not.  I hope that you can get an answer and treatment that helps soon. 

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first, i'm glad you're going to the doctor tomorrow.

second, if it weren't for the rash... i'd say what you're describing sounds a lot like carpal tunnel syndrome. 

if it does turn out that the rash and the pain/numbness are unrelated... and it is carpal tunnel, i wanted to say that after years of pain from carpal tunnel i was on the verge of getting surgery when my MD told me to (in addition to sleeping with wrist braces) take vitamin B6.  Presto... all of the sudden i felt 100% better.  From sobbing in pain and contemplating surgery to no pain.  It was SO weird.  and i'd seen 2 or 3 doctors about it and none of them mentioned it.

Here is a study backing up that my doc is not totally bizarre.

all if this is just in case it is carpal tunnel.

PLEASE let us know what the doc says tomorrow!!!

take care

penny

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Hesitant to add to the speculation (since you don't know what you have yet, Aurelie). But if for some reason you do need hand or wrist surgery, I can tell you that it has improved drastically in the past 16 or so years. I had a wrist surgery in 1989, and it was a major deal. And I felt grateful that it wasn't a carpal tunnel surgery 'cause I saw what those folks went through.

However, a couple years ago, my mother had carpal tunnel and "trigger thumb" surgery on both sides, and it was NO comparison. They've really got it down to a minor deal, it has improved sooooo much!

And yes, B6 works for some people, but not for all. Of course worth trying. (I remember the first time I'd heard of it was in an interview with Gina Schock, the drummer for The Go-Go's, who swore by Vit B6 for her own carpal tunnel. Did I just date myself?)

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Guest ~Aurelie~

revlow penny skaz~

thanks for writing your thoughts and experiences.

skaz i'm glad you're doing so much better. your surgery however, sounds pretty major. i can't DO surgery where you're put under. i woke up during a surgery as a child and was unable to move or speak or open my eyes to let the doctors know. it was like being in a black hole or buried alive. i still have flashbacks about it. very very scary.

penny i take b6 as part of a b-complex vitamin with the rest of the b's. do you think adding an extra dose of b6 is worth a try, and if so should i take it at the same time as the others?

revlow thanks for letting me know the wrist/hand surgeries nowadays are so much less invasive. i MUST be awake for it if i have to undergo it and it sounds like they allow you to be awake?

i haven't gotten in to see my doctor yet. hopefully this week. i'm getting even more worried now because i'm getting these bizarre headaches, different from my usual migraines, where i get this sudden lightening like zap of pain through my head-- top left and side, and i feel like i will collapse, but i haven't yet, and it only lasts for a minute or less. but they're happening more and more. they're very shocking each time they occur.

has anyone ever heard of this?

thanks again!

aurelie

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Heya Aurelie,

Glad you're seeing your doctor soon.

These new headaches might be because you're so worried.

They might also be a variant on the migraine, or something completely unrelated.

With a new headache, you really need to be examined to make sure nothing nasty is going on!  No matter how brief the headache is, we don't mess around with heads.

Certainly your hand/arm symptoms go along with carpal tunnel, but there are a lot of other possibilities, and I'm going to hedge b/c I'm being your friend and not your doctor!

(But BTW, carpal tunnels are frequently done in the hand surgeon's office, with a nerve block, awake.)

;)

If the headaches increase in frequency, please go to the walk-in or emerg, if only to have someone lay eyes on you and see you're okay to wait for your doc.

--ncc--

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Ditto everything ncc said. See your doc.

Again, since you don't know what's the problem yet, the following is just FYI. Not at all a suggested dx. (What do I look like? A doctor? ;) )

(But BTW, carpal tunnels are frequently done in the hand surgeon's office, with a nerve block, awake.)

<{POST_SNAPBACK}>

That's exactly how they did my mom's. Done as an outpatient procedure. Each time I waited less than hour in the waiting room for her. That's it.

It's simply amazing how much this field has improved. Back when I had my surgery, in the US there were only a couple guys in the whole country who were considered to be specialists in the wrist (that is, besides being hand surgeons). I had midcarpal instability from a torn ulnar ligament (I know, way TMI!). It was hours of surgery and I had to be in the hospital four days -- and the type of surgery I had was considered far less of an ordeal than carpal tunnel at that time.

Back then, they went through the palm side of the hand for carpal tunnel -- big long scar, more difficult to heal on that side as well. Now it's a just teeny incision on the upper side. I couldn't believe how simple it was for my mom in comparison to what I'd seen before. It truly is amazing. And my mom's hand surgeon was a just a guy at Kaiser HMO; my surgeon was one of those elite wrist guys at a university teaching hospital, the best of the best. The field has come that far.

Anyway, all this is besides the point. Get thee to a doc, Aurelie! You need to not ignore these symtoms and find out what's going on, if only for your own peace of mind.

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Guest ~Aurelie~

hi ncc and revlow and everyone. i thought i owed you an update since you've been so kind and helpful. i didn't make it to the er the other night because i was just too immobile. have had less of the sudden lightening bolt headaches yesterday and today, but still happening. i had my appointment today, but it wasn't with my usual FP as she wasn't available. i saw someone else and she was as thorough as she could be for a 15 minute slot. she want's me to get an appointment with my usual FP and have some tests done, one for possible carpal tunnel (what are the tests for that?), and a CT scan for my head.

YIKES!

The last time a hospital wanted me to have a CT scan i tried twice and had panic attacks both times so i never went through with it. I am extremely claustrophobic, and having my head strapped down and positioned lower than my feet is extremely terrifying for me-- PTSD related. even thinking about it can give me a panic attack.

i asked the doctor if i could have my partner in the room to hold my hand while i have the scan, and she said no because of the radiation. so i asked if there was a special suit he could wear and she said no. [i know that sounds funny-- it even makes ME laugh].

she told me to go home and discuss with my partner and see if we can come up with way's that might help me get through it. i'd definitely be taking some clonazepam, but honestly, i don't think that will totally do the trick. 

**If anybody has any suggestions for how i could get through a CT scan without panicking or sliding right into flashbacks, I would very much appreciate hearing what you have to say.**

I AM PETRIFIED!!!! yet i know how important this is. my partner really wants me to go through with it this time, and i have to admit, i am very curious as to the results of said test.

thank you!!

aurelie

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Heya Aurelie,

Good girl getting the tests!

For the CT take whatever sedative you have (Klonopin sounds okay) 30 minutes before the test.  It's kinda claustorphobic but pretty quick.

Tells you what is/isn't going on with your brain.

MRI is a smaller tunnel, and if your doc is still wondering after the CT, you might get one.

The test for carpal tunnel is weird but kinda fun (I had this in residency as part of a neuro elective).

They put little electrodes on your fingers and zap (feels like putting your finger in a socket) your arm nerves with very tiny needles.

In some of the tests, you feel a zap.  In others, you can feel and see your muscles jump.

It's called EMG/NCS.

Electromyogram and nerve conduction studies.

Just think of it as a neat test, b/c it is, and it'll tell whether you have carpal tunnel.

Again, good girl for getting seen.  We can always tell a lot just by looking.

--ncc--

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Guest ~Aurelie~

Heya Aurelie,

Good girl getting the tests!

For the CT take whatever sedative you have (Klonopin sounds okay) 30 minutes before the test.

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Aurelie:

I know...don't you wish ncc could be your FP? I do. (Although I'm very fortunate that I have a wonderful internist as my primary doc, and ncc knows I do. So ncc...would you and my doc be my personal "team" of wonderful docs???)

Here's my experience with all this. Hope it helps...

Okay, as far as the EMG/NCS for carpal tunnel: I've had it done twice. Ncc described it accurately. It's all pretty mild. The zaps are nowhere near an electrical *ZAP* like you're thinking. It's hard to describe. Kinda like a very mild funny bone sensation? (Do you think that would describe it, ncc?) Nothing horrible. And each of these just lasts the briefest of milliseconds (technically don't know if it's milliseconds, just sounds right).

It is really interesting. If you can get your mind into it, the experience is actually a neat little window into how your nerves and muscles work. If you can sort of detach yourself and look at it as if you were watching a science/medical documentary, it is fascinating.

I'd imagine they will take some x-rays? I can't remember what all they did with my mother (who did have carpal tunnel). ncc knows better than I.

With me, they did another 2 other tests: an angiogram and dynamic x-ray video studies. But that was because I had torn ligaments. Extremely unlikely you'd have something like either of these. And if for some chance you do, they are not a big deal.

As for the CT Scan: it is really brief. I've had more CT Scans than I can remember; I think 4 in the last 1.5 years alone? I've had both head and sinus CTs, and they are so quick. Really. The machines are so sophiticated now that it's over before you know it.

Now, I don't have claustrophobia. I have also had several MRIs, which do take longer. So, even though I'm not panicky about it, I did need to calm myself. I found that slowing my breathing and meditating helped tremendously. If you haven't done meditation before, just saying something (for example the word "one" or "I am") over and over again slowly in your mind will calm you. Really.

You can get through this. I have chatted with many techs in radiology departments who deal with this everyday, including with people who are claustrophobic. It's a large part of their job, and they're skilled in helping you get through this. And you will!

Keep us posted. If there is any way I can help, please let me know.

Take care,

revlow

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Guest ~Aurelie~

yes revlow i do agree about ncc. i hope her patients know how lucky they are to have her for a FP, and tell her so. i would tell you ncc!!

revlow thanks for sharing your experiences. it really does help me to imagine going through it myself. makes it all less "unknown territory", which makes it all less scary.

i was reading a site about claustrophobia in CT and MRI scanners, and i panicked and started sobbing, JUST READING! gosh. i will practice some meditation and try to wrap my brain (no pun intended) around the idea of having the scan. 

i really need for my pdoc to get me into EMDR as fast as possible and i'm going to ask her at next appointment, but that's not for 2 more weeks. it's still worth a try though, right?

say, how brief is the scan? last time they tried to give me one they said about 20/25 minutes. that was about 5 years ago. are the machines faster now?

I

HOPE

SO

!!!

thanks revlow ;)

aurelie

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Heya Aurelie,

You're all very sweet.  Thanks for the warm fuzzies ;)

Don't sweat the CT/MRI.

Roughly 10-20 minutes, depending.

If you need sedation, take sedation.  The techs have seen it all before, worse than you.

Whatever you've got, they've seen worse.

Definitely,as pigs said, find out from your doc how much Klonopin would be appropriate.  I would take it in the waiting room.

In terms of the nerve tests, Revlow gives a good description.  The feeling, I would say, is like that -- like a funny-bone feeling, but for like a fraction of a second.

It doesn't hurt.  Feels weird, but doesn't hurt.

And really, it's kind of neat, I think, b/c you get to see the readouts of how your nerves are doing.

Hang in there, Aurelie, you're doing the right thing.

--ncc--

yes revlow i do agree about ncc. i hope her patients know how lucky they are to have her for a FP, and tell her so. i would tell you ncc!!

revlow thanks for sharing your experiences. it really does help me to imagine going through it myself. makes it all less "unknown territory", which makes it all less scary.

i was reading a site about claustrophobia in CT and MRI scanners, and i panicked and started sobbing, JUST READING! gosh. i will practice some meditation and try to wrap my brain (no pun intended) around the idea of having the scan.

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Heya Aurelie, revlow,

Re. sedation.

Maybe things are different in the States.

Here:

If you're a patient *in the hospital,* likely sedatives can be given on the spot, b/c there'll be a standing order for "Ativan prn for scan" so the nurse can just administer it.

For outpatients, the family doc (or whoever sent the patient for the scan) is responsible for prescribing sedatives.

I think so the radiologist isn't responsible for prescribing sedatives to a patient they've never met.

So, Anelize, to be on the safe side, get your psych or FP to scrip you the sedatives.

That's also why I think taking some of your own Klonopin might be a good choice.

--ncc--

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Heya Aurelie,

AnotherBP is right that a chiro wouldn't ask for these tests.

That's b/c a chiro *can't* by law order them.

An **ethical** chiro will tell you to get these tests from your FP/GP/specialist, b/c a chiro *can't order them* him/herself.

Your symptoms demand further testing.

Demand it.

Do what your doc says, and don't think twice.

--ncc--

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Yup. Couldn't agree more. Chiropractors certainly have their place as medical professionals (I've gone to them, and gotten help, when appropriate). But when it comes to symptoms like you describe, more is required. Like specific diagnostic tests.

As an aside, I wasted a lot of time on chiropractic, acupucture, physical therapy (with a PT who had me doing stretching exercises; *not* good for torn ligaments, but of course she hadn't bothered to actually dx it!), all kinds of other therapies (god, I can't even remember all the names), before I found out I had torn ligaments in my wrist. And finding out was by accident. I went to see a thoracic outlet specialist in the ortho dept. at a large university medical center. He took one look at my wrist, and immediately brought in the wrist specialist, who in turn brought in about 30 med students, interns, etc. (The "ducklings" as I began to think of them.)

Apparently, I had a "classic" case of midcarpal instability. I hadn't even thought of mentioning it to the original orthopod, 'cause by that time I had gotten so much run-around being told that it would "go away" -- by chiropractors, acupucturists, PTs, and yes, even some docs -- that I'd tried to put it completely out of my mind. However, by that time, I also could barely even sign my name to a check. My wrist was that screwed up.

Don't f*** around. Get the tests your doctor has ordered.

I thought of another relaxation/meditation technique. There's a lot of 'em, but I particularly like this. Gently slow your breathing down. Then think to yourself: "Breathing serenely in" as you breathe in; and "Breathing serenely out" as you breath out. It's great because the timing of this thought is perfect for a nice, slow pace in your breathing.

Best,

revlow

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Guest ~Aurelie~

hey ncc, revlow, anotherbp~

thanks again! i'll be sure and post back about tests once they happen. i really appreciate all of your thoughts and help. and revlow thanks for that breathing exercise.

aurelie

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  • 1 month later...

Hey, ~Aurelie~...

Thought of you and am wondering if you've had these tests yet? Excuse me if you'd mentioned when they were scheduled here, and they haven't happened yet. What can I say...I'm too lazy to read through the whole thread.

So, if you've had them, what did you find out?

Hope you're feeling better.

Take care,

revlow

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Guest ~Aurelie~

hi revlow and ncc. sorry didn't see these posts. how are you two doing?

um. no. no tests. no hospitals for *body* stuff. just can't go through with it.

had a mammogram and ultrasound recently i think, and was baaaaad. so couldn't convince myself to go for the other tests.

but thanks for asking.

oh. also pdoc says headaches are probably from dissociation. so. maybe everything is happening because my brain is all wrong.

aurelie

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Hey Aurelie -

Gee you're tougher than me - I don't mind the CT scan stuff but I hate getting my boobs squished!!!  Ouch!!!  Plus I have a secret vain fear that they won't spring back into shape but just stay all flattened out and weird like that - totally ridiculous, I know, but I thought we could all use a little comic relief at this point .......

Are you still having trouble with your arm and hand, and were you able to see your regular FP?  I hope so, that sounded painful for you and something where your regular doc who has seen you before could probably rule out lots of things from a simple office visit without a bunch of tests.

The rest of this post is long - lots of info about carpal tunnel syndrome so be forewarned!!

If it does turn out to be carpal tunnel syndrome, I thought I'd chime in with my two cents as I also had it in both hands and eventually had surgery on one, which turned out to be a good decision.  I worked in the trades for many years so got carpal tunnel from gripping tools all day; it went away when I went into an office environment.  However, anytime I did any simple repair work around the house; i.e., using a screwdriver, painting, etc., my hand would bother me for days afterwards and that's what made me decide to have surgery in 2000. 

One simple way to figure if you've got carpal tunnel or not is to notice if when your hand and fingers are numb, is your pinky included?  Your pinky nerve doesn't pass through the carpal tunnel with the other nerves.  The other nerves are getting pinched because the tendons are inflamed from over use and pressing on the nerves which all pass through the little tunnel at the base of your palm. 

Carpal tunnel can make your whole arm become tingly/sore as you start to hold your arm in different positions to try to take the strain off your hand, without even realizing it.  If carpal tunnel seems to be the trouble, a big help is to get a wrist brace and wear it while you sleep.  Make sure you get the kind that has a hard piece to hold your hand back away from your wrist, almost as if you were going to wave your hand, but not that extreme of an angle.  The idea is to keep your hand from pointing down and compressing the nerves at the base of your palm.  Wearing the brace at night might take a little getting used to, but when you wake up and your hand(s) aren't numb and you can brush your hair, you won't mind at all or even notice you're wearing it.

I also recommend searching the web for carpal tunnel syndrome stretching exercises.  There are some good ones and if you do them throughout the day it will also help a lot with keeping the blood moving and keeping your tendons and muscles from tightening up too much.  Paying atttention to the position of your hands and arms while you work, sit/lie to read or watch tv is also helpful.  Do you rest your head on your hand using your elbow, for instance?  All those little things during the day add up.

I'm very glad I did have surgery on the hand that bothered me the most.  My biggest recommendation would be to go to a specialist hand surgeon, not just an orthopedic surgeon; that showed up again and again in my research prior to having it done.  I never had the electric sensation test the others here mentioned; my doctor used kind of a mechanical pencil thing for the same effect, which was to see if I had feeling in my fingertips after having me hold my hands in towards my elbows so they'd compress the carpal tunnel and make the nerves go numb if that was the problem.

It was outpatient surgery done under a nerve block for just the hand/forearm. Besides the nerve block at the hand, they gave you Valium ahead of time to calm you down and insisted you had your pain meds prescription filled on the way home or even ahead of time.  The recovery wasn't bad and I did all the exercises so got full motion and strength back.

Well, sorry for the over-long post, but I hope it will reassure you that if it is carpal tunnel syndrome it won't be anything you can't handle.  If you're still having pain like you described I hope you do get in to see your regular doctor.  Maybe if you can get across that you're not comfortable with a lot of tests they'll try a little harder to diagnose you using their knowledge first.  Good luck to you.

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Guest ~Aurelie~

catnapper

oh my gosh i don't know how i missed this.

this is so helpful and thoughtful of you.

thank you very much.

your surgery experience sounds positive.

i'm glad it all went well for you.

you have written a lot here.

maybe will print to have and read over.

thanks!

aurelie

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