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Carpal Tunnel Surgery comments


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Hi Forum,

 

This is my first post to Thumper Talk. I hope some of you find my comments helpful.  WARNING…its lengthy!  Having researched the heck out of this surgery I found that I really didn't find a description of the process that covered all my questions.  I'm attempting to do that now, and if you really don't have a dog in the fight so to speak (don't want to be bored by a medical procedure that won't apply to you), skip this post now.  

 

Also, I AM NOT A DOCTOR AND THIS POST ISN"T MEANT TO BE A SUBSTITUTE FOR PROPER MEDICAL CARE AND ADVISE.  SEE A DOCTOR IF YOU THINK YOU HAVE CARPAL TUNNEL SYNDROME.  

 

I had carpal tunnel release surgery a week ago today.  I'm in my late 40's and have been pretty active with my hands over the years.  

 

I have a construction background and my CT symptoms started about 10 years ago when I was assembling telescoping gym bleachers like you'd find in a high school gymnasium.  There is a lot of repetition and weird finger, hand and arm angles in the construction of bleachers, as well as the repetitive use of power tools, namely impact wrenches.  

 

I also have a competitive shooting background with pistols, again occurring over the past 10 years or so.  Many thousands of rounds down range not to mention the home ammunition manufacturing (ie., reloading) that goes along with it.  Lots of rounds thumbed into a pistol magazine.  Lots of trigger pulls.   Lots of shots recoiling into my palm.    

 

Then last year I got into dirt biking.  New KTM 350 XCFW and about 1600 miles of western desert and mountain riding between May and September this year.   Had a blast but my hands took a beating and the CT symptoms spiked dramatically.  

 

Symptoms:  numb thumb/index/middle fingers on both hands.  I clutch with my middle finger and brake with my index finger.  My left hand and especially my left thumb seemed to hurt the most.  At the peak of my symptoms I'd wake up overnight, hands feeling like they were on fire, numb (not the pins and needles feeling you get when your foot falls asleep).  My hands would fall asleep while on the phone, even after a few minutes.  Most of the time when I drive I have my left hand at 12 o'clock on the steering wheel.  Lately I've had to switch back and forth from my right hand to my left hand and even put my hands at 6 o'clock because my hands were always falling asleep.  After enduring sleep-interrupted nights for the last half of the summer and first half of the fall, I decided to see a doctor and get the problem solved.  

 

I went to a hand specialist who sent me to another specialist who gave me a nerve conduction test.  This is a test where they hook up electrodes to your arms and then mechanically fire the various nerves in your arms.  My understanding is that there are three main nerves in your arm going to your hand, the ulnar, the radial and the median.  CT stems from the compression of the median nerve as it passes through the Carpal Tunnel.   The test showed that median nerves in both my arms showed moderate CT syndrome.  FYI, the doctors rate it Mild, Moderate and Severe.  Apparently if you are rated Severe, you have long-term, somewhat permanent, nerve damage.  With Moderate, you have slight nerve damage but readily correctable structure surrounding the nerve, therefore relatively rapid improvement and healing (I hope).  

 

So I had the surgery a week ago.  Did both hands at the same time and did it in the doctor's office under a local anesthesia.  Essentially he cuts a 1" incision into your palm to expose what's called the palmar fascia.  If you've skinned a deer before you've seen this stuff…..its white and almost like a thick sheet of rubbery cartilage-like stuff.  He cuts through this stuff and exposes the carpal ligament.  This ligament is the culprit in the whole CTS game.  It joins two bones in your hand, the hamate and another one I forget the name of.  In the tunnel formed by the carpal ligament and the two bones runs the tendons for your fingers and the median nerve.  

 

So once the carpal ligament is exposed, the doctor "released" it (cut it).  It spreads apart, opening up the tunnel and taking the pressure off the nerve.  He then sews the skin back together.  The palmar fascia and the ligament then heal on their own.  The gap in the ligament will scar but the tunnel will be bigger (the ends of the ligament will not join back together, there will be scar tissue closing the gap.  The distance between the ends of the ligaments will remain the same as they were immediately after the cut……make sense?).  

 

Expect to be driven to and from the dr's office.  I could not have driven.  Once the procedure was over and I was stitched back up (5 in each hand) , my doctor wrapped my hand/wrist area in gauze, then put sort of a half-cast over my palm and wrist area, then covered up all of this with an Ace bandage.  If you already have CT splints with the metal inserts in them, then you know what I'm talking about when I say that the cast material locked my wrist in a neutral position.  

 

The Miracle.   Okay, maybe an overstatement on my part but I have to tell you, for the first time in quite awhile, I slept the entire night the day of my surgery.  Didn't wake up once overnight.  No numbness or burning.  Nothing.  In fact, since the surgery I've had zero numbness or burning in my hands.  The surgery really works, at least to this point.  

 

Pain pills…. the dr prescribed hydrocodone, which I had filled, but I maybe took a total of 7 advil and 2 Tylenol the first day and a half and I hadn't had anything since.  

 

I kept these dressings on for two full days, only taking them off on Thursday morning (my surgery was on Tuesday morning).   During this time you are essentially helpless.  That may be a bit of an exaggeration but every little thing you do with your hands is painful.  Stretching your fingers out hurts.  Doing any sort of pulling, tugging, twisting, etc. hurts.  Opening a bottle of water?  Forget about it!  Lifting a gallon jug of milk?  No way!  Pulling your sweats down to take a piss.  Hurts!  Taking your shirt off?  Almost impossible!  Even opening the refrigerator door hurt.  I had to get a length of paracord and tie a big loop around the door handle so I could use my foot to pull the door open.  Bottom line, the first two days are hang out on the couch, catch up on TV series you may have missed, and let someone wait on you.  

 

Since taking off the half-cast and Ace bandage on Thursday, I put a gauze pad over the incision (dry, no healing goop like Neosporin), tape the pad to my palm and wrist, then put my CT splints on.  I get my stitches out next Monday.  That'll make 13 full days since the surgery.

 

Oh, I did a light workout (nothing related to the use of hands like push-ups or pull-ups) on Thursday and have a few times since.  Running is no problem.  Certain core and leg exercises aren't a problem either.  Lunges, crunches, bridges, planks, no problem.  It will be awhile before I can do a push-up or pull-up though.  Funny thing after the first workout, I couldn't get my shirt off.  It was wet with sweat and was stuck to me.  I had to fashion a hook out of a coat hanger in order to pull off the shirt without hurting my hands too much.  It took a while but I finally got it off.  WARNING…..everything takes a lot longer than you're normally used to.  Showering, going to the bathroom, shaving, eating, tying your shoes, you name it, just takes a lot longer than you normally take.  

 

Right now, a full week after the surgery, things are reasonably back to normal.  I say reasonably because doing anything involving any expectation of strength out of my hands is a pipe dream.  Typing is not a problem (as you can see by the length of this post!).  Office work and paper shuffling not a problem.  Phone not a problem.  Something like refilling the copier not a problem.  Lifting the box of paper….problem!  Carrying a gallon bucket of water….problem!   Going to the gun store and fondling your next 300 Win Mag…..problem!  Going to the motorcycle shop and climbing on a new KTM……that would probably be comical to watch as I tried to do it without using my hands.  

 

Opening doors…..at home, twisting the door knobs the first few days was painful even when I used both hands.  Now I can open doors at home okay with only one hand.  Opening commercial doors…….almost impossible with two hands the first few days (unless they had light closers and I could get a toe wedged in the crack of the door to help me).  Now, all commercial doors are a two-handed proposition.  In the next couple of days though I should be healed up enough to be able to open them one-handed.  

 

I asked the doctor about recovery time and physical therapy.  His comment was that recovery time was based on the levels of pain experienced with each task and how I tolerated it.  No PT is involved in the process.  I'm sure when I get so that every day tasks are performed without the stitches and CT splints on and without a lot of pain and soreness, I'll start experimenting with some specific stretching and strengthening exercises for my wrists and hands.  I've already started squeezing a balled-up sock to see where my pain threshold is.  

 

Sorry for the length of this post but like I said, I hadn't found anything that addressed my own concerns about the surgery enough and I tried to make this the answer to my own conundrum.  I will provide another update here in a week or so and let you know how its going.  I can't wait to get my stitches out next week and hope to be able to do some shooting and to work on my bike by New Year's Day.  Riding may take a while longer.       

 

 

 

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I'm in the same boat man. I'll tell you my side. I'm currently 30yrs old. I've been wrenching, riding MX and shooting for the last 16yrs. I've been feeling pain at night and during my days I got riding. I've gone to my doctor and he said that I have CP damage. He gave me some braces to use at night which he said would help but after my last visit he said he recommends the surgery to open up the passage. My worries is hell I'm to young for this shit,then again i don't know what to expect down the road if I don't do it. Also the recuperation process is how long? Yeah those are questions I still need to ask and go from there. Let me know how you bounce back. PM me I'd like to know more details.

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Sorry to have not replied to your post 09BigRed…..been busy with other things and time slipped away from me.  So I'll get to your concerns first, then give the topic some general comments.  

 

30 years old isn't "too young" for this condition (CTS).  The doctor that performed the nerve conduction test told me his office where he did his residency was in close proximity to a Honda plant.  He said that guys in their twenties would come to the office and he'd test them and they'd have severe CTS.  So it doesn't matter how old you are.  I think the biggest two factors in this condition are use (or abuse) of your hands and wrists, and genetics.     

 

I would assume, based on my own experience, that your doctor would order a nerve conduction test.  As I understand it, this test serves to confirm the CTS diagnosis and rule out other medical conditions that may be causing your symptoms.  

 

So here I am two weeks and five days from having the surgery.  I got the stitches out on Monday (five days ago).

 

For starters, a few comments about the "pre-stitch-removal" stage.  Not sure if every doctor makes their patients wear the splints for 12+ days and while the stitches are still in, but I must say, I believe that leaving the stitches in and leaving the splints on to protect them was a brilliant move.  There were several occasions when I took the splints off to do things like shower and shave, and I would overextend the wrist/hand range of motion and get a shock of pain.  Keeping the wrists in a neutral position using the splints just keeps you safe from setbacks due to overextending and possibly opening the incision or damaging any scar tissue that may be building at the incision site.  

 

On the day the stitches came out, my doctor was very pleased with the incision sites and gave me a lot of confidence that the healing process was well underway.  The skin had sealed up pretty well…there was however a lot of dryness and itchiness right on the scars.  The doctor said to knead the incision sites with my thumbs to break up the scar tissue.  I've been doing this fairly frequently and I must say, it is a painful process, but then again I can also say that the range of motion improves with every kneading session.  As I drive down the road I rub my hands on the steering wheel.  Painful, but feels good.  

 

Range of motion…….right now I'm back to where I was before the surgery.  I can do wrist stretches in either direction and feel normal pulling, but no pain that I would associate with stress to the incision site or to the underlying tissue building going on where the ligament was cut.  I can roll my wrists all around and not feel any pain.  Side to side, up and down, no pain.  

 

Strength….one of the biggest gripes I have had over the past two weeks is the inability to open bottles and jars.  The first 3-4 days I couldn't open anything.  The next 5-7 days I could open most things but not without slight to severe pain in my hand.  Over past couple of days I've been able to open anything without any discomfort at all.  What a great feeling!!   

 

Today I started doing the wrist exercise where you have a 5# weight hung from the end of a piece of paracord that's attached to the middle of a length of dowel or a cut-down broom handle.  I'm sure there's some fancy word that everyone but me knows, but anyway, I hope you get the picture.  You hold this thing out in front of you and wind up the weight to the broomstick, and wind it back down, using only your wrists.  I can do that with zero pain, but I must say, I'm only able to do it a couple times before I have to rest for a bit.  

 

I'm convinced that two weeks of relative inactively with my hands, wrists and forearms cost me some strength, but honestly, not enough of a loss that someone using their hands for normal stuff would notice.  In other words, if you're tuned in to the true strength of your hands, then you'd probably notice the loss.  But if you're just an average joe that's sipping lattes at Starbucks and checking email on your iPad, you probably wouldn't notice.  But then again, you probably wouldn't be having CTS surgery to begin with!!!  

 

Dirt biking…….the very first thing I did when I came home from getting my stitches out was to go over to my KTM, put my hands on the handlebars and test the clutch and brake levers.  I'm convinced I could have fired up my bike and ridden down the street without any clutching or braking issues (I clutch with my middle finger and brake with my index).  And no, I haven't ridden yet.  Too cold, snow on the ground, been doing other things.  

 

Shooting…..today I can do anything with a Glock pistol that I could do prior to the surgery except…slam a reload. When I change mags the base plate of the fresh mag is right smack on the incision site.  Today I slammed one in and was reminded of the surgery!!  Yeow!!!  But if I shifted the mag to the fleshy part of the heel of the hand (sort of in line with my pinky) then slamming a mag in was no problem.  

 

Soreness.  I would compare it to a bruise.  Maybe one that was obtained while practicing palm strikes on a wall for a while.  The heel of my hands feel bruised and when I hit them on anything or press on them, well, it hurts, but not so much any more.  

 

Bottom line (and maybe conclusion?) to this whole CT thing.  Man am I glad I got it done!  There may be one or two things I'm not able to do now that I could prior to the surgery but I gotta tell you, it won't be long before that problem is solved.  And, the nice thing is that now my grip strength and wrist and forearm strength will improve because now I won't be afraid that too much strengthening exercises will exacerbate my CTS.  

 

I hope everyone who's read through both posts finds the information helpful and I hope I was able to answer some questions and fill in the blanks for you on some of this.  Let me know if you have any questions.    

 

 

 

 

 

 

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Another update……..I had my surgery three weeks ago yesterday, on Dec 9.  Things are going great!  

 

I wanted to address some progress points.  

 

Strength……after having my hands/wrists basically immobilized for close to two weeks, the strength is returning but short-lived.  I'm having to work with a hand gripper several times a day, and also that 5# weight on the end of the string thingie.  These implements help.   Also doing wrist curls (palms facing up and palms facing down)…..was using 5# dumbbell, now up to 15# dumbbell.  So that's coming along nicely.  

 

Pain……as I mentioned in my last post, my palms felt like I've been doing repeated palm strikes on a really hard heavy-bag.   Bruised is probably the appropriate descriptor.  The kneading and breaking down of the scar tissue has resulted in what I imagine is a tenderized feeling.  

 

Flexibility…….arms straight out in front, palms facing down, bending my fingers back (up)…..my range of motion isn't near what it was before the surgery.  Also same position only bending the fingers down….same result.  Having to do a lot of stretching both ways to get range of motion back. 

 

Understand that 99% of the population probably never does these types of stretches and thus probably has about the same ROM that I have.  I'm just hyper-sensitive to it, was before the surgery and now see that I'm less flexible now than before.  BUT….that'll change with stretching so I'm cool with where I'm at now. 

 

Now for the good stuff…….this morning I was able to do 10 push-ups, palms flat on the floor.  Pain was there but compartmentalized…….drive on right!?!  Push-ups seem to help that flexibility issue above.  Pain is confined to just right on the heel of the hand.  Feels like there's a knot right under the scar.  Where most people have dip right at that point, I have a raised area right under the scar.  And that's where it hurts.  

 

Bottom line to this post………..I'm over-the-moon pleased with the progress I've made in the past week.  Strength is coming back and the pain is receding and I definitely see light at the end of the tunnel.  I feel like I could definitely go dirt biking today and be okay.  Maybe not as confident as I was back in Oct after riding the whole summer, but definitely able to get around and do most of what I was doing prior to laying off in Oct.  And that's due to the lay-off, not issues I'd have with my hands.  

 

Any questions, let me know.  

 

 

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  • 4 weeks later...

Going on 7 weeks......so I'm pretty much doing everything I was doing before the surgery with two differences. One is that I'm not feeling any numbness at all at any time day or night with either hand. Obviously, this the reason I had the surgery so I would have to say, 100% success. No, I have not ridden yet.........we are expected to experience warmer temps next week and I hope to get out and ride.

The second difference........one of the things that worried me before the surgery was the reviews and reports I read from people still experiencing pain months after their surgery. Well, I still have soreness around the incision sites and any impact around those sites results in pain. So I kinda get what those people might have been complaining about. BUT.....its not a deal-breaker if you are considering the surgery. If you've ridden a dirt bike long enough, you've crashed and been bruised up and dinged up, possibly broken some bones or gotten stitches. Trust me, you already know how long this pain will be around and you know that, just because you get stitches out or just because the doc says you're cleared to ride after breaking a bone, doesn't mean you're magically pain-free. There's pain that'll dissipate over time, you just gotta be patient.

So there you have it. If your doctor said you have moderate or severe carpal tunnel, follow his advice and don't hesitate to have the surgery. The nights you'll sleep like a baby are well worth any pain or discomfort you'll seldom feel when going about your post-operative every day life. I'll post something after I ride.

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  • 1 month later...

Finally got around to riding the other day. Rode 13 relatively easy trail miles and felt ZERO pain or discomfort. Was able to brake and clutch single-finger like I used to do, only my hands had ZERO decrease in sensitivity or control. I'm totally pleased with the results. Still feeling a bit of discomfort right on the incision site but its going away noticibly.

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  • 5 weeks later...

Rode yesterday.  50+ miles of trail.  Had a great time with zero pain or discomfort in my hands.  Did a ton of clutching and braking and never felt any numbness, discomfort or pain in my hands, wrists or arms.  Never dumped the bike once (last year this was an every ride occurrence).  Was riding desert trail around Murphy, ID.  I have no way of knowing, but it sure felt like I was going faster than I ever went last year.  Several times on some straight stretches I looked down and saw 55+ mph on the speedo, which to me is flying.  Was hitting stuff this time and getting a lot of air, when last year I was hitting the same stuff and not leaving the ground.  

 

Bottom line is that its really really nice to be able to ride and not have to consciously think about my hands and how I'm going to manage a clutch pull or a brake or a quick turn.  

 

As far as any residual pain (or rather discomfort) goes, there is a little remaining, not on the incision site, but just to the side (on the thumb side).  I never feel this discomfort unless I press pretty hard on it or hit it unexpectedly.  

 

Overall, great results and great benefits from the surgery.  

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  • 1 month later...

Fresh update...... Its been a little over five months since the surgery. Dirt biking has been great. Several long rides with zero issues.

What prompted me to write update has been some lingering soreness and some varying pains in either hand. The causes, near as I can narrow it down, was due to weight lifting. I've been doing power cleans and I think the jerking, combined with the rapid hand/wrist movements, contributed to the pain. At one point I had difficulties bending my thumb, or supporting any weight with it.

I also experienced increasingly poor range of motion bending my hand back.

I haven't done to good of a job massaging the scar tissue and area around the incision sites. Frankly, if you use your thumb to massage your other hand, it starts getting sore. And I just forget too.

The solution......I bought a lacrosse ball. I can press it between my hands and roll it around, or I can set it on a flat surface and roll my hand around on it. It works similar to foam rolling, if you're familiar with that method of stretching. I believe its called myofascial release. You can also roll your forearms. Might be a good remedy for arm pump. Do it before you ride, and after. And I can do it as I'm driving too. I have a truck with a large console lid, and a pretty wide arm rest on the door. Just cruise down the road rolling away.

The good news is I haven't had a single instance of hand pain while lifting, or doing anything else for that matter. And my range of motion when I bend my hand back is coming around.

Hope you learned something!

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  • 3 weeks later...

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