This is the tragic timeline of the demise hands/life.
Sometime in April: I'm on vacation back east, visiting my Aunt. We had just made the four hour car ride to visit my grandma on the Cape. My Aunt has a crushing migraine. I tell her to go upstairs and rest while I remove the luggage from the car. Later that night, we go to a bar to see a band play. We have a few drinks over a four hour period. At home, I notice all fingers but my pinky are numb in both my left and right hands. I'm freaked out. My mother has Multiple Sclerosis, and when anything ever goes wrong, I immediately fear that I have MS. Frantic, I called my boyfriend, convinced I had Multiple Sclerosis, but while holding the phone with my right hand, the tingly/numb sensation stops. The left is still experiencing symptoms. He tells me I have carpal tunnel syndrome. He tells me to wrap scarves around my hands and wrists so that I can't clench my fists at night (I do this, and I grind my teeth a lot). They feel better in the morning, but I'm shaken.
Between April and June 4th: I want to confirm this supposed carpal tunnel syndrome. My boyfriend presses on my anterior wrists, but I have no tingling or numbness when he does this. The whole time, he is explaining to me that this is called Tinel's sign, and then tells me the difference between signs and symptoms. He tells me this is good experience for med school since I'll have to learn this soon. Next, he tells me we are going to do Phalen's maneuver. I hold my hands in flexion and then extension for 30 seconds. No results. Then he has me do it fast, holding for 1-2 seconds each time. Immediately, the tingly/numb feeling is in my fingers on my right hand. (Pinky and thumb excluded.) He tells me that it's carpal tunnel syndrome, not MS. I feel better but I'm annoyed there's something wrong with me.
June 4th: My family, boyfriend and I go to Ikea for furniture for my new med school apartment. Shopping is fun, but I'm annoyed no one lets me carry anything when we're leaving. I finally talk my boyfriend into letting me carry a small box with a $10 lamp inside. Since we bought hot dogs on the way out (how can you not, they're $1!), I carry my hot dog in my right hand and hold the box with my left. After a few minutes we're at the car, and the fingers on my left hand are numb (index, middle, lateral half of ring finger). It's a hot day. I freak out, asking my dad if it's MS. We agree it's the probably carpal tunnel since I was carrying the box. I worry that because it was unilateral, it could be MS. I stretch out my fingers and keep my left hand immobile. The tingly/numb sensation goes away after about 20 minutes. I worry that I won't be able to help move myself into my apartment and my sister and brother will resent me for that. I hate it when people don't pull their own weight.
June 5th: I vacuum out my car as I'm cleaning everything and packing the weekend before I move to my apartment for med school. When I remove my right hands from the vacuum, it's stuck in the shape I had been holding the vacuum tube. I try moving my fingers and can't. I have to peel my fingers off the vacuum. Flexion of my fingers, especially my thumb, is limited and the digits start shaking uncontrollably when flexed. My fingers are numb and tingly (thumb, index, middle, lateral half of ring finger- not the pinky). I think it's funny when I show my dad that my thumb shakes uncontrollably. My dad doesn't, makes me ice my wrist/hand, take motrin, and stop packing for the day. He warns me that tendon injuries can take weeks, months. I don't think it's funny anymore. Estimated time of returning to normal: 2 weeks. I'm annoyed it will take that long.
Between April and June 4th: I want to confirm this supposed carpal tunnel syndrome. My boyfriend presses on my anterior wrists, but I have no tingling or numbness when he does this. The whole time, he is explaining to me that this is called Tinel's sign, and then tells me the difference between signs and symptoms. He tells me this is good experience for med school since I'll have to learn this soon. Next, he tells me we are going to do Phalen's maneuver. I hold my hands in flexion and then extension for 30 seconds. No results. Then he has me do it fast, holding for 1-2 seconds each time. Immediately, the tingly/numb feeling is in my fingers on my right hand. (Pinky and thumb excluded.) He tells me that it's carpal tunnel syndrome, not MS. I feel better but I'm annoyed there's something wrong with me.
June 4th: My family, boyfriend and I go to Ikea for furniture for my new med school apartment. Shopping is fun, but I'm annoyed no one lets me carry anything when we're leaving. I finally talk my boyfriend into letting me carry a small box with a $10 lamp inside. Since we bought hot dogs on the way out (how can you not, they're $1!), I carry my hot dog in my right hand and hold the box with my left. After a few minutes we're at the car, and the fingers on my left hand are numb (index, middle, lateral half of ring finger). It's a hot day. I freak out, asking my dad if it's MS. We agree it's the probably carpal tunnel since I was carrying the box. I worry that because it was unilateral, it could be MS. I stretch out my fingers and keep my left hand immobile. The tingly/numb sensation goes away after about 20 minutes. I worry that I won't be able to help move myself into my apartment and my sister and brother will resent me for that. I hate it when people don't pull their own weight.
June 5th: I vacuum out my car as I'm cleaning everything and packing the weekend before I move to my apartment for med school. When I remove my right hands from the vacuum, it's stuck in the shape I had been holding the vacuum tube. I try moving my fingers and can't. I have to peel my fingers off the vacuum. Flexion of my fingers, especially my thumb, is limited and the digits start shaking uncontrollably when flexed. My fingers are numb and tingly (thumb, index, middle, lateral half of ring finger- not the pinky). I think it's funny when I show my dad that my thumb shakes uncontrollably. My dad doesn't, makes me ice my wrist/hand, take motrin, and stop packing for the day. He warns me that tendon injuries can take weeks, months. I don't think it's funny anymore. Estimated time of returning to normal: 2 weeks. I'm annoyed it will take that long.
June 16th: I've been wearing a brace on my right hand (bought at the drugstore), it's incredibly painful to flex or extend my fingers, and I have piercing pain on the anterior side of my wrist. Sometimes the pain is posterior. Tingly and numb sensation is intermittent. I see plastic surgeon specializing in hands (#1). Diagnosis of carpal tunnel syndrome is made upon reflection that I'd had tingly/numb sensation in fingers (index, middle, lateral half of ring finger- never the pinky or thumb) since high school. This would occur when I woke up in the morning and last all day. The surgeon gives me a steroid injection in my right wrist. I've never been in so much pain for the following 5-7 days. Surgeon warns I might need one in my left hand, but I think I'll be fine. I freak out about medical school and am desperate to know if I'll be okay by then. He thinks I will be. I feel a bit better. He tells me he only wants to do steroid shots once since I'm so young and he doesn't want to demyelinate my median nerve. He warns me that I'll probably need surgery during my m1 summer. I think this makes the most sense, since there is no other point in my medical career that I'll have that many months off. I'm a little annoyed because I was planning on pursuing research during my m1 summer, and I'm worried about how much time it will take for the surgery and recovery. Will this limit the research options I'll have?
June 21st: 8am, I go to work. I start having the same type of pain in my wrist in my left hand as I do in my right. I leave work, go outside and call my sister to drive me to the plastic surgeon specializing in hands (#1) for the steroid shot in my left hand. I don't think it's safe for me to drive myself. I have something close to a nervous breakdown in the car- I'm worried about medical school starting on August 1st. I need to be in perfect condition. Everyone tells me I'll be okay by then. I get the steroid shot in my left hand. I cry a lot, in part because of the pain, but mostly because I'm worried about medical school.
June 22nd: I quit my job early. I can't use my hands. My sister washes my hair for me, and I sit at home watching tv/movies and crying. I want to read books, but it's too painful to turn the pages. Cue dramatic weight loss because it's too painful to eat. I don't want to see or talk to anyone because if anything relating to medical school or research is brought up, I start crying.
July 31st: My dad makes me drive for the first time since my last steroid shot. Incredibly painful. My hands are weak and it's difficult to grasp the steering wheel. I'm nervous I won't be able to drive to med school. I want to talk about "back up plans" in case my hands prevent me from going to school. We don't talk about it, because everyone says I'll get better. I'm starting to doubt that.
August 1st: Orientation week for med school. I start using my hands to get dressed by myself. I relieve my sister of her hair washing duties and start doing it myself, despite the pain. I figure I have to get used to it anyway and it should be better by now. Maybe the pain is from not using my hands for so long. I can't explain the twitching of my fingers. This makes me nervous because this happened on June 5th, when everything fell apart. The twitching. What is it, my tendons or my nerves? No one knows. All day, I have constant pain. I'm worried but I have to think positively. So I try not to think about it at all.
August 4th: I make a friend. She invites me to go shopping. This interferes with my strict regimen of post-orientation ritual of hand-care: icing (20 mins), resting (10 mins), heating hands with paraffin (20 mins), resting (10 mins), repeat. I go with her anyway, taking my ice pack. I feel like an idiot, but I'm optimistic and tell her my story between laughs. We're sure I'll be fine by the 8th when classes start.
August 8th: Classes start. I still have constant pain, weak hands. I decide not to drive because this heightens my pain for the rest of the day. Two other m1s live in my apartment building. They're really nice and take turns driving me to school. I promise that as soon as I'm better, they can have unlimited rides whenever/wherever they need during the next four years. The first day is all intro material that's familiar, but I cry when I get home because of the pain. I couldn't hold a highlighter during lecture, nonetheless take notes in the margins. It looks like a 5 year old attempted to annotate my notes. I'm frustrated and angry that my hands aren't better.
August 18th: My counselor emails me telling me that I can have time and a half on our exams on the 30th and 31st. I have to schedule a meeting to tell him that it's not about the time constraint, it's not merely about pain. When the pain increases, my motor control falls drastically. I explain that it's not simply painful to hold a pen, it's that I cannot write with it. It has been so bad this week that in the mornings, I can't put my binders in my bag. After dropping them several times, I finally end up kicking them into my bag. I explain everything in more detail. I ask for someone on faculty to sit in a room with me while I take the exam and have that person transcribe my answers for me. The problem is that we have a 3-hour anatomy practical. They legally cannot do this. I am referred to another counselor who is higher up. We go over the same things. He points out that I won't be able to participate in clinicals which start after our first exams. Can I take a blood pressure? No. We talk about taking a medical leave of absence. I do a lot of crying but I understand, and a tiny part of me feels relieved. Medical school is hard on its own, but trying to study through mind-obliterating chronic pain and having to find completely new study habits because I can't use my hands has been rough. He makes it clear that since I won't be able to take the exams, this is my only option. I think I'll be able to get the surgery and come back for the next block, but he tells me I should take the whole year off and I'll have a spot waiting for me when I return next year. I grudgingly accept this. I go home. I tell my dad. I tell my best friend and boyfriend. I stay in bed for the next four days crying. I feel like I have no purpose in life and I stop trusting the doctors. I'm nowhere near better. I'm desperate for surgery, because I think I'll miraculously be healed. This is all I think about. People start telling me that maybe medical school wasn't meant to be, or ask me if I was really sure I wanted to be in medical school. I want to scream.
August 24th: I see a neurologist about my hands. Now that we have time to do a proper workup, my dad wants to rule out every other possible cause to make certain it's carpal tunnel syndrome. He doesn't want me to get surgery. I pass the nerve conduction study, meaning there is no permanent demyelination of my median nerve. The neurologist tells me there's no clinical indication for surgery at this point. I maintain poise (I think?) but I am furious. I need that surgery. I need to go back to medical school.
September 5th: In an odd turn of events, my best friend (never a proponent of the surgery) tells me about the pain specialist she sat next to on the plane back home. I start to think acupuncture is the answer. I make an appointment with the DO he recommended, who specializes in pain management and acupuncture. The earliest I can get in is October 24th- I think I might even be cured by then, so who knows if I'll even go to the appointment. I am a bit optimistic, but worried. As always. Meanwhile, the neurologist ruled out rheumatoid arthritis, multiple sclerosis, and hypothyroidism. I am frustrated- not because I wanted any of those diseases- but because I still have no answers. I'm worried that without knowing why this happened, it could happen again next year. Or in residency. Or in my fellowship. I don't think the establishment will be that forgiving another time around. Maybe they'll be mad at me that I didn't get it taken care of this year. I'm desperate.
September 13th: I finally have the ultrasound that my neurologist ordered. Later I find out it's not tenosynovitis. Again, I am frustrated not because I wanted tenosynovitis, but because I still have no answers. I don't write about it. I'm exhausted.
September 18th: It's Sunday. My dad drives me over to the house of plastic surgeon specializing in hands (#1) (we're family friends). He tests for signs of carpal tunnel syndrome. He refers me to plastic surgeon specializing in hands (#2) aka House v.2 for a second opinion. He tells me to go ahead and try the acupuncture because it can't hurt.
September 21st: I see plastic surgeon specializing in hands (#2) aka House v.2 and he tells me it's not carpal tunnel syndrome. I'm not that surprised since that's what my dad and I had been thinking, and also what plastic surgeon specializing in hands (#1) had seemed to confirm a few days ago. He's not sure what to make of it, and apologizes that he doesn't know what it is. He wants to consult a rheumatologist about labs (I think?) and then get back to me.
September 28th: I go out to dinner with my dad and boyfriend. We talk about research, medicine. We order cappuccinos after dinner. We talk about coffee. My dad mentions that his coffee habit started in medical school. I start crying and run to the bathroom, freaking everyone out. I come back. Proceeding cautiously, no one mentions medical school again. Instead we talk about how I shouldn't be doing anything with my hands. No typing, no Cedar Point this weekend with my former med school classmates. Maybe that's a good thing. I don't want to break out in tears at Cedar Point too.
the saga continues...
