Advice appreciated...
Moms View Message Board: General Discussion: Archive October 2007:
Advice appreciated...
Okay I have been dealing with what my regular dr thought was a classic case of carpal tunnel since July. The pain has been getting worse and worse.
I went to my regular dr first thinking he would tell me who I really needed to see. He saw me first in the middle of July. Gave me a brace and told me to wear it 24/7 (unless it would get wet) and to take 4 200 mg ibprofen 4 to 5 times a day (yes i asked him but he said it is okay). He then told me to come back in 10 days if it was not getting better. So after Labor Day (about 10 days) I went back with worse pain. He then sent me to a orthopedic hand/wrist specialist.
I went to him the first available appt. He did x-rays and said that it definately looked like carpal tunnel or something like that and since the x-rays came back clear, he sent me to a neuorologist for a Nerve Study.
I went and had that done the next day (9/12). It was extremely painful, but the nerves came back all clear that there was no nerve damage to be found.
I go back to the ortho on 9/20 who agreed with the neurologist that there was no nerve damage but that I was having severe pain in my hand and wrist and he thinks it is nerve pain by the symptoms I have had. Tingling, numbness, and some aching. He gave me some nerve pain pills called (Lyrica) and told me to come back in 6 weeks.
Since then the pain has moved up my arm and is now no only effecting my hand and wrist but a strip below my elbow and one between my elbow and my shoulder. The worst part is that now there is an area on the back of my upper arm that has become hyper sensitive (if someone barely pokes it I just want to cry and even me touching it lightly hurts). I am not supposed to go back until Nov 1.
I don't know what to do. On one hand I want to call and make another appt, yet on the other hand I want to try to stick it out.
Any suggestions. I am still taking up to 4 ibprofen up to 4 times a day and that Lyrica which helps some but not a lot and only sometimes.
What would y'all do?
This is really effecting my life. I can't even push a shopping cart around without severe pain. Everything is becoming a challenge and of course it is my right arm and i am right handed.
I would think about going to a second ortho. And, having had a similar experience, I would wonder if the problem may be in the nerves in the neck portion of the spine. I have arthritis in my neck and it was actually diagnosed because I was having pain in my shoulder, upper arm, and all the way down to my wrist and hand (though your pain is going the other way). Or you may have a nerve "pinch" that is not constant and not yet causing nerve damage but is causing a lot of pain.
But if you are still having pain, someone needs to do some more tests to find out why. It has been about 3 months, which is a long time to "stick it out". I sure wouldn't want to think about surgery given the current diagnoses or lack thereof, and the negative results of the EMG (and yes, they hurt like the devil - when it hurts it means the nerve is functioning). But I also wouldn't want to keep on sticking it out for so long.
I have to agree with Ginny about the root of the problem being in your neck. I have had similar problems with numbness, tingling and pain in the hands, arm and shoulder and it stems from the neck. In fact I wake up several times a night with my hands numb and tingling and have to shake them until it stops then rearrange my pillow so my neck is supported. I also went through the tests for carpal tunnel of which I do have. My sister just had neck surgery a month ago for the very same reason and is now on the mend. She was in constant pain as the spine was pressing on nerves. I wouldn't wait any longer it will only get worse.
I just had a nerve conduction/EMG study done - yes, they are VERY painful! It confirmed I have *moderate to severe* carpal tunnel syndrome in both hands. BUT I also have disk problems in my neck, which partially contribute to some of the pain.
If you have herniated disks, arthritis, bone spurs, spinal issues in your neck they will cause symptoms all the way down your arms to your hands. I'd recommend seeing another ortho doc, or even a neurologist. It sounds to me like an MRI might be necessary. Xrays, etc. will not show soft tissue/disk problems, but an MRI will.
I feel for ya! I am going through the same thing.
{{{{{{{{{{{{{{HUGS}}}}}}}}}}}}
OH - 800 mg of ibuprofen 4/5X daily is a LOT - it can cause stomach problems, not to mention tax your liver. I think the *safe* dosage for an adult is 2400 mg, which you are exceeding.
The docs I work with, often prescribe 800mg three times a day, for acute inflammation, but I don't think it's meant for long-term use, at that amount. Ibuprofen can be hard on your kidneys, too. I think if it's hurting that much, you need to get a second opinion, or go back to the doctor to look into what else might be wrong.
I am trying to keep the ibprofen to a minimum but I hurt so bad. I try to only take it 3 times a day.. because it is starting to irritate my stomach a little. Thank you for the advice. I think I just needed that push to go somewhere else. I didn't really like the dr response when I went in after the nerve study. It was almost like he didn't believe me or something and that the pain couldn't be that bad if I didn't have any nerve damage.
I think the spot on my arm where it is super sensitive is what really got me thinking. My mom had back surgery when I was a kid and she had a spot on her leg that was like that until she after the surgery when the nerve was no longer being pinched or something. So it kinda scares me.
I am going to give this guy one more shot.. Just because my regular dr says he is the best around. Maybe I just didn't explain exactly what was going on to him or something. I don't know.. But this time I have specific notes on what different types of pain I have been having and where. Hopefully that will help him.
TRUST ME!!!! STOP THE IBUPROFEN!!!
I was on prescription motrin for a few years because of endometriosis and other problems. I brought it up several times to my doctors about the safety of it, and they just shrugged it off.
Well, for several months, I had severe pain in my back and chest. Pain as in, thought I was dying pain. I've been through a lot with medical problems, but this scared me. I felt such a pending doom, and no one could do anything....except give me more Motrin.
Well, fast forward, and I am not throwing up several times a day while having the pain. Totally dehydrated. My husband has it out with my doctor and insists they put me in the hospital. They do. They find out I have a fist size ulcer that is just about to break through my stomach lining. My gastrologist told me that if I were any older, he would have started cutting it out because it was so bad it looked like stomach cancer.
I am still on Nexium, several months later, and really have to watch my diet. And I can never touch motrin or nsaids again. Really makes it tough dealing with headaches or anything because tylenol doesn't help at all.
Sorry to get into all of this, but just be careful. The whole stomach thing is a lot to deal with, and it, too, is long and drawn out.
That is a very high dose of ibuprofin. Did your doctor tell you to eat something (something substantial) before taking it, to help protect your stomach. And I agree, you can't take that kind of dosage for very long. I would hope your doctor is thinking about regular blood tests to check for potential liver or kidney damage. And, of course, no alcohol at all while you are taking that kind of dose.
When I say eat something, I mean like a container of yogurt, half a sandwich, half a bagel, milk and a couple of pieces of toast, at least. Ibuprofin will indeed tear up your stomach.
Here's an information page from the Mayo Clinic on Ibuprofen. Ibuprofen It lists precautions, side effects, and what kinds of problems to watch for.
My clue that you need to go back, or see someone new asap is that the pain is getting so much worse. It's not the same, it's not better - it's substantially worse. That tells me that whatever is causing the pain may be getting worse. I would see someone right away. Sticking it out is not noble and does not make you a better person - it just makes you hurt.
I hope you feel better soon!
Ame
Ditto! Taking that much ibuprofen for that long is not good for you, and worsening pain is definitely cause for seeing a different doctor!!
I made an appt but they can't get me in until Wed.
And yes I always eat something before taking the Ibuprofen because if I don't it hurts my stomach.
Thank you for all the support. I really needed it yesterday I was really down about everything. Mainly because I am not able to do all the things independently that I used to. Little things like taking out the trash and going to the grocery store, I now have to either have someone else do or someone has to go with me. And of course DH is forgetful when it comes to things I shouldn't do so I end up doing those things because I don't like to ask for help and I am pretty stubborn.
I'm glad you are going back. And, I would really try and cut down on the Ibuprofen. I am having tendon problems with my foot, and my doctor was very clear on the amount of Ibuprofen I am to take, and yours is WAY over what I am taking.
I feel for you. With my foot, it is very painful by the end of the day. I don't complain(what good would it do) So, I think dh tends to forget. I just have to tell him what I need him to do, so I can stay off my foot in the evenings. You really need to ask for help.
If your doctor doesn't seem to take you seriously, then I would see someone else. They should be doing whatever tests are necessary to get to the bottom of the problem. I have very horrible swelling with my foot, so there isn't a question about there being a problem. But, I have had to go through several tests, x-ray, bone scan, and now MRI, to find out what is going on. Hopefully, after the MRI we will know. I guess my point is, sometimes, it just takes several tests to find out exactly what the problem is.
Hopefully, you can get some answers on Wednesday. But, if you aren't happy with the doctor's response, definitley get a 2nd opinion.
I'm glad you're going back, too. I've had trouble with my neck and I know how depressing it can be to live with chronic pain. I will keep you in my thoughts. And, ditto on seeing someone else if necessary. No one knows the level pain you are dealing with but you. I had the same problem with my doctor. For me, it was my physical therapist who really listened and directed towards someone who could help.
I hope all turns out okay. We are here if you need to talk.:-)
((HUGS))
I was thinking about the EMG. It only measures the nerves between the electrodes or contacts the doctor places on your skin. For example, if one electrode is on your finger and the other on your shoulder, it is only measuring nerve conduction between the shoulder and fingers. So if your problem is in your spine, that probably wasn't measured. I suggest that you talk to your doctor about what part(s) of your body are to be included in the MRI, and whether there might be some value in making sure your cervical and upper thoracic spine are included (neck up to the base of your skull, and the upper part of your spine between your neck and the lumbar area.
The other thing I want to say, Tara, is I urge you to learn how to ask for help and gracefully accept help. In 1980 I woke up one morning with excruciating lumbar pain and was diagnosed with a ruptured disk. Treatment was different then, and the orthopedic doc said he would put me in the hospital in traction for a month if I weren't a single parent, but that I had to spend 24/7 flat on my back except for meals and bathroom and on a very firm surface for a month. At that time my sons were 19, 14 and 13. They did absolutely everything - cooking, cleaning, shopping, laundry, helping me sit up and lie down when I had to get to the bathroom or eat. I did a lot of thinking during that period - not much else to do except watch non-cable daytime TV (yuck). I realized that I get a lot of pleasure helping other people, and that when I asked for help, people got pleasure out of being able to help me. My sons specifically were absolutely wonderful and felt really good about the tables being turned and them taking care of me. I spent most of my time on the living room couch because it was very firm and a nearby bathroom. My youngest son would sometimes come downstairs if he woke up late at night and saw that I had left the light on, to be sure I had gotten to sleep and make sure I was alright. (The other wonderful thing my sons did was throughout that period and for a long time thereafter, they never quarrelled in my hearing - which I still think was absolutely amazing.)
By your profile, you have an 11 year old and a 13 year old. I suggest you sit down with dh and your kids and level with them. Tell them you are in a lot of pain (and worried about what the cause might be) and that you need their help in doing things that you have been accustomed to doing - that you'd really rather be able to do those things yourself but when you do, it hurts. And tell them the kinds of things you need their help with. I think you may be pleasantly surprised about how your kids will rise to the occasion if you give them a chance. (And don't forget, they are old enough to start learning how to cook with your supervision.) Give them a chance, and give dh a chance to help.
I also remember my dear mother, who, when she was living with me, drove me batty sometimes by insisting on doing almost everything herself. She had arthritis and a really bad knee, but she would take a basket of laundry down the stairs by going down backwards and moving the basket one step at a time, and pull it across the basement floor to the washer by a rope - and reverse the process coming up. I told her many times that she should leave that kind of task to me, and her response was that she didn't want to "be a burden". I finally told her it burdened me to worry about her taking such risks and I would feel a whole lot better and worry a great deal less if she would just let me take the baskets up and down - which finally got through to her and she started letting me tote the baskets. We worked out a compromise - what things I really wanted to do for her because of her bad back and knee and my fear of her falling or otherwise hurting herself, and what she should continue to do because she needed to be doing things and to not feel she was a burden. Almost to the day she died she was doing 90% of the meal preparation and cleanup, and after I toted the baskets up she put her clothes away herself. She did all the dusting, I ran the vacuum and mopped floors. All in all, she felt useful and not a burden and I worried a whole lot less. A long story, I know, but do try to find compromises that will have your family helping you and keep you from feeling like a helpless burden - I'm sure those compromises are there if you think about it.
Later addition, after a good night's sleep. Tara, I know every mother does her best to protect her children, especially from any problems mom might be having. That's a natural and good instinct. But at some point one has to realize that withholding information about physical problems is not really good. I'm sure your kids know you are having problems, but don't know the extent of the problems, and are possibly feeling helpless about it. If you clue them in and tell them what they can do to help, I strongly suggest it will (a) make them feel better to know; (b) make them feel better because you are treating them like mature people; (c) and give them an opportunity to demonstrate how mature they can be by helping. The other thought I had was to try really, really hard to be patient. By that I mean that if someone doesn't do a chore the first time you ask, don't go ahead and do it yourself, out of frustration and out of the natural desire to see that things get done right away. Ask again, calmly and nicely, and maybe remind the person you asked that these are exceptional times and that is why you are asking. And have some sensitivity that your dh's and children's priorities are not the same as yours and they may not have the same sense of urgency about getting the trash out or taking the laundry down or up.
Ginny, you give such excellent advice!!
If you require an MRI, then you should be having an MRI of your C-spine, the cervical disks/nerves affect the arms/hands.
Symptoms of a cervical herniated disc
A cervical herniated disc will typically cause pain patterns and neurological deficits as follows:
C4 - C5 (C5 nerve root) - Can cause weakness in the deltoid muscle in the upper arm. Does not usually cause numbness or tingling. Can cause shoulder pain.
C5 - C6 (C6 nerve root) - Can cause weakness in the biceps (muscles in the front of the upper arms) and wrist extensor muscles. Numbness and tingling along with pain can radiate to the thumb side of the hand. This is one of the most common levels for a cervical disc herniation to occur.
C6 - C7 (C7 nerve root) - Can cause weakness in the triceps (muscles in the back of the upper arm and extending to the forearm) and the finger extensor muscles. Numbness and tingling along with pain can radiate down the triceps and into the middle finger. This is also one of the most common levels for a cervical disc herniation (see Figure 1).
C7 - T1 (C8 nerve root) - Can cause weakness with handgrip. Numbness and tingling and pain can radiate down the arm to the little finger side of hand.
It is important to note that the above list comprises typical pain patterns associated with a cervical disc herniation, but they are not absolute. Some people are simply wired up differently than others, and therefore their arm pain and other symptoms will be different.
Since there is not a lot of disc material between the vertebral bodies in the cervical spine, the discs are usually not very large. However, the space available for the nerves is also not that great, which means that even a small cervical disc herniation may impinge on the nerve and cause significant pain. The arm pain is usually most severe as the nerve first becomes pinched.
Just a little info................
I also have to second what Ginny said about telling your kids what's going on. I have dealt with many health problems, some life-threatening, since 2001. My oldest was in Kindy, so there wasn't too much I wanted to share with her. However, I found, that when kids don't have the facts, they make them up themselves. Not as in lying, but they fill in the blanks with things they imagine and many times it is much worse than what is going on in real life.
My kids are always aware of what's going on with me now. They don't necessarily get all of the details, but I don't hide things from them. They do so much better now because they KNOW what is going on, and they trust me to keep them informed, so they don't imagine all kinds of things up.
And, as Ginny said, you would be surprised at how much your children are willing to do when they know they can help, especially when health problems are involved.
My children are well aware of my pain but right now they also know that I don't know exactly what is causing it.
We had a family meeting yesterday and they say they are going to try to help a lot more around the house..
Thank all of you for the advice and Wednesday can't get here fast enough for me.
I'll keep you in my thoughts and prayers, Tara.
Well here is what happened at my appt.
They decided that it still could be in my elbow and the only way to fix it is surgery, but the amt of pain I am in they think would cause nerve damage, so I have a MRI tomorrow for my "C-Spine" to rule out that being the problem. I am really beginning to believe that it is my neck or shoulder because the pain is becoming more localized at times in my shoulder and lower neck.
I am still a little irritated that they told me if I didn't think that the Lyrica isn't working that I should ween myself off of it, but even after I told them that I am being woken up 4 or 5 times a night while taking sleeping pills they still didn't prescribe any thing for the inflamation or pain.
Well hopefully something will come out of the MRI but I won't find anything about that out until 10/30.
This may not be a popular suggestion, but something to consider and do your own research on. I would have as many medical tests as you can and see if traditional medical doctors can come up with a sound diagnosis, then before going into surgery I would consult someone who specializes in Chiropractic and Acupuncture medicine. The acupuncture might actually relieve some of your immediate pain and you might want to try it sooner than waiting. It's not as controversial as the chiropractor just make sure that the needles used are one time use needles. The doctor will come in and you will see that each needle is sealed in plastic. It does not or should not hurt and you can expect to be there for about 30 mins and they may ask you to come back daily to help with the pain.
Ladies please don't beat up on me; I'm just making a suggestion. I know that chiropractic methods are controversial and that's why I suggested she do her research before considering this option. 
Good luck, I know how taxing chronic illness can be. Hugs.
My son sees an acupuncturist, and it works for him. But, whether acupuncturist or chiropractor, it is important to have a sound medical diagnosis first, so the alternative treatmetn doesn't make things worse.
I'm really surprised they are making a diagnosis and recommending surgery before the MRI. And that they aren't taking seriously your complaints of continuing pain severe enough to interrupt your sleep. If it were me, I'd go to another doctor, because I don't think this doctor is taking you seriously.
Chai- not about to beat up on you. LOL I've had both chiropractic and acupuncture in the past. Either of them could be helpful, or neither could work for her, each case is different. I do agree that another opinion would be a good idea, too.
IMO, the C-spine MRI is a good starting point. And that being said, a reputable chiropractor won't do ANY adjustments to a neck/back/spine without having at minimum, Xrays first, and depending on the situation, an MRI, to rule out herniated or ruptured disks. So many variables go into which course of treatment is indicated, or that you choose.
I am having a lot of hand issues right now, as I said above, and some of my pain/numbness/tingling, etc. is from my neck. I have a herniated disk, spinal stenosis, arthritis, DDD and bonespurs in my neck, and there is some pressure on nerve roots. I had trigger point injections in my neck yesterday also.
Tara, which doctor did you see today, the neuro doc or the hand specialist? I am really surprised that all they are giving you is Lyrica. From what I know, Lyrica is given for nerve pain, and diabetic peripheral neuropathy. I think it's also used in some cases for treatment of fibromyalgia. I'm not *that* familiar with it, but it appears to work similarly to Neurontin. If it isn't helping your pain, then I would really wonder if it's truly nerve pain you are having.
At any rate, have your MRI and see what that shows. I know how frustrating it is when you are in constant/chronic pain. Let us know what you find out!!!
No advice, just hugs.
(((((((((((((((((HUGS)))))))))))))
I hope you get to the bottom of this soon.
Okay well the MRI showed a protruding disk at C6 or C7, I can't remember which.
I am going to a different dr by the end of the week to look at different options since the one I have been seeing is a hand specialist.
Is there anyone here that has any experience with this? I need to know what to ask.
I do know that the hand specialist said something about a cortizone shot being an option. I don't know much about them but I know I have heard they are not a good thing for some reason.
I guess I will be looking that up soon.
Any advice would be greatly appreciated.
Tara, I had a steroid shot done in my hand a month ago. I don't know the negatives, but boy was it a gift from God! I feel so much better and I am really sad that doc 1 didn't try that option first. It sure would of made my life a LOT better.
I had steriod injections twice in my back that really did a lot of good for my arthitic joints. No steroids are great for you for an extended amount of time, but they sure can help you.
Well, some of us are not surprised that the problem is from a bulging disk. I am so glad you now have a reasonably firm diagnosis. It's clear the MRI was the right thing to do. I would strongly recommend that you now see either an orthopedic doctor (a different ortho from the one you first saw, who doesn't sound like a doctor I would want to go back to) or a neurologist - or maybe both, before deciding on any treatment. I had a ruptured disk that healed after several months, back in 1980. More recently, I have had problems with arthritis in my neck causing disk problems, and physical therapy and exercise have helped tremendously. If it were me, I'd be looking for an orthopedic doc or neurologist who prefers conservative treatment, and see about starting with physical therapy and exercise, with anti-inflammatory meds.
Steroids are basically superpower anti-inflammatories. I have twice had a round of oral steroids for specific reasons, and they worked well. Steroid injections for strained/sprained/swollen muscles, and in the back, are a very common treatment. You do not ever want to overdo it. I don't know what the guidelines are for steroid shots, but I do know my doctor would not prescribe the steroid oral medication more than twice in a three month period and then at least three months off. I also remember that at a former law firm, we had a case where a podiatrist gave steroid injections every couple of weeks for a 4 month period with very harmful results to the patient (then our client). But one or two rounds of steroid injections in a year is not uncommon, has a strong likelihood of helping, and is unlikely to harm.
Here is a link to, of all things, Blue Cross of Tennessee and their guidelines for approving payment for epidural steroid injections for low back pain: injections
From Consumer Reports list of the 10 most overused treatments and medical tests:
BACK SURGERY. Don't rush to surgery for a simple slipped disk. In 90 percent of cases, the pain goes away on its own within six weeks. In stubborn cases, surgery, which can cost $20,000 plus physician's fees, can relieve pain somewhat faster than physical therapy and medication, a recent study showed. But it also found that both groups of patients wound up with similar improvements after two years.
I am so glad that you at least have found out what is causing your problems. Now, are your kids and dh being more helpful? Are you being more patient about letting them help at their own speed instead of your speed?
I note that one of your doctors was recommending elbow surgery before the MRI was done. I hope you never, ever have to deal with that doctor again. Sheesh!!! And, a hand surgeon has no business talking about treatment for a spinal disk problem - especially since that hand surgeon couldn't make the connection some of us made, that your pain could be caused by a spinal problem.
I was just talking with my tennis partner yesterday about this very same thing. She said she had to have neck surgery for a ruptured disc. She went to orthos for her numbing hand and elbow but then they did an MRI and found the root of the problem.
Before the surgery she would go to PT and they would (somehow) put her into traction to lift/stretch her neck and she could actually feel the numbness go away but when they would slowly take her out of traction, her numbness would come back.
Just a thought. Good luck and keep us posted
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