So, this week I'm being "good" and staying home, trying not to stress my wrist. My main goal is to keep it from getting worse, so that my wrist pain won't ruin my vacation. I'm even hoping that real rest (is that possible?) might make the pain go away, but I think I'm dreaming on that one.
The pain first started late last spring or early summer. It wouldn't be there all the time, but could be acute with some activities, bending it just so or picking up something heavy like a pot full of water and cooked spaghetti. I had my PT work on it, and tried my own home solutions like ibuprofen, heat, wrist splints. And it might go away for a day or 2, then it would come back.
So, in July I saw my internist, who referred me to a hand specialist, who diagnosed deQuervain's tendonitis. Let's see - there was a wrist x-ray in there, and my internist took some blood samples, including requesting a test for rheumatoid arthritis, though at the time I didn't know he ordered that test. Anyway, the hand surgeon gave me a cortisone shot, and it was like magic! Within a week, the pain was gone.
And the pain stayed gone.... for 4 months. It came back a week after visiting my mother in Huntsville, AL. At that time I had a removable rigid back to my chair, which you put on by lining up pins on each side with sockets mounted onto the canes of the back of the chair. My chair is getting old, as I'm mentioned before, and the canes are not really steady now. Plus I suspect the mounts had gotten bumped slightly from travel inside the belly of the plane. But after that trip, I found the back even harder to put on, and to remove. When removing it, it would get stuck and I'd have to jerk it really hard. To get it in I had to hold it carefully, steady, and slowly lower it down first on one side - but not too quickly or the lock would click on the first side, and then it would be too low to get the second pin in! So, you had to be reallllly steady. All of this matters, because every time I got in and out of my car, I had to remove the back before folding the car to load it in my ChairTopper. And I had to do it one-handed, yes, with my right hand, while my left hand held my body steady. I'm a high level para, so I have no trunk muscles, no muscles lower than shoulder height. Which means no balance, and no way to get myself upright if I keel over. So, picture this - sit in the driver's seat of your car, feet already in place. Twist your body to the left and one by one, remove foot pedals and seat cushion. Then spin the chair around, so you have the back toward the car. Then, with left hand holding the side of your seat, or maybe one wheel of the chair, as you lean out of the car - with your right hand yank unlock the 2 pins on the side, and grab the handle at the top of the seat back and yank up. It wasn't easy. And made harder by equipment that wasn't fitting quite right.
One of those yanks, possibly a few together, brought back the tendonitis pain. I suffered with it for a month, and on Christmas Eve finally begged for another cortisone shot. The doc said this was the last time though, after this I was looking at surgery. The shot did it's work again, but the pain really only stayed away for about a month. This time when it came back, I couldn't point to a specific event that caused it. And this time, it is a steady pain, worse at specific moments, but it doesn't even totally go away either.
Meanwhile also in December, I was back to my internist, for a physical this time. My RF (rheumatoid factor, the first screening test for rheumatoid arthritis) was high, so he ordered a retest. It also came back high, so I was referred to a rheumatologist.
I saw the rheumatologist in late Dec, and he took more blood, and I have an appointment for this Friday for an ultrasound of my wrist. From what I understand, I'm not really presenting a normal pattern for rheumatoid arthritis, but the later blood work and ultrasound will better answer that question. He's more inclined to think all I have is overuse of my wrist, resulting in the deQuervain's, though it is possible that this is just the first sign of a larger problem.
Anyway, all this is background. What's getting to me today, is that it seems like there's no way to reasonably rest my wrist. I'm so dependent on my arms for everything. I'm not driving anywhere this week, unless I see it as super essential. Even my PT appointment got cut. Driving hurts a little, and the transfers in and out of the car are painful. So, Jim is doing all the errands like picking up cat litter, and returning library books. I've come up with another way to do my carseat transfer, but I do worry I'll strain some other muscle or joint. So, I have to be careful. Last weekend, when Jim and I went out, he drove and gave me pushes.
I'm cooking simpler fare. I'm taking Aleve and applying heat. I've stopped wrist stretches and exercises. I'm pushing myself less, since I'm not going out. I'm skipping showers - that eliminates 4 transfers. If I don't shower I get dressed on the bed when I first get up, then 1 transfer from bed to chair. If I want a shower, then it's bed to chair, chair to shower seat, shower seat to chair, chair back to bed to get dressed and then bed to chair again - 5 transfers. Hey, I'm not doing anything to get sweaty, and not seeing anyone either, so skipping a shower or 2 won't hurt me.
Resting my wrist any more than this, or if I get surgery then recovery as well, would mean asking others for help. Jim would have to take on a fair amount of helping me, and I really hate to ask him. I'm not entirely sure where this comes from, but I don't want to be dependent on him. I want to carry my load in our relationship, and if I can't do my usual share of taking care of the house, I'll feel dependent. I also have this fear that this dependency will become permanent. It's like becoming disabled all over again, learning to live with less, and I'm fighting it.
I know quads who need personal care attendants daily. I have always expected I'll end up needing assistance eventually. But I'm not ready yet, and I honestly don't think my wrist is going to bring this about. All the same, I can't seem to figure a way around this pain, to make it stop. It feels like nothing I do will help. At least, nothing I do alone.
I'm about to have 4 weeks of reasonable rest. This week at home. Then 3 weeks of travel, where I'll have fewer transfers in and out of cars, no driving, someone pushing me most of the time, no cooking or laundry, and no care of cats (cleaning cat boxes for example). I'll be as rested as I can be. If I still have pain when I return, and I suspect I will, it'll be time to really figure out what is going on, and what to do to make it go away, and stay away. If it is truly only de Quervain's tendonitis, I'm headed to surgery and will need help for a while. I do want to try to understand why I got the tendonitis in the first place though, so it doesn't come back. If something else is going on in my wrist, I want to know.
This isn't the first time I have had tingling in that hand. Some years ago I had a similar problem, but it was mostly tingling without the wrist pain. After extensive testing, they didn't really have a diagnosis, but found I had a cyst on my spinal cord near the injury level. Perhaps the cyst has become a syrinx? Perhaps it has moved and caused me to lose some muscle strength in my wrist? Though I'm right handed, I have often favored my wrist. I don't use my right thumb while typing for example.
Yes, my right wrist hurts. It's consuming my energy, even robbing me of sleep, when I still have a lot of thing to do to get ready for our vacation. This trip is beginning finally to feel real and I'm pretty excited about it. Everything will be done in time. Most of the prep already is done. The most time consuming thing left is packing. And I think I can do that without hurting my wrist more. Argentina and Antarctica here I come. Probably just one more blog this week, then the next one will be from the other side of the world.
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