and on and on....

I feel like a broken record, going on about my wrist pain. But isn’t that how it is when you are in chronic pain? It’s all you can think about, and it colors everything else in your life.

I have a living, breathing example of this right under my roof, and I’m not talking about myself. Shakespeare is doing so much better since his surgery, it’s amazing. Not only does he not limp anymore, but he’s a happier kitty. He is more active (though still the least active of the 4 cats), and more affectionate. He even seems to be getting along better with the other cats. Really, he’s like a different person. Sometimes a pest now, with his appeals for attention. At times I feel really guilty, that we didn’t see him limping earlier, or check his paws earlier. Had he been in pain the whole time we’d owned him? (2 years) I want to get mad at the vet that she didn’t check his paws, but who would have thought to check? He was declawed, why look at the paws? This isn’t a common problem. So, with effort, I put all these feelings behind me, and am glad he’s doing well now. Sometimes I wish these cats could talk, tell me what’s wrong – though I imagine what they’d say would run more like, “treats, can I have treats now, more treats… time for dinner, ok, now time for dinner, dinnertime…. Ooh bird!.... and oh that feels good, scratch me here, now here, and over there, and by the tail…. NOT the stomach!” (repeat each section about 100 times) Anyway, Shakes was in constant pain, and now he’s not, wouldn’t that be nice for me too?

It was an interesting visit with the rheumatologist. He gave me more than just relief that I don’t have rheumatoid arthritis. He gave me a sample nsaid cream, and a prescription for it and an oral one if the cream doesn’t work. He thought that a TENS machine or PT ultrasound might help my wrist, and wasn’t so sure I needed surgery. I have tried ultrasound some, but perhaps not consistently enough. I made an appointment for another hand surgeon for next week, for a second opinion.

The cream is definitely helping with the pain. And it made me wonder – at the beginning of my vacation I was still taking naproxen sodium as I had the week before the trip started. Perhaps that was why the pain went away? And it stayed away because my lifestyle was so stress free. But when even the lightest stresses came back, without the anti-inflammatory to compensate, then the pain came back easily. Thankfully, not too severely.

I have to say that when asked where the pain is on a 1 -10 scale, I only say 2 now. Before the first cortisone shot it was a 7 or 8, before the second shot it was a 5. So, relatively speaking, this is much better. In fact I barely call it a pain, it’s more like an ache. My wrist feels like it’s being squeezed, my fingers tingle a little. Most of the time it’s a 1, but once in a while I move just wrong, or I push back on it, this is about once a day – and it’ll spike to a 4, so I figure a 2 is a compromise. The pain isn’t acute, but it is chronic, and I don’t see it going away without some kind of help. But, I don’t think this is pain worthy of surgery, not yet anyway. I have to explore other options, and I have to figure out what is causing it in the first place. Because, my greatest fear is that I could have the surgery, and a long difficult recovery, and then not knowing what caused the overuse stress exactly – I could cause the pain to come back again anyway.

Several things are on my list for possible sources of wrist pain – transfers, driving, pushing my wheelchair, cooking, typing, everyday activities like dressing or activities I do in the bathroom. (Of course I do a lot more activities, but the others don’t seem like ones that stress my wrist, though I could be wrong.) On vacation I did very little of all of those – except for the everyday stuff and typing – isn’t it nice to know that my blog isn’t causing me pain! I did push myself about some, but probably less than I do at home.

And since I’ve been home I still haven’t done much driving or cooking. This is because the day we got home we started a huge electrical project that we had set up way back in November. We’re upgrading our electrical panel (which means getting a new one) and getting rid of all the aluminum wiring (should have been done ages ago). This has meant totally new service from the street to the house as well, which in turn has meant trenching and boring a channel to put conduit…. We chose to do this project right after vacation because at some point we knew we could have 2 days without power as they reconnect the new copper wiring to the new panel, and disconnect the old. Last November we started eating down our fridge and freezer, so that it’s now pretty bare. Less food to store at our neighbors that way! And also, consequently, less cooking for me now. And with all the work going on, I’ve been sticking pretty close to home. The switch off day is this Friday, so hopefully by mid next week it’ll all be done. Can’t wait!

OK – so assuming my stress list is pretty complete, there are only 2 activities I’m doing that I imagine are causing my pain at this time – transfers and just generally pushing my wheelchair. That doesn’t mean that driving or cooking (or anything else) might not cause pain later, but at least not now. I have to work with what I know to be problems first, tackle others as they come later. It’s good timing that I am buying a new wheelchair this year, perhaps I can reduce some of the weight I push around. There are some other types of handrims than the ones I have, that are easier to grip, fitting your hand better. Changing how I transfer is a harder problem.

But look at my list of possible stresses, and no wonder I’m overusing my wrist – My stresses, aside from cooking and typing, are things that wrists aren’t really meant to be doing. It isn’t that I’m trying to lift weights, I’m just trying to live.

Transfers are using your wrists by putting weight on your hands as you slide across a board to get in and out of a car, or without a board (in my case anyway, some use boards all the time) onto and off a bed, shower seat, toilet.

Pushing my wheelchair, using hands and wrists to walk.

Driving is hand controls, one hand to steer with a “suicide knob”, the other to accelerate and brake with a lever that controls the foot pedals.

Getting dressed means leaning to one side on the bed, pulling up pants on that side, then leaning to the other side and pulling again. There’s a lot of gripping and pulling in getting dressed. It takes me 20 minutes to put on socks, underpants and pants. It’s a small task, not hard, but does take practice.

So, I am a broken record, talking about the same story over and over. At least that’s how it feels. I know each doctor visit takes me one more step on the way to understanding all of this, even when I disagree with them. I just wish it didn’t take so long. So, next week, perhaps I’ll get some idea about whether surgery is going to be the only fix in the long run, and also some idea whether it’ll come back easily. I don’t know whether this doctor will have any better idea than the last hand doc (or the rheumatologist for that matter) what the specific causes are. It may be that I need a more specialized session with my PT, or even another PT, who has a rehab specialty. But I’ll keep chipping away at this, and for good or bad, I’ll be posting about it again too.

I think there is a key point here, that’s not really about my wrist or a new wheelchair or even planning a vacation. One of the challenges of dealing with a disability is that so many things take a lot of time. Injuries, pressure sores, overuse complications can all take months to understand, resolve and heal. The funny thing is that some things for us heal very quickly, like broken bones. But the general rule is that healing will take a while.

Medical services are not set up to be quick. I first started trying to reach the rep at Mobility Solutions (and I do think they are a good business, or I wouldn’t stick with them) last Thursday, and finally he called me back this afternoon, 6 days later. Except for last Friday, I’ve been home all these days, so it wasn’t that I missed his call. He’s overworked, on the road all day, not even able to check messages. I have his email now, so hopefully we’ll have an easier time communicating. And I’m documenting in the blog each step of the way, which will show how long buying a chair will take.

My situation isn’t urgent either about my wrist or my new chair, or I might insist on faster service and earlier appointments. Waiting weeks and weeks for appointments is annoying, not to mention not really good for your body. It’s one thing to have slow service while making plans for a vacation, though I might make an argument that this is also annoying since all those slow responses were disability related also. But still, it’s even more frustrating when it’s health related.

OK, I’m done now, I’ll turn the stereo off. It’s a beautiful day outside, mid 70s and sunny, and I’m going to go enjoy it. Then later I plan to look over all 500 Antarctica photos on the computer, and pick out my favorites to show someone tomorrow. My wrist still hurts, but life is good.