Thursday, February 14, 2008

A most useless doctor visit

For the past few years I've noticed that my wrists have been getting sore after extended periods of computer use. Knowing what this could mean, I attempted to cut down my computer use, and started using programs that encouraged me to take regular breaks1. The soreness became more frequent and came on with shorter periods of use (which is, I might point out, one of many reasons why my posting frequency has dropped precipitously), and then recently I started noticing tingling in my fingers and my mouse hand feeling itchy. So, I decided that enough was enough: it was time to head to the doctor.

The nurse who first saw me had carpal tunnel syndrome herself, and she shared her experiences. Unfortunately, they boiled down to “don't do what I did - I had to have surgery, and still can't use my left hand all that well.” Practical advice on how not to do what she did was rather lacking from her monologue.

So, in came the doctor. He did the usual asking what was wrong, and after my explanation he said, “Well, you've got carpal tunnel syndrome.” He made the diagnosis without ever touching me, or without asking any clarifying questions. Given that after reading online I'd found that there are a few possible conditions that have similar symptoms, I was surprised that he didn't. He then proceeded to explain what causes carpal tunnel syndrome (pressure on a specific nerve; it's always interesting to listen to how doctors dumb down explanations) and that if it got bad enough I might have to have surgery.

Did he bother to say what I needed to do to avoid said surgery? No.

He then asked me whether I used a computer at work, and after I replied with a yes (and that I had a suboptimal work arrangement), he said that that was almost certainly the cause.

Did he bother to ask me if I did other activities (like, say, playing the guitar, or blogging) that might be related? No.

He did, however, go on to talk about how employers are very worried about carpal tunnel syndrome due to the fact that it's the #1 worker's comp injury, and that I should talk to my HR department about getting something ergonomic for my setup (his primary suggestion was, I kid you not, “a gel wrist-pad”). Did he give me any real suggestions on what to do to make my workspace (at home or work) more ergonomic? No. Did he bother talking about any of the range of possible treatments, and discuss with me which would be most appropriate? Other than suggesting that I take off my watch and get a gel wrist-pad, no.

He did ask if my hands tingled when I woke up (which is a symptom of sleeping with bent wrists, an indication that wrist braces may help if worn while sleeping), but then quickly went back to talking about worker's comp.

After a nearly useless conversation, he briskly asked me if I had any other questions, and then shooed me out the door. I learned more in a half hour of web-browsing the night before the appointment than I learned from him, and I'm now left to search the web for more information.

1 Initially I used Ubuntu's built-in typing break program (found in the “Keyboard” menu, at least for Ubuntu 7.04). While this was an excellent start, it was suboptimal (it didn't have an option for micro-breaks, and it would lock the keyboard without much warning, which was frustrating if I was in the middle of a sentence). I also tried a Google Desktop add-in, but that was even less useful (as it just brought up a popup window, which was easy to ignore if I was busy). Most recently I've started using Workrave, a free Linux and Windows program that appears to be excellent: it has both micro- and macro-breaks, gives plenty of warning when breaks are about to appear (I can finish my sentences now!), and is very customizable.

1 comment:

Radagast said...

Importing comments:

Please check with a physiotherapist. I've been going to one off and on for several years, whenever I start to develop another RSI. If you can find one qualified in the "[Robin] Alexander technique," so much the better. My physio has used a combination of manipulation treatments with prescribed regular exercises to get me better than the previous "normal," including complete relief to what my doctor blew off as bursitis due to middle age.
April 3, 2008, 8:45:29 AM PDT – Like – Reply

I'm sorry to hear about your experience. And "they" wonder why we try to find (aka are driven to find) information on the web. I think the chief reason I don't have carpal tunnel after many years of computer work is that I have always stretched my fingers and palms upwards/backwards with the other hand. My sister has had operations, on both arms/wrists, I think, and still has problems. I hope you don't end up as she did.
March 2, 2008, 6:48:37 AM PST – Like – Reply

Thanks for the suggestions! Unfortunately, I've touch typed for most of my life, and have used ergonomic keyboards (Microsoft ones) for about 14 years now.

I should go find some good stretches!
February 16, 2008, 11:55:41 AM PST – Like – Reply

i have had some pain from excessive typing in computer-related jobs. the first time this happened i learned how to type properly (i had been 'hunting and pecking'), which helped a lot. after a great deal of typing with good technique, the pain resurfaced and i replaced my flat keyboard with a microsoft 'natural' keyboard, which was awkward at first but helped a great deal. i never reached the point of being diagnosed with carpal tunnel or having symptoms while not typing, but if you are using a flat keyboard i would highly suggest trying the microsoft 'natural' or similar ergonomic keyboards (i also had a fujitsu split keyboard which was adjustable in the angle of the split, as well as the incline to which the entire keyboard was propped, which was neat to experiment with, but ultimately i went back to the microsoft one).

i have also found that stretching exercises provide some relief. fortunately i have had only minor pains from the guitar
February 16, 2008, 1:39:13 AM PS