Carpal Tunnel/ Cubital Tunnel Release Surgery

As you may know from previous posts, I have suffered my entire life with overactive sweat glands on the back of my left hand. It has taken me over 10 years, 5 dermatologists, moving 1200 miles from home, completely new physicians and opinions, to finally discover a possible cause for this. After seeing a Neurologist in Georgia and being put through a nerve Conduction study for the first time, I was diagnosed with severe cubital tunnel syndrome and moderate carpal tunnel syndrome on my left side. It is not on the right side which makes it slightly more convincing that it could be the cause of the sweating. I also experience tenderness, tingling, and numbness on and off on that side. I was scheduled for surgery before the end of the year. I had the surgery two weeks ago now. In case you are wondering, pre-op is very simple, much like any surgery. They gave me a light sedation before doing a nerve block on my left side which was excruciating but I was drowsy so it wasn't too bad. They did extra topical anesthetics on me because of my history of not responding well to pain medicine. I had them keep me on Toradol since I cannot handle any narcotics. The surgery went quick and I woke up with my limp arm in a sling to hold it up. my hand and elbow were wrapped up tight and I was out of there in no time. My recovery consisted on 3 days of pain and swelling before I realized I needed to elevate and ice my hand. Then when I got through that weekend I immediately started touching my fingers together and trying to use the hand little bits at a time. After a week I was doing really good, bandages off, showering myself, driving with one arm, starting to pick things up with the arm. After two weeks I am almost completely normal. The steri-strips are gone, no stitches just some glue, but I am using my hand completely and applying pressure to it like door knobs and the steering wheel. I am glad I went through with the procedure, however, I am not noticing any immediate results. The hand is still sweating, though it may be due to the irritation of the nerve as it heals. The numbness and tingling are worsened as the wrist and palm now ache off and on and get sore with movement. The elbow just hurts when pressure is on it. I have been told expect 5 weeks for complete healing and tenderness to go away. I have also been told it can take a year or two for nerves to fully recover when damage has been done so it may take awhile for me to know if this was a permanent fix or not. I do plan to keep everyone up to date as time goes on.

Returning Home

I was sent home on Day 4, a beautiful Saturday where I fought discomfort and worsening nausea as the day continued. I finally ate a good meal when I got home, and relaxed in my dad's armchair as I was visited by my friend Rose for a short bit, and then my boyfriend that evening. Little did I know my situation would go from bad to worse. I spent my first night home in excruciating pain and vomiting too much to take more pain medicine. I went twelve hours without anything in my system to help the pain, throwing up, unable to relax, unable to lay flat, and begging my mother to take me back to the hospital. I just wished something would make it stop, or at least make it manageable. I knew in that moment that I shouldn't have stretched the truth earlier that day. When I was asked if I had been eating well, how my pain was, if I was ready to go home, and I answered that everything was fine, I really meant 'It's all terrible but I'd rather be miserable in my own home than in a hospital. This was not however how that worked out. Instead I was sent home early, crippled with pain and nausea, and experienced one of the worst nights I can remember. All that wishful thinking turned into a nightmare that I struggled through in agony.

Me after surgery, first meal

Sunday was the day we began to catch up to the pain. I made the decision to not try the Oxycodone, that it was just too much nausea for me to gain anything from taking it, and I'd rather be in pain. Instead I tried taking Ibuprofen and Tylenol only, around the clock. I forced myself to eat before the pain medicine hit an empty stomach, and took Zofran constantly. By Monday I had the nausea under control, and spoke to the surgeon's Physician Assistant about my concerns. I told her I refused to take narcotics, and she switched the Ibuprofen to a stronger anti inflammatory called Naxoproxen. That seemed to help, and instead of the dose on the bottle saying to take it every twelve hours we did it every eight hours. Once that was controlled I informed Jamie that I could not lay down flat, my shoulder blades and upper stomach just hurt too much. I also had developed a cough, sharp upper left rib pain near my heart, and the feeling that my rib cage was cracking constantly. I was advised that it all was normal, to keep forcing myself to take deep breaths and take some GasX for the stomach pain. Most patients prefer sleeping in a recliner after heart surgery anyways, she said, so it was no surprise. I did not realize at this point that some of those symptoms were not typical post surgery aches. I would find that out Wednesday evening.

Get well flowers from Robbie

My days home consisted of round the clock medications, force feeding myself as I grew an appetite, trying to build up to a bigger walk, and constructing a better sleeping plan through all my discomfort. I struggled to keep my cats from jumping up on my chest, like they love to do, and keeping myself comfortable. Refusing narcotics seemed easy after what I had been through the entire week of the surgery with the throwing up. There is nothing worse than heaving after your rib cage has been broken, other than your entire rib cage being broken of course. One important landmark of being home was figuring out how to move around, which I did with the heart pillow from the hospital and propping myself up with a million pillows everywhere I went. I was supposed to start out slow with walks and increase a few minutes each day.  My first walk made me realize how much my heart was altered. Where I used to run three miles a day, I was winded by slowly inching myself thirty feet. I could not travel alone, I could not easily move, and I was saddened by the setbacks to my physical fitness. My legs had swollen from the thirty pounds of water weight I put on, to the point where bending my toes was uncomfortable, and the skin felt like it was ripping when I moved. I kept hope that in two weeks I would progress as predicted, losing most of the fluid retention in my body, and gaining up to a comfortable thirty minute walk daily. I knew I would improve if I kept positive and reminded myself that there must be a recovery period after such a severe setback. Plus, I had so many people praying for me all over the map that it was impossible for me to not improve eventually. It would take time to get back to where I was, but it was going to feel so good when I reached my peak athletic performance level and could look back on the mountains I had to climb to get there. Nothing worth having comes easily.

Horse Show

On day 10 after Gall Bladder surgery I was up early and gathering my gear for my first horse show of the season. It wasn't a horse show like many, because this was a MINIATURE horse show and you don't ride minis! All the animals were beautified for the weeks ahead of the show and the day before and day of they were perfected for the ring and judges eyes! Showing is something I'm allowed to do with the miniature barn I'm allowed to visit frequently and help out at. Me and the owner, Wanda, have a great connection and we are like family! 'My horse', Miracle, is a mini that she keeps at her barn and lets me see as often as I need or want to. If I'm feeling well I'll try to be there twice a week or more, cleaning out the barn, refilling water buckets, taking the babies for walks to get them used to halters and brushing down any in my path. There's quite a few of them, at one point close to 40 of them!

The show went well, I stayed in the shade, tried to remember to relax, and went in three classes. A show is split up into multiple classes where the judge looks for different things in each class and judges accordingly. You can enter more than one in a day, and enter different classes with different horses. In the last classes of the day, called Liberty, you have 1:30 to dance with the horse to music of your choice without touching them with the whip, while the judge looks for teamwork, enthusiasm, changes in gaits (speeds) and directions, and the animals cooperation. You then have 3 minutes to get the halter on the horse and lead them out. Miracle ran for the majority of the class, more than she usually does or ever has before, switching directions even though not as frequently as I wished. At the end she ran right to me playfully taking another lap and putting her head into the halter for me. Talk about teamwork. The video will be on my mother's youtube channel (alagash98) and probably on my facebook accounts as well.

Heres a picture of me and my best bud waiting for class #2, and some of us just chilling!

Surgery Recovery and Response to Clindamycin (First month)

It's four days after surgery and I'm on zero pain killers. My head hurts and my stomach is aching with sharp radiating pains, but it's not any worse than other pains and being on narcotics is bad for your stomach and causes additional problems so I'd rather tough it out from here. I had a rough nights sleep last night on no medicine but part of that was due to being stressed out because of a relationship upset. Yes, I'm a regular teenager with average relationship struggles that come and go and sometimes can't be overcome and can end a great thing at a not so great time. On the day of the surgery I came home before 3 pm and was on Tylenol Codine and ibuprofen and whatever else they gave me through IV. I got to lay in my comfy bed and be in great pain. The next day I rested and spent time with Mike. I was in so much pain that he had to do pretty much everything for me including sitting me up since my abs hurt so bad, and feeding me. I couldn't cough, standing up caused me to be in so much pain while my stomach adjusted that I couldn't breath, and my abdomen was full of carbon dioxide from the laparoscopic surgery. There is four incision and one big one along the bottom of my belly button which makes five (there are two in my belly button I believe). Today I am feeling much better, my head is killing me and my stomach hurts worse when I move but in general I am much better than the past few days and I am happy for that. I see my Lyme doctor on Wednesday to discuss how the clindamycin is working through IV. I believe it has reduced headaches and brain fog and maybe even generalized pain, but I need more time to figure it out. Hopefully he won't change it for another month. Next post, on the new car!
Surgery:

New Bigger Bed

Some of my posts have been delayed by the whole 20/20 experience along with the gall bladder problems all at once in the past few weeks. However I did want to follow up one of my earlier posts. I was looking for a bigger bed to fit my mom on it with me and give me more space to spend the long terrible sick days in. We found a beautiful mattress box spring and frame set from a college student for $300  a few weeks ago, and picked it up with the help of my boyfriend and his dad's truck. Then we ended up selling the adjustable bed and making back $200 to ease the financial burden. Now I've just been looking for 400-500 thread count sheets so I can really enjoy the experience of having a bigger bed and spending 3/4 of my time in it. When the news crew contacted me I had just finished setting up the bed and getting my room all clean and gorgeous. Today I just packed up some random cluttering items and my old sheets and bed skirt into a tub and slid it under my nice new storage space. The smile it brought to be able to put stuff under my bed made me want to post and update everyone on that situation. I get my surgery tomorrow Morning on my gall bladder at 7:30 AM and I will be able to recover in the nice big bed for the next few weeks.

Recovery from Surgery NOT as Expected

When I arrived for surgery I was scheduled to be rolled into the OR at 4 PM. I Wasn't actually rolled in until about 5:15 PM due to a delay of doctor communication. Basically my PCP never sent over the note that she physically examined me and cleared me for surgery. By now we are very used to the mishaps between doctors and their disorganization.

The surgery went well. Final report was that the bone was fairly long and sharp and was twisting instead of curving causing extreme as I re-injured it endlessly by sitting, snowboarding, skiing, horseback riding, etc. As this was probably a genetic defect in the Coccyx itself , It was definitely nothing any other doctor could have helped and it was time for it to be removed and the area to properly heal. The procedure caused excess bleeding, more then normal, from inflammation of either the Lyme bacteria in the injured area or the tailbone injuring it continuously, but basically it bled a lot.

After the procedure I was in so much pain I didn't even want them to bring my mom in but I was rolling onto my stomach screaming as soon as I woke up from anesthesia. We stayed for 3 days with no answer for the pain and I fought the grueling hour and a half ride home from Lebanon in pain. Then I suffered through days on 6 mg of Hydromorphone (stronger then Morphine, 4mg is maximum recommended dose). Finally we took me off of Hydromorphone and raised my Ibuprofen level since its an anti inflammatory and I usually take 800 mg anyways. That was what made the most difference. I took Tylenol Cod #2 at night to get me through and faught the days until now, 3 weeks out, I have equal amount of pain as I suffered with for 2 grueling years before surgery. I am back in the driver's seat, preparing for the upcoming ski season, going for walks to begin to build my stamina slowly. Everything is falling into place with the tailbone recovery, now we just have to finish the rest of my recovery process.

Surgery # ? (Coccygectomy)

I have been chasing the doctors in circles about my chronic tailbone pain, trying to get answers. Multiple times I've posted on this blog about it. Literally, a pain in the butt. Finally, we saw an amazing orthopedic specialist through Dartmouth in Lebanon, NH called Dr. Bernini who has told me I am a good candidate for a Coccygectomy or tail bone removal. He said that a normal person has a sacrum of fused bones and at the bottom a flexible coccyx of 3-5 bones, but mine is only two stiff bones very near the skin causing coccydenia (coccyx pain or tailbone pain). We asked if it was a degenerative feature because my mother ad her mother also had coccygectomys for coccydenia. He replied that only the Maharaj's in India were known to have long coccyx as a sign of royalty.

So, on October 18th I will go in for my surgery and get my tailbone cut open for the second time and go under anesthesia for the millionth time in hopes to be part of the 90% whose pain was eliminated with such surgeries. It should be a couple weeks of recovery and hopefully not a rough first few days. Deep breath, maybe I'll finally be able to horseback ride comfortably.

Trying a New Oral Contraceptive

The last birth control I was on was for the ovarian cysts. This time around we are trying a contraceptive called Seasonique which stops the cycle and would treat the symptoms and pain of endometriosis. Hopefully this will work better than the last one. My ultrasounds have all been clear and not found any evidence of cysts since the initial cyst and surgery. We just are at the last rope and thinking maybe some endometrio cells escaped from the surgery or maybe the Lyme has caused my womanly parts to form endometriosis from all the inflammation and cysts. Therefor I would have pain all the time like I do, and some cysts like I have had, and a contraceptive that stops the cycle for 3 months should help. Now its just a waiting game to see if it works.

Coccyx or Tail Bone Problems

Last year in January I was exempt from horseback riding due to tail bone pain that we called pilonidal cysts. The cysts and glands were all surgically cleaned out and removed and i dealt with additional hyper trophic scarring issues. Basically the skin scarred irregularly, probably from the Lyme, and was raised and painful, pulling at the tissue around it. I proceeded to seek Cranial Sacrael Therapy which massaged the tissues to soften them up, and keep a silicone 'scar away' scar patch, kind of like a band aid, on the scar which led to it ultimately softening up. By the end of summer I was still suffering from deep tail bone pain that was located at the tip of the tail bone, or the coccyx. I tried to work through it to horseback ride, but it wouldn't work. It was far too painful and I found myself consciously leaning to one side or the other when I would sit to avoid or reduce pain. I attempted to snowboard this past January, and after a few falls on the hard snow, right on my tail bone of course, I changed back to skis and gave up. After the snow boarding I had such bad pain from sitting or moving around that I returned to the surgeon. She said I could have broke or bruised the bone and sent me to an orthopedic specialist to get it looked at. We took ex rays and conclusive bone CAT scan which proved no visible break. He was not willing to do a Coccygectomy or surgery to remove the coccyx bone because he claimed it was unnecessary and would cause additional issues. I am still suffering with pain, which my Lyme Doctor claims is just Lyme Inflammation. So After my most recent Lyme Doctor Appt I picked up some Capsaicin .1% Arthritis cream made of menthol and chili peppers to try a new idea. basically i'm applying the cream twice a day to my tail bone area, and the extreme burning sensation is supposed to exhaust the nerves after a few days and reduce the pain. I have to apply it four times a day, suffer from severe burning, and wait for possible relief. It has proven to work before, but will it work for me? We will have to see. it's very uncomfortable, and painful, but not unbearable to return to horseback riding (if it works). I may be skeptical but it seems like a worthy idea, and I'm willing to try anything while i wait for my Appt. with a pain specialist.

Ovarian Cysts

Through the ski season I felt a strong rib pain that i thought was fr4om a tumble I took at a race practice the week before. It turned out this 'rib pain' that we thought was a fracture, then pleurisy, was actually a tennis ball sized (6 cm) ovarian cyst on my right ovary. It was large enough that it led me to the ER, thinking it was appendicitis, and then shocked an ultrasound technician when we discovered it was offsetting my uterus. In early February I went in for a laparoscopic cystectomy to remove the cyst. Everything seemed alright and the GYN said my ovary should be fine. In two weeks I was cleared to do whatever I wanted and had the stitches taken out, and I returned to school the following Monday. After taking it slow for awhile i was able to go skiing and my abs started feeling 100% again. I have three small incisions, one invisible one in my bellybutton, one on my lower left side along the pant line that might be the only visible one, and one in the center on the bikini line. The surgery may have been small, but was still a surgery, and threw my whole body off. I suffered with pain for a little while, and dealt with nausea and swelling at the site of the surgery. After the two week mark I tried to return to school once but couldn't make it and instead waited until the following Monday so I had the weekend to rest. I suffered with a lot of bleeding after the actual surgery, but it went away within a week and I was only left with cramps. A month later I had the worst period cramps ever, but they were followed with 7 days of heavy bleeding and then they cleared up after that. You may be asking why mine was removed when most people's burst or are reabsorbed. Mine had plagued me with symptoms for two months, was fairly large, and keeping me from school. Therefor we decided not to take the step of waiting to see if it would reabsorb. I thought I felt multiple cysts since then, and upon returning to the GYN we decided it could have been, but since she did an ultrasound and didn't see anything more, we would keep an eye on it. An option for me would be to go on birth control because it helps reabsorb cysts and reduce how many arrive. However, birth control and antibiotics both reduce each other's effectiveness and we decided instead of throwing my body off, we would treat the Lyme and put my on a diet. A few natural things we are now going to try to keep the cysts at bay- keep my weight in the lower range of my BMI, apply progesterone cream to my inner forearms mid-cycle to assist with hormone regulation, reduce caffeine, sugars, lactose, and increase exercise. We shall see overtime how this will work.

Recovering from Surgery

Hey everyone!
I got my stitches out Tuesday, exactly 4 days ago. I was told I was a tough cookie, had high pain tolerance, and healed nice and fast! I'm still healing of course, but the stitches being out is better. The only thing is she warned me that usually she only takes a few out, and I need to be careful not to over-do it the next week so that I don't rip it back open :-0 so I'm sincerely taking it easy.its hard though when I've spent so much time inside! Wednesday I was not going to go to youth group, but the thing was, it was my 15th day not getting out (other than the doc.s) and I needed to relieve some of my cabin fever...... I miss the horses and riding, and skiing, and being outside in the fresh air and sun! I went to youth group and had a warm welcome! It was awesome! Thursday I was going to go to Concord, NH because a bill was being proposed to protect NH MD's from treating Lyme Disease. I wanted to go so bad but snow kept my ride home and therefore I was stranded with no ride and watching it on the news, seeing all the familiar faces of my NH lyme buddies on New England News! I was sure upset.... But god kept me home for a reason, because I'm glad i didn't over-do it! Friday I stayed home, and hung out. i watched Castaway, what a sad but interesting movie. I made up my own ending to it, so the real ending didn't appear as sad and depressing, but I won't spoil it for anyone... hehe.... Now today is Saturday and I'm missing my mini horse Miracle and wanting to see her so bad, so I'm going to try to convince my mom to take me down to see her for a little while. I'll have to take it very easy though.... But oh, it will feel so wonderful to get out and underneath the blue sky, and feel the cool weather touch me cheeks! Just breathing in the sunshine and fresh air will be a relief! Not including the smell of the barn, and touc of the horses! It's true, horses have healing elements! :-D

Pilonidal Cyst

Hey everyone, again...... Well Wednesday the 13th I went in for surgery. For months I have had issues with a Pilonidal Cyst. Basically, the Pilonidal glands are right above and along the tailbone. Some people have issues with these glands as they get older and grow, and the glands may become blocked and create a cyst. The cyst and glands are very painful if this happens, so with my horseback riding and different activities the only result was to remove the problem so that it won't reoccur later on. They went in, with about a 3 inch incision, and scraped out the cyst and glands. This has left me with a very painful cut, with 8 stitches, to tend to as it heals over the course of a month. Its the 6th day after the surgery right now. The 1st day afterward I got really sick from the pain med.s! The 2nd day was a little better but sore, I was finally allowed to shower and run some hot water over it. The 3rd day was yet again a little better and I was on my side the entire day. The 4th day was yet again a little better, but that night I was up throwing up pain medications. The 5th day I was tired but able to sit upright on a soft pillow, and today I am much better. I've been up walking around and sitting on a pillow all day, so its been a good and fast recovery so far! The stitches look good and are only sore. I will be able to move some more in a week or two. The surgery went well, and they did not find any infection or anything. I am on 3 antibiotics for the Lyme Disease, so the possibility of getting an infection there now is extremely slim, I should heal nice and steady!