Wednesday 8 September 2010

What do you want?

One thing I neglected in yesterday's post was a question the doctor asked me which I struggled to answer. The question was "What do you want to get out of this?"
I found it hard to answer beyond a nebulous "for my hand to work better". After some fumbling, I expanded to "for my fingers not to be so clawed". On further contemplation (I've spent a lot of time travelling over the past day), I thought of another question the second doctor asked: "Do you have trouble dressing?" Considering the two together, I realised that my trouble answering the first question lay in that I was considering what changes I wanted to my hand, rather than the changes I wanted to the functions I can perform with it.
So, with this in mind, here's my current list of things I'd like to be able to do well/better/again (in decreasing order of importance):
  • Pull things out of my pocket
  • Button a shirt (including the top button)
  • Open a door
  • Touch Type
  • Shake hands
  • Carry a coffee/mug
  • Tie shoe laces
  • Carry 3 schooners
  • Hold a pen

Tuesday 7 September 2010

Hope

"Where there is life, there is hope."

Today, not for the first time, I had a doctor use that fateful term in reference to me: "Interesting". It would appear that the particular combination of weaknesses and (comparative) strengths in my right arm presents some food for thought for those medical professionals who specialise in the hand.
The first doctor I met today, just after greeting me and welcoming me into his office, said "Your handshake tells me a lot of the story". After nearly an hour of describing my history and issues, then moving my arm, wrist, hand, fingers and thumbs in every conceivable direction I then went to see a second doctor to repeat the process.
The prognosis? Well, they confirmed that my wrist flexors aren't working and the extensors are over active. This is causing issues for the rest of the tendons in my hand and wrist. So what can be done about it? Well, for starters I go back to my OT for a sensitivity study (the sense of touch in my hands, not my emotions) and to try a different style of splint/brace to help me with the clawing in my fingers. Then, in a couple of months I go back to see the hand specialist - given the variability I've had with strength in my triceps, he'd like to confer with colleagues to give the nerves time to "settle down".
When I go back we'll discuss some of the different treatment options, each of which have different risk/reward profiles. These options range from fusion (I didn't like the sound of that) to hooking my brachial muscle up to a different tendon - it would appear that whilst my brachial muscle is working, but isn't actually connected to anything functional and is therefore quite useless.
As my case is "interesting", he also discussed bringing me in to a meeting of specialists, where I'd be the subject of a round table discussion. I think it'd be a pretty interesting experience to be a live case study in that sort of scenario.

It was a good experience in that while I visited a surgeon, he wasn't in a rush to cut me open, and was quite concerned the result wouldn't be positive if he did - there are pretty much two type sof muscles in my arm: dead and weak, and surgery runs the risk of making the weak ones weaker. Having said that, for the first time in a while there are multiple potential treatments, some of which may make things better rather simply preventing them from getting worse. This inspires some hope in me.