I love my orthopedic doctor even if he is small enough that I could bench press him if I was into that sort of thing. And even if he often sounds like a wind-up doll where you pull a string and out comes a canned speech. In his case his canned speeches are explaining in great detail, what he’s seeing on your x-rays, what he thinks is going on that’s causing your pain and additional steps needed to gather more information before a conclusive diagnosis can be made. When I pulled the string for the last time today at my long awaited appointment and I got the speech where he walked me through the various approaches he and I can take to getting rid of the worst of the problems going on in my arm---needles-and-pins several inches above and below my elbow when I type and the feeling of dead weight at other times.
He quickly ruled out the failed elbow surgery I had back in
1999 that was x-rayed again in 2019 where it was discovered that I’ve got a loose
screw off in La-La-Land in my lower arm and another screw that had backed out but is
still attached to one of the two bones it originally held together. In my mind
I thought that loose screw had migrated and was pressing on a nerve and it was
time to get the last resort elbow replacement we talked about back in 2019. After a few touchy-feely tests he didn't even feel the need to x-ray it to know my theory was wrong. Nope, I just have to keep doing what I've been doing for the past 15 months which is not lifting
anything above my waist and always keep elbow tucked into my waist when I do
pick anything up because the tactic has done a good job of keeping the shooting pains I get when I
do forget at bay.
He did take lots of x-rays, though, of my back, neck and upper arm but before taking them Dr. Bones asked me to do a series of things that he said are going to sound silly but would give him some diagnostic information. He really does like to over explain himself which I like because you never have to ask questions or get home feeling like you should have asked such-and-such. He had me hold the backs of my wrists together at shoulder height for two minutes to see if it cause the needles-and-pins. It didn’t. Then he had me stand with my head and shoulders back and, sure enough, the needles-and-pins replicated within seconds but it wasn’t until after he looked at the x-rays that he explained that if the needles-and-pins was coming from a carpal tunnel issue I wouldn’t have been able to do the wrist-to-wrist test. Evidently, carpal tunnel pain can go well up past your elbow.
The head and shoulders test, he said, is backed up with an
x-ray showing I have an issue with cervical vertebra C-6 in my neck. He also told me
that having the needle-and-pins happening only on the inside of my arm is
another indication of a C-6 involvement and it rules out some other causes that stem from more general health issues---heart, diabetes and something else I've forgotten. Still, he’s sending me to see a hand specialist
to get tested for carpal tunnel just to make sure it’s not contributing to the maze
of stuff going on in my arm. Given how much I type a mild case could be likely.
Once that test is done, he’s having me back in the office to map out a course
of treatment. In the meantime, he’s putting me on a six day round of
prednisone. I love that drug! Every time he’s given it to me in the past all my
joints magically feel great and I feel like a 30 years younger version of
myself. The prednisone probably won’t do anything to address the
needles-and-pins, he says, but either way it's giving him more information to work with. Prednisone is in the corticosteroid class of drugs and according to Google, "It prevents the release of substances in the body that cause inflammation." But doctors don't like you to be on it long term---trust me, I've asked---because it can also suppresses your immune system.
Also going on in my arm was pain and clicking in the
shoulder joint. He had shot some gel-like stuff in that joint five years ago
and he did a labrum tear surgery in the area six years ago. Thankfully, all the
range of motion tests he had me do today indicated the labrum tear repair is still
holding up. I was happy about that. My great-niece-in law had to have hers done
over already and we had our surgeries done on the same day. As for the
bone-on-bone in the shoulder joint that is causing the clicking and pain in my upper arm, the x-rays shows it’s not a large area and
he thinks another round the gel stuff will work well again, which I got
today. Instant relief and I'll be able to sleep on that side again!
Back to how the cervical vertebra C-6 problem is treated. There
are surgical and non-surgical approaches and my bone doctor always starts off
with the lowest possible treatment to get the job done and he works his way through
them until we find out what works. The first car on that treatment train is
medications ending with surgery as the caboose. The other treatment cars in
between the engine and the caboose are things like neck braces, injections and
physical therapy. And he didn’t say it but I can see a new computer chair in my future. My posture while using my current chair is terrible. Whatever I have to do to get rid of the needles-and-pins I'll do because I can't stand typing like this. It's frustrating!
There are several different surgeries, including an implant fusion, that could be done on my neck but other than touch on the topic Dr. Bones is saving that canned speech for down the road, if needed. My next appointment is early in October which means this whole thing is going to take some time to work through. But let me tell you, I feel like dark cobwebs have been cleaned out of my head. I was so sure I would end up with the elbow replacement with its painful turn-buckle cast and long therapies afterward in the middle of my moving project. Knowing that’s not on the table will go a long way in getting my mojo back. I was/still am seriously getting concerned about the level of depression I’ve been nursing lately. It's not like me to be stuck on the dark side for such a long stretch. ©