LA RSI Support Group

A Post From SOREHAND,
reprinted with the permission of the author

 


"Pam's Story" is reprinted here in its entirety. Pam Morency's injury occurred while doing data entry at a medical billing service.

Pam Morency
pbjent@aol.com

I also have ulnar neuropathy in my dominant right arm and hand. I was diagnosed with this after EMG testing in 1988. This injury was from repetitive computer use at my data entry job. My workstation was not adjustable and I had no forearm support. My first symptoms were tingling and numbness in my little and ring fingers and pain in my arm, especially at night. I'm sorry to say I continued keying on the computer for a couple months after my first symptoms while I waited for an appointment with a nerve specialist. The pain got worse in this time. My first EMG showed the ulnar nerve being compressed around the elbow. A custom splint was made for my arm to keep it from bending and I was ordered to stop doing data entry work.
    In 1989 I had ulnar nerve release surgery. On a follow-up appointment with the orthopedic surgeon, I could not bend my arm up more than half way. Intensive physical therapy was ordered to loosen the nerve because scar tissue from the surgery had entrapped the nerve. The pain of tearing the nerve from the adhering scar tissue was indescribable but I was told if I did not do the exercises then I would not regain the movement of my arm. That was enough incentive. Several months after my surgery, I continued to have the same tingling, numbness and pain as before the surgery. Another EMG was done and confirmed my suspicion; the nerve was still being pinched and no improvement was evident. Another surgery to transpose the ulnar nerve was recommended.
    I was wary of having another surgery. I sought two other physicians' opinions and all agreed that without the second surgery the nerve almost certainly would not improve. After waiting another year (with no improvement) I met with a neurosurgeon in a large city; a 2 1/2 hour drive from our home. He also recommended the second surgery. A few months later, I finally consented and the surgery was scheduled. The nerve was relocated to the inside of my arm to remove it from the area of compression. I was in the hospital for several days. My husband stayed nearby and was my only visitor because of the long distance from home. I had a five year old daughter staying with relatives and I missed her immensely. I was also in a lot of pain and called home in tears. It was a difficult time. I was very happy to get the okay to go home. An appointment was scheduled to have the stitches removed.
    After being home a few days I noticed my index and middle fingers felt strange. They just didn't seem to have any strength, and when I put any pressure on them they would bend involuntarily. This concerned me as those fingers had not been affected before. I talked to the neurosurgeon about this at my next appointment. I still remember his words, "that's normal." The following weeks brought a new intensity in pain. My hand had lost more strength and the area above my elbow was swollen and extremely sensitive. If even slightly touched, the sensation was that of hitting your "funny bone", (which is actually the ulnar nerve.) On my last visit to the surgeon I voiced all these concerns and he seemed at a loss for words.
    Back home I made an appointment with my rehabilitation specialist who had performed the two previous EMGs. Another EMG was done. I will never forget that day. He examined my arm and hand and seemed concerned. He performed the nerve conduction test and gave me the bad news. The second surgery was unsuccessful, and in fact my nerve was severely damaged-- a 95% loss. I was in shock as he held up both hands to compare. My right hand had hollow areas where the muscles had atrophied. I was devastated. I was told nerve regeneration is very slow and with the degree of damage I had I could not expect improvement.
    Over five years have passed since my last surgery. The pain I live with every day now is far worse than the pain I had before either surgery. I get waves of pain so intense in my little finger and ring finger it takes my breath away. It often feels like there is a fire in my arm. The considerable loss of strength never improved. I have burned my little finger twice because I've lost feeling in it. Obviously, I have not been able to return to computer or office work.
    I, like many employees, did not want to complain. When I finally had to fill out a work-related injury form, my employer was displeased. I fear their action was all too typical. When it was obvious my injury couldn't be fixed in a few days with a bandage, they made little effort to help me. I missed my co-workers and the socialization. After the second surgery they stated that there was no work available for me with my limitations and I was done. This was hard on my self-esteem.
    There is a silver lining to my story. After my injury, my husband designed a forearm support that greatly reduces the risk of cumulative trauma disorders from repetitive computer use. He is now an ergonomic specialist; his job is to help people work more comfortably to reduce the risk of injury and illness. I remember him working on his "idea" in our basement after my second surgery. It was difficult for him to accept that he couldn't do anything to change the outcome of my work-related injury. He poured his frustration into educating other computer users on the importance of forearm support. Surface EMGs validate that there is a reduction in muscle activity using a forearm support while typing. We now both feel very strongly that people need to work at comfortable workstations. Discomfort is usually an indicator of a larger problem. If someone is experiencing pain and numbness in their hands I would suggest they not delay in getting medical attention.
    My biggest regret is that I continued to key thousands of strokes a day even with my symptoms. The "only ifs" haunt me. I have to accept that my arm and hand will not get better and I must live in pain. I sincerely hope your decision will lead to a positive outcome for you.

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