Well, FINALLY, my health insurance has approved my MRI Arthrogram for my wrist malady.  This approval is only good until April 6th, apparently.  Gotta get in and get out!  I was so happy when the nurse from the doc’s office called to tell me.  I had actually called them this very morning and they told me things weren’t finalized yet, however my blood work came back and I do not have rheumatoid arthritis.  I coulda told them that.  LOL

Anyway, the sucky thing is, the nurse faxed my referral over to the imaging place, however, there’s apparently no mention of which compartments in the wrist the doctor wants the dye to be injected into.  I guess there’s different compartments in there and depending on where you have pain, that’s where they inject the contrast dye and if it leaks out, you have a tear in that ligament.  So, because the imaging place has no “orders” on what they’re specifically going to do, they had to call the doc and verify things, which means I have to call back tomorrow to make my actual appointment.  PITA, I tell ya.

I don’t see how this MRI arthrogram *wouldn’t* show anything going on in there.  It’s not any better, and in fact, seems to be getting worse.  It’s not sharp pain, but more diffuse pain, however, it’s more constant now, and sometimes goes up into my arm and elbow.  And my hand gets SO TIRED.  Things are just wrong in there.  My DRUJ clunks together (where my ulna meets my radius) and my hamate bone pokes further into my palm than my other one, and my lunate feels twice as big as it is whenever I bend my wrist forward and back. (Probably from the puffy swelling going on in there.)  Here’s a pic of where the bones are if you want to know which bones I’m talking about.  No, this isn’t my wrist:

My hand still feels like I’m typing under water.  The weird boneless feeling I had when I got out of the cast has mostly gone away so I guess that was the reason.  But I can just feel the weakness in there.  It’s weird.  But the pain is definitely getting worse.  So here’s hoping this MRI tells all.

~~Becka

I saw the hand surgeon today.  He spent a good, long time with me, answering questions and manipulating my wrists in different ways.  He did say my left wrist felt different than my right, and noted my puffiness in the joint.  However, he’s not convinced I have a TFCC tear.

I was right when I said I think I have a negative ulnar variance, however, he says he believes it happened when I broke my wrist as a child and the bone didn’t grow correctly.  Because the ulna is shorter, it’s less likely the TFCC will tear, as a positive variance, when the ulna is longer than the radius, can poke through the thin membrane of the ligament.  However, he didn’t rule it out completely, because it’s altogether possible I tore my TFCC YEARS ago, and it has since degenerated, or has torn again due to my mysterious trauma in December of pushing myself up off the couch.

He wasn’t convinced any of my other ligaments holding the wrist bones together were torn either, as I didn’t yell and scream in pain while he was manipulating the joint.  It was uncomfortable, and I told him there was a dull ache, but nothing sharp and breath-taking.

He still wants the MRI, though, as that will definitively prove or rule out any ligament tears.  They will shoot my wrist up with contrast dye in a few key compartments and if the dye leaks out of these compartments, then a tear is present.  Of course, as with all health care red tape, I need to have the MRI approved by my insurance before I can get it done.

In the meantime, because my mother has Rheumatoid Arthritis, he ordered a blood test to rule that out as well.  Normally, RA manifests over time, but there are cases where a sudden onset of symptoms can flare up with no warning.  And due to the fact my wrist is a bit swollen with fluid, he wants to rule that out as well.  I was able to get my blood drawn before I left the hospital, so that was good.  Still won’t have the results for that for a few days.

Hopefully my insurance won’t deny my MRI.  How much would that suck?!

But even the ladies in the lab drawing my blood were singing my doctor’s praises, along with my physical therapist.  The guy was very nice, he listened to my questions and wasn’t in a rush.  I really like him.  And he’s moving his office closer to Hillsboro; bonus! 

At this point, though, I’m rooting for a ligament tear over the arthritis.  If it’s something that can be fixed with a suture as opposed to, “Sorry lady, you’re f**ked.”, then I’m all for it!

In the meantime, I’ve gotta hurry up and wait.  Again.

Wrist Saga, Chapter Eleventy.

~~Becka

In going online, I’ve noticed there really aren’t any external pictures of wrists with a TFCC tear.  So, since mine is visibly different from my healthy wrist, I thought I would post pictures of them here for a comparison.  First, here is a pic of my healthy right wrist with my hand flexed back.

Everyone has that “fat pad” on the underside of their arm that runs in the middle of the wrist.  You can see it in the picture as the bump under my veins.

Now, take a look at my ouchy left wrist:

Same hand flexion, about as 90 degrees as I can get it.  You’ll notice my “fat pad” in the middle of my wrist is bumpy.  Also, the dark spot next to it is a depression that shouldn’t be there.  Eww, I know.  But if I’m going to document this saga, gotta take pics of the nasty, right?

Also, the interesting part is, I’m now showing classic signs of Carpal Tunnel Syndrome.  I’ve NEVER had this before and do not have it in the other hand.  Tapping on the middle of my wrist shoots pins and needles into my fingers, as well as tapping on the radial side of my wrist shoots pins/needles into my thumb.  My physical therapist said it’s likely the inflammation is putting compression on my nerves.  Interesting, since my nerve test in January was normal.  Getting worse before it gets better?  Hmm…

Anyone else with a TFCC tear see a visible difference in their wrists?  Before you had surgery?

~~Becka

In the writing world, I decided to send my full western novel, RENEGADE, to Carina Press.  What can I say, they called for historical manuscripts on their blog, and one of their editors wanted to find that one author who could “single-handedly bring back the western”.  Naturally, I had to submit. 

Since I’m obsessed with reading and writing westerns these days, I figured it would be stupid of me to ignore that call.  Being one of the premier western authors for Carina would kick ass.  Of course, if they don’t like the book, I’ll send it to Samhain.  I’m thinking even if they reject it, Samhain is an excellent publisher I would be proud to publish this book.

I still haven’t heard back on either of my submissions.  I’m still waiting for word on THE FALL OF JERICHO from Carina and RIDE THE LIGHTNING from Samhain.

On a personal note, I’m feeling a bit down in the tooth lately.  My wrist problems are really worrying me, mostly because this stupid injury keeps getting worse it seems.  I feel like I can’t see that darned hand surgeon soon enough.  What really pisses me off is the fact I didn’t do anything to facilitate it.  I didn’t fall, wasn’t playing sports, didn’t torque anything heavy.  I’m beginning to think I actually tore my TFCC 22 years ago when I broke my wrist as a kid, and all these years later, some random “straw” broke the camel’s proverbial “back”.  For the life of me, I can’t remember my pain levels in the days after I got my cast off as a kid.  I DO remember the hellish pain of tweaking my wrist so they could take the necessary x-rays.  I remember the pain of having to stretch my thumb so it sat a special way in the cast.  I remember the bastard doctor forcing my wrist to bend 90 degrees up and down mere minutes after my cast came off.

I’m freaking out a bit, because I know I’ll need some kind of surgery to solve this problem.  Regardless if I need something minor or major, the fact remains something needs to be done.  I can’t just live like this.  Not with the evolving pain.

Good news is, my elbow is much better, and just feels like a pulled muscle in my upper and lower arm now.  I can fully extend it without a problem.  Wrist though, is still stiff and sore.  Probably because I’m still mostly wearing the brace.  I take it off many times a day to flex a bit, just to get my range of motion back somewhat, but I can’t be without it for long.

What does this mean for my writing?

Good question.  Well, I obviously cannot write for long stretches like I used to.  I can write in short bursts.  Maybe I’ll concentrate on some short stories.  Or perhaps I’ll just take a tad longer to write a full one.  I do know I can edit, add, delete stuff to existing stories without a problem.

Maybe Someone Upstairs knew this injury was coming and that’s why I was inspired to write eight stories last year.

This sucks.  If I can get well within a few months, I’ve still got the rest of the year, right?  RIGHT?!?

SIGH.

~~Becka

As you may or may not know, I’ve decided to get a second opinion from a well-known hand surgeon who works out of St. Vincent’s here in Portland.  I had to borrow my x-rays from Doc #1 so I can bring them to the appt. with Doc #2.  My appointment is two weeks from today, Feb. 25th, unless someone cancels (then I can get in early).  Needless to say, I’ve been poring over my x-rays, trying to self-diagnose.  LOL  I don’t know what it is, but looking at these x-rays is fascinating to me.

LOL at my wedding ring – the kids found that highly amusing.    Please forgive the poor quality of this pic, I had to hold up the x-ray to the light while holding my iPhone and trying to get a pic that wasn’t blurry as heck.

Anyhow, if you look, you’ll see all the little wrist bones (seem to be) fine.  The large bone in the arm is the radius, and the smaller one is the ulna.  My ulna appears to be somewhat lower than it should be.  If you look at normal x-rays, the ulna bone lines up with the radius.

After doing some research on other x-rays and people with the same kind of malady, it would seem instability in the TFCC can lead to subluxation of the ulnar head (or partial dislocation).  Let me tell you, this feels so unimaginably WEIRD.

I’m typing with two hands right now, but my left hand doesn’t always do what I want it to.  My wrist feels like a limp noodle when it’s not in the splint.  It’s still tender from getting out of the cast a few days ago, but that doesn’t have anything to do with my instability.  The immobilization of the cast just makes for a stiff, sore joint, not an unstable one.

Hence the second opinion I’m getting.

And my pain is evolving.  I’ve always said it’s been evolving, but it’s just odd.  I’m wondering if it’s possible for a TFCC tear to get worse once it’s torn?  At the beginning of December, when this saga began, I had soreness, like a sprain.  It wasn’t in any one place, it just hurt.  Then, I began getting specific pain on the ulnar side of my wrist, that would hurt whenever I would twist my wrist or hold something heavy.  When it was getting worse and wasn’t going away, that’s when I went to Doc #1, and the clicking began.

I felt unstable in January when I got my cast on.  While in the cast, my wrist felt swollen, and still feels full, not of blood, but it’s a little puffy.  Now, I have a sometimes sharp pain in the center of my wrist, on the bottom, like beneath the carpal tunnel.  And sometimes this ache spreads to the bottom half of my palm.

The only time my wrist feels “normal” is when I’m in the splint.

It’s just been so odd to have this malady get worse.  Could it be the TFCC tear caused the ulna to deviate, which is stretching the ligaments even more to tear further?  Or perhaps in a new place?  I don’t know.  Obviously, I’m not a doctor.  But this not knowing is killing my inner child!

Let’s hope Doc #2’s office calls me to offer me an appointment sooner than two weeks.  In the grand scheme of things, two weeks is not a long time.  But when it’s tacked on to an already long 3 months of WTFery (I’m counting December as the first month), it’s just that much longer I gotta wait.  Because if I do need a procedure, I’ll probably need to be scheduled a few weeks from Doc #2’s appt.–even more waiting.  I’d like to speed the process up a bit.  Heh.  Is that even possible?

~~Becka

Yay, here I am for the first time in a long time, typing two-handed.  Got my cast off today, and was fortunate enough to have my first physical therapy today as well.  After taking a history from me, the therapist decided on a mild therapy, putting my arm in a machine with some sand blowing around in a dry heat, which felt omg SO GOOD!!!  After a few minutes, I could move my wrist a bit more, even though it’s still very stiff and sore.

And my elbow.  Wow.  It’s so happy to be un-bent, however, the pain is intense.  Not so much in the elbow itself, but in the muscles that pull taut when straightening things out.

Anyway, after the sand/heat machine, the therapist put this bandage on me that has a battery that time-releases a short bit of medicine into the skin for about two hours.  It’s like a mild shot of cortizone.  So I’ve got to do this therapy twice a week for four weeks.

The doc said, “It’s going to get worse before it gets better” due to moving the wrist after weeks of immobilization.  He said even if it hurts, he doesn’t want to see me again until the four weeks of therapy are up.  If this hasn’t worked, (ie., my pain hasn’t lessened) then he will send me to the guy who mentored him a few years ago, who practices at OHSU.

He also prescribed for me prescription strength Naproxen (sp?) to be taken twice a day.

However, I heard news of another hand surgeon who works out of St. Vincent’s, an apparently “brilliant” man and a nice guy to boot.  He’s got so many patients that he’s taking appointments six weeks (or more) into the future, but the good news is, I will be done with my physical therapy by then and I can be able to get a second opinion.  Even the therapist was a little shocked that I hadn’t gotten an MRI to see how big/where the tear was.

I wasn’t able to call the hand surgeon today as it was too late in the day when I got back from the therapist, but I will call him tomorrow to make an appointment.  If anything, he’s closer to me than OHSU.

So the doc did give me a brace to wear, which feels pretty good.  Still owwy, but that’s to be expected.  At this point, they want to see if my ouchy-ness is still due to my TFCC tear or due to the fact I’ve been immobile for 4 weeks.  Probably a mixture of both, I’m thinking.  If the therapy works for me, then I’ll just cancel the appointment with this other doctor.  At the moment, everything is still up in the air.

But the most amazing news ever is the fact I’m no longer in the cast, I no longer have to take trash bag showers, and my elbow is no longer bent.  Even so, I still hold it at an angle because it hurts to fully extend it. 

So, it appears to be another waiting game.  But the fact the therapy feels so good coupled with the doctor I can get a second opinion with and the fact I’m no longer wearing my cast, today has been a good day.  And DH took the day off (or rather worked from home) so I didn’t have to tote around my legion of kidlets.  He loves me.  <3

~~Becka

Trying so hard not to whine about this dang cast.  For the most part, I’ve achieved that goal, letting the occasional whine out on Twitter or Facebook.  (My website is where I “update” you about my condition, not whine.  Never whine. LOL)

But let’s face it, folks.  I’m so done with this damn thing.  Sleeping has become a chore; I’m not sure if it’s due to being uncomfortable, or being irritated that only a few positions are “comfortable”, although “comfort” and “cast” are oxymorons.  I have “good” days and “bad” days (and days I “overuse” the “quotes”), but mostly bad days.  I’ve had to up my pills (Ibuprofen and Tylenol), and I take them more often these days.

I can feel a tightness in my wrist when I flex my fingers.  Almost like things are swollen.  Feels like there’s something IN there.  Sometimes, I can still feel the instability when just pressing my fingers together, like when you snap or do the okay sign.  Things aren’t right in there.  But this stupid treatment must finish before we can move on, and therefore I have five more days in this prison sentence.  That’s what it feels like to me at times.  (Okay, so I do whine on my website.)

But you see, this conservative treatment “needs” to be done first.  Even though every other story I read online is about the surgery.  Why aren’t there any other stories of casting before surgery out there if this is the normal treatment?  I don’t know.  I’m getting jaded.  I’m getting pissy.

Makes me wonder, though, if there’s more red tape after I get my cast off?  Do I have to go through X amount of physical therapy before they’ll decide something more needs to be done?  Depending on what my doc says on the 9th, I might look for a dang hand surgeon myself and get a second opinion.

Things.  Aren’t.  Right.  It’s not getting better.  And I’m pissed because this is wasting time!  But if I call my doc, they’ll just tell me to come in on Tuesday.  At this point, I might as well go the distance.  I’m a wuss when it comes to confrontation, but if my doc tells me X amount of weeks need to pass with PT before anything more can be done, I’ll ask him about that hand surgeon he knows.

Not that I’m against PT, or that I’m jonesin’ for the surgery, but lets be honest and call a spade a spade.  I know when my body’s got issues.  And right about now, I’m hoping my wrist IS swollen when they take off this cast if only to prove I’m not a whiny little bitch.  Doc.

LOL

Okay, so maybe I am, but I got REASONS!!

~~Becka

Since I don’t have any book/writing updates, I’m blogging again on my wrist.  Today marks the halfway point of my conservative treatment.  Two weeks down, two more to go.  Aside from accidentally popping my DH in the face in the middle of the night (which I have no knowledge of lol), I’ve been adapting fairly well.  It was hard at first to get used to doing everything one-handed, but it’s a little easier now.  I’m sure by the time I’m ready to get my cast off, I’ll be a natural at one-handedness.

Bad news is, my wrist doesn’t feel any better, even in the much more comfortable cast.  Sometimes, it will be good to me all day, only to randomly start hurting in the evening, despite the fact I haven’t done anything to facilitate the pain.  Other days are just bad days where it seems I’m popping pills all day.

I’m a little concerned, because the Ibuprofen says not to take longer than 10 days, unless instructed by a doctor.  I guess this counts as “being instructed by the doctor”, but it still worries me.  I doubt my pain will magically go away when this cast comes off and in fact, there’s no doubt in my mind I’ll need to wear a splint, since the doc mentioned physical therapy.  I highly doubt he’ll take off my cast and send me on my way.

But who knows, their office didn’t even give me a sling for this cast-beast, after all.

I’m skeptical this treatment is going to work for me.  If it would, you’d think I’d be feeling better.  I don’t know, maybe it’s the fact I haven’t been able to bend my wrist and its aching because of that.  I mean, I’m not a doctor.  But I don’t think so.  Had a handful of meds for breakfast this morning and I’m feeling somewhat better.

I don’t care if I have to wear a splint after this cast, I just want the cast off!  The bent elbow and trash bag showers have lost their mystique.  LOL  Only light at the end of this tunnel is knowing I now only have two weeks left rather than four.

~~Becka

Over the past few days, I’ve noticed my cast was really loose.  It caused me a LOT of pain because I could move my hand in there.  My hubby told me to call the doc, because I might need a new cast and its better than going the four weeks and doing it wrong.

So I call and the receptionist tells me if the cast is loose, I need to come in.  So I go, and the nurse wants to ask the doc’s opinion.  She leaves me for a bit, then comes back to take the cast off, because I’m going to get a new one anyway.  She wanted to ask the doc about splinting instead, so I could have it be tighter.

I’m in the middle of washing my arm – feels so good! – when he comes in.  He seems annoyed my cast was off.  Then he goes into explaining how they don’t have a full arm splint and why I needed the cast with my arm bent, to prevent looking at my palm, and to prevent the side-to side motion of the wrist.  I told him I understood that, but that there was a lot of play in my cast, which hurt when unscrewing the lid to the milk jug, etc.

I was shocked at his look of shock.

Doc: “You’re not supposed to do that!”

Me: “Well, I didn’t pick up the jug, I was just taking off the lid.”

Doc: “Doesn’t matter, ANY action of the wrist, even small ones, won’t allow it to heal, and I can’t send you to the hand surgeon until we’ve proved this treatment didn’t work.”

(Basically, even if he thinks this won’t work, he’s gotta do it first.)

Me: “I have no problem wearing the cast, it’s just that it was so loose that it allowed for the side-to-side motion.”

Doc: (somewhat mollified) “Okay, then I’ll see you back in a few weeks.”

But now I’m kind of mad because no one told me I couldn’t do ANYTHING with this wrist.  The lady who put on my first cast even told me she’d give my fingers some room to grab things…  True, she’s not the doctor, but it would have been nice if someone (re: the doc) outlined what was expected in the first place.  All he told me was it would be hard, I’d need people to help out, and I’d have lots of physical therapy after.

SIGH

So, doc leaves, and the nurse puts on cast #2, and all the while I’m thinking the doc just chewed me out (dramatics added for effect) for doing the right thing by coming in and changing my cast.  Even the nurse said sometimes the arm shrinks in there, swelling goes down, etc., causing the cast to get loose.  I just feel like the doc thinks I’m whiny.  The splint wasn’t even my idea and he marches in there as if to tell me I will wear this cast, by gawd… (again, dramatics added).  And I was a little miffed that he couldn’t see the evidence of my loose cast for himself because the lady had already taken it off.  It was like he thought I was being whiny and there probably hadn’t been anything wrong with it.

I understand his decree of total rest, I do.  But if I’d been TOLD THAT in the first place, I might not have had so many issues.

Still would have needed a new cast, though.

I decided to go purple with the new one.  But I’ve still got glitter!  It’s much skinnier than my first one and it feels SO MUCH BETTER!  Oh my gosh, night and day difference.  Can’t move anything around in there.

Doc’s probably off some place shaking his head that his patients are dumbasses.  LOL  Or maybe he woke up on the wrong side of the bed.  He *was* wearing a full suit, whereas the other times I’ve seen him, he was business casual.  Maybe he was stressed about something.  Maybe I just blew it all out of proportion.  But I’ve got news for ya, doc.  NO ONE wants this wrist healed more than I do.

And that’s a fact.

I did notice that while my elbow was somewhat tender, I could bend it all right once I was out of the first cast.  But my wrist – forget about it.  It hurt to just hold it while the nurse prepared the new casting material.  My ulnar side was much more swollen that it had ever been.  This does NOT bode well for getting the cast off in 3 weeks…

My daughter said, “Wow, Mommy, your arm looks much skinnier in that cast!”  I said, “I wish the rest of me looked skinnier.”  One of the nurses going to lunch in the parking lot snickered as she overheard me.  LOL

Anyways, here’s to doing/holding/carrying/twisting/lifting absolutely nothing until February 9th.  For all intents and purposes, I’m one-handed.  And yes, I’m typing one-handed right now.  Yes, it IS a giant PITA.

Pic of purple cast:

~~Becka

Since there’s not a lot of posts/blogs/forums/stories online about casting treatment for a TFCC tear (read: there aren’t any), I decided to document my experiences here.  Besides, I’m sure some of my readers are curious as well.  All the posts will be categorized with the tag “TFCC Tear Treatment” if you want to find the entire saga easily.

You see, all the info online that I can find, even the stories of others with this malady, have had the surgery or scheduled one.  I haven’t found anyone in a cast for non-surgical treatment, but as I understand, that’s the default treatment.  If the TFCC cannot heal itself, then you get the surgery.  But I haven’t found anyone who’s healed with casting alone.

So we’ll see if this works.  If anyone reading has found my site and healed with casting and physical therapy let me know!  I’d love to hear your story.

Okay, so not quite one week in my full-arm cast and I can safely say this is a pain.  Showering is an adventure with trash bags and duct tape, and yes, I have fashioned for myself a wire hanger itch-scratcher.  I’ve bent the wire in half so it looks like an elbow, I’m not ripping up the padding in my cast, don’t worry about that.

My doc’s office didn’t give me a sling so after a few days of intense pain at holding it up, (I was crying, making my kids cry in the process) I went out and bought one myself–The Ultimate Arm Sling, if you must know.  Aside from that, the Aleve wasn’t doing anything for me.  since it seems as if my doc’s office is determined to torture it’s patients, they said to try Ibuprofen with some scattered Tylenol and some Vit-C, as Vit-C has been shown to help speed healing (I guess).

The sling has helped A LOT, but the cast is so heavy, it hurts my neck to wear it all the time.  When I’m sitting I prop it on a pillow and when I’m doing chores, I’ll wear it.

The Ibuprofen and Tylenol seem to have helped better with pain management than the Aleve.  Of course the sling is also a big help.  When you’re holding up the cast with just your arm muscles, it would seem you are also engaging the ligaments in your wrist, as mine was on fire after just a couple of errands.  So be wary of that if you have this injury with a big heavy cast.  The point of the huge full-arm cast with the bent elbow is to prevent supination of the wrist, or twisting your arm to look at your palm.  But it’s so hot and uncomfortable!

I get this cast off on February 9th, and after that is PT, so we’ll see what happens afterward.  I’m wondering if the casting is nothing more than a “smoke screen” for health insurances to cover the surgery, to prove they did “conservative” treatment first.  I seriously have not found any stories of anyone in a cast for a TFCC tear.  Everyone with a story online talks about surgery.

Here’s hoping this works for me.  I have no idea how big my tear is, but I’ve got to wonder if it got bigger over time, as my pain before I went to the doc was getting worse, not better…  My fingers and strength in my left hand are so weak now.  I don’t know if that’s because the cast is preventing the wrist to compensate for their weakness or what, but just taking the lid off the gallon of milk is a chore.  I can’t hold on to anything to chop for dinner, either.  Not just because its awkward, but because there’s no strength.  And when I try to hold something harder, I feel my wrist pop and slide, like the bones aren’t stable.

That’s a bit scary for me.  I have just over three weeks in this thing and I’m only feeling a little worse than when I got it on–with the strength in my hand, and the bone popping.  (Gross, I know)

Anyway, I don’t know if I’ll need a brace after the cast but probably, considering I’ll need the PT.

People online talk about how you don’t really heal 100% from this injury, about how your wrist will always be weak.  Mine’s been weak since I was 13, now it’s gonna be even moreso?  I’m 35 now and already falling apart.  Lovely.

Until the next update.

~~Becka