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"What the Hell(tm) is a Cubital Tunnel?" by Troy H. Cheek on Nov 29, 2004
So, I went back to see my doctor at the appointed hour, after a month of new medication, new diet, and new exercise program. With, incidentally, a detailed log of all the blood glucose readings I'd been taking all month at least twice a day. Knowing that if I didn't show marked improvement, he just might have to put me on insulin.
Things did not start well. After a month of eating less, exercising more, and taking pills designed to help me lose weight, I'd somehow managed to gain five (5) pounds. Also, the girl from the lab came in because "the doctor wants to run a few little tests." Last time she said that, she took three huge vials of blood. Not right away, mind you. First she had to dig around for a while looking for that real good vein in my elbow that was right under the surface. She didn't give up digging deeper until she ran out of needle. This time, she went into the other elbow.
And took five (5) huge vials of blood.
My blood pressure was, surprisingly enough considering what I'd just been through, perfectly normal. Which is ironic since stroke-level high blood pressure was the reason I started going to this doctor to begin with.
Then the doctor came in. He examined my detailed log of all the blood glucose readings I'd been taking all month at least twice a day. Wow! Quite an improvement. Better than he'd hoped. Better than he'd thought possible. Almost miraculous, as a mater of fact. Worth writing up in the medical journals.
Of course, he was still going to have to start me on insulin.
We started going over the labwork on the blood I'd given the last time I came in for an office visit. I don't remember the exact numbers, but they were bad. Damn bad. Van Damme bad. My "bad" cholestorol was over 300, whereas normal people have total cholestorol less than half that. Some test that was supposed to tell my average blood sugar over the last 90 days showed an average of over 350, over three times the normal reading, though this was flagged by the lab as possibly inaccurate due to the fact that the particular version of the test they ran wasn't designed to measure anything near that high.
You know those horror/science fiction movies where somebody takes some samples and sends them off to the lab, and the lab calls back and says "Where'd you get this blood? A dead chicken?" That's what the situation was beginning to feel like.
At this point, I decided that a little levity was in order. "Well, doc, in that case, explain to me exactly why I haven't died yet."
"Actually, I can't," he said, and continued discussing the results.
My, but that was a tad sobering.
Then came the girl who was supposed to show me how to inject insulin. Unbeknownst to her, I have a little experience in that area. My mother and girlfriend are both diabetics, and I've helped them any number of times with their injections. I demonstrated the proper methods before she finished explaining them. I like freaking out medical professionals.
She didn't have one of the two types of insulin I'd be using, so I got to demonstrate the second type with a shot of B-12. "At least this will help with my hangover," I joked. That didn't go over too well. Neither did my saying that I didn't need a prescription for needles since I already had a supply lined up.
But, of course, she and the rest of the staff got their revenge. They scheduled me to see a specialist.
Since I was a young man, I've had numbness and tingling in odd parts of my body. They come and go. I was told a long time ago that these were the beginnings of migraine headaches, which fortunately no longer progress into eye-watering, skull-splitting, three-day orgies of pain and kaledioscopic vision distortions. I just get tingling or numbness for a while. So I just ingore these little attacks. Since I've been diagnosed with diabetes, I've been keeping better track of them, as diabetics are supposed to suffer from something called neuropathy. As near as I can tell, neuropathy roughly translates as "something we don't understand is wrong with your nerves."
I've been boring my doctor with reports of numbness and tingling for years. His response is always the same thing, that this couldn't possibly be neuropathy caused by my high blood sugar. Until he got my lab results last week. Then suddenly, it was entirely possible that my last bout of numbness in my hand, which had actually lasted for weeks by that point, was due to neuropathy caused by my high blood sugar. So he arranged for me to see a nerve specialist.
The specialist, it turns out, didn't know squat about neuropathy. His job was to determine what else the problem could possibly be. He poked and prodded on my hand and arm, twisting and turning. Finally, he found a place he could gently tap with his little finger and get the reaction he was looking for.
That reaction being the sensation liquid fire coursing through my veins.
Or maybe that's "cursing," since that's what I started doing.
Nope, no neuropathy. Or, rather, I might have neuropathy, but that's not what's causing the problem today. Instead, I had a little nerve tunnel problem.
One of the many suggestions that my doctor had over the years for the source of my tingling was carpel tunnel syndrome. This was not caused, by the way, by years of spending entirely too many hours every day banging away on a computer keyboard. It was not caused by hours of driving every day. It was caused by the way I slept.
I sleep curled up on my side with one arm up under my head. This, my doctor told me, was irritating some nerves and giving me carpel tunnel syndrome. The solution was to wear a wrist brace while I slept. This would protect the nerve.
What actually happened was that every time I'd roll over in the night, I'd club myself upside my head with the metal rods in the wrist brace. That wakes you up really quick.
It also keeps you from sleeping curled up on top of your arm. Which, according to the specialist, was the only good thing that came of it, because the nerve channels that I needed protected weren't in the wrists. They were in my elbows.
Instead of carpel tunnel problems, I had cubital tunnel problems. The cubital tunnel is where the ulnar nerve is routed around the outside of the elbow. It's what you hurt when you hit your funny bone.
My cubital tunnel was messed up and the accompanying nerves damaged from years of sleeping curled up on top of my arms, which stretches the nerve. Also driving for hours each day, since I usually prop up on one arm while driving with the other. Also by peering myopically at my computer screen from only a few inches away, which causes me to type with my arms all kinked up.
Oh, and the way I sit in doctors' waiting rooms with my elbows propped up on the chair arms while holding a book up to my face? That's a double whammy, putting pressure directly on the channel while the arm position also stretches the nerve.
The solution was to prescribe me some anti-inflammatory drugs and also give me some splints to wear while I sleep. These things keep me from bending my arms. No more sleeping curled up. No more sleeping, period. It's damned near impossible to get to sleep when you're used to curling your arms and end up fighting with a splint all night.
Finally, I get to have a nerve conduction test to determine the extent of the damage. The drugs and splints and basic posture changes might be sufficient for me to recover in time. Or I might require a very simple, very common operation. More a "procedure" than a surgery. Very minor. Something you could almost do in a doctor's office. They just have to make a 12 inch incision down my arm and flay all the muscle and tendons away from the bone.
Then they simply re-route the problem nerve to a more protected place where it will not be stretched as much, like inside the elbow.
Right where labgirl likes to dig with her needle.
Copyright 2004 by Troy H. Cheek. Reprint with prior written permission only. Comments and questions to $mail:theview$
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|This page last updated on Nov 28, 2004 by Troy H. Cheek|