Carpal Tunnel, Klonopin, and Crazy

The thing I have been fearing most for my entire life happened to me in the spring of 2010–I Was struck by a pernicious nerve disease that was sure to render me disabled.

 Ever since I was a little boy I was obsessed with inexplicable cramps, pains, twitches, and other odd things our bodies do. To the average person these sensations were the normal course of living a life in a biological body made up of cells, chemicals, and nerve bundles–but to me these were signs of the impending doom of great suffering, disability, and yes, death!

My earliest bout of hypochondriasis (which I’ve learned is the real medical term for health anxiety) was the morning in sixth grade when I woke up with a severe cramp in my lower right side so severe I was barely able to stand upright. When I stumbled out of bed, and felt the sharp pain in my side I knew it was cancer and soon I would be lying in a hospital bed, surrounded by friends and loved ones sobbing, “Oh he is too young! What a tragedy!” To which I would reply something very profound like, “I have loved you all.  God speed and I will be waiting for you on the other side.” But  by the time I was struck with this intestinal cancer, my mother was used to my phantom illnesses (and the not so convincing phantom ones when my only goal was to play hookey) and said that I either had to go to school, or go to the doctor. This was cancer, and there was no playing around on my part, so I readily volunteered and we headed to our family physician, Dr. Nelson, who was a friend of my parents. After arriving at his office he asked me to lie down on the exam table and pull down my pants. As he talked to my mother about his upcoming vacation and some remodeling he was doing to his house, he slipped on some latex gloves and  lubed up a finger with KY Jelly. “What are you doing?” I asked, unaware of what was about to happen to me. “Just lay down,” he said, “try to relax.”  And then shoved his finger up my ass, dug around for a bit  and said: ”I think he has appendicitis.” While this is certainly a better diagnosis than cancer, it wasn’t better than the ass raping I had just experienced. Up until that point in my life, I had no idea that anything was stuck up someone’s ass. Ever. And to a twelve year old boy it was the ultimate violation and before I was able to think about the various complications of an appendectomy, I fainted. Right there on the floor of the doctor’s office.

When I awoke, Dr. Nelson said he couldn’t be one hundred percent certain of the diagnosis but on that day we were lucky because Dr. Roja, a proctologist from Victoria, was at our small county hospital seeing a patient, so he suggested my mother rush me right over and have the good doc take a lood. The ride over was filled with shame and despair–I had been violated in front of my mother, who found my ass raping and subsequent fainting spell a bit humorous, and as soon as I was able to gather my thoughts, I was able to consider the myriad complications of my impending appendectomy. Bleeding, infections, ruptures, discovery of some terrible malignant tumor deep in my intestine what was making my appendix hurt so.

 When we arrived at the hospital I was robed and rushed into an exam room by several nurses who cleaned my butt and put me up in a holster of some type to make the exam easy. This wasn’t the sly and unexpecting ass raping I experienced in Dr. Nelson’s office. No, this was a systemized affair with many players, including three young nurses who, along with my mother seemed to find my terror humorous. Lo and behold, here comes Dr. Roja, who was probably 6’7″ with fingers the size of bananas. I gripped the bed with fear when he snapped the latex glove on his hand and lubed up. After several excruciating seconds of him digging deep in my bum, he pulled his finger out, yanked off the glove and said to my mother: “He’s constipated.” No cancer. No appendicits. Constipation. The cure: two Ex-Lax and a couple of hours on the toilet that night.

Fast foward twenty-five years and countless other near death experiences, including cancers, strokes, and rare and virulent illnesses and we arrive in spring 2010, when, after several weeks of clomping up and down the halls of the capitol in dress shoes, I developed pain in both feet. Explainable, right? But shortly after that, I was at the gym one afternoon bench pressing when all of a sudden I felt a pop on both hands and they began to burn like they were on fire. And for the next few months, for the entire session, I hobbled around on my sore feet and constantly rubbed my aching hands. Clearly something systemic was happening to my body. What could this be, I wondered? At first I wasn’t worried–I’ve been a very active man and although I immediately catastrophize any pain, I’ve gotten used to them coming and going all over my body. But this lingered. And lingered. And lingered. When session finally ended on June 23rd, I was no better off, so I began what would be an epic journey of doctor visits, tests, prescriptions, and therapy.

It began on July first when I had back to back appointments with the foot and hand doctors. The diagnoses: metatarsalgia in the feet and muscle/ligament strains in my hand. The cure: rest. Easy enough. I follwed the instructions, the feet got better, and the  hands seemingly did as well. But then Chris and I went to England for two weeks and my hands began to burn like fire after carrying my large suitcase up and down stairs everyday as we moved hotels. When we got back I went and saw a different hand doctor, who I will refer to as the Evil Dr. B_____. He said I had tenosynovitis and put me on a prescription of Celebrex and Prednisone. This was my first true plunge into the world of pharmaceuticals and I will just say this about these two drugs: they are the devil. Prednisone spiralled me into a world of insomnia and anxiety that I couldn’t believe was possible. It was terrible and although the I took both medicines for only one week, it took me a very long time to get over the trauma of the side effects, one of which was a growing belief that something was terribly, terribly wrong with me. And my feet began hurting again. So I consulted the internet and discovered that I had rheumatoid arthritis, lupus, multiple sclerosis, along with some ALS thrown in for complete destruction of my body and life. And this began an epic medical odyssey that would include blood tests, body-wide xrays, an EKG, nerve conduction studies, electromyography, and an MRI, and it would also include the administering of various medicines besides the prednisone and Celebrex, including Ambien, Mobic, a cortisone shot, Zoloft, Clonazepam, Lunesta, Lortabs, and a round of antibiotics. I began talking to everyone about my hands and feet pain and the response was seemingly universal: “That sounds like something systemic!” and “I’m really worried about you.”

So I found a general practitioner, who I will call the Dr. Wood the Good, who gave me a complete physical in September, including xrays, blood work, and an EKG. Results: excellent health. He told me that I had been hard on my body and after years of heavy physical activity it needed to rest. I followed his advice and rested easily for about a month, but the hands and feet didn’t get better. I went back to the Evil Dr. B_____ just to see if there was anything else I could do to speed up the recovery of my hands. This time the prognosis wasn’t good, as he told me, “There’s nothing I can do. Obviously, you have something systemic going on.”

Systemic. “Well, I went and had a full physical just last month! All my tests came back ok!” I argued

“Well, maybe your doctor is not trained well and maybe he doesn’t know what he’s looking for,” he barked back at me. “It’s been months and your hands and feet aren’t getting any better. Clearly, there’s something wrong with you.”

“Like what? What could it be?” I pleased.

He shrugged. “It could be anything. Rheumatoid arthritis, gout, lupus, maybe even a malignancy.”

I knew it. I knew it. Here it was on the Friday afternoon. The dreaded diagnosis I had been waiting for. “Doctor, you’re scaring me,” I said.

He shrugged again, “It is what it is. I’ll refer you to a rheumatologist.”

This was terrible, this mysterious disease that was well on its way to destroying my life, slowly hobbling and crippling me. Before long I’d be in a wheelchair going from specialist to specialist, and after that I would be bedridden and spoonfed until my feeble body finally collapsed under it’s own malfunctioning destruction. NERVE DISEASE!

I rushed to Dr. Wood the Good first thing Monday morning and told him he’d missed something–the hand doctor had put the pieces of the puzzle together. I had something seriously wrong with me! He shook his head and said, “he’s a hand doctor.” After a careful examination, he said that maybe it was carpal tunnel syndrome and was going to refer me to a neurologist. I argued that I had seen two hand doctors and neither thought it was carpal tunnel. Well, maybe Dr. B_____ is the one who isn’t trained so well, he snorted.

So, in order to save some time and space here’s the chronology of what happaned next:

-The rheumatologist says I don’t have any disease.

-The neurologist conducts a nerve conduction study and an EMG on both my hands and feet, which show I have severe compression in my wrists, nothing wrong as far as nerves are concerned in my feet. Thus, he diagnosis carpal tunnel syndrome in my wrists and mechanical problems in my feet.

-Dr. Wood the Good gives me a cortisone shot in my wrist, which provides no relief. Also recommends occupational therapy, which I attend several times a week for several weeks.

-When these two attempts to resolve the carpal tunnel dont work, he recommends surgery, but I request a second opinion from another neurologist to make sure it is indeed carpal tunnel. This doctor says no, and says I should get an MRI–AN MRI!!!!–to see if there is any sort of demylenating disease going on. (At this point you should be able to infer the up and down pattern of my mental health. I am convinved I have something seriously wrong with me and that crippling disability is just down the road. I am no longer sleeping, I’m obsessing about my health, I’m not interested in anything, and I’m severely depressed. I began crying to Chris every ten to twenty minutes that I have a nerve disease.)

-The MRI comes back perfectly normal, but the second neurologist still doesn’t think it’s carpal tunnel so he puts me on Zoloft and Klonopin, the latter of which is good for relaxing but I’m scared of pharmaceuticals. Zoloft makes me absolutely bat shit fucking crazy. Twitching, headaches, unstoppable hunger.

Still none of these efforts stop the pain and the more I use my hands and feet the more they hurt, so I break down and go to the foot doctor one more time (plantar fasciitis is the diagnosis this time and again the cure is rest) and schedule my carpal tunnel release surgery. Dr. Hubbard performed the surgery, and it was a breeze. Great drugs, great hospital staff, in and out prededure, and instant relief from my carpal tunnel symptoms. And what’s best is that the scars look like I’ve been crucified, so I get to play Jesus often, which is super fun.

It’s been fourteen weeks since my surgery and the healing has been long and slow. After several weeks pain free, the hands became sore and irritated and still are. I’m told it can take months to heal completely but I want some relief NOW! My mental health depends on it. It’s still difficult for me not to think I have somthing wrong with me. I miss painting and lifting weights. Cooking causes me discomfort. Typing irritates my hands. My anxiety is still pretty amped. I still turn to Chris, hold up my healing hands and cry, “NERVE DISEASE!” (He’s really sick of that game.) Since the Zoloft was a terrible fit for me, Dr. Wood the Good suggested I try some Celexa and see if it can’t alleviate the anxiety. He seems to think that if I stop obsessing, then my symptoms will be much less. I tend to agree with him. But at this point my mind has become a beast of its own will, completely untrained and undisciplined. After months of focusing on every little twitch, pain, and ache, I’ve developed mental habits that are very very bad for me. But guess what? I’m still alive. While the physical takes a long time to heal, so does the mental. I’m thirty-eight and a half years old now. I’m not close to death, but it is getting closer. I don’t want to be one of those people who freak out at every little physical setback, I want to be one of those courageous people you hear others talk about, the ones who despite not being able to walk, are record-breaking swimmers, the ones who can’t hear but yet write music, the ones who have a terminal illness but yet still enjoy the here and now. I’m a long ways from that, though. I’ve got much to work on to be that courageous. Through this whole process I’ve felt weak, and even humiliated at times, but I’ve learned my lesson. I’m a little stronger and a little braver, and I’m gonna be just fine.