Nutz
04-03-2007, 03:53 PM
I just recently found this wonderful forum and I'm hoping that your experiences and vast knowledge will help me and my husband.
Some background -- My husband noticed muscle atrophy between his thumb and forefinger of his right hand several months ago. It's remained relatively the same since then. He also gets a bit of tingling in the fingers and stiffness when straightening out his arm from a bent position. He tends to sleep with his arms above his head which causes his arm to stiffen up. His work involves using power tools and lots of "clamping and crimping" motions. In the past 3 years, he's used jackhammers for 10 hrs/day for 5 days straight and he's also done alot of shoveling of dirt, snow, digging ditches, pulling out trees, using a pick and axe (We've been totally renovating an older home).
He had a nerve conduction and EMG test done last Thursday on both arms and hands. The NC showed carpal tunnel, but the neurologist who performed the EMG was "confused" by his results. He said he has ulnar nerve damage but didn't call it cubital tunnel. He asked him if he was diabetic (which he isn't, but it runs in his family) and said "your doctor will have to do his homework on this one." ??? Our PCP is concerned also because he said this indicates that something else is going on in the body. My husband had a regular full blood/lipid panel done just 5 weeks ago and everything was fine, but his PCP ordered additional tests - B12, ANA, sendimentation rate, fasting glucose and TSH. I'm not sure what he's looking for, but he has me worried.
Anyone have any information they could share with us? I'm mainly looking to find out if any of you have had similar symptoms and a similar diagnosis of ulnar nerve damage without having "something else going on in your body"?? Couldn't this damage be from everything he's done and continues to do on a daily basis?
Thanks in advance for any help you can give--it's much appreciated.
God bless,
Some background -- My husband noticed muscle atrophy between his thumb and forefinger of his right hand several months ago. It's remained relatively the same since then. He also gets a bit of tingling in the fingers and stiffness when straightening out his arm from a bent position. He tends to sleep with his arms above his head which causes his arm to stiffen up. His work involves using power tools and lots of "clamping and crimping" motions. In the past 3 years, he's used jackhammers for 10 hrs/day for 5 days straight and he's also done alot of shoveling of dirt, snow, digging ditches, pulling out trees, using a pick and axe (We've been totally renovating an older home).
He had a nerve conduction and EMG test done last Thursday on both arms and hands. The NC showed carpal tunnel, but the neurologist who performed the EMG was "confused" by his results. He said he has ulnar nerve damage but didn't call it cubital tunnel. He asked him if he was diabetic (which he isn't, but it runs in his family) and said "your doctor will have to do his homework on this one." ??? Our PCP is concerned also because he said this indicates that something else is going on in the body. My husband had a regular full blood/lipid panel done just 5 weeks ago and everything was fine, but his PCP ordered additional tests - B12, ANA, sendimentation rate, fasting glucose and TSH. I'm not sure what he's looking for, but he has me worried.
Anyone have any information they could share with us? I'm mainly looking to find out if any of you have had similar symptoms and a similar diagnosis of ulnar nerve damage without having "something else going on in your body"?? Couldn't this damage be from everything he's done and continues to do on a daily basis?
Thanks in advance for any help you can give--it's much appreciated.
God bless,
Sponsor
Shshi
04-04-2007, 08:33 PM
Hi,
The neurologist is looking for B12 deficiency, Lupus, and thyroid problems, among other things. These can all cause problems with the peripheral nervous system, as can peripheral neuropathy.
You might want to get a second opinion on the results of the EMG/nerve conduction study.
I hope everything turns out alright!
Lisa
The neurologist is looking for B12 deficiency, Lupus, and thyroid problems, among other things. These can all cause problems with the peripheral nervous system, as can peripheral neuropathy.
You might want to get a second opinion on the results of the EMG/nerve conduction study.
I hope everything turns out alright!
Lisa
Johands333
04-06-2007, 06:29 PM
Nutz,
I am not sure why the doctor was confused on whether this is carpal tunnel or not. From what you describe about your husband's type of work and how he sleeps sounds like the type of activities that would bring on carpal tunnel. He should be sleeping with wrist supports. You have no idea how much your hands get twisted while sleeping. The supports will keep his hands straight. The work he does uses his hands way too much. How old is he? How long has he had his job? For me, it took about 5 years of carpal tunnel getting worse before I got to the point where I said Enough! I couldn't take it anymore. You don't want him to get to that point. I was on Naporsyn for 5 years. Aleve is a lower dose of that, I think. It will mask pain, but it won't go away. Most of what I've read here and online is that carpal tunnel doesn't get better, it only gets worse or stays the same for a time. If necessary, your husband should get a second opinion.
I am not sure why the doctor was confused on whether this is carpal tunnel or not. From what you describe about your husband's type of work and how he sleeps sounds like the type of activities that would bring on carpal tunnel. He should be sleeping with wrist supports. You have no idea how much your hands get twisted while sleeping. The supports will keep his hands straight. The work he does uses his hands way too much. How old is he? How long has he had his job? For me, it took about 5 years of carpal tunnel getting worse before I got to the point where I said Enough! I couldn't take it anymore. You don't want him to get to that point. I was on Naporsyn for 5 years. Aleve is a lower dose of that, I think. It will mask pain, but it won't go away. Most of what I've read here and online is that carpal tunnel doesn't get better, it only gets worse or stays the same for a time. If necessary, your husband should get a second opinion.
Nutz
04-09-2007, 12:06 PM
Thank you Shashi & Johands333!
I so appreciate you posting your thoughts and advice. And, yes, we are getting a second opinion from another neurologist/neurosurgeon, but we have to wait until April 18 for the appt. because he's so busy. My husband did have his additional lab work done last Thursday, but we haven't gotten any results yet obviously.
To answer your questions, Johands333, he is 46 and he's been doing his type of work for the last 20 years--some years more, some years less. We've been doing this "house renovation" for the past 32 months without many breaks. It seems that all the work has been hard labor and when he starts something, he doesn't quit until he's finished. I remember after using the jackhammer for 4 days straight, his arms were numb and his elbows were giving him all sorts of discomfort. It took several weeks for it to subside, then he was onto digging ditches and replacing roof shingles! I believe his nerve damage is most likely due to what he "does" and not so much "systemic," but I guess we'll have to wait and see. I'm praying that his lab work shows that nothing is wrong. BTW, he doesn't have "pain" -- he says his fingers get tingly and his forearm will get cramped or stiff when he's on the phone and sometimes his elbow gets achy, but he says he never has pain.
Again, thank you so much for your insight and kind words. This forum has been so helpful -- thank you again,
God bless,
I so appreciate you posting your thoughts and advice. And, yes, we are getting a second opinion from another neurologist/neurosurgeon, but we have to wait until April 18 for the appt. because he's so busy. My husband did have his additional lab work done last Thursday, but we haven't gotten any results yet obviously.
To answer your questions, Johands333, he is 46 and he's been doing his type of work for the last 20 years--some years more, some years less. We've been doing this "house renovation" for the past 32 months without many breaks. It seems that all the work has been hard labor and when he starts something, he doesn't quit until he's finished. I remember after using the jackhammer for 4 days straight, his arms were numb and his elbows were giving him all sorts of discomfort. It took several weeks for it to subside, then he was onto digging ditches and replacing roof shingles! I believe his nerve damage is most likely due to what he "does" and not so much "systemic," but I guess we'll have to wait and see. I'm praying that his lab work shows that nothing is wrong. BTW, he doesn't have "pain" -- he says his fingers get tingly and his forearm will get cramped or stiff when he's on the phone and sometimes his elbow gets achy, but he says he never has pain.
Again, thank you so much for your insight and kind words. This forum has been so helpful -- thank you again,
God bless,
Johands333
04-10-2007, 08:34 AM
Nutz,
My husband remodeled 2 bathrooms. He also was online a lot and played golf. During a 2 or 3 week period he woke up every night with pain that sounded to me like cts. He didn't have any pain after that. Getting back to your husband. You don't necessarily have pain, numbness is the biggest symptom. My fingers would feel like I had paged through 1,000 sheets of paper. It was like there was no feeling in the tips. As it got worse, I would have pain in my wrist and arms. My hands were swollen, but I never noticed. We were down in warm, sunny FL out on a golf course. A lady came up to me while my husband was playing and she asked why I wasn't playing. When I told her I had cts, she said she could see how swollen my hands were. They were puffy. Mostly in the area between my thumb and pointer fingers.
My husband remodeled 2 bathrooms. He also was online a lot and played golf. During a 2 or 3 week period he woke up every night with pain that sounded to me like cts. He didn't have any pain after that. Getting back to your husband. You don't necessarily have pain, numbness is the biggest symptom. My fingers would feel like I had paged through 1,000 sheets of paper. It was like there was no feeling in the tips. As it got worse, I would have pain in my wrist and arms. My hands were swollen, but I never noticed. We were down in warm, sunny FL out on a golf course. A lady came up to me while my husband was playing and she asked why I wasn't playing. When I told her I had cts, she said she could see how swollen my hands were. They were puffy. Mostly in the area between my thumb and pointer fingers.
Nutz
04-10-2007, 12:53 PM
Hi Johands333,
Thanks again for the info. See, I was thinking he had to have pain, so I was misinformed. But, he has just the opposite of swelling--he has muscle atrophy between the thumb and forefinger which indicates (as far as the reports show and what I've found online) ulnar nerve entrapment and/or damage, but his PCP keeps saying he has CTS and "something" is going on with his ulnar nerve. I'm in the process of obtaining the original nerve conduction and EMG report for our second opinion and I'm quite interested in reading it myself to see what it says since his PCP still says he's "confused." ??
Again, thanks so much for your kindness--it truly helps to talk to someone about this, I so appreciate it--God bless you,
Thanks again for the info. See, I was thinking he had to have pain, so I was misinformed. But, he has just the opposite of swelling--he has muscle atrophy between the thumb and forefinger which indicates (as far as the reports show and what I've found online) ulnar nerve entrapment and/or damage, but his PCP keeps saying he has CTS and "something" is going on with his ulnar nerve. I'm in the process of obtaining the original nerve conduction and EMG report for our second opinion and I'm quite interested in reading it myself to see what it says since his PCP still says he's "confused." ??
Again, thanks so much for your kindness--it truly helps to talk to someone about this, I so appreciate it--God bless you,
Nutz
04-13-2007, 11:18 AM
Good morning,
Well I was finally able to get my hands on my husband's nerve conduction/EMG test report. BTW, his lab results were all normal--thank God! The report says this:
Polyneuropathy affecting bilateral median & ulnar nerves.
Superimposed bilateral carpal tunnel syndrome with chronic motor denervation.
Site or level of lesion for ulnar nerves is not identified. There is an acute motor denervation in the distribution of the right ulnar nerve. Clinical correlation is required.
I assume the "clinical correlation" part is the lab work that was just completed. And I believe the "acute motor denervation of the right ulnar nerve" is the muscle atrophy he's experiencing between the thumb and forefinger of his right hand.
So, based on this info, do you think he'll need surgery for both CTS and the ulnar nerve?
Thanks again for your help!
God bless,
Well I was finally able to get my hands on my husband's nerve conduction/EMG test report. BTW, his lab results were all normal--thank God! The report says this:
Polyneuropathy affecting bilateral median & ulnar nerves.
Superimposed bilateral carpal tunnel syndrome with chronic motor denervation.
Site or level of lesion for ulnar nerves is not identified. There is an acute motor denervation in the distribution of the right ulnar nerve. Clinical correlation is required.
I assume the "clinical correlation" part is the lab work that was just completed. And I believe the "acute motor denervation of the right ulnar nerve" is the muscle atrophy he's experiencing between the thumb and forefinger of his right hand.
So, based on this info, do you think he'll need surgery for both CTS and the ulnar nerve?
Thanks again for your help!
God bless,
Nutz
04-18-2007, 12:01 PM
Well, still no answers and more questions... Neurosurgeon says his carpal tunnel doesn't warrant surgery (this coming from a surgeon) and says that he has "peripheral neuropathy" but he can't tell from the results of his EMG what is causing the nerve damage. He said we have to go back to the neurologist who did the EMG tests (who was even more vague than anyone else and has no bedside manner to speak of) for further testing. I mean, everyone is so vague! What are they looking for?!
When I do a search of peripheral neuropathy it says it can be caused from diabetes (which he isn't--his blood glucose was perfect last week), alcohol abuse (he very rarely drinks), vitamin B6 & B12 deficiency, AIDS, repetitive stress to the nerve (like using power tools, jackhammers, type of work), exposure to toxic substances, kidney/liver disease, and some cancers. He tested negative for ANA which is rheumatoid arthritis and lupus, his thyroid tests were normal, but he was a little low in Vitamin B12. I don't know what to think..... All I know is that I'm worried sick...
When I do a search of peripheral neuropathy it says it can be caused from diabetes (which he isn't--his blood glucose was perfect last week), alcohol abuse (he very rarely drinks), vitamin B6 & B12 deficiency, AIDS, repetitive stress to the nerve (like using power tools, jackhammers, type of work), exposure to toxic substances, kidney/liver disease, and some cancers. He tested negative for ANA which is rheumatoid arthritis and lupus, his thyroid tests were normal, but he was a little low in Vitamin B12. I don't know what to think..... All I know is that I'm worried sick...