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Old 06-30-2007, 07:14 AM   #1
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jaderiver HB User
Ulnar Nerve Compression of the elbow (frustrated!)

Here is some background and symptoms...

Last year in March 2006 I had surgery for ulnar nerve compression on my left elbow. Nerve conduction test was done which showed severe compression. After surgery my symptoms of buzzing sensations, twitching, burning pain improved tremendously. The only symptom left was some mild burning off and on around the incision area but was told it is normal, can take the nerve up to a year to heal. Everything was going fine. About 4-5 months after surgery my left arm was injured, nothing broken, it was sprained or bruised.

Around January 2007 I started to experience the same symptoms prior to my surgery; buzzing sensations,occasional twitching of the palm and little finger, burning pain in the palm below little, ring finger, burning at the elbow. I figured this was temporary but it has stayed, been ongoing for 6 months now.

I was sent for another NC test two months ago which showed mild compression at the elbow.

Since January I have been following conservative treatments that were recommended to me by the neurologist such as wrapping my elbow in a towel at night (jelly roll style) to keep my arm straight, not leaning on my elbow, taking vitamin B6, and physiotherapy. I did go for hand physio but they said there is nothing they can do for me. I do my own physio at home.

My symptoms are slowly becoming worse. I have numbness in my little finger,it's been ongoing for 6 months, it comes and goes, but is more frequent now, worse. With my elbow it feels like someone took an elastic band and tightened it around the elbow. I can bend my elbow but it feels weird, almost hard, difficult to describe.

For the past three weeks, the numbness in my little and now ring finger has increased, occurs more frequently and for longer periods of time.

So this problem has been ongoing for 6 months now.

I did see my family doctor and he said you will probably have to live with this for the rest of your life. I don't think a surgeon will help you. He didn't refer me to anyone.

I did seek a second opinion from another doctor and she said "I'm not really sure." I asked if she could give me a referral. She said "I really don't know if a surgeon would help you."

I wonder if scar tissue is building up and when I asked the doctors mentioned above they said "Probably."

I keep trying everything they tell me to do (conservative methods), but unfortunately I am not seeing a positive difference with this problem.

To see a specialist/surgeon I need a referral.

I emailed a hand surgeon in the USA with the same information as above and this is what he said...

"You should see somebody before the nerve is permanently damaged. You will probably need repeat surgery."

So I feel like I am at my wits end. I am a patient person and will try methods recommended but at the same time none of this is helping me.

Any tips, ideas?

Last edited by jaderiver; 06-30-2007 at 07:17 AM.

 
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Old 07-01-2007, 02:48 PM   #2
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john449 HB User
Re: Ulnar Nerve Compression of the elbow (frustrated!)

I agree with the MD who said you should see a surgeon. What I wonder (not being familiar with protocol in Canada) is why you can't return to the surgeon who did your original surgery? Would think since he has already been involved with your care that he could see you without a referral.
The great advantage to this is that he knows what he did with your nerve the first time. The surgery for a trapped ulnar nerve varies a bit depending on exactly where and how the nerve is compressed in the cubital tunnel and also on the technique preferred by the surgeon to protect the nerve from further injury. But definitely, with your symptoms worsening I would get this seen by someone who can do something about it. Good Luck!!

 
Old 07-01-2007, 10:19 PM   #3
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Thank you for your help John.

Oh sorry, lol, I forgot to say in my original post that my surgeon, the one who did my operation, retired last summer, about 3 months after my surgery.
After surgery my arm was alot betterI had one follow up with him and the surgeon said my family doctor should be able to continue with the follow ups. I didn't ask for a referral at that time because I figured I was on the road to recovery and the surgeon thought I was making good progress.

I asked my family doctor in regards to him doing the follow ups,and he said "If I feel like it."

I could try to get a copy of the surgery report from the hospital (I have never done this before, but I assume patients can acccess this with a consent form, pay a fee?) and see what type of surgery was done.

And if I manage to get a referral for a new surgeon I could take the copy with me.

I do think I need to see someone, it's just I am experiencing so much trouble getting a referal.

My neighbour suggested I go to the ER and tell them that I am experiencing troubles. She thought maybe the hospital would refer me. I think it is a good possibility but at the same time I feel guilty for going to the ER when I am not severly injured or sick, others that need it more than I do.

Last edited by jaderiver; 07-01-2007 at 10:29 PM.

 
Old 07-05-2007, 01:59 PM   #4
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Update...

I got a referral! I headed to a walk in type clinic, told the doctor my symptoms, past surgery etc. He said "I can't do anything for you but I will refer you to someone. He is referring me to a neurosurgeon at the main hospital and if that doesn't work out I will referred to a plastic surgeon."

I know it will take at least 6 months to see the neuro or plastic surgeon but I am just glad I was finally referred.

 
Old 07-08-2007, 08:47 PM   #5
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Glad to hear you are getting some attention. Your question about retrieving your surgery records is important now. Down here we can get our records, usually with a small fee for processing. Would definitely recommend you have all pertinent information with you when you see the neurosurgeon especially with the wait (6 months, oh my). Good luck..

 
Old 07-10-2007, 07:15 PM   #6
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Quote:
Originally Posted by john449 View Post
Glad to hear you are getting some attention. Your question about retrieving your surgery records is important now. Down here we can get our records, usually with a small fee for processing. Would definitely recommend you have all pertinent information with you when you see the neurosurgeon especially with the wait (6 months, oh my). Good luck..
Thanks john. I actually phoned the neurosurgeons office and was told it will take about a year to get in. They don't book appts in advance, phone about two to three weeks before your actual appt. It goes by priority, the surgeon goes through the referrals. People who have brain or spine problems I imagine would be more priority compared to my problem.

We do have some good specialists where I live but the waiting list is long. I believe there are two to three specialist who deal with this type of problem where I live.

I am considering going out of Province. I found a hospital in Ontario that has nine hand surgeons, at least 4 of them are interested or deal with peripheral problems. I may try and see if can get in sooner. I would need another referral .

I phoned about my surgical report, the fee is $25.00. I plan on getting a copy of it for my own records, to take with me to appointments.

 
Old 07-13-2007, 06:49 PM   #7
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

One other quick thing - a test you can easily do. Spread your fingers widely apart on both hands, then ask your husband or a friend to squeeze your fingers together. If it's much easier to squeeze the fingers together on the affected side then you are losing muscle and it becomes a bit more important to get something done quickly. (Just concerned about that one year wait). Happy hunting..

 
Old 07-15-2007, 10:53 AM   #8
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

hi, i have much of the same pain ect. that you describe. mine was caused after a cervical fusion at level c-6c-7. the pain i am getting is from the c8 nerve root which in the ulnar nerve root. mine is rsd. i would suggest you go to see a pain management specialist. i am no professional but all you are saying is the same that happened to me. if it is rsd, the sooner you find out, the more posibility that you will get pain relief from treatment. unfortunately, i ****** too much time away with my surgeon and second opinions that the treatment hasen;t really helped and the rsd is getting worse by the day. many docs have not heard of rsd or don;t really know what it is. as far as i know, a pm doc does know all about it and he is great in trying different things.. what ever your problem, i hope for you that it gets better, good luck, patti

 
Old 07-19-2007, 03:50 PM   #9
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Quote:
Originally Posted by john449 View Post
One other quick thing - a test you can easily do. Spread your fingers widely apart on both hands, then ask your husband or a friend to squeeze your fingers together. If it's much easier to squeeze the fingers together on the affected side then you are losing muscle and it becomes a bit more important to get something done quickly. (Just concerned about that one year wait). Happy hunting..

Hi John,

Thanks for your help! Yes I am familiar with that quick test, physiotherapist etc did it in the past. I asked a friend to squeeze my fingers on both hands for comparison. The affected (left hand) side is weaker. I wouldn't say as severe compared to last year prior to my surgery, but there is weakness. Also my little finger on affected hand does not spread apart nearly as well compared to my normal right hand.

I found a doctor in Toronto, Canada, and was told it would be a 7-8 month wait for a consultation, so I am hoping to get a referral to see him. Where I live it will be at least a year or more.

Last edited by jaderiver; 07-19-2007 at 03:50 PM.

 
Old 07-19-2007, 03:53 PM   #10
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

I'm sorry to hear you are going through this. I'm glad the pain doctor is helping you. Any relief? This is something I could look into. I have burning pain at my elbow, little, half the ring finger, palm below these two fingers.

Quote:
Originally Posted by pattihabs View Post
hi, i have much of the same pain ect. that you describe. mine was caused after a cervical fusion at level c-6c-7. the pain i am getting is from the c8 nerve root which in the ulnar nerve root. mine is rsd. i would suggest you go to see a pain management specialist. i am no professional but all you are saying is the same that happened to me. if it is rsd, the sooner you find out, the more posibility that you will get pain relief from treatment. unfortunately, i ****** too much time away with my surgeon and second opinions that the treatment hasen;t really helped and the rsd is getting worse by the day. many docs have not heard of rsd or don;t really know what it is. as far as i know, a pm doc does know all about it and he is great in trying different things.. what ever your problem, i hope for you that it gets better, good luck, patti

 
Old 07-25-2007, 02:32 PM   #11
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

I received my surgery report in the mail today. I am guessing he removed the scar tissue/ adhesions. Also moved the nerve over? Not sure what it all means. Here is the OR report...

Procedure Performed: Neurolysis left ulnar nerve.

Preamble: This lady presents with cubital tunnel syndrome following an injury to her left elbow.

Procedure: Following routine prep and drape and application of a tourniquet, a curvilinear incision was made around the medial epicondyle of the elbow, extending into the upper arm and forearm. The ulnar nerve was identified proximally and traced down into the cubital tunnel. The roof of the tunnel was divided as a square-cut Z-plasty for future pulley reconstruction. The nerve was then traced through the tunnel and Osborne’s band was divided the two heads of the FCU separated. Throughout the tunnel, the nerve was severely bound down with heavy adhesions, and using magnification and micro instrumentation a complete external neurolysis was carried out, freeing all adhesions from the nerve until it lay freely. The pulley was then reconstructed by transposition of the Z-plasty and the wound closed using subcuticular 3-0 Monocryl. A medium Hemovac drain was inserted through a separate stab wound, and an occlusive dressing applied. The patient left the OR in satisfactory condition.

Last edited by jaderiver; 07-25-2007 at 02:33 PM.

 
Old 08-07-2007, 05:29 PM   #12
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Another update...

I did see the rehabilitation doctor I also go to last week on Monday. I mentioned my hand, symptoms etc becoming worse, referred to a neurosurgeon, year wait and that I would like to see a hand specialist in another Province. I could tell she didn't like the idea of me going out of Province. I told her I weighed the pros and cons and if I can get in sooner in another Province.. she interrupted and said she would refer me to a plastic surgeon in our city, said the neurosurgeon would probably not be interested in my case. She gave her receptionist the referral and asked her to phone a few plastic surgeon offices and ask which one is the quickest to get in. I know the one at the main hospital (one doctor she is thinking about) is suppose to be excellent, deals with medical issues only. The other one does a mixture of cosmetic and some hand surgery.

I have no idea how long the wait will be to get in, hopefully not a year. I plan on waiting until the end of this week and then phoning the rehabilitation doctors secretary to see what place I was referred to.

Last edited by jaderiver; 08-07-2007 at 05:30 PM.

 
Old 08-28-2007, 05:27 PM   #13
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Re: Ulnar Nerve Compression of the elbow (frustrated!)

Update..

I found out a new plastic surgeon moved to the city and it only took me two weeks to get in to see her. I met with her today and she will be operating on my elbow. Once she opens up she will know whether I have scar tissue around the elbow or if she needs to move my nerve over. My last operation was just scar tissue removal.

Also my wrist will be operated on as well, same arm as elbow problem. I had dequervains tendonitis surgery a few years ago, problems after surgery. Not the surgeons fault. I was in a violent relationship, arm was being hurt through abuse. Anyways there was delays in healing of it. The pain is back, she thinks either scar tissue or maybe a neuroma in the area.

I will likely have surgery in September or October of this year.

 
Old 09-25-2007, 07:48 PM   #14
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sandra195 HB User
Re: Ulnar Nerve Compression of the elbow (frustrated!)

I had ulnar nerve surgery a few months ago and have just found out after a visit to a chiropractor that I have a problem in my cervical spine as well. Although the surgery helped, I think the "root" of the problem may have been at the spine. Working on it, improving. Good luck to you.

 
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