Day 1 Another Day 1

Hi everyone, greetings from down under,

Here I am after 3 neck surgeries and lastly a carpal tunnel release surgery on my left hand still suffering with lots of thump symptoms (pain, pins & needles with burning sensation sometimes and freezing other times) Also lately pain started shooting up my arm and dispersing in to the hand. Had detailed post surgery MRI, Ultrasound and Nerve Conduction studies after the carpal tunnel surgery. According to the doctors who wrote the reports for these scans/tests, they show some abnormalities but none of the specialist Doctors (hand surgeons, Neurologist, an MD with PhD specializing on Hand Therapy are convinced that they are the cause of my symptoms, then what is it, go figure!?!

The surgeon who operated on my hand has no clue why I am not recovering on contrary getting worse. He referred me to a Neurologist who thinks I developed "Complex Regional Pain Syndrome" and wants me to take anti-epileptic drugs starting with 300 mg a day and increasing it to the level whatever I can tolerate!?! possibly up to 3000 mg a day (No way I'm going to do that). Seen another hand surgeon for a second opinion, he is also lost as to why I am not getting better (it's been 6 months since the carpal tunnel surgery) and says sometimes surgery back fires as it is in my case. He says he can attempt a drastic surgery of burying the nerve in to fat obtained from some other part of the body but says success rate is 50 % and it might also make it worse! He referred me to the hand therapist doctor I mentioned above, who recommended some hand exercises which did not help at all after doing them for a month.

I am a person who thrives on being physically active. I used to swim 1500 meters a day five days of a week, love gardening, love working around the house fixing/improving/maintaining things. Can't do any of that at the moment because any activity involves usage of the left hand increases my symptoms. Heavier/longer the work/activity/exercise worse are the symptoms. This is so much depressing for me. Started using anti-depressants but quit them about a month ago. Trying very hard to resolve the issue without reverting to them
and trying meditation to calm my body & mind at the moment.

Like most of the people on the forum, I've turned to TMS approach as the last option/remedy (thanks to my wife who directed me to it) I am reading Dr Sarno's "The Mind Body Prescription" at the moment and a lot of other articles found on the Net and also watching videos on TMS.
To be honest, even though I believe some of my symptoms could be created by TMS, I still think some portion of my symptoms are physical. Very very suspicious that the surgeon did some sort of damage to my median nerve on my left wrist during the surgery. (Median nerve is the one that controls most of the fingers in a hand and is the culprit in most nerve related issues in a hand.) Because my symptoms worsened after the surgery and I regret having the surgery so strongly. I wish I could turn to my pre-surgery status and would be very happy with the symptom level I had at that time now

But I am very much looking forward to be proven wrong and to discover that all of it is TMS.

Arnie

 

Hi, Arnie. You shouldn't have more surgery or take the medication which would not get to the reason you have pains. I definitely believe they are caused by some harmful emotions, as Dr. Sarno writes.

I doubt the surgeon did any damage to your wrist. Try not to let that thought or fear prevent you from totally believing in TMS. The faster you accept TMS, the faster you will heal. And try not to be depressed. Think positive and try to enjoy being active. Swimming could be the best.

And do some more journaling, to discover the emotions causing your pain.

 

Thanks Walt, I will definitely will not have anymore surgery and take any medications.
The reason I think the surgeon might have done some damage to the nerve is that my symptoms increased 2-3 times more after the surgery and he has no answer at all!?!?!
He is not even interested in seeing me anymore, and telling me to go back to my family doctor to chase it up.
But including him I am done with all the doctors.
Yes I am trying to be active as much as I can but it is increasing my symptoms so it is a bit of struggle at the moment.
Following the structured program too. Hopefully it will get better.

 

Hi Arnie!

If the nerve conduction studies and other tests were normal, then its unlikely that the symptoms are coming from surgical damage to your median nerve. Also, if it was truly from structural damage to the median nerve going through the carpal tunnel, the sensation wouldn't be shooting up your arm. It would be only in your hand. That should help ease your fears. I'm sorry you had to go through so many surgeries. Orthopedic and neurological surgery has a long way to go from a TMS standpoint...as a PT I see many patients I believe had surgeries like yours that were possibly not necessary. But healing from those surgeries is still very possible despite that!

That being said, it sounds like at least many of your symptoms are TMS-caused. CRPS is known to be a variant of TMS as well. It's great that you found the Sarno books and this message board, these and the SEP should be immensely helpful! Don't ramp up your activity too quickly, rest, do your normal routine and focus on the TMS strategies.

If you have more specific questions on your symptoms or anything feel free to message me.

 

Thanks MindBodyPT.
What's puzzling is that post surgery nerve conduction study show very minimal improvement compared to the pre-surgery one on some sections of the study and none whatsoever on some other sections even though MRI shows carpal tunnel ligament is not intact anymore (or is completely cut off) !?! Thus the Neurologist who did the post surgery study reported that the surgery did not address the problem. But the hand surgeon who did the surgery claims he did !?! Well, I suppose he is not going to accept it even if he really messed it up, would he? That's why I went and saw another hand surgeon. He is not too helpful either.
The specialist who wrote the report for the MRI indicates in the report that at the level of the proximal carpal tunnel the free edge of the carpal tunnel ligament on the medial side is not displaced in volar direction and this could reflect a potential site of incomplete release. But none of the surgeons thinks this is an issue!?!

These sort of findings keep me thinking that there is a physiological part of my problem.

When I look back now, I can see that my hand-thumb symptoms were most probably only TMS before the carpal tunnel surgery and also some thing to do with brain plasticity. I have been reading Norman Doidge's books on brain plasticity. Through his books found out about Michael Moskowitz and his web page Neuroplastix.com where he claims that one can get rid of pain using brain plasticity. Both Doidge & Moskowitz (there are other s too) explain how pain is registered in brain and remains there even if the acute trauma causing the pain is not there anymore. They also both claim that this registry of pain in the brain can be removed thus relieving the person of any pain.

What I believe now is that after 3 neck surgeries my neck was finally stable and pain free but somehow the nerve pain on the thumb that was registered when neck problems started with disc herniation remained in the brain even though there was nothing wrong with my hand-thumb. But following conventional medicine and its practitioners I ended up having the carpal tunnel surgery to get rid of it but the surgery made it worse by creating real trauma on my wrist (even after 6 months, the surgery location is inflamed and very sensitive to touch) Now my brain says "hey, I've been telling you that something was wrong with your thumb-wrist-hand even though there was nothing wrong with it, so it was definitely TMS at that time, now you created real acute trauma there and gave me more ammunition to fire at you and here I am firing at you with more/stronger symptoms.

But as I said, I am done with conventional medicine and trying to resolve my issue thru TMS & Brain plasticity but still can not get rid of the idea that some of my symptoms are physical.

 

Ok, it sounds like in general you have the right idea about all of this! MRIs, however, will always find abnormalities. (I experienced this when I got a spinal MRI showing 2 herniated discs.) Even if the carpal tunnel ligament suffered damage from your surgery, that should be healed after 6 months. Acknowledging that there may or may not have been a "mistake" during the surgery is important, however, at this point in time that should have healed. Having all of these surgeries must have been a difficult thing to go through! Glad you have found TMS and won't have to go down that road again.

The ideas about neuroplasticity are perfectly in line with TMS! This explains the CRPS you've been experiencing (pain and swelling at the site after healing has occurred). When people talk about pain from "central sensitization" this is the same thing. The general idea that the brain learns pain patterns that persist after tissue healing finishes is another way of explaining an aspect of TMS.

Keep telling yourself that your body has healed from the surgeries, that your symptoms are brain-caused. Unlearning the idea that your pain is physical takes time and dedication. You're on the right track! Keep reading, journaling and working on it.

 

Keep telling yourself that your body has healed from the surgeries, that your symptoms are brain-caused.

I do but the surgery site is still very sensitive and according to all doctors except the one who did surgery, the tissue at surgery location is inflamed under the skin even though skin (the cut/scar) has healed fine.
It would have been much much easier to accept it as 100 % brain (or TMS) produced symptom if I only had pain in my thumb with or without activity but the surgery location is in constant pain and I can not put any pressure on it such as pushing yourself up while getting up from a sofa or chair, or gripping a tool. If I do pain shoots up dramatically and takes a few days to settle down. when I say settle down I don't mean it disappears, it just goes back to roughly the level before the activity

Even if the carpal tunnel ligament suffered damage from your surgery, that should be healed after 6 months. Acknowledging that there may or may not have been a "mistake" during the surgery is important, however, at this point in time that should have healed.

Yes it should have been healed after 6 months but going back to my above comments, even though the scar has healed but not the tissue underneath it. I don't know if it is the carpal tunnel ligament and/or some other tissue too but the tissue underneath the scar has not healed. No doctor has any answer about the time it will take to heal. The best answer from medical establishment so far is "your question about time to heal is equivalent to the question of how long is a piece of string" This makes my blood boil. Is this how far modern medicine has come?!?!?

Keep telling yourself that your body has healed from the surgeries, that your symptoms are brain-caused.

That's what I have been trying so hard but having some physical evidence (scar tissue underneath the skin at the surgery location) as I mentioned above makes it so much difficult.