MD's Diagnosis of Carpal Tunnel

I am a chocolatier making decorated and filled chocolates, a very mentally demanding but fulfilling job. It fits in well with my perfectionistic tendencies and my nagging desire to please people. A few weeks ago, as I was beginning plans for holiday production (last year I made about 3,000 chocolates for Thanksgiving and Christmas--working alone), my right hand became numb and there was occasional pain running up that arm. Since I am right-handed, this presented a huge obstacle to my work. I finished the current batch with considerable pain and unrelenting numbness. Given my history of many TMS issues, I immediately assumed this is another one--the correlation between the onset of pain and my chocolate work was almost laughable in that it was so obvious: I want to make chocolates for the holidays, but don't want to make so many that I am exhausted; on the other hand, the thought of cutting production and limiting sales makes me feel guilty for not living up to my standards and customers' wishes. But, following Dr. Sarno's advice in his books, I went to my primary care physician, and of course his preliminary diagnosis was carpal tunnel syndrome. He wants me to go for an EMG test. The part of his diagnosis that has me concerned the most is when he said that if I ignored treatment of the problem, I would have permanent nerve damage. That was scary. I would like to know for sure whether there is medical evidence for this view--or is it yet another example of when non-TMS-aware MDs make assumptions of what "ought" to happen if the patient ignores their advice? And please don't advise me to "go to a TMS doctor." I wish I could, but there isn't one anywhere near me, and I doubt there is any MD who would "see" me via video.

 

They are so F-ing full of SH-T. I just got mad at them reading your post.

That is their favorite Boogie Man. I have been safely running, falling, fighting and ...well you know, aggressively for 23 years since I got that stupid warning about my spine. I even fell and Broke my Back with NO nerve damage.

No wonder we've turned into such gossamer's with all of their very very negligent sayings. Remember... Doctors always err a hundred yards to 'safe' because of the general misinformed view that structural changes cause 'damage' which is just WRONG.....also, they'd rather say that to a thousand patients and be 'safe' rather than risk being wrong once.

Funny. I was just fighting a TMS in my leg issue and when I started winning, it went into my thumbs...both of them were excruciating! Right when I had made the decision to start putting a lot more time into guitar and a writing exercise I do every morning FLAMES.

and then I laughed at it and told it it wasn't being particularly original or creative..and it went away overnight. Mind you, i have been doing this crap a long time.

SCREW 'em. Start working on what's really the problem....the first part of which is a "Life search"... it's not in your hands, it's in your Life. The Holidays are so fraught with moral imperatives (rage makers for the unconscious) it would be it's own sub forum on this forum (LOL!)

Focus on your unconscious anger about your pre-disposition to want to do things for others and your hands will be aces!

 

A very helpful response. For years I have been learning from your blunt, tell-it-like-it-is responses here and on the TMSHelp forum. Your example of planning to work more on guitar and writing and immediately getting pain where it would matter a lot made me (almost) laugh. It's very similar to my experience with starting to make chocolates. This morning orders began coming in for Thanksgiving chocolates, so I'm trying to behave as if everything is going to be OK. But a customer and friend saw me just as I was entering the PCP's office this week and learned why I was there. Today she wrote: "My understanding is the surgery to correct is a minimal procedure. Might be worth pursuing." There is that seed of doubt again. And apparently it is true that the surgery is minor, and but it is also true that it doesn't work some of the time and works only temporarily sometimes.

 

I already responded to your other post and have little to add to what I already said, but you definitely can be seen by a TMS doctor remotely, even more so now than it was 6 years ago when I had a consultation with Dr. Gietzen listed here on TMS Wiki list of practitioners. He looked at my EMG (yes, it was a bad one and I had been told by my docs that nerve damage was irreparable), and confirmed TMS diagnosis. I am forever grateful to him for clearing the fog out of my brain.

My CTS diagnosis is still on my medical record, but I do whatever I wish to do with my previously "irreparably damaged" hands, so I don't really care about their diagnosis which has nothing to do with my hands.

Now, you have two options:

1. believe that it is TMS and take the route that many of us travelled successfully to a complete recovery
2. continue going on a circuit of doctors who ping-pong you from one specialist to another - I did that for a while, too! - and spend the rest of your life there. Surgery may help, but success rate is about 50%.

The choice is yours. The worst you can do is to sit on two chairs between two options, bunch of people spend years on this forum absorbed in their doubts and their pain.

If you care to read my success story, you can find it on this forum. Once again, I was where you are now, and I am 100% healed.

 

That's what the A-hole who operated on me said about my back... Then when I didn't get better in the correct window of time I was launched onto the chronic pain scrap heap.

Lots of stuff is minimalized... That's ALSO why we have a healhcare problem in America. Drs and others throwing 5-10 and 20 thousand dollar procedures around on the flimsiest of circumstances with minimal if any diagnostic.

I had pain in my sternum for a minute. My doctor (after 5 minutes) decided I needed to have my gall bladder out. I asked how much it cost and she didn't even know. (it was about 10K). I told her I had no insurance and that it would wipe out my life savings. Couldn't care less. "Well , it could crystallize and break off and go into your pancreas and then you'd get an infection and DIE"

Then I read online that many people get the procedure and still have that pain. Knowing who I am, I opted to risk it... the fact that I am alive and typing to you means a lot of long odds were already defied (LOL)

That was in about 2011 or so.... it never even remotely bothers me anymore. It was TMS

We're all gonna die... but not all of us get to live.

 

TG957, This was very helpful information, especially about seeing a TMS doctor remotely. I'll look into that. I am basically a "believer." I overcame excruciating back pain and it has not come back. Same for tennis elbow and legitimate thumb injury that was too slow in healing. The difference this time is that in those previous episodes no one told me that I could permanently injure myself if I ignored standard treatments. I will look up your story.

 

Baseball65, I have insurance that pays for all these procedures (so far), but I think it is extravagant to let my fellow taxpayers (via Medicare) cover some frivolous tests. When my dermatologist was not satisfied and wanted to do yet more tests, I finally said no, that I didn't want to go through the discomfort and I also didn't want to dump all this on Medicare. You are right, doctors call for an MRI at the drop of a hat. And we wonder why Medicare is going broke!

 

Without Hijacking your thread, I did notice that back when I was married and HAD insurance, My wife would run the kids to the doctor if they had a sniffle.

Now that those same kids are adults, they wait until they are almost dying before going to a Dr. Because they can't afford insurance..and they both work their ass off full time in construction. The 'basic' insurance is like 8k a year...and they don't pay a cent until your another 6 or 7 out of pocket.

It's like a really bad coupon.

So I give a system about a fifth of my total annual income to have some very distracted person give me 5 minutes of their time?

I pay cash for everything. I ASK how much it is ahead of time and talk mad smack when the price changes AFTER I asked. It's funny to watch them squirm. It was hard to take 'healthcare reform' serious last decade when they weren't addressing the main problem which is the IDEA that Dr/s and their toys are somehow more valuable to society than say, construction workers or Food providers. it's a culture wide problem mostly rooted in our fears.

Thank God Sarno set us free from that crap.

 

@TG957, I got your book from Amazon and am almost finished. What you went through with pain and the experiences with the medical community is shocking. I don't know how you persevered--but obviously you did. I followed your lead and contacted Dr. Gietzen, who go in touch within a day or so. He was in Haiti doing his volunteer work there and, at first, thought he would not have a satisfactory internet connection for a session. But he emailed a bit later and said that his connection was now fine at least for a while. So we had an hour-long session later that same day. You are right, he is compassionate, calming, helpful. The fact that he is an orthopedist was perfect for my preliminary carpal tunnel diagnosis. He explained that he used to send patients for the CTS surgery but now believes it is a good "placebo" for some people and currently takes a more TMS-oriented approach for such symptoms. We will probably have another session when he is back in the U.S. His view of my symptoms helped strengthen my determination to treat the hand pain like TMS. I have started making the large Thanksgiving batch of chocolates and am doing my best to ignore the pain (or, as I type this, the numbness in the three affected fingers). So far I can do the work, but have to stop and rest my hand. I can't honestly say I am making a lot of progress, but as I have been through multiple other TMS issues in my life, I am persevering. Dr. Gietzen recommended that I cut down on the Christmas chocolates, and I had already more or less decided on doing just that. I have written the email that will go to the customer list explaining that the quantity available will be less. I suspect the reaction that a true people-pleaser has to disappointing people will make my symptoms worse.

 

@Jim D. , thank you for the feedback! My family members who have not had chronic pain before were advising me to trim the part where I talk about this medical ping-pong between the doctors, but I left it there on purpose because people need to know that it is a very typical experience and they should be ready to keep their cool. I am certain that my symptoms would have not accelerated if I had a right doctor from day 1.
As for your work, if I could suggest, I would not ignore the pain, I would rather confront it in a very deliberate way from the TMS perspective. I can't recommend meditation strongly enough to everybody who has any signs of anxiety, OCD or depression. If you are interested, tomorrow I am hosting a free meditation session to talk to folks about how I was able to learn meditation despite my prior complete disregard and misunderstanding of it. I posted about it on the general discussion thread.

Best of luck to you!

 

Could you say more about this distinction? Dr. Sarno said "think psychological, not physical." As much as I have always questioned the grammar of that statement [can't help it, I'm a former English teacher--diagramming sentences was my nirvana], but I took it to mean, among other things, that when pain strikes, the individual should switch to thinking about what might be the psychological issue behind it.

 

People do it in their own ways: some yell at their brain (which never worked for me), some think about what caused the pain (which is a classic Sarno's approach). I personally immediately started thinking about my fear being completely ungrounded, or started my next meditation session as soon as possible.

I am a firm believer that each person should be their own doctor and do what works the best for them. A CRPS patient who I work with came up with an ingenious solution: she puts together jigsaw puzzles, and that reduces her pain. Would it ever occur to any TMS doctor or coach to come up with this method? I seriously doubt. There are no standard prescriptions in the TMS world, it is not Big Pharma :=).