Dequervain's or TMS?

Hi I'm Ryan an Optometrist, 36 years old (male), with previous history of on again off again back pain.

In the summer of 2012 i started having pain along my right wrist, and it keep bothering me for about 3 days and then the same sensation happened in the left wrist. I tried everything from splitting, icing, stretching, exercising, and nothing seemed to help. I had lots of lab work done, and nothing inflammatory or auto-immune showed up. Went to a Orthopedic specialist and said they could inject Cortisone into the sheath but declined. Eventually my stress lowered and both hands returned to normal. I had a lot of stress from employing another doctor, and running multiple offices. The other doctor quit and that seemed to reduce my stress. No symptoms at 5 months after initial onset.

In August 2014 the same pain (all the same as last time) again returned in my right wrist, and again started in my left wrist a couple of days later. Again I've tried everything I can think of to resolve the issue such as splitting, icing, stretching, exercising. My regular PCP thinks it is Dequervain's and suggested cortisone injections since I've tried all sorts of treatments for 8 months now.

I refuse to believe her Dx of Dequervain's since it resolved on its own before. When preforming the Finklestein test I really don't notice pain. My pain is most sensitive to clothing that touches the wrists from a long button shirt. Sometimes my hands feel super warm, and sometimes really cold. Sometimes the pain isn't along the thumb/radial wrist area, but will be in the forearms. Then the next day, it will be back along the thumbs. Then some days it will be on the front radial thumb area. Always symmetrical in both areas.

I'm a very stoic person, perfectionist, quiet, repressed person. I don't tend to speak up a lot. I feel lonely a lot of times, since I have no real friends.

Stress areas in my life around August 14 include: We had our third child in May '14 but I wanted only two children. This caused friction through the pregnancy between my wife and I b/c I wanted to get a vasectomy but she had other biblical views. I love my daughter but our relationship always suffers when we have a new baby. I love my wife but miss her.

Since I'm self employed I worry about money a lot since I'm the only one working. I hired an additional secretary to help cover the summer rush of eyecare, but in early August 14 she wanted to stay on and I didn't say no (never fired anyone). Since I really don't have the extra income to afford her I feel like this puts stress on me.

One of my favorite hobbies is video gaming, and always seemed to stress in July '14 if I couldn't enjoy this hobby any longer.

I stress over becoming disabled and not being able to provide for my family.

I'm thinking about getting another PCP's opinion and see if they can MRI the tendons along the wrist to make sure they are not inflammed. The previous time subconsciously I got better without thinking about it. I guess this time I'm doubtful til i get an MRI to rule out all physical problems. I'm trying to avoid Cortisone shots or sugery. I did buy Dr. Sarno's book but haven't read it yet (The Mind body Prescription).

Sorry for the long post and thanks for any advice.

Ryan

 

Ryan, welcome to the forum. This is a wonderful place to find support.

I think that your diagnosis sounds like RSI, I looked at wikipedia, so just an uneducated guess. Along with all else going on for you, it sounds like TMS. Even a planned baby causes stress and conflicting feelings, ie, I am totally in love, but please stop crying, teething, growing out of your shoes! Not to mention, when you love this vulnerable little person, it makes you vulnerable.

I noticed that when it was time to let a temp go, you felt you would be firing them. It isn't the same as firing. That is pretty hard on yourself. Personality pressure adds to this TMS stuff.

I would explore this forum and read about success stories, as well as peoples struggles, that is where I saw myself. Also, the free SEP here on the wiki is very helpful for understanding what is happening, psychologically and then being manifested physically.

Educate yourself, read Dr. Sarno, Steve Ozanich, and others. Its the knowledge penicilin, and it has no nasty side effects!

Lizzy

 

Hi Ryan,
Welcome. With the on and off nature of the pain, the lack of physician diagnosis for anything serious, and you connecting on-set to stressful periods ---it sounds like TMS to me. Also, you see your personality type fits, and that the symptoms strike right at what is important to you --gaming to relax. Two more pieces of evidence.

As Lizzy says, you should do the SEP here, read success stories, read Dr. Sarno.
http://www.tmswiki.org/ppd/Structured_Educational_Program
The SEP has a good broad range of activites.

Also do Alan's here: http://www.tmswiki.org/ppd/TMS_Recovery_Program

Good luck in the journey, and feel free to ask questions!

Andy B.

 

Hi, Ryan. Excellent advice from Andy and Lizzy. I can only echo it and urge you to start the
Structured Educational Program. It will guide you through simple, short daily activities that
will lead you to TMS healing, as if has done for me and many others.

You are apparently a conscientious person with a perfectionist and "goodist" personality,
concerned that you may not be the perfect parent, or other matters.

I too am a self-employed person, a freelance writer of books for more than 40 years.
It's wonderful not to work for anyone, but monthly income to pay the bills always has been
and still is stressful.

It's understandable that your secretary wants to keep her job, but you may have to bite the bullet
and let her go because realistically you just don't have the money to keep her on.

Try to be positive, that your work will pay better. The future will be brighter.
Try to live in the present, not worrying about tomorrow.
Breathe deeply, and if things get too much, laugh it all off.
Laughing sends healing forces to our mind and body.
You can find free videos on Youtube about the benefits of laughter.

 

Thanks all for the encouraging words and the programs that you mentioned. In the early fall of 2012 I visited a PCP (third opinion) who looked at my hands, blood work, height (5'10") weight (170lbs) and my emotional well being. He told me you're fine, you'll get better. After that I started to focus on other things and not so much my hands. Then a full recovery took place.

On Friday night I told my wife that I didn't want anymore kids. For the first time she stated that she didn't want another pregnancy or child labor again. We cried, laughed, hugged and had a nice dinner out together.

I have started going back to some gaming and trying to just play without worrying about pain. Maybe an hour total a day, used to be about 2 hours at night time when everyone when to bed. My wife goes to bed at 9pm usually which I just can't do.

I still believe the most serious stress area of my life is getting rid of my additional secretary. For nine months I've lacked courage to tell her that she's not necessary anymore but I always regress. This week's goal will be to sit down with her and plan an exit date. Her position is quite a waste of monetary resources that I could be using for planning a second vacation a year for my family, or renovating.

My other goals will to become more outspoken, and friendly. I have various co-workers, & friends at church. A true friend may never exist for me other than my wife, but what's the worst that could ever happen? I may just find one !

Thanks again everyone. Especially Walt about the healing power of laughter. I've been trying to avoid yahoo/msn news since most of its negative, and signed up to receive positive messages from various sources.

Ryan

 

Ryan,
Many people find as they address TMS that they assert themselves in new ways in relationships. This sounds like you...
Andy B.

 

Its been about two and a half months since I've last posted. I really haven't gotten any better. I finally did end up finishing Dr. Sarno's book, and see myself a lot in his book and believe in TMS. I'm contemplating on buying Steve O's book to read as well.

TMS makes sense to me and wish my pains would go away. I did end up seeing a new PCP doctor that spent thirty minutes with me and said it was highly unlikely that I would have de quervain's syndrome in both thumb areas within days on two separate incidences. She did say that a therapist or life coach would be beneficial which I agree. The pain still mirrors itself a lot between the two hands. I've seen X-rays which look normal, Rhuematoid factor was negative. It wouldn't be so bad if the pain wasn't constant, a low 3-4.

I have resumed some of my video games at night time for about an hour every other night. Although when I play I don't seem to enjoy them as much anymore since I'm concerned if I'm over working my thumbs. In the past when I did video game a lot, Playstation has these trophies for doing various tasks throughout the game. I've always strive to 100% the game, and will purposely avoid playing some games if I don't think I can 100% it. So I would miss out on other games I would want to play because I would spend an additional month trying to 100% a game.

I don't believe my brain is still one hundred percent convinced since its telling me to still see an orthopedic specialist. I may just see one so my brain will be appeased. Fear still engulfs my day as I'm wondering if I'll ever get better again. My additional secretary leaves in about four weeks, which is a huge load off that I'm looking forward to.

For anyone who has done therapy would you suggest psychotherapy? I live in Kansas so a TMS therapist or physician is not readily available, although I do travel to Los Angeles at Christmas time. Is skype with a TMS therapist a better way to go?

Thanks for any input.

 

Hi Ryan, that quote above is exactly what is keeping your symptom alive. If you can find a way to stop your fear and stop focusing on your symptoms, stop worrying about it is getting worse... you will be cure. No fear, no tms.
Tms can not exist without "fear". No one, no one ever, can ever cure his/her tms/mind body symptoms if he/she can not stop FEAR. If fear exist symptoms will never leave.
So instead of trying to cure your symptoms, try to stop fearing your symptoms.
De Quervain's disease is tms. Doctor have no idea what caused, they just have a name for it. Just like name for CFS, fibromyalgia, tmj, arthritis, carpel tunnel syndrome, tennis elbow...
No one ever die from de Quervain's disease. No one ever got permanent nerve damage from it and just about everyone suffer from it will get better over time without doing anything. Happy, content, at peace people don't get it no matter how much they use their thumb. People rarely suffer from it if they don't know the name of the disease. Massage technician use their thumb much more than anyone and they rarely suffer from it. Typists in the 60's never complain about it. It don't even exist in most third world countries where people use their hands and "thumbs" all day long doing manual labor works.
I'm sure God don't make your body any less able than he made other. So I think instead of spend your time worrying about your body, you should spend more time and effort to make your life a much happier one. Make more friends, spend time doing loving activities with your love ones, do charity works....
Good luck Ryan,

 

Thanks Balto for the reassurance. I never thought about massage therapists in the amount of work they do with their thumbs. You are also right that it isn't a condition that will kill me if I live with it.

Again that you for your post. I intend to read as many books on the subject as possible. I also saw you found comfort from listening to a doctor reassuring you that emotions can 'Help and heal your neves" by dr claire weeks.

 

How are things going for you now?