Slept bad last night. Arm didn't hurt but shoulder was sore again only while sleeping (I am sleeping basically flat). Suddenly I'm wondering if all the iced green tea I was drinking is keeping me up at night.. hmmm.
Had my first post-op appointment today.
The bandage was changed. I still need to keep the arm elevated for one more week. doh. At work Im talking with people holding my arm up while sitting like Im in school and have a question.. I find it funny. Most of the time I'm not in my office so its about the buildings talking with others on projects.
Today the top of the arm near the armpit is definitely more sore. The bruising has been going away, but for some reason it is much more sore today in that region. When I raise my arm up it is sore. The doctor said it is good the bruising is showing up there, as that was is hoped for by elevating the arm. I was surprised at how clean the incision looked. ie not much scabbing, etc around it.. just the skin almost perfectly sealed together in a fine line. Sometimes sutures pull the skin up one one side more than the other. I have to give Dr. John Cook in Newport Beach credit here (besides being a cool doctor who will take the time to explain things in more detail if you want to know - he has also been more cautious with rushing to judgement I needed surgery until was has a solid case for it).
We did some minor strength tests - for ex. I hold my fingers together and he tries to get them apart. I was instructed though not to use the arm for really anything yet.. not even flossing - although I can't reach that close to my mouth with that arm yet, so I'm to keep working at increasing range of motion. It seems I may be losing a little size in the arm already even with the swelling.. the definition isn't the same in some spots.. my Wife disagrees though.
I asked if during surgery the problem was identified. He said the nerve appeared to be thickened at one spot of compression . This can happen from aggravation of the nerve.
That being said.. here is an interesting abstract from a study
http://www.neurology.org/cgi/content/abstract/63/9/1675
"Conclusion: More pronounced ulnar nerve thickening at the time of the diagnosis is associated with poor outcome at follow-up, especially in conservatively treated cases, while "electrodiagnostic signs of demyelination on testing indicate favorable outcome"
and... in my case conservative treatment didn't work.
Why didn't my "in situ" procedure work? The doctor explained a possible case - in the "in situ decompression" procedure the tunnel itself is opened up. Think of your nerve going through a hose. If the nerve gets too big for the 'hose' it will have pressure on it. The tunnel is cut open to release that pressure. If the cause is not the tunnel being too tight and the nerve is being pressed on my other structures (muscle) then in situ decompression doesn't seem to be the right choice to resolve it. Unfortunately it doesn't seem there is a check ahead of time to determine which is the choice to use.. although in my case nothing was lost by trying in situ, I feel zero effects from that procedure and have just a small Z shaped scar on my elbow from it.
The doc also didn't feel numbness in hand was a big deal.. since it is on the whole hand and seems to be pretty minor, prob because of swelling. He did the roller point test which is a wheel with spikes on it they roll across fingers to check if you feel the same sesitivity in each finger/hand. It was pretty close between left and right.. but not as 'sharp' feeling on the surgery arm (even close to the incision it felt more like a long scratch than individual points).
Here are pics today after bandage was removed before the smaller one was put on.
A lot of the yellow is brusing, but also a lot is from the ointment they use before surgery.
It looks all like there are raised lines because the bandage was just on pretty tight.
The new bandage is now much smaller and easier to move.
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