Docs, question for my wife

[stomachmonkey]

43 good health, no issues.

Past 2-3 days she is complaining that her arms, both of them, from elbow to fingertips feel like they are asleep but without the pins and needles sensation.

She went to Rapid Med yesterday, took blood, waiting for results, they suggested she see a neurologist, prescribed her Methyl Pred which she started today.

This morning she woke up and her hands are slightly, noticeable but not grossly, swollen.

Shes a bit freaked out and can't get a neuro appointment till Monday.

Any ideas?

[Jim Bremner]

I'm not a DR.


This might work, if not it might help relaxe her.


I thought that I had carpel tunnel going on. I just had some thight muscles in my chest.



Have a massae therapist massage the pec muscles right next to the arms.

[Noah930]

Cubital tunnel? Carpal tunnel? Cervical radiculopathy? Those would be more likely diagnoses. And they're easily treatable (and can wait until Monday or even next week). There are less common things, too, that are potentially horrible (spinal cord tumor), but the likelihood is pretty low so no sense in worrying her.

Which fingers? All 5? Or just the pinky and ring fingers?

[Rikao4]

No Dr..
one of the side effects of that med. is fluid retention..
if she's having circ. issues now..
the med could be making it worse..


Rika

[Noah930]

If it's just the ring fingers and pinkys (aka small/little fingers), then it's more likely to be cubital tunnel syndrome. She gets it because she's sleeping with her elbow bent. Just sleep with elbows straight and it'll go away. There are fancy splints you can buy that velcro around the elbow (imagine velcroing a magazine rolled up around your elbow to keep it straight), or your wife can just remind herself to sleep with her elbows straightish. Or wrap a towel around the elbow.

[bivenator]

Not a doc, but checked on the side effects of methyl pred. Rikao is correct that swelling in the feet ankle and hands are common with that med, the source that I checked recommended seeing a DR asap for this side effect. You described it as "slight swelling" so perhaps a call to her GP would be in order. Being saturday, the office is probably closed but we have a nurse to answer non emergent calls on the weekends at our office.
IMHO, Rapid Med was too quick to prescribe a med without having gotten any labwork on which to base thier decision.
Any neck pain or history of back problems? I like noah's cervical radiculopathy diagnosis.

[stomachmonkey]

Thanks,

It's all the fingers on both hands.

Swelling showed up this morning before she even picked up the script so we'll watch for additional swelling. Good to know that side effect, if it gets worse it's something to consider to keep her calmer.

She says it's bothering get more at night.

Personally I think it's stress. She gets stuff going in her head and let's it take over.

[Rikao4]

if she has rings on get them off ASAP..
if she can't get them off..
cut them..
the ring..not the finger

Rika

[lane912]

Originally Posted by Rikao4

if she has rings on get them off ASAP..
if she can't get them off..
cut them..
the ring..not the finger

Rika

side note: had to do this once when i worked at a jewelry shop. finger was swollen and purple. it was hard to get the saw-blade under the ring, it got tighter once i took a saw-blades width out of it. had to use pliers to get it off at that point.

[BlueSkyJaunte]

10% of us have the nerves flipped--I have carpal tunnel syndrome but it manifests in my pinky/ring finger. Sleeping with my elbows bent, wrists bent, arms under my head, whatever, definitely aggravates it.

[Noah930]

Still, the most statistically likely etiology of your wife's symptoms is going to be carpal tunnel or cubital tunnel syndrome. Both are often common at nighttime. (Common things happen commonly.) The textbook says carpal tunnel (median nerve compression at the wrist) affects the thumb, index finger, middle finger, and half of the ring finger. Cubital tunnel syndrome (ulnar nerve compression at the elbow) affects the other half of the ring finger and the pinky (small finger). But sometimes people don't perfectly fit the textbook presentation. Some 15% of people have a Martin-Gruber anastamosis where the median and ulnar nerves connect in the palm, possibly giving some sort of cross-innervation.

See if she can differentiate which fingers bother her (get numb) more. Do they ever go numb during the day? Does she get these symptoms by turning her neck left and right or moving it around? What happens if she bends her elbows and holds them in that position for a minute? Do her hands go numb with that? What happens if she holds the backs of her hands together and flexes the wrists at a 90 degree angle with the fingers pointing at the ground? Does that recreate the symptoms? If you lightly tap on the palm side of the wrist, do the fingers tingle? If you tap at the "funny bone" does that cause the fingers to tingle? Which ones?

[sammyg2]

Has she been sleeping differently lately? When I was in the hospital after back surgery the lower half of my hands went totally numb.

Turns out I was sleeping with my hands up on my chest for hours at a time because of the meds and it was pinching the nerves to my hands.
I changed my sleeping position (the nurses rolled me over when I passed out from the demoral shot every 3 hours) and all was well.

[Crowbob]

Though it's probably way too early to tell, she may be experiencing an atypical symptom of cervical disc disease. Were she to be describing pain rather than a neuropathic sensation it would lead to possible Reflex Sympathetic Dystrophy Syndrome. Personally, I think there is a significant psychological component to RSDS. Do a search on RSDS or Complex Regional Pain Syndrome. Because of my psychogenesis theory, I would also advise you not to suggest these as possible diagnoses to her. They can mysteriously exacerbate, become chronic and be debilitating (with opiates being of benefit). The swelling would tend to rule out Raynauds which is a sympathetic vasospastic disorder affecting the hands and fingers which can be dramatic. Both of these are highly unlikely. Or its nothing at all and goes away which is usually the case in an otherwise healthy person.

[Laneco]

***I am NOT a doctor*** nor did I sleep in a Motel 6 last night but as you can't get further medical until Monday, maybe a long shot would work out.

I have a vertebrae misaligment that when I sleep on it wrong, makes my hands/arms numb. When it's minor, it's just the outer two fingers, but when it's bad, it's the whole hand and wrist along with swelling.

I've experimented with pillows under the back, even a rolling pin while laying on a hard surface. The weird spot is toward the upper section of my shoulder blades. IF I can rock back and forth on a pillow, a rolling pin, even a tennis ball, I can get it to move back where it is supposed to go. The numbness disappears within 5 minutes but the swelling takes a day or so.

LIke I said, I'm not a Doctor, but this shouldn't be harmful to her and there is a slim chance it will help.

angela

[stomachmonkey]

I'm thinking pinched nerve or something similar. She slept last night, no swelling this AM and generally she's feeling normal.

Thanks for all the input.

[BlueSkyJaunte]

Originally Posted by Noah930

Some 15% of people have a Martin-Gruber anastamosis where the median and ulnar nerves connect in the palm, possibly giving some sort of cross-innervation.

I never did get a name for it from my neurologist. Now I know.