Median

Thursday, July 05, 2007 | 10 comment(s)

Statistically speaking, a median is the point in a probability distribution above which 50% of observations reside and below which the other 50% live. Or mathematically:



In a civil engineering sense, a median is a section of space that separates highways.



In human anatomy, though, the median nerve is the nerve that runs from your shoulder all the way to the tips of your thumb, index finger, middle finger, and (oddly enough) just the the one side
The Ulnar Nerve
The other side of your ring finger and your little finger are the bailiwick of the ulnar nerve. Interestingly, the ulnar nerve is the only exposed nerve in your body. When you hit your "funny bone" (actually named for the "humerus" bone in your upper arm), you're actually hitting the exposed portion of your ulnar nerve and sending crazy pain all the way down to your pinkie.

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of your ring finger.


The past few weeks I've been doing some pretty serious manual labor around my house that has involved using a jackhammer, swinging a sledgehammer, a pick, and an ax. Two weekends ago, I built
I Have to Give Credit
Although they're not pictured in the little lightbox of photos, I have to give credit to my brother-in-law, Chris, and my father-in-law, Aloysius, for helping me dig the trench for the retaining wall. Also, my Dad and his friend, Chuck, came down from Philly and helped me build the wall. These were two men on a mission and we knocked it out in a day. I can't thank them enough for their help.

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a retaining wall along my driveway. For the two or three days that followed that, my fingers would go numb throughout the night and intermittently during the day, too. By the end of the week, though, things were much better.

Then last weekend, I built a bunch of shelves in my attic and basement (I have a sense we're going to be in serious need of storage soon) and started to chop up a stump in my backyard that needs to come out. Again, my fingers went numb for several days afterwards.

I'm pretty sure what I've been experiencing is carpal tunnel syndrome, and my median nerve is getting compressed by stressed out and swollen ligaments and muscles following rigorous labor. I've treated it with a decent amount of aspirin
NSAIDs
Non-steriodal anti-inflammatory drugs are key. Tylenol simply masks the pain, whereas NSAIDs actually treat the underlying inflammation. Given the choice between aspirin and ibuprofen, I choose aspirin because there are several negative findings related to ibuprofen and kidney damage.

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and rest.

These episodes of my hands going numb have been pretty frightening for me. I think about how much I currently rely on my hands, and how much more I'm going to need them (I'm gonna have a lot of diapers to change soon!). Thankfully, aspirin, combined with rest, seems to work pretty well.

In my hyper-anxious internet research mode, I found out that in addition to all the other things diabetes increases our risk of developing, carpal tunnel syndrome is also on that list. In fact, there's a study that concludes that diabetics have an 85%(!) likelihood of developing carpal tunnel syndrome over their life-time.

Great, just great.

I'm starting to feel like I'm getting old.
And I'm sure having diabetes for 28 years isn't helping matters any.

10 Comment(s):

Blogger cesnh said...

I haven't done near the work you've done but - did do some deck painting last week and experienced the numbness also. It was/is a first for me and had me somewhat worried. I don't like having to deal w/ more of our diabetes risks.

Blogger Minnesota Nice said...

Kev,
I have had cts for 25 years, give or take. The symptoms wax and wane and of course there seems to be a direct correlation to how much I am using my hands.
Keyboarding doesn't bother me, but when I was assembling some stuff from Ikea was the worst (I now have an electric screwdriver).
Knitting and playing the violin are not too bad, if I keep them in moderation.
Also, not only "repetitive stress", but leaving your hand in one position for too long is bad - this happens when I go bike-riding, although it's not as serious as years ago when they had the old Schwinn 10 -speeds where you had to bear a lot of weight on your hands.
The median nerve enervates the thumb, pointer and half of the middle finger (but on the diagram it looks like it branches along both sides of the middle finger). The dr will no doubt ask if the numbness is localized there. It happens when you sleep because most of us tend to sleep with our wrists curled, putting pressure on the ct. I also have problems with my ulnar nerve, which you can see on the picture runs up the ring and pinky fingers.
If the symptoms continue to bother you at night, maybe you should consider going to Target and getting a couple of cheap wrist braces to wear while you sleep - they do help - but you'd have to be careful not to whack Meg in her sleep.
Also, at the end of the day, I sometimes dump a couple of ice cube trays in a big lobster pot, fill it with water, and take turns dunking each arm up to the elbows, alternately for about 30 seconds each, for a total of 5 minutes.

Little things add up to cause symptoms, and little things help to alleviate them.

Good luck.

Blogger Chrissie in Belgium said...

Kevin, I have had carpal tunnel operations in both wrists. When I quit my job in finance and moved to our house in the country in Sweden I worked constantly with the renovations. The problems even started after I scrubbed the apartment we had sold in Stockholm before we moved to our house in the country. My wrists and entire arms hurt like HELL that first night in our house. As usual I over-did the scrubbing. In self defence, it doesn't hurt until after you have done the damage. Then I refused to take a break! There was so much to be done ..... Then I got stiff shoulders on top of the aching arms and wrists. Don't be so stupid as me! Be easier on yourself. Not everything has to be done now, before the twins are born! I knew I did not HAVE to do everything so quickly, but I wanted to.... and dam it all I was going to do what I wanted! Stop and don't push yourself so hard! And get medical help before it is too late. I waited too long. My frozen shoulders remain. Eventually I got carpal tunnel operations in both wrists, but I waited too long. It wasn't until we moved to Belgium that I finally accepted the operations. The doctor said I had NO CHOICE! It can be really hard to find competent help with stiff shoulders. Make sure you get the best advice out there and don't wait too long and stop trying to do everything RIGHT NOW. Learn from my mistake please.

Anonymous Jana said...

Well, you've helped me figure out what was going on with my fingers a couple of days ago...I had burning pain in my pinky and ring fingers of my right hand...so it must be that ulnar nerve. The elbow in my right arm is extremely loose from an old gymnastics injury, and it pops and clicks a lot, so I wonder if I just got that nerve pinched for a bit.

One of the other things that diabetics are more likely to get that I suffer from is trigger fingers, which is basically swelling of the tendon(s) in your fingers. When you bend your fingers, the swollen tendons sometimes get caught and can potentially be "frozen" so badly that you can't straighten out your finger even using the fingers of the other hand (in which case a trip to the doctor is required for a steroid injection into the tendon). Luckily, in the last year or so for no apparent reason I've been having much less trouble with my fingers. The only time they continue to consistently lock up is when I'm cooking...chopping vegetables, etc.

Blogger Scott K. Johnson said...

I've been heavy on the keyboarding (computer, not musical) for as long as I can remember.

The only time I ever dealt with CTS was during a 2 month long stint at UPS loading trucks.

I got a couple of nice wrist braces that I wore when I was loading and at night, and that seemed to help.

I too notice that I have some of the numbness when I've worked a lot with my hands.

I too recommend some wrist braces to wear at night.

Blogger Kevin said...

Kathy: Thanks for the pointers. I worry about cts keeping me from my guitar playing. Hopefully it's all about moderation. Also, I'm wondering whether you considered the ct release surgery at all. There is some research that indicates that the surgery can be just as effective among diabetic patients.

And Chrissie: I'm wondering whether your experience with the surgery has been positive. Any problems afterwards? Or are your hands "good as new" now? What are the drawbacks of the surgery? I almost feel like if this is something that persists, why not go right to the surgery and have it fixed?

Blogger Minnesota Nice said...

Yes, the surgery was suggested right away. But I hate doctors, hospitals, and medical procedures. So there.
I never had any real pain or muscle weakness, or I may have taken a stronger interest.
It has just settled into something that comes and goes and I rarely give it any thought.
Now the trigger finger, that's another situation. I got good results from the cortisone injection I had a month ago. But if it keeps coming back I won't like it. It is truly disabling when your finger locks in a bent position throughout the day. Very vexing.
I suppose you could ask your endo next time you go, but then, she would just whisk you off to a hand clinic.
These decisions are complex. Yikes. Always something.

Now I'm thinking back to this gizmo I ordered online a couple of years ago which was supposed to fix ct in one month. It had resistance bands attached to the tip of each finger and you pulled against them several times a day. Maybe that's what gave me the t.f. Certainly makes sense.

Blogger Emily said...

I had a fairly bad CTS flare up when I first started college and had my very own computer for the first time in my life. In addition to doing lots of school work, I was also playing around with it a lot. Since then I have had a few minor flare-ups, but now that I know what it is, I have learned to rest when the first signs of symptoms show. Too much mousework is what kills me, so I usually use a brace when I am doing a lot of spreadsheet work at work. I tried a number, but I found the IMAK products to be the most to my liking, being supportive without being too constricting or uncomfortable. I use the smartglove for the computer, and the pil-o-splint for sleeping if things get reaaaalllly bad.

http://www.imakproducts.com/Products/SmartGlove.aspx?Navigation=PainRelief&Browser=PainRelief

Best of Luck.

Blogger Alison said...

Quite a few months back my right hand would randomly fall asleep at night. Completely freaked me out. I determined it was due to my mouse, my mouse pad, and how i positioned my arm when i was on the computer.

I found this website Ergonomic Times after making an "OMG My Hand's Going Numb" type post on my blog and someone from the site happened to see it I guess and directed me their way. I bought an ActiveWrap wrist gaurd from them (works great) and an ergonomic mouse. From somewhere else I got a mousepad with a little wrist rest on it which also helps with support and bloodflow apparently. My symptoms eased immediately after that.

I still overdue it from time to time, but I recognize what it is now and can take steps to correct it before the symptoms show up again.

I hope you're able to find something that helps! :)

Anonymous In Search Of Balance said...

Sigh. Why don't our foolish bodies understand that diabetes is MORE than enough to occupy us? I hope your hands feel better soon....

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