Pregnancy Ruined My Wrist

This was originally written on Saturday, July 26, 2008:

Now that my son is out of the newborn phase, I plan to return to fiction writing. I stopped last July when we put our house up for sale, then in August we moved and I became pregnant (a.k.a. sick) and now, since April, I have been consumed with being a new mommy. BUT it's time I get back into it, even though my new novel is going to be more difficult than my last three.

I was watching Heath Ledger's True Hollywood Story the other day and loved one of his quotes. It was something like, "If you make creative decisions based on what other people think, then you're going to make really boring decisions."

That is SO true. When I write with my mind wondering what other people are going to think, I end up censoring it to the point of it being very bland and I hate it because it's not real. The book I'm working on now is darker than the two I submitted to Harlequin and, every now and then, I'll think if this gets published I don't want everyone thinking this dark character is me! But then I end up getting writers block!

I can't hold back on my book OR this blog just because someone might read what I write and decide they don't like me anymore. It's worth it to "take risks" if I can help someone, which has always been my point as a fiction writer--and now with this blog.

Anyway, since my last post last week, I had my wrist appointment. Turns out I have de Quervain's Disease AND Carpal Tunnel Syndrome. No wonder it's been such a pain (literally)! (I've written two posts about this: the first explains what de Quervain's is and the other includes exercises to do to improve the condition)

I feel like I should just camp out at doctor's offices these days. Joe & I never even had a family physician because we never went to the doctor the five years we've lived here--but after the past year of going to my OBGYN regularly, as well as all of Logan's trips since his birth, I'm getting used to it!

I wasn't sure who to go to for my wrist, but found a top-rated guy in Omaha who is both a family physician AND an orthopedic doctor. Originally I was just going to make an appt. for Joe to get his cholesterol checked, as well as his back looked at to kill two birds with one stone. (Joe's been wanting to have a physical because his last one was 7 yrs ago right after his dad died of a sudden heart attack at the age of 58. . .and also his back has been hurting for, um, twelve years but he's never gone to the doctor for it. . .don't even get me started!)

I talked to the receptionist on the phone to find out more about the doctor and learned he actually specializes in wrists! So, of course I made an appointment for myself as well.

I made Joe go with me just incase it was a scary place, haha, but it turned out to be awesome. Except for the fact that it was super far from where I live, the doctor had recently moved his practice into a beautiful new building and everyone there was super friendly. At first a male nurse took me to the back and asked me questions (he had a baby the same age as Logan) and then the doctor came in who was very nice, personable, and confident with his knowledge. He showed me pictures of de Quervain's and carpal tunnel, and explained everything in detail to me.

I answered his questions and did different tests with my hand and wrist, then told him exactly what I was feeling with each movement. He also took an x-ray and it was apparent that I have inflamation around my tendons. It was shocking to see all of the calcium deposits (it looked like white junk) floating around my wrist.

He confirmed what I'd read--de Quervain's and carpal tunnel are often caused by pregnancy due to all of the swelling that occurs inside of the body. It's actually pretty common. However, in most cases as soon as women have the baby the de Quervain's and/or carpal tunnel go away. In a small percentage, though, it doesn't and so physical therapy is necessary. If that doesn't work there are also anti-inflammatory drugs but they aren't safe for breastfeeding, then a splint, injections, and finally surgery. He is confident that my wrist will improve just with physical therapy, though, so hopefully it won't come to anything else. I'm not thrilled about the idea of scheduling my days around physical theraphy for the next 2-3 weeks but I guess if it makes my wrist return to normal then it will be worth it--because it hurts really bad.

I told my mom how I remember lying in my hospital bed after I gave birth and thinking, man, my wrist hurts. Looking back I find that almost humorous. I'd just given birth and the pain that I was aware of was in my wrist!!!!!

Also, every now and then I start to think I'm getting signs in my left wrist as well (until now it's only been in my right). So I definitely want to prevent it from getting worse. I guess there are computer keyboards that are better for your wrists so maybe I should get one because that's probably making the carpal tunnel worse. Geesh, there's always something, isn't there?

De Quervain's Tenosynovitis

On July 14th I posted a blog (click here to read it) about my current wrist problem, caused (surprisingly) from pregnancy. It was confirmed by an orthopedic doctor on July 25th that I have de Quervain's Tenosynovitis, so I thought I'd post a follow up blog with more information about it.

WHAT IS DE QUERVAIN'S TENOSYNOVITIS?
de Quervain's tenosynovitis is a painful condition affecting the tendons located on the thumb side of your wrist. A tendon is a strong band of tissue that attaches muscle to bone. A sheath, or covering, surrounds the tendons that go to your thumb. Tenosynovitis is an irritation of this sheath.

HOW DOES IT OCCUR?
de Quervain's tenosynovitis usually occurs from increased swelling in the body from pregnancy, or from overusing your thumb or wrist, especially in activities that move your thumb directly away from your wrist such as skiing or hammering.

WHAT ARE THE SYMPTOMS?
*Pain when you move your thumb or wrist
*Pain when you make a fist
*Swelling and tenderness on the thumb side of your wrist
*Feeling or hearing creaking as the tendon slides through its sheath

HOW IS IT DIAGNOSED?
Your health care provider will examine your wrist and thumb and find the areas that are tender and painful to move. An x-ray may be taken to be sure you don't have a broken bone.

HOW IS IT TREATED?
The initial treatment for de Quervain's tenosynovitis is a splint that will cover your wrist and thumb. It is important that you protect your thumb and wrist from activities that worsen your pain.

Treatment may also include:
*Placing an ice pack on your thumb and wrist for 20 to 30 minutes every 3 to 4 hours until the pain goes away
*Doing ice massage for 5 to 10 minutes several times a day
*Taking an anti-inflammatory medication
*Having an injection of a medication like cortisone
*Surgery

You will be given rehabilitation exercises to help speed your recovery and prevent the problem from returning. The longer you have symptoms before you start treatment, the longer it will take to get better.

My doctor prescribed physical therapy for me, but first I plan to ice my wrist and try the following exercises. My doctor was confident that although I've had the wrist pain for 3.5 months, my de Quervain's should be gone within 2-3 weeks of rehabilitation exercises.

1) Opposition stretch: Rest your injured hand on a table, palm up. Touch the tip of your thumb to the tip of your little finger. Hold this position for 6 seconds. Repeat 10 to 12 times.

2) Wrist rock stretch: Hold your injured hand out in front of you in the handshake position. Make a fist with your injured hand, but tuck your thumb inside your palm. Move your wrist down, hold for 5 seconds, then move your wrist up and hold for 5 seconds. Repeat 10 to 12 times.

3) Thumb extension: Hold a small weight (a soup can, for example) in your injured hand. Rest your forearm on a table with your wrist and hand hanging over the edge of the table. Starting with your hand in the handshake position (thumb up), move your wrist up and down. Repeat 10 to 20 times.

4) Wrist extension: Start in the same position as for the thumb extension (holding a small weight, resting your forearm on the table), but this time turn your hand palm down. Bend your wrist up, hold for 2 to 3 seconds, then bend your wrist down and hold for 2 to 3 seconds. Repeat 10 to 20 times.

5) Palm-down curl: Stand with your hands at your side, holding a small weight palm down in your injured hand. Keeping your palm down and bending your elbow, slowly curl the weight up toward your shoulder as far as possible. For each repetition, move your hand down to the starting position more slowly than you lift your hand toward your shoulder. Repeat 10 to 20 times.

6) Finger spring: Place a large rubber band around the outside of your thumb and the rest of your fingers. Open your fingers to stretch the rubber band. Repeat 10 to 20 times.

Hopefully this works because I'm still waking up in the night or morning and finding my wrist locked and in pain with my hand numb, which means it takes awhile before I can start using it (and therefore have a hard time picking up my baby). He said I also have slight carpal tunnel, but these same exercises should help. I've since learned of several other women with similar experiences (my hair stylist said her entire forearm was numb for a month after her baby was born) but most never realize the connection since it's only a small percentage that still have it three months after their baby was born. Lucky me. :p

de Quervain's Disease

Ever since my last two weeks of pregnancy, my right wrist has hurt. It didn't phase me at the time, considering I had a zillion other discomforts as well! I figured the pain was caused from sleeping on it (since I could only lay on my side while pregnant, I put my hand under my head and stayed in that position pretty much all night)--and it would go away once my baby was born.

Instead, my wrist pain got worse, especially during breastfeeding. I figured it was because I had to hold my son's head in one position for a long period of time. However, even when his neck became stronger and I could support his head with my arm, my wrist still didn't improve. I've tried every position out there but my baby turns three months old this Friday and my right wrist is worse than ever.

The nights are the most painful since I'm not using my wrist. A dozen times I've gone to pick my baby out of his crib and my wrist doesn't even work--so I nearly drop him!!! This is very scary. There is no swelling, redness, or any problems with my fingers or other wrist or joints--but an intense pain grates through my right wrist, and lately my lower thumb as well.

This has been going on for so long now (24/7) that I've decided I must go to the doctor. I plan to make an appt. tomorrow, but thought I'd try first to figure out what I have. So I went to Web MD and was fascinated that there is actually a PREGNANCY-related wrist problem!!!! Who would have thought?!?! (I was thinking my wrist just fell out of the socket or something but it sounds like hormones are to blame.)

At first I thought it might be carpal tunnel syndrome (since I'm also on the computer a lot and that can be caused by pregnancy due to swelling) but the more I read, the more it didn't fit.

Instead, my gut instinct tells me I have de Quervain's disease. There are A TON of website forums out there with women who are complaining of my exact symptoms/wrist pain following the birth of their baby and are searching for answers. Most all are breastfeeding, and most all end up being diagnosed with this wrist disease.

Even if it turns out I have something different, I decided I better let others know to watch out for this common pregnancy-caused condition because I've been suffering for three months thinking I just had minor joint pain that would go away any day--but de Quervain's won't without treatment. Don't suffer longer than you have to! According to Web MD:

de Quervain's Disease is inflammation of the tendons and the tendon sheath on the thumb side of the wrist. It may occur from injury to the wrist or tendon or as a result of activities that require repeated wrist and thumb movements, such as knitting, wringing clothes, or lifting heavy objects. It can also be the result of swelling and hormones during pregnancy.

Symptoms may include a grating feeling in the wrist and pain and weakness along the thumb, wrist, and forearm. Pain increases with activities such as lifting or pouring.

Initial treatment consists of rest, splinting, stretching, and medications to decrease inflammation. Physical therapy, a steroid injection, or surgery may sometimes be needed.

This pretty much describes me to a T, with the exception of doing anything to cause my wrist to hurt. Like I said, it started within my last two weeks of pregnancy so I was hardly active! (And I don't knit.) But, I do notice it hurts the most when I lift things with my right hand. And, I am breastfeeding, which is when the de quervain-causing hormones are the strongest. An article from the Journal of Family Practice says:

. . .a number of women in their last trimester of pregnancy or who were nursing mothers developed de Quervain's disease. Schumacher reviewed six cases of de Quervain's tendinitis occurring after the fifth month of pregnancy. Five of the six continued to have symptoms postpartum. All five were breast-feeding their babies.
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As if us breastfeeding mothers don't have enough problems to deal with!!! I am at least glad to read that it is not a permanent condition. It's serious at the time for those who are dealing with it, but not serious long-term or in connection to any other problems. If my doctor doesn't provide relief for me, then (after reading the case studies in the above article--which, btw, it almost always occurs in the right, not the left, hand even for me who is left handed) it sounds like once I cease breastfeeding my wrist will return to normal. . .so sometime within the next year. :/

For my follow up post, click here.