Today I went in for an MRI. This time, they injected me with a contrasting dye
that is supposed to help the nerves show up better. I see the doc next Wed 12/19 to hear
what it all means. Below is a scan of one of the images from the MRI session:
Perhaps I can use this for a new promo picture, as I think it
really shows the "inner me" ;-)
Nice folks at the lab. It's an inherently uncomfortable process physically,
and they were all anxious to offer whatever creature comforts possible under the circumstances.
The imaging session involves being shuttled into a narrow tube, lying down.
The technician communicates with you via speakers and microphone inside the tube. It is
quite a tight fit. Inside, the area is lighted. During the periods when you are being scanned
(by, apparently, nuclear and electromagnetic energy) you must lie COMPLETELY MOTIONLESS for periods
of 5 to 10 minutes. You cannot twich, scratch, or even swallow. These are very long minutes.
The technician explains everything that is going on before it happens. When a scan begins, there is a series
of very loud, metallic knocks that resonate throughout the chamber and seemingly throughout your body.
The knocks then suddenly speed up to something comparable to a jackhammer sound that lasts the remaining
time. During this time there is no other sound in the world and communication with the
the technician is quite impossible. When it stops, it is at least as disconcerting as when it starts, but
there is relief that you've gotten through it.
Occasionally during the jackhammer period, other harmonic tones - each quite surreal - come and go.
The best comparison I can draw is to "Sister Ray" by the Velvet Underground. The continuous thud of
Mo Tucker's simple, unstoppable drum throb, danced around by John Cale's bass, and the "Kinura" sound
of the organ, violently entering and exitting without warning. Surprisingly, it is more
reminiscent of this pattern than of Lou Reed's later Metal Machine Music noisefest.
Music is offered through headphones in an attempt to alleviate the upsetting noises. For the
first scan, I accepted the music but found it just all the more disturbing. For the second and subsequent
scans, I asked that the music be silenced and attempted to simply connect with the overwhelmingness of the machine's
noise. Strangely, this proved far more tolerable.
UPDATE 12/11/01 (and appended to on 12/14)
Yesterday I attempted to practice for the first time since, uhhh... "the incident".
I was able to manage only a few minutes of the most basic 2-finger fingerings.
I would estimate my finger strength (compared to 2 weeks ago) at:
5% (little finger),
20% (ring finger),
70% (middle),
and 75% (index).
When I play slide guitar, I use a heavy brass slide on my little finger; obviously,
this will be the last capability that will be recovered (right now I cannot even keep the slide in position on the finger, and it
just slips pathetically off onto the ground).
This is actually a slightly better report than at this point during the
original injury period 2 years ago. I will boldly project 80% recovery in 6 months. Patience is now the key. Again, I am quite
optimistic and I consider this incident less serious than the previous one.
Based on past experience with this condition, I would guess that I will begin
the long painful process of physical therapy in about 2 months. This period cannot begin until
the shoulder pain and the finger numbness have subsided. At that point, my fingers will be somewhat
useless appendages until several months of therapy have brought them back to life.
I look forward to this period and to working with the therapists.
I am quite optimistic as to my recovery, due partly to an understanding of the process based on
prior experiences. Last time, while I cannot say that I ever regained 100% strength, my playing within the
new limitations actually improved significantly. It's funny how being deprived of an activity that one loves
can actually make one love it more and acknowledge its necessity to life.
UPDATE 12/6/01
Well... yesterday Dr. Collins ran me through his battery of nerve tests. I have, indeed,
damaged the nerves in my shoulder again. As I type this, I must reposition my
torso every few seconds in an effort to keep a step ahead of the pain; the same holds
true 24 hours a day, continuously shifting my body as each new position becomes unbearable. Sleep is...
a challenge.
Things are improving, however. The first 2 days of this particular outburst
were absolutely devoid of ANY sleep. On day 3 (and with some fairly heavy pain
medication), I could manage brief periods of sleep that lasted between, say, 30 seconds and 10
minutes in length. On Day 4, the longest stretches increased to 20-30 minutes. Day 5 increased these even more.
Last night (day 6), I slept for 3 long periods of 2-3 hours each.
I have scheduled an MRI for next Thursday 12/13 which will help Dr. Collins assess
the extent of the damage and determine the next steps. In addition to the pain medication, I am now also
taking Prednisone, which is supposed to speed regeneration of the nerve cells.
I am otimistic that this episode will be less severe than the one I experienced in late 1999, which resulted
in a full year of immobility of my left hand.
UPDATE 12/3/01
I've been playing a lot lately, and unfortunately it has taken a physical toll.
My left shoulder is once again in some pain, despite the medication
that my neurologist has prescribed. My two smallest fingers are also completely numb. Having played some
long shows successfully over the past few months, I'm afraid I got a little "cocky"
and mistakenly thought I could continue to increase my playing schedule.
I will make another entry here after seeing Dr. Collins on 12/5.
I have added some more detail to the "background" section below, based on more doctor's
information.
UPDATE 5/7/01:
I did a show at The Panama Bay Coffee Company in Livermore, California on
Saturday, May 5 (see the schedule page
for the next one). My left hand problems were their worst in quite a while.
This was partly due to having had to lug my equipment several blocks from my car
due to the streets being
closed for an event. Fortunately, the police allowed me access after the show
so I didn't have to lug it all BACK those same several blocks.
During the show my left hand "seized up" quite a number of times, and continued its
spasmic behavior during the drive home. The hot water soaking had little
effect this time. The condition worsened as the night went on.
As soon as I got home, I soaked it in hot parrafin wax, a "moist
heat" treatment that is more effective than the hot water. As I write this (2 days after),
my fingers are still tight and sore.
Almost more troubling was a similar, but brand new, problem with my
RIGHT hand! During one song ("Long Lashes"), my middle finger basically stopped working.
I pick with the thumb, index, and middle fingers. This happened at the very end of the show,
and I packed up following that song.
UPDATE 3/4/01:
My hand behaved well for my February Virtues of Coffee show
unlike January's (see below).
No seizing up, no monkey fist, all went rather smoothly; the only medical problem
turned out to be that I was getting the flu, and woke up the next day with a raging
fever! Oh well... :-)
The difference from January? I had been regularly doing my exercises and my
"tractioning". The January problems turned out to be a very real "reminder" that
the therapy DOES, in fact, help quite a lot.
Anyway, the last vestiges of the flu are leaving my body now. March's show should be a
delight... the first one this year in truly "good health"!
UPDATE 2/13/01:
My January show at the Virtues of Coffee
went very well... until my hand "seized up" about
halfway through it. When it cramps up, the fingers simply will not move,
and are "frozen" into something like a monkey fist. It hurts, and it happens suddenly.
I discussed it with my chiropractor and favorite deep tissue therapist Dr. Colleen Piva, who
suggested a very simple treatment: next time
it freezes up, I should hold it under hot water for a few minutes.
I have since had occasion to try this out, and am happy to report that,
in an emergency, it is remarkably effective.
I have now also renewed my formerly lagging efforts at home therapy as recommended by Dr. Piva.
These include daily "traction" sessions, where I stand upright with a series of pullies
and a hanging weight to counterbalance my chin and force my spine into an over-corrective
back-bend. Also on a daily basis I do simple "doorway stretches" for more immediate relief.
I will soon be posting photographs of these exercises. It's all a problem with my posture.
BACKGROUND:
Why would a healthy, happy 49 year old guitar hacker want to talk about
"Medical Stuff"?
I'm just now recovering from a strange nerve condition
that had prevented me from playing the guitar for about a year.
It all started with a pain in my shoulder...
No, excuse me - it was an EXCRUCIATING pain in my shoulder.
I was diagnosed by some very good doctors, including a neurologist
who described a tiny little nerve cluster in my shoulder that got all
twisted around as a result of my
Darwinian
transition from being a SEATED to a STANDING guitarist.
The hapless shoulder was the fulcrum of my new posture.
The pain lasted several months.
No medication is effective in treating the pain. Prednizone can help, but
only slightly, and the side effects can be extreme. The pain increases
when laying down; sleep is virtually impossible during the pain phase.
When the pain finally subsided, there were several more months
of total numbness of my left arm and hand, accompanied by tingly waves.
There was no sense of "feeling" in my fingers, and the "tingling" felt like
my whole arm was "asleep". Practicing the guitar continued to be quite impossible.
There are several terms to describe the condition:
Brachial Plexitis Neuritis
Neuralgic Amyotrophy or
Parsinage-Turner Syndrome
One of the tests administered to check on my progress was
very weird
indeed:
First, a nerve map was painted on my back and shoulders, for reference.
Then, electrical needles were inserted into specific nerve centers
and individually sparked.
We all watched to see if each respective finger
jumped
in response to its charge.
Fortunately, each digit leaped up like a trained dog; it was a major relief,
but a very creepy experience.
I would like to thank the following who have assisted in my treatment:
Dr. Carol Lamb, MD
Dr. Eric Collins, MD
Sharlynn Shikuma, MPT
Dr. Colleen Piva, Chiropractor
Dr. Karlotta Bartholomew, MFT