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Howard Tayler - My hands... so numb...
Ramblings of a Happy Cartoonist
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My hands... so numb...
I haven't started signing books yet, no.

For the last two weeks my fourth and fifth fingers in BOTH hands have been tingling, pins-and-needles-ish.

It's not carpal tunnel. That's the 1st and 2nd fingers, and the doctor did a couple of quick tests for CT, both of which were mostly negative (which means I may have a little bit of CT symptoms, but it's not serious enough to cause the numbness.)

The problem is not the tingling. The problem is that when I draw or write, my entire right arm starts to go numb. Or sometimes not, and I'm fine.

The doctor suggested an MRI. I'm not keen on spending $5,000 as a first resort, especially since it would be $5,000 of my own money. And extra-especially since a little googling turns up "thoracic outlet syndrome" as a probable diagnosis. It's one of those damnably contested diagnoses like "chronic fatigue syndrom," where the patient can go from doctor to doctor for years and be accused of everything from hypochondria to malingering depression.

This page talks about the symptom "tingling fingers:"
http://www.wrongdiagnosis.com/sym/tingling_fingers.htm

There are lots of possibilities, but the 4th and 5th finger tingling points straight at "Thoracic outlet syndrome:"
http://www.wrongdiagnosis.com/t/thoracic_outlet_syndrome/intro.htm Sure, it might also be diabetes or multiple sclerosis, but I'm not exhibiting any of those symptoms (and I'm not half hypochondriac enough to imagine them into place).

The good news is that the problem has not slowed my output. I'm pretty sure I'll be able to crank through the sketch editions and two additional weeks of buffer with little trouble between now and May 20th. But it's probably going to hurt a lot, unless I can get in touch with a physical therapist who thinks he can tackle the problem without forcing me to spend hojillions of dollars on (probably) unnecessary diagnostics.
Comments
sqlrob From: sqlrob Date: May 6th, 2006 09:01 pm (UTC) (Link)
Just take care of yourself Howard. Don't do yourself any permanent (or for that matter, any) damage.
darthparadox From: darthparadox Date: May 6th, 2006 09:17 pm (UTC) (Link)
Hm. Postural problems were mentioned as a cause of the syndrome, and I've been down that road before. My experience is that the best approach is, instead of all the therapy and professional opinions and such, to evaluate your work area - relative positions between chair, desk, floor, whatever - and adjust anything that feels unnatural. I raised my keyboard about two inches at work, and my posture improved immensely, and with that my lower back pain subsided nearly immediately.

That's been my experience, anyway. It's a pity ergonomics isn't taken more seriously in general - it can be hugely helpful.

Best of luck.
howardtayler From: howardtayler Date: May 6th, 2006 09:19 pm (UTC) (Link)
I'm looking into that. The challenge there is that I've had this setup for years with no trouble. Sure, I may need an ergonomic fix, and that may mean spending several hundred dollars on custom furniture for my office (money well spent, if that's what it takes) but I see that as a long-term solution that I can't approach until I know what "normal" feels like again.
paulpenguin From: paulpenguin Date: May 8th, 2006 08:00 am (UTC) (Link)
Eh, I went back and read this after I already wrote my tome down below, but I felt the need to reply here too. I just finished finals an hour ago and I'm toked up on caffiene, so I'm feeling cheerful and talkative (the latter of which is unusual for me).

My personal thought is that in most cases it is probably unnecessary to spend a lot of money to get an ergonomic solution, although if that's what it takes, I definitely agree with you that it is money very well spent. God only gives us one body each.

As I mentioned below, my computing chair, which I refer to as the Ugly Chair, was yielded by the college dumpsters back where I grew up after everybody moved out of the dorms for the summer. It goes up a lot higher than a lot of office-type chairs, which is important to me because I have long legs (which really is the source of a lot of my problems--I live in a world designed for people six inches shorter than myself). My desk I built myself. It's a massive affair, since it has to hold my computer, my MIDI keyboard (which is one of the ginormous models from the late 80's) and two monitors, but it was designed with the Ugly Chair in mind, so that the keyboard tray is just above my lap and the monitors are at a comfortable height.

I think what I'm trying to say is that if you end up redoing your setup, start with the chair and work from there. Then if you don't mind doing the work yourself, you can have a setup that is designed exactly for your body.
lodo_bear From: lodo_bear Date: May 6th, 2006 09:31 pm (UTC) (Link)
Should we start a "Save Howard's drawing hand" fund?
howardtayler From: howardtayler Date: May 6th, 2006 10:59 pm (UTC) (Link)
Nah. Just keep buying books. I'll figure out what the problem is, and take the necessary steps to fix it.
larksilver From: larksilver Date: May 6th, 2006 11:44 pm (UTC) (Link)
While whatever the tingly thing is in my hand isn't carpal tunnel, but a related syndrome whose name I can never remember, the exercises for carpal tunnel DO help, a great deal. Numbness in the hands, dropping things (ugh, this one is more bothersome than the pain and numbness, honestly), and occasional pain can be helped a lot by these exercises.

In particular, the one where you hold your hand flat and pull down on it like a lever from the wrist, holding it at the point of streeeetchiness for a moment before going the other direction (front, and then back, of course. Side-side would do harm, not good). The first few times I did this exercise, it was terribly uncomfortable - and it still can be, if I over-stress my wrists - but it did get easier, and it did help.

I had a doctor friend tell me once her theory on these repetitive motion issues, namely that they seem to happen to people whose hands are always busy, more than those who tend to be somewhat slacker-ly. Hard as it is for busy people to, say, rest a sore foot (I walked on a broken one for a month before taking doctor time - foolish girl, i know), it's even harder when the hands are the problem.

For me, "taking a break" often means going to my computer and.. you guessed it.. playing a game or typing on LJ. Not exactly restful to the hands. So, I might go craft... nope, hands again. okay, how about.. no, that requires hands. baking? nope. argh! So... sometimes it gets pretty bad before I'll be forced to sit on my hands and do nothing for a while.

Anyway... it might be helpful to you to take some of the precautions and perhaps even try some of the strength/flexibility exercises designed for carpal tunnel sufferers. Taking a break for a few minutes every hour and doing something different - or heck, even nothing with your hands during that 5-10 minute time can make a huge difference, even with non-"syndrome" hands.

Take care.
mrmeval From: mrmeval Date: May 7th, 2006 01:56 am (UTC) (Link)
I've got surgury due the 15th. I'm on cobra at 400 a month which means I'll pay a small percentage. I hate that I could not walk in and get health care at the same rate a megacorp pays for it. Though if I keep my cobra for way to damn long I can then buy health care at a reasonable rate.

zoyx From: zoyx Date: May 7th, 2006 02:59 am (UTC) (Link)
The Zoyx physician isn't handy, so I will have to take a crack at this diagnosis.

Does the tingling come with dizziness? You said these symptoms were episodic. Does it only occur when you have your period? If so, you may have and ovarian cyst. Time for a barium enema!!
wren08 From: wren08 Date: May 7th, 2006 03:21 am (UTC) (Link)
You might look into a chiropractic visit and/or a massage therapy visit first. If you have a bone slightly out of line (can't imagine how that would happen, sitting at a desk drawing for hours)or a muscle that's knotted up just wrong it could be impinging slightly on a nerve.

Just make sure that the massage therapist is licenced! Many of the people who practice in spas or chiropractic offices aren't.
gurgi From: gurgi Date: May 10th, 2006 08:45 pm (UTC) (Link)
Many of the people who practice in spas or chiropractic offices aren't.

Happy Ending?
galbinus_caeli From: galbinus_caeli Date: May 7th, 2006 06:43 am (UTC) (Link)

I had this.

Tingling in fouth and fifth fingers of one hand.

It did turn out to be my posture at my desk. I have/had a bad habit of sitting with one foot beneath my thigh and leaning on the opposite elbow. Which was attached to the fingers that were going numb. My solution was to stop doing that. And it worked.

This is in a chair that I had been using for twelve years (Well, I might have a different exact chair, but it is the same model) Doing the same work that I have done for seventeen.
treebones From: treebones Date: May 7th, 2006 07:26 am (UTC) (Link)
With luck, you may just need bodywork.

People who work extensively in a hands-forward posture, particularly if they sleep on their sides at night, sometimes get chronic tightness of a set of muscles called their scalenes. The nerve which innervates the fourth and fifth fingers (the brachial plexus) passes between two of the layers. If this muscle group locks down hard enough for long enough, it can cause this pattern.

Am I remembering correctly that you've got a massage therapist you work with? Check with her about her training and see if this is something she's at all familiar with. If she's not trained for a problem of this type, let me know; I can find a list of nationally certified practitioners in your area.

Your problem may be from another area entirely, mind you. But this is a whole lot cheaper than *starting* with the MRI.

paulpenguin From: paulpenguin Date: May 8th, 2006 07:46 am (UTC) (Link)
Good point about the sleeping. THis is something that most people don't think about when they have RSI-type symptoms in the hands, but it can make a difference.

I have problems with my wrist (mostly tendonitis type stuff), primarily from playing the cello. I was talking to a friend of mine, who's a professional violinist, and the first thing he suggested was wearing some sort of wrap or brace at night to keep my wrist straight. Usually I just wear a simple elastic wrist wrap ($3 at Walmart) and that helps a lot. Fact is, i wear that thing most of the time, especially when I'm playing, although it definitly helps with long gaming sessions too :-)

Besides the muscle tightness that treebones mentioned, if you sleep on your arm or hand funny, you can pinch nerves. Apparently, sleeping with your hand under your pillow is a common culprit (I do it anyway, because it helps to keep my wrist straight). And, of course, while having a wife to snuggle up to is a lovely thing, there are potential problems there too.

As a string player and a cellist (which is just asking for wrist and back problems--which i've had), I feel like something of an evangelist for a couple little-known but important posture issues, which may be important for drawing, too, so I shall mention them here.

Despite most of our chairs, the human body is not designed to bend 90 degrees at the hip. I've heard that the ideal neutral position is about how you are when riding a horse, but since I've only ridden a horse once and found it to be a generally painful experience, I can't speak to that. However, I can say that if your thighs are parallel to the floor and your back is perpendicular, you're in trouble. Once your hips hit the end of their range of motion (which I believe is somewhere in the 80-85 degrees area), your lower spine takes the rest, which, if you're sitting still for an extended period of time to provide a stable platform for your arms to do stuff (like play the cello or draw), puts a great deal of static loading on your lower back, which is a Bad Thing. In my experience, while I first feel it in my lower back, this tightness moves into my shoulders, which limits their range of motion and then my arms and wrists have to do extra work, which will eventually lead to much suffering.

The simple solution is to elevate your sitting platform and either tilt it forward or at least have it relatively flat (since most chair seats tilt back). In my case, I have a wedge-shaped cushion that will convert most chairs to be relatively comfortable for playing and I have a hideous swivel chair that my mom pulled out of a dumpster with the intent of reupholstering, but that I stole when I moved out because it has the three virtues of a flat and level seat and it can go up pretty high and good lumbar support.

I'm sure that I've posted a lot of common sense, but I've found that because I had to change my posture in a big way or risk serious damage to myself, that I have a more complete picture of how some things work, so now I go around telling all my string player friends how to sit :-)
From: larsiusprime Date: May 7th, 2006 06:49 pm (UTC) (Link)

Don't worry bout it

I ordered one of the sketch editions; if your hand is about to fall out, I'll be just as happy without a sketch as with one, if that makes it any easier ;)
howardtayler From: howardtayler Date: May 10th, 2006 07:19 am (UTC) (Link)

Re: Don't worry bout it

I took your money, you're getting your sketch. End of discussion. :-)
rbradakis From: rbradakis Date: May 10th, 2006 07:03 pm (UTC) (Link)

Re: Don't worry bout it

Sure, I want a sketch in my book.

EVENTUALLY. Dude, take your time!
gurgi From: gurgi Date: May 10th, 2006 08:48 pm (UTC) (Link)

Re: Don't worry bout it

No kidding... If my Sketch ruins his hand... Then, there'd be no more Schlock...

Ok, the thought of that depresses me... I'm gonna go cry now...
alcestis_snow From: alcestis_snow Date: May 10th, 2006 01:30 pm (UTC) (Link)
try an elbow brace or an ace bandage. the ulnar nerve is also the nerve you whack when you whack your funny bone. if other things aren't helping, try going stylish with a brace. who knows?
From: betsumei Date: May 10th, 2006 09:33 pm (UTC) (Link)
If you wanna sign/sketch mine with your other-hand/mouth/toes/I-don't-wanna-know to save some strain, go ahead. Or heck, if you wanna *gak* let mine sit for a while until the problem goes away, go for it. I can read all the Schlock online still, right? :P
If you wanna come up to Canada and pretend you're me to get an MRI, just let me know so I can shave my head in advance. You can pass for 20, right?
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