PROTECT YOUR FIST
Fred Ryan, W3NJZ, FISTS #10212
After many years of CW operating I developed "glass fist", or Carpal Tunnel Syndrome (CTS) in both hands. I write this to let you know how to recognize the incidence of CTS, how to know when it is time to seek surgical relief, what to expect from the surgery, and what not having surgery done may lead to. CTS can be a career ender for CW operators.
My first symptoms began last summer when I would feel a tingling in my fingers while driving. Thinking that it was poor circulation I ignored it for a few months as it apparently had no effect on the functioning of my fingers. Suddenly my right arm would start aching while asleep. The pain would waken me and I found that if I would sit in a chair, letting my right arm hang down limply at my side, the pain would disappear after ten minutes and I could return to sleep. After another two hours the pain would recur and I would alternate from chair to bed all night. My ability to send code was not affected at all at that time (high speed on a bug and very high speed on a keyboard). It took me about two weeks to figure out what was going on with my arm and the answer came from searching the internet for medical problems where it suggested CTS. I contacted a hand surgeon who referred me first to a physician who performed Nerve Conduction Test s to determine the severity of the problem.
The Carpal Tunnel is a region in the wrist where the nerves to the fingers and the tendons are close together and in time the tendons may begin to do damage to the nerves, leading to CTS. The Nerve Conduction Test places electrodes on both the upper arm and at muscles in the hand. An electrical shock is applied to the arm and an instrument measures the delay time for the nerves to transmit that impulse to the hand, as well as attenuation in the transmission. It is a predictor of CTS nerve damage and can dictate the need for surgery. The tests showed that I had severe nerve transmission loss in the right hand and moderately severe loss in the left. Another week was lost in waiting for an appointment for surgery on the right hand. During that week I suddenly lost the ability to use either the bug or the keyboard and had to drop out of CW altogether. The surgery on the right wrist was done in early December and two things followed; the pa in disappeared at night and my sense of feeling in the fingers also disappeared, not something I expected to happen! My only CW QSO was on New Year�s Eve when some QRQ buddies joined me using straight keys! My left wrist was operated on in late January. It had not reached the pain stage yet but I didn�t want it to progress that far as permanent nerve damage can occur of you wait too long. Occupational therapy followed both operations.
Now, seven months after surgery on the right hand and five after the left, I can operate CW at about 95% of my prior capability, although fastening buttons is still challenging. The surgery itself does damage to the nerves that results in a loss of feeling, greatest in the thumb and least in the small finger. The loss of touch will make it impossible to perform many tasks such as picking things up or fastening a button. Fortunately most of that will slowly return over the following year. If surgery is put off too long, permanent damage of the same sort will occur to the sense of touch that will not be cured by time. From my experience the following advice is given to my fellow FISTS operators. At the first sign of tingling in the fingers that can be shown to not be related to poor circulation, get a Nerve Conduction Test performed. If the loss is severe an operation is suggested without delay. At that time you may start feeling pain du ring the night, an indication that the condition is advanced and that the risk of permanent nerve loss is close at hand. If the nerve damage is not severe a watch should be put on the condition until surgery is indicated. I welcome comments by any of the FISTS family who might be orthopedic surgeons specializing in such surgery. I hope that this writing gives you some good guidance. Don�t lose your fist!