Tag: carpal tunnel surgery

Update on the hand and the tour

Carpal Tunnel Update

I have been testing my surgically repaired hand and all seems to be going well. A couple of days ago I managed to do my bird dog stretches with my hand flat on the floor. The incision on my wrist is healed and there is very little in the way of numbness in my fingers. I don’t know if it is related but the persistent nerve pain in my cervical spine seems to be gone as well.

The Mule Is Back

After weeks of below-average temperatures and riding in the basement, I’ve managed to get outside for some riding. The Mule has returned from its winter physical and all is well with the bike. Switching bikes always involves a couple of days of aches and pains but I am adjusting. After my first ride two days ago, my upper back was unhappy but that seems to have resolved. Somehow my left butt cheek is very sore probably because I am not used to the big Catalyst pedals on the bike. I have been having all kinds of leg cramps which are responding to an extra post-ride banana. Life is good.

I was so eager to get back on the bike that I overdid it a bit. My first ride was a 40-miler including a decent hill across the river in Maryland. Yesterday I did a 35-mile loop that included a roller coaster trail along I-66 in Arlington. I was feeling quite fat and sucking wind, especially on the last one steep hill. Oof. So despite temperatures (finally!) cresting 60 degrees, I took it easy today, riding a flat 30 miles. I felt fresh at the end. It didn’t hurt that I was wearing shorts. (Something about long pants just seems to make riding harder.) In any case, I need to up my longest ride distance quite a bit, because the Natchez Trace tour just through me a couple of curveballs.

Tour Changes

As I posted recently, the tour itinerary began in Nashville where participants would meet up and be shuttled to Natchez, nine-hours by van to the south. My plan was to drive to Nashville on April 5 and drive home on April 15 after the tour.

Today, I received the official tour package from Adventure Cycling. It included several surprises. First, the tour participants are gathering in Jackson, Mississippi. Instead of a ten-hour drive to the start in Nashville, I face a 15-hour trek to Jackson. So I’ll be leaving on the 4th and stopping halfway. After the tour, a shuttle back to Jackson is offered for an additional $75. Under the old itinerary, the shuttle was included in the tour fee. (I’m not happy. ) The new itinerary includes a whopper of a day, 91 miles. Mercifully, there is only 2,800 feet of climbing on that day. The first day is a shuttle from Jackson to Natchez and 12 miles of riding to a hotel (included in the tour price). On Day 3 there’s a hotel in Jackson, the same one where we will meet on Day 0. Somehow the overall mileage increased by 30 miles. No rest for the weary.

Whenever I start worrying about my ability to handle these miles, my wife reminds me that I’m going to be carrying about 25 or 30 fewer pounds of gear on this trip compared to my usual self-contained tours. (I will need to carry rain gear and basic tools and repair stuff but no camping gear, off-bike clothing, and such.)

DateStartFinishMiles
Day 0Jackson0
Day 1April 7JacksonNatchez12
Day 2April 8NatchezHermanville60
Day 3April 9HermanvilleJackson49
Day 4April 10JacksonFrench Camp83
Day 5April 11French CampShannon72
Day 6April 12ShannonTishomongo55
Day 7April 13TishomongoHohenwald91
Day 8April 14HohenwaldNashville67
Day 9April 15NashvilleJackson0
Total489

I looked into alternatives to driving but I hate boxing the bike and schlepping it to and from airports. And then there’s the fun possibility of losing or breaking the bike in transit. Flights from DC to Jackson are all one-stops out of BWI which is an hour from my house. So with boxing the bike, driving to BWI, waiting an hour or so to board and five plus hours on the plane, I’d be eating up a day of my time anyway. I checked Amtrak; it doesn’t go from DC to Jackson. So car it is.

I am actually looking forward to the riding part of this tour. The before and after not so much.

Prepping for Spring and Beyond

Carpal Tunnel Recovery Update

The recovery from carpal tunnel surgery is going splendidly. Immediately after the surgery my hand was so weak that I was restricted to lifting anything heavier than a paperback book. Yesterday, 23 days from the surgery, I easily lifted The Tank and, later, The Mule onto my bike rack. The next milestone will be when I can comfortably do a bird dog pose during my daily stretching routine. My guess is that will happen next week.

I no longer have any stitches or steri strips on my incision site. I keep it covered with an oversized band-aid to be on the safe side.

Bike Physicals

As I alluded to above, I took The Tank to Beth at Bikes at Vienna for its annual physical and picked up The Mule. Beth spec’ed Wolf Tooth cushy handlebar tape for The Mule. It seems a bit like overkill but I suspect that I won’t feel that way once I get the bike out on the road. Once I try this tape out, I’ll decide what kind of tape to put on The Tank.

I had Beth install a Paul Mini-moto v-brake on the front wheel of the Mule. I had installed one on the back a couple of years ago and love it. Mini-motos brake better (I can even skid) and are much easier to adjust. Moreover, they disengage much more easily when changing tires. No more knocking the brake pads out of alignment for me.

Natchez Trace

Having signed up for a one-week, van-supported tour of the Natchez Trace Parkway I did a little research on what I am up against.

Adventure Cycling rates this as Level 4 out of 5 for difficulty. I think the rating reflects the fact that there are three days between 72 and 82 miles. They will certainly be a challenge but most of the route isn’t very hilly. Judging from some Strava metrics I have seen, the rides around my neighborhood have about 30 feet of elevation gain per mile. That’s less than all but two days on the tour.

I also checked how this compares to my ride up the Maine coast in 2022. Google Maps says that from Wells to Bar Harbor is 220 miles and 8,200 feet of elevation gain, 37 feet per mile. I handled this without much trouble. And it’s much less than the 45 feet per mile between Lexington and Damascus Virginia that I did last summer. I did both those rides unsupported. It’ll be nice not to have 35 pounds of stuff on my bike for this tour.

StartFinishMilesElevation Gain in FeetFeet Per Day
Day 1NatchezRock Springs611,33222
Day 2Rock SpringsRidgeland4891219
Day 3RidgelandFrench Camp821,45018
Day 4French CampShannon701,60023
Day 5ShannonTishomingo541,20022
Day 6TishomingoHohenwald792,90037
Day 7HohenwaldNashville622,18535
Total45611,57925

I have several friends who have ridden or driven the Trace and they all say it’s pretty and pretty easy.

I also will be taking one or two days off before the tour to drive to Nashville so I’ll have fresh legs. The tour starts April 7 which gives me a little over six weeks of time to prepare my aging carcass for the effort.

Hurry Spring!

Temporary Southpaw No More

Tuesday morning was my first post-op appointment with my hand surgeon. As expected my (3) stitches were removed. They were replaced with three steri-strips, which will hold the incision together for the next week when they should fall off.

I disclosed all my symptoms to the surgeon and he said “That’s normal” over and over again. I have various pains in my hand and even my elbow but the doctor said that unless they persist they are not a big deal.

I go back to the doctor in mid-March for another status check. In the meantime, I can use my hand “as tolerated”. It was time to put the hand through its paces.

Later in the day we had our second significant snowfall of the season. Mrs. Rootchopper and I went outside after three hours of snowfall and had at it. There was about two inches of snow on the ground and more was coming down fast.

I started by using a tool to clear the snow off our cars. My right hand didn’t much like this but once I warmed up, adapted my grip, and gave most of the work to my left hand, I had no problem. Next I picked up a snow shovel and cleared the sidewalk, driveway, and other areas. No problem. My hand was a bit sore but functioned well. More snow fell overnight so I went back out before breakfast and had at it again. If anything, my hand tolerated round two of shoveling better than round one.

Second snowfall of the winter

Yesterday, I took The Tank out for a ride. This was my first time on a conventional bicycle since the surgery. I made it ten miles without discomfort. I soldiered on, moving my hand position and unweighting my right hand, for another 20 miles. At the end of the ride, my neck hurt much more than my hand. My body is a wonderland of pain. Before riding today, I rotated the handlebars a smidge toward me. That did the trick. My neck tolerated the ride just fine. My hand held up without discomfort for 18 miles. I continued on as before, for another 12.

My bigger concern during today’s ride was the scary drivers I encountered. One driver turned sharply across my line of travel. I made eye contact and yelled at him. I could see that his car showed signs of multiple fender benders.

Earlier I passed Porto Vecchio, a condominium on the Mount Vernon Trail. Today, a car blew through the red light across the trail to make a left turn across traffic heading in both directions. How the seemingly oblivious driver avoided a crash is beyond me. Not to be outdone, left-turn driver was immediately followed by a right-turn driver who blew through the red light, just as a driver who hit me at this very spot in 2019. I third car pulled up aggressively as if to blow the light. I yelled at the driver to stop as I about to cross in front of the car. WTF.

After the snow shoveling and bike riding, I iced my hand for a half hour. So far, my hand seems to be bouncing back from these efforts without problems.

Sooo,

Today, I signed up for the Adventure Cycling Association’s van-supported Natchez Trace bike tour. It’s 456 miles in seven days. I have been putting off this decision for days, thinking that I might not be in shape for some seriously long days in the saddle (the longest day is 82 miles). Thanks to the van, however, I’ll be touring, for the first time, without carrying 40 pounds of gear; I only have to carry rain gear, some basic bike tools that I carry all the time, and snacks.

My next objective is to lose some weight in the next seven weeks.

No gut. No glory.

Temporary Southpaw – Ice, ice baby (Day 7)

On Friday and Saturday I woke up with a sour stomach and light head. I suspected that my rotating diet of pain killers was the cause so I quit taking them. I took an anti-nausea pill that the surgeon prescribed and it worked okay. Since then I’ve done nothing for my hand and wrist other than wrap it up with an ice bag.

The hand seems to be working fine except when I try to lift things or twist them. Both these movements are painful. Hopefully this is temporary. There is no sign of bruising now and the incision seems to be all but healed. Tomorrow morning I go to the doctor to have the stitches removed and to get my instructions for further recovery.

As luck, good and bad, would have it, we’re getting a snow storm tomorrow afternoon. That means I won’t be tempted to ride an upright bike until Saturday at the earliest. This will allow more time for recovery. The bad part is that riding my recumbent in the basement is sooo boooring. It also means that I probably won’t be of much use for storm clean up unless the doctor says otherwise. So far my recovery has been exactly as he said it would be so he’s the boss.

No longer having pain killers in my system I could drink beer at yesterday’s Super Bowl party. (Baseball season can’t get here soon enough!) I didn’t intend to do dry January but that’s the way things worked out. I should be dry again or nearly so for another month or two.

Off to the basement for two hours of reading and riding….

Temporary Southpaw – Day 4

Last night I slept well, having taken a Tramadol around 11 p. m. I wrapped my forearm with ice and took it off after a short time. When I awoke, my fingers were completely nimble but there was still some residual numbness which should go away as the median nerve heals. The base of my hand feels like I caught a baseball without a glove on.

After riding and showering, it was time for the big moment. Off came the bandage. First came an ace bandage, then layers and layers of what looked like cotton. The last bit was some small bits of gauze over the wound.

The incision is about twice the width I was expecting. Judging from the bruises on my wrist above the incision, I am guessing that the doctor needed to fish around for a clear path to the ligament.

The surgeon closed the wound with three stitches. I was expecting to put a regular band-aid over the wound but I clearly needed something bigger. Fortunately, I had a perfectly sized flexible mega-band-aid. I put it on right after taking a much-needed shower.

Big boy bandage

I’ll be taking pain meds and icing the area on and off until next Tuesday when I go for my post-op appointment. I suspect the stitches will come out then.

Temporary Southpaw – Day 3

Last night was a bit of a set back. I took Tramadol at 11 and it seemed not to work very well. About 2 a. m. I popped some ibuprofen and, a couple of hours later, strapped an ice bag to my hand and wrist. That did the trick. I woke up with barely any discomfort in my hand. Somehow I was still groggy so after breakfast I hit the couch for an hour-long nap, with the ice bag once again strapped to my hand and wrist.

Next up, I tried to do my neck and back exercise routine. I omitted a couple of poses (bird dog and a psoas stretch) because they would have put weight on my right hand. The stretching went well.

I headed to the basement for a two-hour session aboard Big Nellie. The gears are changed using something called Grip Shifters which require a twist of the wrist. My right hand could shift up without pain but shifting down was uncomfortable. The bike is set up on a resistance trainer so it’s entirely safe to reach over with my left had for downshifts.

After the ride I took a sink bath (not wanting to risk getting the bandage wet in the shower), took some extra strength Tylenol, and hit the couch for another session with the ice bag.

When I woke up my hand felt very good. It still won’t bear much weight and there is pain in the fleshy part of my palm on either side of the ligament that was cut, but the numbness is all but gone in my fingers. Of course, how good I feel may be a product of the medications so I still need to be careful. The doctor did say, however, that the mobility in my fingers should improve after a couple of days so I am right on track.

Tomorrow I get to take the bandage off. If the wound looks okay, I’ll switch to a band-aid. I am looking forward to taking a shower.

Onward!

Temporary Southpaw – Day 2

The post-op instructions say, “The more you elevate and ice, the happier you will be!” Accordingly, I spent most of yesterday and today trying to keep my hand above my heart and using an ice pack, both to keep swelling down. I had some use of the hand but mostly it was achy all day. I have been taking big doses of ibuprofen and acetaminophen for pain. Before I went to sleep last night I popped a Tramadol. I put in some ear buds, turned on a brown noise video from YouTube, and fell fast asleep. Sometime in the middle of the night, the video was interrupted by a loud, obnoxious ad. I woke with a start, disoriented.

Once I figured out what I was going on, I switched to a non-ad app and fell asleep until about 7:30. I woke with no pain at all in my hand. At 8 my surgeon called to check up on me. From what I can tell, the recovery is going just as he said it would: no swelling, manageable pain, and no discoloration of the skin.

With the surgery sedative was out of my system, I drove (okayed by the doctor) to cut my hair cut, then to a bookshop for some entertainment.

There are two things I am prohibited from doing: getting the surgical bandage wet and lifting anything over 5 pounds. So far I’ve managed to keep the bandage dry. I decided against wrapping the arm in a plastic bag and taking a shower, opting for a sink bath this evening instead. (I can reach about 80 percent of my body without difficulty. The rest will have to wait a few days.

(I was a little worried about bathroom activities but I can use my right hand to brush my teeth and my left for other hygenic activities.)

Instead of riding in the basement, I took another day off. No riding. No stretching for my neck and back. My body needed the rest anyway. My legs are happy; I am going up stairs like a beast.

With each passing hour I get a little more mobility in my hands. I need to stay aware that the pain medications are blocking the usual warning signs of damage.

My expectation is that I’ll be in good shape to replace the big surgical bandage with a band-aid in two days. Then I can go about my business (including taking a shower) albeit with the same five-pound lifting restriction. I cannot immerse the hand in water for four weeks.

Onward.

Temporary Southpaw Eve

Just to bring folks up to date, I have moderate carpal tunnel syndrome in my right hand. Some days I have no problems but, more typically, if I do something that stresses the base of my hand (e.g., pushing a lawn mower, riding a conventional bike, shoveling snow) my hand goes numb. Sometimes it’s only a finger (usually the middle finger) or two; other times, like during today’s ride on The Tank, my whole hand just kind of checks out.

The nerves in the hand are extensions of nerves that pass through a structure called the carpal tunnel at the base of the underside of the hand. The tunnel is capped by a ligament. When the ligament gets tight or inflamed, it impinges on the nerves leading to the hand causing the symptoms. If left untreated, the condition can become constant and painful. Typically the condition is caused by repetitive stress, like riding a bike a bazillion miles.

Tomorrow morning I will be undergoing endoscopic carpal tunnel release surgery on my right, dominant hand. The surgery is low risk and should take no more than 15 minutes. (For reference sake, this is about as long as each of my cataract surgeries.) The procedure is pretty straightforward. I will be given mild sedation (comparable to my cataract surgeries or my colonoscopy) and a local anesthetic in the area of my hand and wrist where the surgeon will be working. The surgeon will make a small (less than an inch wide) incision in the underside of my wrist just below my hand. He then will insert an endoscope into the slit and, using a tiny camera, maneuver it into position beneath the ligament. Once in place, he will sever the ligament using a surgical blade inside the endoscope. After he removes the endoscope, he’ll clean the wound with some saline, stitch the incision, and bandage the area.

After the surgery my job is to ice the area intermittently and to keep the wrist above my heart to promote healing. After three days, the surgeon’s bandage will come off and I will replace it with a Bandaid. In one week I go back to have the surgeon assess my progress. During this period, I am prohibited from raising more than five pounds with the hand. He said that I should be able to ride my conventional bike after a week. I think that’s pretty optimistic but we’ll see what happens. In the meantime, Big Nellie and I will be hanging out in the basement.

In preparation for the surgery I’ve been trying to get some minor tasks out of the way. I went to the pharmacy to get my post-op medications (anti-inflamatories, pain killers, and anti-nausea drugs). This was the first time I used my new Medicare D insurance and I shocked at the cost. My out-of-pocket expense for the three post-op medications was less that $3. (I am not making this up.) I also refilled my asthma maintenance medicine. It is $20 cheaper per month than my old insurance. My asthma rescue inhaler cost only $5. Dang.

Since I won’t be able to ride The Mule for a week anyway, I spent the last week riding it daily, until I reached 78,000 miles on the odometer. Then I drove to Bikes at Vienna and handed over my steed to mechanic Beth for some TLC. I told her about the surgery and she suggested a more cushiony bar tape that should help my hand over the coming weeks.

While we were chatting, Beth told me about a friend who had the surgery about eight years ago and said that it was a total success. Joan, a reader whom I met in Wyoming on my 2022 bike tour, told me that she had carpal tunnel release surgery on both wrists after riding the grueling Paris-Brest-Paris randonneuring event years ago. She, too, had excellent results. While waiting for her wrists to heal, she trained for a marathon (because she is an athletic beast!).

I’ve been spending much of the rest of my time doing small tasks that I’d rather not deal with using my left hand. These include changing the water filter in my refrigerator, installing new wiper blades on my car (the rubber on the old ones was disintegrating!), pumping up the tires on my bikes, and doing laundry.

I hope to post an update about my progress a few days after the surgery.

In unrelated news, during my ride today I passed a man mowing his lawn. I think he takes this Groundhog Day thing way too seriously.