Tuesday, November 27, 2012

Tennis Elbow update

As many of you have heard or read....I have bilateral tennis elbow.  Initial onset was April 2011.  Yes, you read that correctly....a freaking long time ago! 

I have been to so many doctors about this condition.  The first one was actually a random walk in clinic doctor because I was just starting to have pain and couldn't get in with a doctor in Gettysburg for over a month and didn't want to wait.  He said I had tendinitis and give it lots of rest, ice, and 2 Advil three times a day.  Lots of NSAIDS and I went with it.


Advil went with me everywhere

The next doctor was my primary care physician in Gettysburg, Dr. Douglas Eyer, who I really liked going to.  He diagnosed the tennis elbow and got me hooked up with a tennis elbow strap or brace to wear around.  O yeah, and more ice and NSAIDS, this time of the prescription variety with Meloxicam I believe.  And then my first round of physical therapy, I think with Scott but I'm not sure.  Pretty helpful overall initially, but I never felt truly better.  A couple months of that with no relief then came my first steroid injection of many.   During this time I was also seen by one of his other doctors in the practice who was nice and threw in his 2 cents- not much different that Dr. Eyer's, and he encouraged me to see a specialist as well as get an x-ray of my arm to rule out any possible reumatoid arthritis.  Scary and luckily it came back clear!   After months with still no relief I started going to an orthopedic specialist- Dr. Ivan Miller in Gettysburg.

Dr. Miller had me start using a carpal-tunnel brace at night (both arms at one point) and he also started me on Diclofenac.  He described this drug as a "this is going to kick your ass but will help you."  He wasn't kidding- I have to stay on Prilosec (I sure as anything use the generic equivalent) just to counteract the side affects of this NSAID because it tears up my stomach so badly.  I went back to physical therapy after more steroid injections in both arms this time as they were both pretty bad off.  I was working with Marty at this point and saw the most benefit in all my time when I was working with him.  He was focusing on strengthening my back, shoulders, and posture as well as some deep tissue massage and stretching.  I never became totally pain free but it was getting so much better.  At one point I was able to start lifting again but within 2 months of gently easing back in it was back and flared again hard.  Marty, Dr. Miller, Emily (personal trainer), and I were all very frustrated to say the least. 


These little pills have saved my sanity!

Then I moved.  Moves can be bad for your heath!  After many months away from physical therapy and Dr. Miller the pain inevitably flared up again and I was back to square one.  I started again with my new primary care and sports medicine doctor, Dr. Kindschi.  After another thorough exam and MRI she started thinking outside the box and listed a variety of alternative options I could try aside from what I'd already been doing.  Among them was seeking an opinion of a hand specialist, dry needling (think acupuncture), prolapse therapy (sugar water injections), PRP (platelet rich plasma- which is all the rage right now with pro athletes but extremely expensive at $500 a shot and not covered by insurance), or surgery.  Yikes the scary S word!!

So now we arrive to today and my 6th doctor seeing about my chronic tennis elbow.  I saw Dr. Keith Segalman at the Curtis National Hand Center at Union Memorial hospital.  Conveniently right down the hall from my sports med/primary care physician who is based out of Union Memorial as well at the Arnold Palmer Sports Medicine Institute.  Dr. Segalman was a nice guy who did a thorough yet probing exam of both my arms.  We talked about similar options as Dr. Kindschi but he centered on three things- anesthetic treatment of the elbow via a Novocain-type drug injected into the painful area.  Second was PRP, but what he mostly focused on was the big S word. SURGERY. 

Luckily the surgery is a quick, out-patient procedure that has a "quick" recovery time.  He said I would be in a sling for about 10 days, then 12 weeks of minimal use with physical therapy worked in to gradually build my use and strength back up.  Full activity by 12 weeks out or so with no pain.  And the success rate is 90%!! Those are some great medical odds right there.


Carpal tunnel brace, how I loathe you

So why didn't I schedule the surgery for tomorrow? I'm scared, plain and simple, and there is no rush or pressure.  So for today we did the Novocain injection and I'm researching and weighing my odds about surgery.  He also wants me doing some deep tissue massage of the elbow area itself which as he demonstrated to me today....hurts.  He said I should be pressing hard enough that it hurts a little. Great.  And more icing, some different stretches and here is a big thing...he doesn't want me to use my hand to grip anything unless absolutely necessary.  He wants me to keep my arm relaxed and avoid anything that requires me to grip with my right hand- especially hand shakes or holding something tightly.  Seriously?!  He suggested that I wear my wrist brace during the day as well as at night to keep me from feeling the urge to use my hand.  So...I am going to try my very best to take his medical advice to heart and try to figure out what is going to be best for me.  Maybe surgery, maybe not...


Any advice from a current sufferer or do you struggle with a tendinitis of a different area? Help!

10 comments:

  1. I have no experience with this. Could this be from riding?

    ReplyDelete
    Replies
    1. No, very unlikely riding had anything to do with this, but good idea! Stemmed from an overuse injury caused by over lifting with bad form, most likely.

      Delete
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