Sunday 29 April 2012

Living alone: the dangers of RSI

Repetitive Strain Injury, also known as repetitive stress injury or... *grabs his arm, feels the color drain out of his face* Gee sus H. K-rist! *Stops dead in his tracks, bows his head slightly and shuts his eyes while waiting for a wave of excruciating pain to pass over his consciousness* Excuse me, but sometimes that really f**kin' hurts. *Looks at the clock in the system tray on his computer* Oooo, time for more drugs! Woo hoo! ... I would do a fist pump but I know I would end up regretting it.

Three weeks ago, I do my usual weekend marathon of walks, exercises, stretching and just about nonstop tapping away at the ol' keyboard. In my time, the term square eyes referred to those watching TV all the time but I now see that Urban Dictionary has updated the expression to include staring at computer screens. Moi? Guilty as charged. After all, my daytime gig involves working with computers. After hours, I am on the Net researching, blogging, and using Facebook, Twitter and some other social media networks. Oh yeah, I don't have a TV meaning I'm saving myself the monthly cost of cable and meaning whatever TV I do watch is over the Internet. Add that all up and you've got me glued to a laptop professionally and personally just about twenty-four by seven. Oh, should I mention that the company gave me a Blackberry so I can always be on call? The benefit, however, is that I don't have a telephone so no monthly costs for a land line either. No TV and no telephone may sound like living off the grid but believe me, I am very much plugged in. Who needs a magazine rack in the bathroom when you have a Blackberry or, for that matter, an iPhone? Just make sure you have a firm grip when you lean over to flush.

I get up Sunday morning and am feeling something in my left shoulder, a dull pain. Muscle strain? It wouldn't be the first time I have overextended myself. I do try to do something every day, some sit-ups, push-ups, a walk or jog, with the idea of trying to stay in reasonable shape. I'm not a health nut but having done this since I was 16 years old, I now feel psychologically off-balance if I don't do something on a regular basis. Besides, I admit to having a sedentary lifestyle so it is more than important to offset that with regular movement.

As the day wore on and the next day in fact, I realised I had done something to myself but not the usual type of thing where you feel your muscles protesting a workout. No, this very much felt like something I had done to myself six or seven years ago.

I was sloppy at the computer tending to slouch in my chair. When using the mouse, I would rest my forearm on the edge of the desk. Okay, I had been doing this on and off for years but obviously more off than on. At this time, I had moved and gotten myself a new office desk but one which did not have a proper keyboard tray. I had the keyboard and the mouse on top of the desk and the angle was such that I was reaching up and over to operate the mouse. Add to that hours of work slowly sinking lower in my chair and I'm guessing I was leaning my forearm more and more on the edge of the desk.

One thing led to another and I started to feel an ache in my forearm. This just got worse and worse until it was throbbing 24 hours a day along with my fingers tingling. Some research on the Net and some visits to my doctor confirmed I had a repetitive strain injury. Okay, that may have clarified things however the remedy turned out to be anything but a quick fix. If you bruise yourself, damaging muscle tissue, you can count on the body to get in there with all due haste. However, damage other things like ligaments and joints and you are now looking at the body taking longer to deal with the problem. With RSI, you seem to have damaged your nerves whether the nerve fibres themselves or the sheath which encloses them and this requires weeks if not months of healing.

I stopped using my right arm. Okay, the occasional thing like buttoning a shirt but I stopped typing with two hands and only used my left. It took a number of weeks of wild aiming, but I managed tame my mouse by learning how to use the device with my left hand. I can say that today I am completely ambidextrous when using a mouse but I do find that now I tend to favour my left hand. That way I can surf while drinking coffee or snacking with my other hand since I am right handed.

It took weeks for the dull ache to subside. I had it twenty-four hours a day and it was very, very distracting. I remember sometimes having trouble concentrating on anything whether work or even something recreational like watching TV. There was this constant and unrelenting pain in my forearm. I wouldn't call it excruciating like bring you to your knees pain but it was this ever present background pain. Then I would occasionally twist my body or forget and use my left hand and that dull pain would jump up to say hi with a sharp jab which would make me wince or even say "Ow" out loud.

It took weeks for the dull ache to subside; it took a couple of months before I went back to using my right hand without fear of a relapse. After figuring out that my condition was probably connected to resting my forearm on the edge of my desk while using the mouse, I vowed to not do that again.

Oh? I vowed never to do that again? Oops, here I go again. Who wants to be the first to say, "Health is everything"? Oddly enough from my reading about RSI, people have to make sure they don't make things worse. First of all, one should avoid the activity that created the problem in the first place. For me, no using of my left hand and arm so picture me typing all this with one hand. Doable but frustratingly slow. The problem, as I see it, is that I can take some medication like ibuprofen, feel a bit better, and then start doing that activity which caused the problem in the first place. If you're going to let a body part heal, you must be cautious about using it or how you use it.

Giving up a body part can put a strain on other parts. On occasion I have felt some odd feelings in my right hand, fingers and forearm. Sympathetic pain or real pain? I must be careful. I have been "aware" sometimes of the tip of my right index finger possibly from hitting the mouse too much. I have tried switching the buttons on my mouse: the right button does the left click and the left button does the right click. Instead of clicking with my index finger, I click with my middle finger. I have at times "felt my right thumb" and have taken to typing with one and only one finger. God, I'm a wreck ha ha. However, sustain this type of injury and be deprived of a body part and you will understand that saying, "Health is everything."

My Doctor
I've visited my doctor 3 times so far. He's tested me and felt my assessment of RSI is correct. When I mentioned the tingling in my fingers and asked if I was having a stroke, he gave me an EKG which I passed with flying colours; I am in half-decent shape. He concurred with my plan of action: stop using my left arm and let it heal. There is nothing to do but be patient. However he also agreed with my research that people with these types of conditions can exacerbate their problems by stopping all exercise. Consequently, I've started on my own to do a few low impact things. Sitting around all day doing nothing is not just unhealthy, heck, it's boring!

Speech Recognition
I am using Windows 7 and a couple of days ago started playing with the built-in speech recognition software. Having gone through the tutorial, I now see (hear?) that I have a bit to do to learn all the commands. I see that not every app is going to work properly with this input system. Plus, it doesn't seem to know all the words I use. What? It doesn't recognise a single one of George Carlin's Seven Words You Can't Say On TV! Go figure. So until I can figure how to teach the software new words, I am going to have to fall back on spelling any words it doesn't know. Fortunately profanities don't crop up too often in my writing.

Pain Is Debilitating
Twenty-four hours a day, seven days a week. Whew, how do people with chronic pain cope? Talk about bummed out. Having to deal with a physical limitation is frustrating but the constant pain wears you down. I've arrived at the end of the day totalling exhausted even though I haven't really done anything. Although exhaustion may be compounded by waking up several times in the middle of the night in pain and having to take more drugs.

Living Alone
Yvette Vickers was a small-time B movie actress probably best known for a secondary role in the 1958 American science fiction feature film Attack of the 50 Foot Woman and for being Playboy Playmate of the Month for July 1959. As Wikipedia reports:

Vickers was last seen alive in 2010. On April 27, 2011, her body was discovered in her home by a neighbor who had not seen Vickers for some time. The date of her death is unknown, but forensic scientists concluded that she may have been dead for as long as a year prior to the discovery of her body. There were no signs of foul play, and after an autopsy, the Los Angeles County Medical Examiner ruled the cause of death to have been heart failure resulting from coronary artery disease.

It may sound like morbid humour when I wonder aloud about how long would my body go unnoticed but the above is a real life story which suggests there is an all too serious aspect of single life. My own father, living on his own after the death of his wife, my mother, had some health issues which prompted him to sign up to Lifeline, a telephone based monitoring service. Twice a day he was obliged to push a button on a machine connected to his phone. If he failed to do so, the service would attempt to contact him and if unable to do so, escalate the response to the authorities. Obviously there was a protocol if he was out for the evening or out of town. As well, the service included a necklace which had an emergency button

In my posting Living alone: the dangers of BPPV, I described my run-in with the condition known as Benign Paroxysmal Positional Vertigo, a highfalutin expression which basically means your inner ear gets messed up and you are dizzy. But, I mean really dizzy like dizzy I'm going to upchuck if I'm in any position other than horizontal. Hell, my first spell lasted about 4 hours and I couldn't get out of bed! I know you may laugh, but it's at times like this I wonder at what point I would either get my own Lifeline or move to an assisted living facility. At least there's a better chance of my body not stinkin' up the place.

Oh, by the way, since divorce is a topic which crops up periodically, I would add that my research has shown that being married does not mean you are any less likely of dying alone. My father lived on his own for 8 years after the death of my mother. In the article "The Ultimate Threat to Single People: You'll Die Alone" by Bella DePaulo, Ph.D. (professor at UC Santa Barbara, author of Singled Out: How Singles Are Stereotyped, Stigmatized, and Ignored, and Still Live Happily Ever After), the author in talking about the myth of being married means not dying alone tells the story of her own parents. Dad apparently dropped dead alone in the hospital after Mom visited him. In reflecting on my own parents, I can say it was merely chance that saw both of them die during the day while I was around. They easily could have checked out when I wasn't there.

I'm Not Bored
Ever notice how when you're really really sick you're not bored? You can lay there for hours even days in absolute and utter agony and watching TV is the last thing on your mind. Yes, that old mind is quite busy, thank you very much, having to deal with the sensory overload of the body's not too subtle message, "I'm in pain and I am none too pleased about it." Pain takes up a lot of your attention.

Slowly though, as the body rights itself and gets onto a more even keel with pain subsiding, the ol' noggin starts turning its attention to other activities like TV. That is, we start getting bored and I always treat that as the clearest sign that the tide has turned, there is a ray of hope and yes, the sun will shine again. My problem is that I'm not so banged up that I'm bored. Yes, I'm hurting; yes, I can't use my left hand but that doesn't mean my brain is disconnected from reality trying to deal with an overload of pain. My problem is the noggin still churning away as it always does but forgetting what it shouldn't do.

I got loaded up on ibuprofen about a week ago and didn't feel too bad. While on the phone with somebody talking about business, I thought to type up some notes. In order to keep up with the flow of the conversation, I typed with two hands. The call probably lasted no more than 10 minutes.

2 hours later as I was heading home, I could feel it. My left forearm felt like it was on fire. Oh, oh, big mistake. Oh God, I was in agony all evening and most of the night. That was my lesson to not, and let me repeat that for my benefit, to not use my left hand or arm. At all. Is this where I start making jokes about standing at the urinal and asking the guy next to me for help in unzipping? Ah, fortunately I'm not that incapacitated. However, don't say to me, "drop and give me twenty." Even though the problem is only in my left arm and shoulder, the thigh bone's connected to the hip bone and sometimes doing something with my right tightens the muscles on my left side and... *grabs his arm, feels the color drain out of his face* Gee sus H. K-rist! *Stops dead in his tracks, bows his head slightly and shuts his eyes while waiting for a wave of excruciating pain to pass over his consciousness* Whew! Sometimes that hurts and I am being polite in front of you by not using any qualifying adjectives with asterisks such as f**kin'.

Final Word
Life's a bitch then you die? Ha ha ha. I am proud to say I have typed all two thousand, five hundred plus words with one hand, pretty much one finger. Ta-da! Of course, did I have to be so wordy? Top story: man gets RSI in left arm, must type with only right hand, the end.

I can't go for a walk. Oh, I can get up and walk to the kitchen but walking more than a block hurts. It's painful to go to the store and my evening 4 mile walks have been completely curtailed. As I sit typing this, it hurts to have my left arm at my side so I'm holding it up and resting it on top of my head. During the day, I periodically lie down as horizontal seems to be better than vertical.

However, there may be a light at the end of the tunnel and no, it's not a train. I have slept through a night without waking up in pain and having to take an ibuprophen. While I may have started the day with a painkiller, I went through a 16 hour day without taking another. Now as I heal, I have to be careful to not get cocky and set myself back. Crap, it has been 3 weeks. 3 weeks!!! This is going to take months for chrissakes!

I have now bought a cushion to elevate myself in relation to the table I am using as a computer desk. I sit up straight. When I use the mouse, I do not rest my forearm on the edge of the table. Believe me, this is no laughing matter and you do not want to suffer an RSI. Pooh pooh it, if you will, but I am here to tell you it is a very real problem. Now, follow along with me. Bend over and put both hands on your knees. Take a deep breath. Exhale slowly and as you do, say quietly under your breath, "Fuuuuuuuuuuuuccccck."


Wikipedia: Repetitive strain injury
Repetitive strain injury (RSI) (also known as repetitive stress injury, repetitive motion injuries, repetitive motion disorder (RMD), cumulative trauma disorder (CT), occupational overuse syndrome, overuse syndrome, regional musculoskeletal disorder) is an injury of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), sustained, or awkward positions. Different sections of this article present contrasting perspectives regarding the causes of RSI.

Wikipedia: Nerve: Anatomy
Each nerve is covered externally by a dense sheath of connective tissue, the epineurium. Underlying this is a layer of flat cells, the perineurium, which forms a complete sleeve around a bundle of axons.

Wikipedia: Yvette Vickers
Yvette Iola Vickers (August 26, 1928 – circa 2010) was an American actress, pin-up model and singer. ... In 1958, she appeared in Attack of the 50 Foot Woman as Honey Parker. The following year she played the role of Liz Walker in Attack of the Giant Leeches. In 1959, she appeared as the Playboy Playmate of the Month for the July issue.

Wikipedia: Attack of the 50 Foot Woman
Attack of the 50 Foot Woman is a 1958 American science fiction feature film produced by Bernard Woolner for Allied Artists Pictures. It was directed by Nathan H. Juran (credited as Nathan Hertz) from a screenplay by Mark Hanna, and starred Allison Hayes, William Hudson and Yvette Vickers. The original music score was composed by Ronald Stein. The film was a take on other movies that had also featured size-changing humans, namely The Amazing Colossal Man and The Incredible Shrinking Man, but substituting a woman as from the protagonist to antagonist. The story concerns the plight of a wealthy heiress whose close encounter with an enormous alien being causes her to grow into a giantess.

my blog: Living alone: the dangers of BPPV
Okay, I mischievously wrote the title of this article to make things sound ominous. The acronym which stands for Benign Paroxysmal Positional Vertigo gives the impression that the patient may only have days to live but the whole thing is... well, benign. That is to say, not life threatening however suffering from it does raise some issues about those of us who live by ourselves.

Pyschology Today - Jan 23/2009
The Ultimate Threat to Single People: You'll Die Alone by Bella DePaulo
Suppose you really do want people around you when you die. I'll even up the ante: Suppose you want a spouse there with you when you die. Still, I have to wonder: Should you let that wish for your final hours determine the fate of the rest of your life? Should you find someone to marry, even if you are not sure you really want to marry? Even if you do want to marry but have never found a person you truly want to spend your life with, should you marry someone who is a "good enough" partner just to have a spouse there with you at the end?

Uploaded by themoaningcow on Jan 11, 2008
The Sketch Show - Lee Mack Urinal Sketch with Tim Vine & Jim Tavaré
Lee Mack's classic urinal sketch from the UK comedy show 'The Sketch Show'.


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