Tuesday, February 10, 2015

A Diagnosis... Maybe???



So basically a year has lapsed. I have been to 7 different doctors in 3 different states. Needless to say my arm is still in pain and goes numb, and I still cannot play the viola and can barely play violin. So what is wrong...?!?

Originally I was told migraines. I was told that I had a strange symptom of migraines but that I was having migraines nonetheless. Ok I thought as I took my medicine for migraines. Well guess what arm pain still prevailed.

Next I was told migraines and something messed up in my neck. We did an EMG and a nerve conduction study- not pleasant by the way. Nothing really came back besides c7 was a little off but within parameters.  We took an MRI and it came back basically clean. My neck is straighter than most, and showed some signs of whiplash, but nothing that would cause arm pain like mine. Ok so what is wrong with my neck... no clue!

Next doctor said that I had sprained my neck one to many times probably from over playing viola, and that my muscles were in spasm thus causing my pain. He prescribed PT but couldn't really tell me what was going on either.

I did a month of physical therapy on my cervical spine. My physical therapist and I both frustrated by the lack of any improvement eventually gave up. He agreed something was wrong, but could not pin point the problem either.

The next semester of school I decided to just take a break. I continued in my music major courses, but did not take any instrumental playing classes. It was nice but not at all the same as being a normal functioning music major. I have worked for the past five years to be where I am today. I had to work to get into a music school. I had to work to be good at viola, and then abruptly one February morning in 2014 that was all taken away. It was a hard concept to grasp. With no doctor being able to figure out what was wrong I started to feel that this was just going to be life. Life with one functioning arm and one that functions when it so feel the desire to. One that feels like someone is trying to pull my nerves out slowly through my fingers. This is a pain that is so hard to describe, but close to nothing will stop it. This semester of school went pretty well pain wise. I joined my university's cheerleading squad. I had my good days and my bad days. But overall the good days outnumbered the bad days, as long as I didn't try to play my instrument.

Over Christmas break I thought maybe possibly my whatever is wrong with me is getting better and wanted to exercise, something I really haven't been able to do in the past year. So I lifted weights with my sister. This was a really bad choice on my part, and I spent the whole rest of the night and following day wishing I was dead. This day was a reality check for me. Needless to say lots of tears streamed down my face this day. I was still very, very BROKEN. This was so frustrating. I am a music major, but also a person. I need to be able to cook, to shower, to drive with two hands and sleep through the night without waking up in massive amounts of pain. Exercising and playing viola/violin are nice too but not as important. As Christmas break continued I realized I couldn't pick up my brother, couldn't practice, couldn't do a lot of "normal" things.

Then my current semester of school started. I realized with this new pain that I had brought upon myself once again and that wasn't disappearing anytime soon, that I needed to see more doctors! Yay me... (no!)

My primary doctor listened to me, and looked at the report from Houston. She didn't really know what to do other than refer me out to a spine specialist and prescribe muscle relaxants for the muscle spasms and pain.

The spine specialist/surgeon didn't really give me the time of day. He didn't even look at my MRI just the MRI report sent over by my primary doctor. His statement, there is nothing wrong with your neck! Awesome sauce so why the heck do I want to amputate one of my arms then?!? His feedback a very high likelihood of a pinched nerve under your clavicle. Driving home I thought this guy was out of his mind. No joke! But when I got home I went to my magical friend called google. This brought up Thoracic Outlet Syndrome, basically pinched nerves under your clavicle.

The symptoms:

pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. 

So I started thinking, hey guys this sounds a lot like what I have been dealing with....

The condition is common among athletes who participate in sports that require repetitive motions of the arm and shoulder 

How about violin/viola. It is very repetitive and a strange position. 
And then I found this:

A report stating that "musculoskeletal disorders are common in musicians and are characterized by pain and musculoligamentous strain, muscle weakness and loss of motor control in the affected segments.The musculoskeletal problems observed most often in musicians are: overuse (50%), nerve compression or thoracic outlet syndrome (20%), focal dystonia (10%)."

Violinist and violist get this! The normal one we hear of is carpal tunnel syndrome. But thoracic outlet syndrome affects us too! 
Image result for thoracic outlet syndrome

How do they treat it? 
Surgery. 

TOS decompression surgery that involves removing certain muscles in your neck, removing your first rib, or a combined operation to remove both muscles and rib.

Image result for thoracic outlet syndrome

So I went back to my primary care doctor to find out what to do next. Once again she referred me out, but his time to a thoracic surgeon. He specializes in thoracic outlet syndrome. There is a one month delay. So for now I wait, but for the first time in a year, we think we know what is wrong. For the first time in a year there is hope that I will one day play the viola again! For the first time in a year I have hope that this is a curable injury. 

















This had affected my life so much! I had changed my major from music education to just music. I didn't think I would be of much use to a middle school orchestra, if I couldn't demonstrate myself what technique I wanted them to do. I now have hope. I have made decisions career and major wise since this moment that have brought me peace throughout this whole storm, so will I change back? I don't think so, but I will have my music degree if I do ever want to alternatively certify to teach. As for now I am finishing up my music degree, only two more semesters(!) and then off to nursing school. 

Hope is an amazing thing though. I look at my viola case and think to myself one day, maybe even next semester, I can be a violist again. I can feel like a music major again who practices to my hearts desire. There is finally a light at the end of this very dark tunnel. 


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