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Monday, May 8, 2006
By TOM VOGT, Columbian staff writer
"These are working hands," Jacqueline Baker said. "I've had two manicures, on the day I was married and the day after our son was born."
But something was going wrong, jeopardizing the work she did as a nurse and as a custom seamstress, as well as in raising a family.
"My hands started going numb while I was cross-stitching and sewing," said Baker, who runs a home-based business, Fabric Creations.
"And my hands started falling asleep at night; they're not supposed to do that, not to where it wakes you up" because of the pain.
The problem was carpal tunnel syndrome, and the Vancouver woman had a lot of company. According to the Bureau of Labor Statistics, carpal tunnel syndrome is the most commonly reported work-connected ailment.
Still, people don't always understand the affliction, said Dr. Edward Lipp, a Vancouver orthopedic surgeon. Lipp uses a couple of different medical comparisons in describing carpal tunnel syndrome.
"People tend to think it is the same thing as arthritis, or a bad knee, and let it go. You need to think about it like cancer," said Lipp, with Rebound Orthopedics and Rebound Neurosurgery. "If you see blood in your urine, you won't wait until the next time you see it before going to the doctor."
People who notice carpal tunnel symptoms should view them "more like the early signs of cancer," Lipp said.
"When you can't walk, you can get a knee joint replacement," Lipp said. But carpal tunnel syndrome creates nerve damage, Lipp explained, and "You can't replace a nerve.
"I've seen two physicians who let their own hands waste away."
If you identify the problem early, it can be resolved successfully.
"Your doctor can order a nerve conduction test, to measure how much damage has been done. Many people are cured by medication, or something as simple as a night splint, which keeps the wrist straight while you sleep."
Lipp has another illustration for the damage caused when swollen tendons squeeze the median nerve against a wrist ligament.
He calls it "the blind hand."
"I like to envision an eyeball at the end of the thumb and the index and middle fingers," Lipp said. "You can tell the difference between a quarter and a dime in your pocket."
With carpal tunnel syndrome, "You lose the feeling in them, and there is advanced weakness in the thumb," Lipp said. "You can transfer tendons for the thumb muscles, but you're still stuck with the blindness."
Baker said she lived with the problem for three years, wearing wrist braces and trying to treat the symptoms.
Finally, it was time for Lipp to solve the problem. And as surgeries go, it wasn't all that complicated. Baker said she got a local anesthetic and was awake for the surgery.
Lipp eased the pressure on Baker's median nerve by slicing through the ligament it was sandwiched against, near the heel of her hand.
"The ligament was turning black," Baker said.
"The ligament will heal back again, but with more slack in it," Lipp said.
"They wanted to do both wrists at the same time, but with a 6-month-old daughter and a 3-year-old son, that would have been too much," Baker said. "And, I was hoping the second one would get better."
Nine months later, Lipp operated on Baker's other wrist.
Baker hasn't had any problems since, she said.
Now her biggest sewing challenges are figuring out how to handle a custom order like a bagpipe cover, or a wash-and-wear bridal gown for an outdoor wedding. (The bride wanted to launder her gown between the ceremony and the reception.)
While carpal tunnel syndrome is associated with repetitive motion, particularly on the job, researchers still are trying to find its precise cause.
Lipp has researched 688 Clark County carpal tunnel patients for more than five years, and noticed some links.
Forty-three percent of those patients were obese; that's well above Clark County's adult obesity rate of 25 percent.
(Someone with a score of 30 or higher on a body mass index is categorized as obese. A 5-foot-10 person who weighs 210 pounds has a score of 30.1.)
"One patient did volunteer that he gained weight and his carpal tunnel problems increased; he lost weight and the problems decreased."
Did you know?
* Eight bones in the wrist, called carpals, form a tunnel-like channel for the tendons that control finger movement; it also contains the median nerve, which sends signals to the thumb, index finger, middle finger and inside of the ring finger. Swollen tendon sheaths can pressure the median nerve, creating pain and tingling, and leading to loss of strength in the fingers.
* A study of 688 carpal tunnel sufferers in Clark County shows a strong correlation with obesity. Forty-three percent of the patients were obese; that's well above the county's adult obesity rate of 25 percent.
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