[phoenix]

Hello,

Since I was diagnosed with TOS over 2 years ago, I have continued to come to this site to read others' posts and have not only obtained valuable info, but also found comfort in relating to others experiencing the same issues I have experienced for so long. In August of 2005, I had surgery (transaxillary right rib removal), and have not experienced much improvement in symptoms. The pain is ever present, however, the degree of pain is defintely cyclical. After searching for answers repeatedly, I have realized that at this point it is about adapting my lifestyle as well as my career to fit my situation. There is one question I have though that I am hoping maybe someone might be able to either provide me with some insight to or direct me to where I might be able to find an answer. I am a pharmacist and I work with my hands continuously. I am moving into a more administrative role in my career, partially because I want to and partially because my physical state mandates it. All of the physicians I have spoken to have repeatedly told me to find another career, as if that is a simple thing. They also say, however, that although the pain is increased with the continued activity that I am not causing further damage to my body. My question is whether or not continuing to remain active with your hands, shoulder, arm etc.. can cause further damage as it seems that the more time goes on the more I begin to experience different symptoms as well as more severe pain. It does not seem as though simply taking breaks from my activity helps anymore as it used to in the past when I would experience these exacerbations. Does anyone know if I am doing more damage to myself by continuing to work with my hands in the same manner as I used to? Thanks to everyone who does share their experiences in this forum. I'm sure it helps even more people than you know.

[gibbrn]

Welcome to our nice little home!!
Hope you find the info you need.

I will attempt to answer your question. I know that nerve damage can be cumulative. If you don't give the nerves rest to grow at their extremely slow rate then you can do more damage by continuing to do the things that cause your pain or symptoms.

In my experience the more work I do with my damaged arm then the worse I become symptom wise...sounds like the same for you. Now if you do a job that is admin, you will be doing more paperwork, computer work and will likely be doing the same sort of neck extension forward that may contribute to your symptoms.

I was advised not to work I am a nurse and did a lot of fine motor skills with my hands as well. Not to the same extent as you do. I am being advised to take a job doing day work at a clinic which would be about the same type of skills you would do in your admin work and I am unable to do this work.

I hope that you can find a middle ground.....but remember that repetitive strain causes tos and exacerbates symptoms as well.

If you have some sort of insurance then you will find that they may do a functional assessment which could discover what type of work you are able to do. You may also want an independant medical review which could tell you what your restrictions are.

Hope this helps....
best of luck and keep posting we are a great group always willing to help.

hugs,
Victoria

[Sea Pines 50]

hello and welcome to you. that is sure the question that plagues most of us, i must say and what a difficult one to answer. i think each TOS'er struggles to find his or her own way through that one, phoenix.

on the one hand, TOS is a progressive disorder and from my limited understanding anyway there is no known "cure"... so whether we work or not, whether we have the surgery or not, however rigorous we are in our tx, etc., etc., the challenge is always gonna be there. it's a matter of severity and degree. balance is key as in most things in life.

so when you say lifestyle change i think you hit the nail right on the head. more like a sea change, methinks!! and i'm rather surprised, to be honest with you, at any doctor who would say that an increase in nerve sx does not signal at least some caution in terms of doing further damage. it's tricky, of course. chronic pain isn't useful in and of itself. but as TOS'ers, we are certainly told to STOP any activity which increases paresthesia or causes sharp localized pain or even referred pain... whether that occurs during tx or daily activities of living or whatever.

not knowing what type of TOS you've been dx'd with or the cause or anything else and of course, with no alphabet soup after our names we cannot advise you specifically and i know that's not what you're asking here. i think this is a VERY good question for an OT, though, and a good ergonomic work-up of your office environment is certainly something you might want to look into. the sorehand list out of www.ucsf.edu is a free subscription and may give you some good ideas in that area (the archives contain a goldmine of info!) as to monitors, keyboards, mouses, footrests, orthopedic chairs, armrests, the right height/width/adapaibility, etc. of all of it, etc. and there is a new "desk doctor" software program just out which will give you great stretches and breathing exercises, programmable for when to take breaks from the computer and all like that there! perfect for you because you are probably a workaholic like the rest of us...

which leads me to the larger issue, rachael touched on it recently i believe, of just what happens to a TOS'er when we are forced out on disability. i know for me (and i am still on it, damnit!) it is a form of h.e.l.l. in and of itself. my fondest wish is to get back into the workforce in any way, shape or form that i can... but alas! and alack! that is just not possible right now due to TOS nonsense. but as rachael says, we're in pain anyway, so might as well be at work and earning a living rather than sitting at home with no distraction, feeling disenfranchised and miserable, isolated, depressed. i might be putting words in her mouth but i know that's how i feel sometimes, phoenix.

i loved my career and i lost it to TOS after working for as long as i could (i did last for about 28 years, though, not too bad!). now i'm a bum living off the government (SSDI) and i hate it. never even filed for LTD, which i should have done (too late now, oh well!). but this isn't about me, it's about y.o.u.

voice-activated software like dragon naturally speaking (there's another one for MAC users), the right set-up for your office furniture and equipment, maybe a REDUCED work schedule, all those things are worth considering phoenix.

i've come to the conclusion that, at the end of the day it has to be about a different mind-set. we TOS'ers have that tendency to hold so much tension in our bodies, i think. just a personal observation. well, OK, i do, anyway - i really can only talk about myself! don't want to insult anybody out there in TOS-land!!! but dr. jordan did tell me that anyone who has a tendency towards anxiety will have problems with their muscles "splinting" like ours do (e.g. the infamous culprit scalenes and pec minors)...

he also told me to do a little keyboarding every day to keep my manual dexterity (i have severe hand atrophy), which i thought was interesting.

(no comments from the peanut gallery, now!)

OK, starting to ramble and it's not even 10:00pm yet.

again, welcome and i do hope you stick around. good luck to you no matter what you decide and thank you for your excellent post. great thread!



alison
"Be Brave"

PS I never would have admitted to this group that i was a pharmacist, though - what are ya, nutz or something?!?!?!

[Jomar]

Basically I think if you got TOS by work/repetitive motions - then I do think you could be making it worse by continuing to work unless you can make many lifestyle and workplace adjustments.

I think you have to look at your whole body alignment and postures also - how you work and hold yourself.

Is your head forward of your body?
shoulders up, hunched, rolled forward etc??
have a family or friend look and tell you or a PT if you are going to one - if you go to PT and they don't address any posture issues find a better one.

Ergo/posture/bodywork links in the stickys-
http://neurotalk.psychcentral.com/showthread.php?t=84

Stresses/tension = learn to relax , we do hold it in our muscles Diaphragmatic breathing = oxygenates cells , releases toxins from cells and helps relaxation

Since you've been reading for awhile I won't repeat my reminders about finding very good PT, DC or MD.