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The best word for what I am doing right now is really "awfulizing" so I am not sure where it fits into the 10 forms of twisted thinking... maybe magnification? mental filter? overgeneralization? jumping to conclusions?

So here's the deal.....

I had carpal tunnel release surgery on my right hand in November and on my left hand in January. Before the surgeries, I was in constant pain and it really affected my mood. I didn't want to do anything. I just wanted the pain to go away. But the thought of "purposely mutating myself" bothered me so I was hesitant to have the surgery. To explain: the surgery involves cutting a ligament in your hand. I kept thinking "Hmmm that ligament is probably there for a reason... do I really want someone to purposely remove it?"
But in the end I couldn't stand the pain any more and I had the surgeries. The right hand healed nicely. No carpal tunnel pain. In the meantime, the left hand got worse and worse. I had a feeling it was more than "just" carpal tunnel syndrome but I figured I would wait until after the surgery and see how I was feeling. So, I had the surgery and right from the start that hand healed differently. I had to take Vicodin in the hospital because it hurt so much (for the right hand, I got by with just Advil). Then less than a week after I got the stitches out (two weeks post-op), I fell and landed on that hand and the wound opened. So the scar is healing much more slowly and my doctor referring me to physical therapy to help the scar heal better. The scar looks great now, but my hand still hurts. Specifically, my middle and pinky fingers. Sometimes I can not bend them at all and when I try to, there is a lot of pain. Sometimes the middle finger is sort of stuck in a semi-bent position and won't straighten out all the way or bend all the way (and no this is not from "over use" hahaha). I went back to the hand surgeon for his opinion. He said I have something called "trigger finger" in the pinky. As for the middle finger, he feels the same sort of stiffness in my right hand middle finger. He has referred me to a rheumatologist. Apparently, carpal tunnel syndrome can sometimes be caused by auto-immune diseases such as lupus or RA (rheumatoid arthritis). Now, I am pretty sure I don't have lupus, but RA... could be... My doctor asked if anyone in my family had RA and I said I didn't think so, but then when I got a chance to ask my Mom, I found out that my paternal grandmother had it. Gulp. So of course, I have done internet research on RA and trigger finger and I am really nervous that I have RA. Trigger finger is sometimes caused by RA. So is carpal tunnel syndrome. The symptoms I have seem to be consistent with RA.
I see the rheumatologist tomorrow. I know that there is nothing I can do between now and then, and even if I have RA, it is not the end of the world, but I am so nervous about it. I have heard that the medications for RA are horrible - the side effects are sometimes worse than the actual disease symptoms.
I also just want to be free of this pain. I was hoping that once I had the surgeries I would finally be pain free and my mood would lift and I would get back to the gym and feel better. But even if I don't have RA, I am still left with this persistent pain.
I am trying to stay positive and I really think that the big problem is that I have gained a lot of weight and gotten way out of shape in the past year or so. I really think that a lot of my health problems would go away if I lost some weight and got back to exercising.
Just trying to stay real right now but sometimes those mental demons are just so powerful, you know? Thanks for listening.
Chai

Oh I forgot to post about untwisting... Let's try to untwist these thoughts...

1. Just because I have some symptoms that are consistent with RA does not mean I have RA.
2. Just because my grandmother had it does not mean I have it too.
3. I am in a lot of pain now but I will not be in pain forever and it is not an excuse to neglect my own needs and drop all self-care.
4. Just because my hands hurt does not mean I can't start eating better and exercising now.
5. Even if the worst case scenario comes true, it is a very common disease with known management protocol.
6. At least I don't have carpal tunnel syndrome anymore!

I like the term awfulizing because I do it too! For me it has to do with thinking through the worst case scenerio and deciding how to cope with that. Then I figure I can cope with whatever the situation ends up being because I have already planned for the worst.

I am sure that chronic pain has got to be a pain in more ways than one. We often take for granted the times we don't experience pain until we are in an ongoing painful situation. I have not had a headache for a few weeks so the one I have today seems even more painful somehow, even though it is not any different than headaches I have on a frequent basis. It is my desire to get rid of the headache (taking ibuprofen can sometimes take the edge off but nothing works to get rid of them completely) that has me more focused on the pain than if I focus on other things. When my attention is on other things, I hardly feel the headache but when I am thinking about the headache it is magnified.

I wonder if your increased awareness of your physical symptoms has made the pain more predominant somehow. I am not suggesting you ignore the pain but perhaps just knowing it is there and that you can manage it will help you feel less awful about it. I have not done research on RA so I don't understand all the implications the way you do but it sounds like if you do have RA you will have painful symptoms from the arthritis or possibly worse symptoms from the medications. This is certainly not anything to look forward to so I understand why you would be feeling nervous. It also sounds like you could have chronic pain even if you don't have RA if the surgery has not taken care of the carpal tunnel pain and that is not an encouraging thought.

Have you considered how you might manage chronic pain if that is an unavoidable part of your future? I have learned that I have the ability to block pain mentally. It is different than ignoring pain because I can actually block the pain sensation. I think it could be a sort of self-hypnosis but I am not sure exactly how I do it. There is some very interesting research on biofeedback that indicates that our minds are capable of regulating physical symptoms - in fact, my doctor's husband can slow down his blood flow using biofeedback in order to reduce internal bleeding such as bruising which can be a serious health threat due to his hemophelia (sp?). Perhaps as you are doing research on RA you might also find some suggestions for managing chronic pain just in case it is something that could be helpful to you in the future.

I will agree with Denim here. External focus helps a lot with managing pain. It sounds hokey, but once you stop fighting the pain and dwelling on it, it's not as magnified. Sometimes it'll be in the background and you stop and wonder, does it still hurt? And when you do that, of course the pain comes on.

As a hypochondriac and someone whose doctors have yelled at her numerous times for this, I would not going digging around on the internet attempting to self-diagnose or match up symptoms. It is a hypo's nightmare, seriously. Google headache and you can come up with everything from sinusitis to brain tumors and cancer(!). Leave that and the medication treatments to your docs. And remember, what meds and combos that don't work for some, work for others. You're going to scare yourself and cause unnecessary anxiety(which the body has proven to help MAGNIFY pain - Something you totally don't need right now).

Dustie, not Denim. Sorry about that

Thank you Dustie! You make some very good points - especially about the mental awareness of pain. I agree that I could be focusing more on the pain because I expected it to be gone and it is not and maybe I am frustrated about that or using it as an excuse to focus on something other than the psychological/emotional issues that are really bothering me... hmmm... food for thought. Thanks for your reply - it is good to see you here and I like the new screenname
Chai f/k/a NotAMonster

haha good point - thanks



I didn't know that. Thanks for the info. Makes sense. Just writing out my worries helped relieve some of the anxiety about it.

The thing about putting the pain out of my head is it is kind of hard to do that when I literally can't bend my fingers and am "reminded" of it every time I use that hand... but I don't have to make such a big deal out of it. Not the end of the world, will get better somehow. Been through worse.

Thanks gals. Can't wait for the appointment so I can have a better idea of what the heck is going on!

Chai, I like your new choice of usernames too!

Wow, already your thoughts have evolved from being nervous:



to a more positive outlook:




There really is nothing you can do about whatever is causing the pain without additional information and some professional advice to explore your options. Once you meet with the rheumatologist you will have a better understanding about potential actions you can take. The difference between combating "mental demons" and then stating that you "can't wait" to get some answers to your questions has already helped shift your focus and that will allow you to manage your pain with more success.

When our bodies are injured suddenly we have an immediate sensation of pain that is reduced once our endorphins kick in naturally. I don't know if you have experienced anything like this but I have found that there is a sort of "wave" I can "ride" to distance myself from pain. I know for myself that if I focus on the wave I won't even feel the pain in a short time, except for some throbbing from increased blood flow (when I tore the tendons in my ankle it bruised almost immediately from this increase in blood flow but it did not hurt as bad as it looked, LOL). Chronic pain does not provide the same endorphin release, as far as I know, but it is possible to trigger it by applying strong pressure or even a hard smack (which is what we do to horses before sticking them with a needle so they don't feel the poke of the needle). It is interesting how it is possible to use pain to relieve pain but you do need to use caution to avoid problems that result from long term self-injury.

Both my daughter and I saw this same doctor for minor foot surgery and he had this incredible machine that allows you to adjust the level of stimulation from a pad attached near an afflicted body part (it happened to be our big toes, LOL). What this machine did was to send electrical impulses that overwhelmed the nerves and blocked pain in that way. You basically start out with a mild sensation and then turn the knob up until it becomes more of an aching sensation. You could actually see the nerves twitching but there was no pain. I don't know if this sort of thing can be used privately but I found it pretty impressive.

Chai,

ten years ago I bought a house & a business post flood on the east coast. To my dismay both had black mold. Again, ten years ago people (doctors) really didn't have the tools to diagnose fungal reactions/illnesses. In May of 09 I had my great toe on my right foot amputated. I had funal phneumonia, and fungal bone infection in my right foot both from over exposure to mold.... yet the greatest pain came from having to file bankruptcy because I did not have the money to environmentally correct my home... EPA advisors said it would cost in excess of $35 K to repair my home... which at the age of 30 was my 3rd home. My credit score was the highest the banker had ever seen... and yet here I was filing Chapter 7 because I didn't hire a mold expert before buying the house and because I didn't INC my business... 10 years later it seems rational to say that none of this was my fault... yet the BPD side of me says I should have done better.. blah, blah, blah... you know the deal.. and so massive depression set in... even after graduating graduate school with 2x as many classes needed and all with A grades.. I still blamed me... and the entire time my great right toe got worse. My overall health is greatly affected by stress, I know this. But the fungal infection in my foot was active - and finally a progressive orthopedic doctor ordered MRIs to be done.


the MRIs showed the fungal infection - amputation was scheduled... and today even though my 'form' is altered the pain is gone - it had gotten so bad that I couldn't put covers on top of that foot at night while sleeping... shoes couldn't wear.. etc. the joint was 4x the size of the left foot toe... and today pain comes once in a while when the nerves get pissed .. (hahah) but nothing like before. I am not sad that I lost a toe... I am joyful that I saved my foot!!


I also have done lots of research on 'natural' healing aids... and one thing I found that ligaments are greatly affected by Vitamin B Complex (not just one B... like B6 or B12 but the complex) so that my RA in my foot & knee (from a previous motorcycle accident) as been greatly improved..don't know if Bcomplex will help you.. but just an idea.


take care of you - and don't worry about the limbs - it's the soul that makes the journey!
newt

Update:

Saw the Rheumatologist last week. He did a physical exam of my joints and didn't see much swelling/stiffness except for the problems I mentioned in my two fingers. He took x-rays and saw some joint erosion, but only one in a place that would be indicative of RA. Took a ton of blood (I swear I almost asked them to weigh me again after they took out all that blood because surely I would be down a pound or two!). He gave me cortisone injections in the two fingers that were bugging me and by the next day I was pain free! He told me there was only a very low suspicion that I have RA. My follow up appointment was today. Surprisingly, the blood results came back with a very high Rheumatoid factor and one other antibody indicative of RA. He asked if anyone in my family had it, and luckily I asked my Mom this and she told me my father's mother had it. So I could have the antibodies because it "runs in my family" or I could develop RA sometime in the future, but I am not really showing signs of it right now. I just have to keep it in mind that I tested positive for Rheumatoid Factor and get in to see a doc right away if I start getting really stiff joints/swelling/pain/etc.

Overall, I am okay. Not in pain anymore which was my goal all along. And, another positive thing has come out of this: after all of these doctor visits and surgeries, I am ready to start eating healthy and exercising again! I know that a lot of my health issues will improve if I just start eating right, lose some weight and get back in shape. So, now I have more motivation to do that!

I am so glad that you had such good news and that you are now pain free. It sounds like you are motivated to do some additional things to take care of yourself now that you are not dealing with chronic pain.

Since the cortisone injection was so effective in eliminating the pain I wonder if there are topical cortisone creams that would work on a regular ongoing basis. The tissue in fingers is not very deep so a cream could probably penetrate to the source of the pain without needing regular injections. It is great that you found a solution so quickly and that you also have more information about RA so you can watch for symptoms and have it checked out again if necessary.