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I didn’t practice yesterday. In fact, didn’t touch my piano at all. Due to health reasons, I will be taking a one month hiatus from practicing. I’m having a really hard time with this, because since January, I’ve been eating, sleeping, breathing piano. Thursday I went to J.W. Pepper Music and made a list of music I planned on buying this weekend. I don’t know now if I’ll go ahead and get it, or wait and see what happens after the month is over.

So here’s the deal. I’ve been dealing with hand pain for about 2 years. Really bad pain. It was impacting my daily life pretty severely. When it was at it’s worst, I wasn’t able to open doors with handles that turn, open jars or bottles, fasten my own seat belt, walk my dogs, squeeze my shampoo bottle (had to buy really small bottles for my shampoo and lotions). It hurt to dry my hands, wring out a washcloth, pick up a cup, type, brush my hair. You get the picture. The pain was in my hands and wrists. It felt like a combination of my hands being asleep and hitting my funny bone. The pain was pretty constant. My doctor believed it was carpal tunnel, and suggested surgery. He first sent me for an EMG to confirm carpal tunnel. Turns out there was no sign of carpal, and he sent me for several weeks of physical therapy. I had custom day splints and night splints. I didn’t work for a couple of months. The PT and splints helped, and I returned to work and lived with less pain (not entirely gone, but tolerable) for a while. I continued to have times of severe pain, and times of moderate pain.

About a year ago, I developed a painful, pea sized lump on the outside of the knuckle on my right thumb. My doctor said it was a ganglion and would go away by itself. It did not. Shortly after that, I switched doctors (for other reasons), and my new doctor also told me it was a ganglion, and that it would not go away without surgery. Although it was painful, it wasn’t unbearable, so I opted to live with it.

In February of this year, the pain became worse than it had ever been. Within a two week period I developed another painful lump, about marble size, in the “V” area between my right thumb and index finger. It was very painful. And larger mass in the fleshy part of my palm/thumb ~ at the base of the thumb where it joins to the wrist. This was very, very painful. And a lump smaller than a marble and bigger than a pea, in my right wrist. Almost unbearably painful. Also the severe overall pain, numbness, tingling returned worse than ever. It hurts to drive, tie my shoes, dry my hair, put toothpaste on my toothbrush. Pretty much anything I do with my right hand is painful. This time I began having the same pain in both feet, and also had a pea size lump on the bottom of my right foot at the base of my toes.

My doctor’s first suspicion was peripheral neuropathy. I’m not diabetic, but I was told that it can occur in people who do not have diabetes. Before confirming that diagnosis, he wanted to rule out carpal tunnel, so sent me to a neurologist for another EMG. The neurologist did several procedures, along with the EMG. No evidence of carpal tunnel. She also ruled out peripheral neuropathy. She sent me for an MRI and MRA of my back, and MRI of my brain. Among other things, she wanted to check for spinal compression. While they didn’t find compression, or any problems with my brain, they did find that I have osteoarthritis in my lower back. I’ve been dealing with back pain for a few years, and have been to the ER several times for it. That’s another story and has nothing (not much, anyhow) to do with piano. So ~ my doctor decided to send me to a rheumatologist to investigate the possibility of Lupus or MS. Both were ruled out, and the rheumatologist believed it was Rheumatoid Arthritis, and that the masses were rheumatoid nodules. After xrays and bloodworked, RA was ruled out because the bloodwork didn’t support that diagnosis. Lupus and MS were also ruled out. He suggested that I see an orthopedic surgeon to have the masses cut out and biopsied. On May 6, I saw an orthopedic hand specialist. He had xrays taken, bloodwork, and ordered an MRI of my thumb/wrist. He also prescribed Trammadol for pain relief. It has helped some. The xrays didn’t show any arthritis, and the bloodwork showed nothing suspicious. I had the MRI on May 9. I went back for the results of the MRI yesterday, May 13.

So here’s the diagnosis. Masses/lumps on knuckle of right thumb and wrist are osteoarthritis with bone spurs. I questioned why arthritis did not show up on xray. He said sometimes it doesn’t show up on xray, but does on MRI. The mass/lump between my right thumb and index finger is a ganglion cyst. The mass/lump in the fleshy part of my palm where the thumb joins the wrist is Basal Joint Arthritis, for which he gave me a cortisone injection. Yes, you’ve heard right. They hurt. Then he sent me to the physical therapy area to have a custom splint made, which I have to where for a month. It starts just below my elbow and goes to just below my fingertips, also separately isolates my thumb. After one month, he’ll reevaluate, and determine what surgery I need. If the total hand/wrist rest has helped calm down the inflammation and pain, he’ll remove the ganglion and continue to treat the arthritis with splints/therapy/pain medication/cortisone as needed. If there is no improvement, he’ll remove the thumb/wrist joint and graft in tendon taken from my wrist or forearm. The first surgery has a recovery time of several weeks. The latter has a recovery time of 3-6 months.

Bottom line ~ no piano for one month, the reevaluate. Possibly return to playing at that time. Or possibly surgery with a recovery of several more weeks. Finally, possible surgery with recovery time of 3-6 months. If I have to have the basal joint surgery, my thumb will never be quite like it was, but will be usable (and most importantly, flexible).

So ~ that’s the story. Maybe I’ll update occasionally with other piano-related activities. I may do some composing, some music study, some ~ I don’t know. I’d be lying if I said I wasn’t discouraged. But as a friend who is in a wheelchair with MS reminded me ~ it could be worse!

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