Carpal Tunnel and the Trike

The medical bits

It all started with being woken up in the middle of the night with a numb hand. Night after night. And not a usual numb hand either. Before this all started if I woke up with a hand that had also gone to sleep then I would just move and the feeling would go away while I dropped off again. However this was different. The feeling wouldn't leave the hand, usually requiring me to get up and walk about for a while before it would let me get back to the land of nod. Sometimes it would wake me more than once.

As it went on I did some www research. The symptoms seemed to point to carpal tunnel syndrome. But last time I'd thought I'd got something similar I didn't and some physio sorted something out in my back relieving the symptoms. So I went back to my physio. But, while the manipulations and stretches helped, the symptoms didn't recede. So, off to the docs I went.

And one appointment with a specialist later and I was diagnosed with suspected Carpal Tunnel Syndrome. And sleeping with a splint on my right hand. It certainly helped with the night time symptoms but the odd numb hand on the bike, when typing at work and random other times didn't go away. It's a very odd feeling when your hand just goes all pins and needles for no apparent reason. The really odd thing is the feeling of pins and needles on one side of a finger and not the other. CTS is caused by an impingement of the median nerve and, as I know now, this serves the thumb, forefinger, middle finger and one side of the ring finger. The un-affected ulnar nerve serves the little finger and the other side of the ring finger.

The really odd thing for me was that it had always been my left hand that had gone numb on the bike but that hand appeared to be ok. Well, it was. Until one day on Skye, after a long tandem ride. And then the same thing started with it. I couldn't find a splint on Skye but I did manage to fashion one with a Buff and a teaspoon.  This amused the specialist!

Ah, yes, him again. This time he was convinced enough to send me for nerve conduction tests. Another specialist, another hospital and a diagnosis. CTS for sure. The tests were interesting though. Essentially a series of electric shock used to measure the speed of the nerve signals in my hands. And because the speed is slower from the thumbs than the pinkie CTS is a good call. Moderate in the left, slight to moderate in the right.

And then another trip to the first specialist. And a decision to go for surgery, carpal tunnel release. I'm going to have it done in the left hand first. If that goes well then we will consider doing it to the other hand too.

Riding

For the most part bike riding has been ok. Rough surfaces, routes with heavy braking and the tandem in general have given me problems. One or other hand going to sleep. Changing gear is a bit of a lottery when you can't really feel your fingers. Braking isn't quite so bad, but I'm not sure I'm able to modulate it well with dodgy hands. The odd sharp stop has been entertaining! Getting a drink or food has been fun on occasion too.

I'm sure cycling has had some part in the development of the problem but I'm also sure that 27 years of typing, loads of goal keeping and golf have played their part.

General

One of the strangest things is the display of symptoms. At night I realise is because a lot of us sleep with our hands and wrists curled up. That puts pressure on the nerve and makes the hand go to sleep. Fair enough. But it's the other times that surprise me. Holding a coffee cup, hand goes numb. Typing, hand goes numb. Holding a mobile phone, hand goes numb. Doing nothing, hand goes numb. It's just odd.

Although may be not as odd as one of the specialist's tests. He took my arm and tapped down the inside of the arm from the elbow to the hand. Bingo, the hand goes numb!

Then I found clapping also set it off. Hard to enjoy a pantomime if you can't clap along... :-(

Looking forward

I can't say I'm looking forward to the surgery even if it is only a 20 minute procedure. I'm also not looking forward to the recovery either. No work until the stitches are out (minimal typing), no riding obviously. I'm just hoping TV will be good.

Then, once the stithes are away, I need to be careful. Cycling will need to be introduced very slowly to build it up again. And, of course, the right hand is still affected.

And, now, one reason for the trike will be much clearer.  I'm hoping it will allow me to keep my legs strong while I keep the weight off my wrists. And that might keep the Stoker happy. I can do upright riding on the tandem.

Well, that's the plan. Hopefully it will all work out just fine.

The new trike

Well, I did it. Bought a trike that is. Another small test ride with a hard shell seat convinced me it was ok and I went ahead. A couple of weeks later I took possession of an ICE Sprint 26x. Lovely. Since then I have ridden it around here a little and it's still fun but it's also very different. Here it is suspended on a couple of garden walls. It's easier to clean like that.

The new trike

With it being winter the weather is not exactly perfect for getting used to a new pedal driven machine (I can't really call it a bike...) but I have taken a few opportunities. I've been out twice in the dark allowing me to see where lights can be mounted. Rear lights are simple enough, mounted on the neck rest. Front lights are easy enough to mount on the accessory mount beside the chain rings but they aren't very high and getting enough illumination from them isn't easy. I think I blinded a couple of drivers when I was out the first time. The other problem is that I can't adjust them easily on the move because they are along way from my hands.

The other issue is one of storage. I need two sizes of spare inner tube and tools as well as drinks and snacks. With no access to back pockets this is a bigger headache than normal. I now have 3 water bottle cages and a couple of small bags. That was enough space for me to carry some food last time I was out and I even managed a snack on the move. Progress!

Not that I'm able to go very far yet. Last time out I did about 23 miles including the distance to the start and finish and that was tiring. The laid back pedalling action is different. I'm trying to keep the pressure off my knees, the cadence high, and pull the horizon towards the bike. I might feel like I'm getting there but I suspect it will be a long journey.

Now I have a new machine issue, a rubbing front derailleur but I'm not used to a friction shift so that might also take a little time and effort to sort. It needs sorted for sure, I don't need it to be any less efficient.  Which brings me to the question of speed. I feel it's slow at the moment. I'm hoping that with time I will pick up a little but I'm sure I will never challenge the road bike. The tandem, maybe; that's my target for the time being.

Looking at what I've written here it almost seems like I don't like the trike. That's not true, but it's not an unreserved love affair yet. There are other reasons for the trike. But that's a post for another day.

Ride

This latest ride made me feel like I am progressing. It followed a loop I've done often on the bike so I felt I wasn't compromising my distance because of the trike. It also allowed me to enjoy the different view available from the recumbent position.  I saw more buzzards than I have in a while and a kestrel. The wide views were also great despite not being able to see over the hedgerows.