Looking forward to a full 8 hours.

sleepyI just got back in to town after two weeks on the road for work and plenty of fun. And nothing says “welcome home” like surgery scheduled for 7am the next morning. Yep, that’s right. I’ve had enough of this pesky carpal tunnel, and tomorrow morning I head in to the OR for carpal tunnel release surgery.

Going under the knife when you have diabetes is definitely something one needs to consider seriously. People with diabetes have a host of issues to worry about, on top of the stress anyone would experience when going in for surgery. Diabetes can cause wounds to heal more slowly, so careful attention will need to be paid to my incision site. Of course, one of the most acute concerns is keeping BG stable while under general anesthesia. Because you cannot have any food or drink for 8 hours prior to surgery, I will be at risk for a low BG tomorrow morning. In order to prevent needing to eat to treat the low (which would mean I have to cancel the surgery), I will turn the basal rate on my pump down by close to 50% before bed tonight. I may run high tomorrow morning, but my CDE let me know its better to let my numbers creep up a bit than risk a low during the procedure. Of course, my surgeon is well aware that I have diabetes, (He’s been forgiven since that blog post, FYI!) and my step mom will be right there in the waiting room to take me home after the procedure.

With all the risk associated, why go under the knife for something like carpal tunnel, which I could technically live with sans surgery? For me, the issue is quality of life. Contrary to what most people think, carpal tunnel syndrome often does not cause pain while doing the activities that are damaging those nerves (by activities, I mean exactly what I am doing right now – typing!). When I go to sleep at night, my hands get pins and needles numbness so bad that it actually wakes me up. My right hand will sometimes be so numb that I have to pick it up with the other hand and shake it “awake.” This happens at 3am, at 4am, at 5am – you get the idea. Long story short, I haven’t slept through the night in almost two years, and I’ve had enough.

Lack of sleep may help explain my voracious coffee habit, but more importantly, my CDE let me know losing sleep could also be causing glucose fluctuations. Stress hormones rise when sleep is interrupted or deprived, and can cause blood glucose levels to bounce around. So, between my exhaustion and having anything contribute to even more BG unpredictability, I chose to go ahead and book the surgery. Furthermore, my surgeon let me know that once carpal tunnel become severe enough that you begin to lose strength in your hand, you can never get it back.

All in all, I am so looking forward to getting this taken care of and getting my shut-eye back. And, on the plus side, the fact that I knew I would have to take a break from my usual kickboxing workouts is what inspired me to train for my first half marathon – just 6 weeks away!

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Hi Alexis – two quick things – 1. I also suffered terribly from CTS from using the mouse. Nothing helped – TrackBall, wrist wrists, wrist splints, mouse pads —-. Then when I was consulting on site for a client they sent an Environmental Health & Safety manager to see my workspace. I told her my pain and she let me try a RollerMouse from Contour Designs for a day. It took around an hour to get comfortable with it, and the pain has never come back with the severity I had experienced – 8 years now.
2. In training for the ADA Tour de Cure my (new) internist with endocrine specialty had me try an experiment of stopping the metformin for 3 months and seeing if I still needed it to maintain my AUC under 6 (I have averaged 5.7 – 5.9 over 7 years). Answer – not right now. I was up to 6.2 at 90 days BUT had an extraordinarily stressful 4 weeks in the middle of it, with 12 straight 12- 15 hour days and severe emotional and economic stress (not due to diabetes). Probably spiked cortisol and adrenaline and kicked the BG all over the place. We’ll try again later in the year as my return to cycling keeps the weight off and I continue to slim down.
So I’m still proudly wearing the Red Rider jersey and staying on the bike for all the good reasons.

Good luck on the surgery!!

Hey Richard!
1.) I use the exact same keyboard and mouse and have been using it for over a year now, plus I have it in a specially lowered, ergonomic tray to prevent bad posture, and still, the CT worsened. I also wear splints and night and regulary stretch my hands, but to no avail! The surgery has been such a relief for me, no more numbness at night. I am so glad you have not had to go through the surgery though, this is definatley not fun! Not so much painful as it is an utter and complete annoyance.
2.) Interesting with the A1c! I bet the stress had a LOT to do with that, its amazing how much that can bump your BGs around – I bet you see a good number at the next one after the stress has let off a bit and all that cycling pays off. Good luck! Keep riding!

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