CTS, DeQuirvains, Ulnar nerve compression, tennis elbow

I need answers, please help if possible. I developed sudden onset of inability to bend my fingers on my right hand on July 8, 2014. My middle finger was particularly painful. I had been working a lot of overtime, I use the keyboard and more so the mouse to go between multiple screens as well as do a lot of writing jotting down phone messages and filling out fax sheets. I worked 13 hours July 7 and was fine. I only recall several months prior (April 2014) mentioning to my PCP that my elbow hurt and I had a little wrist pain. She advised I see a Hand Surgeon for possible Carpal Tunnel. It went away within the week. (I had moved to a temporary office where the desk was very small and no arm room, I attributed the discomfort to that. I went back to my office and it cleared up.

After the 13 hour work day my right hand felt swollen/tight and I could not bend any fingers. I took 800mg of Motrin and took ice packs to work. (There were only two of us to handle a large amount of work and my heart could not leave my co worker alone to face all that as the work is time sensitive and affects payment to our corporation.) I worked for 10 days in pain with tightness in the fingers until I could see my PCP and then a Hand Surgeon on July 24. Hand Surgeon surmised CTS and wrote me a script for an EMG. I could not get appointment till Aug 18. The pain intensified and now was radiating into my shoulder. I was struggling to write due to the pain traveling to the shoulder. Gripping the mouse was causing the same problem. I went to my PCP Aug 5 and was taken off of work pending the EMG and my Hand Surgeons return from vacation. I kept calling to check for cancellations and was able to get the EMG sooner on Aug 7 or 8. The Physiatrist (Physical Med and Rehabilitation doctor) who performed the EMG said I did not have CTS but upon exam said I had tendonitis and non use and OT was his recommendation. Since Hand Surgeon took me off of work I had to see her for treatment. She was convinced it was CTS and said it doesn't always show on the EMG. She had me splinted at night since first apt July 24 and I was not improving but declining. Saw OT and they thought it was my neck. Since I see a Neurologist yearly for migraines and neck pain and was just about due for my 2 year MRI of head and neck I made apt and got the MRI's, they included the hand. They could not do the elbow or shoulder because only 3 MRI's are permitted at a time. MRI of hand normal nothing seen, MRI of head same as previous, MRI of neck: C4-C5 - Small central protrusion, partially effacing the ventral thecal sac, no significant central canal stenosis, apparently new. C5-C6 - Small central protrustion, no significant central stenosis, unchanged, C6-C7 - Small broad based central protrusion, no central canal stenosis, unchanged. C7-T1 - Very small central disk protrusion, no central canal stenosis.

Neurologist sent me to their pain mgmt neurologist, he reviewed my imaging and did an exam and stated I had DeQuirvains tenosynovitis, tennis elbow and tendonitis in the shoulder and CTS. He said this would take time, maybe a year and only cortisone and non use were the treatments.

Sorry this is long, attempting to give you the picture as best as possible.

Hand Surgeon ordered OT, then did cortisone injection early September. Cortisone reaction unable to sleep = insomnia, about 11 am next day I felt fevered, thought I was ill with a virus, took two Tylenol. Couple hours later noticed face was bright red like I was sunburned. Called Hand Surgeons office, nurse said I had a reaction to the cortisone and to take Benedryl and if it did not help within an hour to call them back. Started feeling some relief, took Benedryl at bedtime and I was fine the next morning. Cortisone worked for two days then all symptoms returned.

Hand Surgeon scheduled surgery for Oct 2. Post op visit 19 days, stitches removed, lots of wrist pain and stiffness, and thumb still really hurting. OT ordered for 4 weeks. Took a week to get appointment. OT saw me 8 times and just yesterday said she wanted to re assess me. I still have zero grip strength and she said there is no sense in continuing OT at this point. She was sending her recommendations to the Hand Surgeon. I left crying. I need to get back to work and I am scared I will never be able to regain full use of my right hand which is my dominant hand. I can type but not for long as the thumb and wrist really hurt. Writing is the toughest and causes the most pain. I tried to write last night and the pain was so intense and traveled all the way to my shoulder. I still wear my splint at night and was awakened multiple times with stabbing pain in the palm side of the thumb as well as the top side of the thumb. This thumb pain travels into my wrist. I am so concerned about permanent damage. I am 47 years old and I don't want to lose my ability to work. I have worked all my life and enjoy working. I like the security of my paycheck and have financial goals to achieve. I don't want to live on a meager disability check. I am scared. My Hand Surgeon says this will take some time and I should notice improvements up to 6 months. In the mean time I could lose my job, health ins and paycheck.

My husband is coming to the appointment Tuesday with me. We are going to ask if this is the DeQuirvains causing the problem. What could be causing the thumb to hurt so badly? Even as I type the base of the thumb is in great pain radiating up the thumb on opposite side of the palm. Writing and griping cause immediate numbness of the thumb, index and middle fingers. I keep dropping things if I attempt to hold them with the right hand.

Please offer your suggestions. Also, what should I be asking at my appointment this Tuesday?

With much gratitude,
ALH