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Dangerous Reading

Wednesday, June 15, 2016

Guest Feature by Dr Robert Keane

Pianists beware! Reading can be bad for you. Reading words, that is, not music.

On the Easter weekend, I read four textbooks I had saved up at school, and I enjoyed reading throughout Good Friday, Easter Saturday and Easter Sunday, with appropriate breaks.

However, I did not realise that my right elbow was positioned in the same place on the arm of my chair and was causing me harm. No indication of this harm was evident till several days later when I felt a small, tingling sensation on the inside of my fourth finger, right hand. Dismissing this as a result of brushing some stinging plant or insect – both of these had happened before – I paid no attention until, a day later, the tingling had spread down my fourth finger and into the fifth, then down to the wrist.

At this juncture I sought aid from chiropractic and physiotherapy, but, despite several treatments including therapeutic massage, nothing made any difference – except to my bank balance.

I had resorted to demonstrating everything for my piano students with my left hand – a useful exercise in itself – and, of course, I consulted the internet, where there is a bewildering quantity of knowledge and gobbledegook on every medical condition.

Most indications led me to the conclusion that I had a trapped or pinched nerve, probably the ulnar nerve at the elbow join, the funny bone. Not so funny, as it turns out.

After some six weeks of constant, burning pins and needles and other dreary pain, the mother of one of my students, who is GP, suggested that I needed to see an orthopedic surgeon. After I somewhat reluctantly agreed – pianists generally do not like the idea of anyone cutting into their hands! – she made the appointments for me: first to have Nerve Conduction Studies (NCS) done, which basically involves having electricity shot down your arms to determine the extent of the neural blockage, and second to see the surgeon. Both confirmed that I did indeed have a nerve "issue" in what is called the cubital tunnel, where the ulnar nerve passes from the upper to the lower arm at the elbow.

There were three possible procedures: neural release (unblocking the pinched nerve), epicondylectomy (cutting into the elbow bones to make the tunnel larger), or nerve transposition, where the nerve is relocated away from the bone.

I entered the Mater Private Clinic for day surgery under a general anaesthetic (a miracle in itself, where the total time of the operation is reduced to one merciful second, so powerful are the gases used) and was released a few hours later with a comforting local anaesthetic to help through the first 18 hours, and some strong pain killers for the next few days or so, until the arm settles down. Many sessions of rehab, various pressure bandages for six weeks, thousands of dollars and heaps of hand and arm exercises later, I shall emerge like a musical butterfly ready to tackle some welcoming Czerny, Joseffy and whatever scales, arpeggios and studies I shall eagerly devour to try to put my right hand technique back together again.

The surgeon released the nerve – the best solution, but urges caution: it could take up to six months to get back full mobility.

Yes, reading can be dangerous!

DISCLAIMER: The opinions expressed in Guest Feature articles are those of the respective author/s and do not necessarily represent ANZCA policy.