I Wish I Knew: Mommy Tendonitis

A year ago today I waked through the door of a doctor’s office and was told that I had de quervain's tendonitis in both of my wrists. In the 7 minutes I  spent with the doctor, he explained that I had severe inflammation in the tendon at the base of my thumb. Every time I used my hands to pinch, turn or twist I was causing that inflammation to get worse. He called this "mommy tendonitis" because a large portion of the patients he sees with it are new moms. My baby was 10 weeks old at the time. Others call it "mommy thumb."

Those at higher risk for getting de quervain's:

-women (most specifically new moms) --- check!
-over the age of 30 --- check!
-having a large baby --- and check! My baby weighed in at 9.7 lbs at birth and was over 14 lbs by 2 months. Not to mention her big sister (who was getting carried a lot still) was 30 pounds.

My problem started some time before my baby was even born though. It was in July (of 2012) when I was 7 months pregnant and the average temperatures were in the 80s and up to the 90s. It was at this time that I began to have significant swelling and would awake in the middle of the night with numbness and tingling in my hands. I told the midwife about this discomfort at my regular check-ups. I was told it was carpal tunnel syndrome and would go away once the pregnancy was over. I noticed it getting worse throughout the end of pregnancy. I often had to switch hands if I was on the phone for more than 20 minutes and would have to take a break if I was writing. The tingling was becoming painful. I was, again, reassured that it would end with the pregnancy.

And as they all do, my pregnancy came to an end, and I had another beautiful daughter. The home health nurse came for my postpartum visit a few days after the birth and I asked her how much longer I had to wait for my pain to go away. She told me it would take a couple of weeks for my swelling to go away. And so I waited.

That 2 weeks came and went and I was in a haze of caring for a newborn and a toddler. One afternoon I tried to open a can of spaghetti sauce for lunch. I tried to use a knife to loosen it. A towel to twist it. I sat on the floor and tried to brace the jar with my knees. We had a can of diced tomatoes instead. Shortly after that, I was trying to dress my baby girl and I couldn't get her onesie snapped. I tried to shake my hands out, thinking it would help. I tried the snaps again. The pain was too bad. I stuffed the open onesie in her pants.

I went to my 6 week postpartum check-up and told the midwife my pain had gotten worse. Not better and certainly not gone. The midwife said that it no longer sounded like pregnancy-induced carpal tunnel syndrome and recommended that I go to a specialist at that point. I allowed more time to pass. While still on maternity leave, I was driving to story time at the library with my mother-in-law. I described the pain to her (she is also a nurse). She told me it sounded like de quervain's. She has had too. She gave me her doctor's name. 

And that is how I found myself at the doctor's office a year ago today. After my visit with the doctor, I went next door to meet my occupational therapist. There I was fitted for splints for each wrist. I could not contain my emotion and I sat in the office and cried my eyes out. As embarrassing as it was, I could not figure out how I was supposed to take care of my children wearing those things. Of course, I could really only wear one at a time (except for at night). I wouldn't be able to drive, eat, or dress myself (let alone my children) if I was wearing both. 

I was able to get through my next appointment at the occupational therapist without crying. But I was still mad, really mad, that I was going through this. He told me that I needed to share it with other moms. Had I not ignored the pain it may have taken as little as a couple weeks with more careful lifting, ice, and ibuprofen. He told me to share my story.

I soon learned why sharing it was important. Many people would ask me what happened when seeing my splint.  I would answer simply, "I have tendonitis." Many replied, "Oh, that's good." I couldn't figure out what they could possibly think was good about being in so much pain that I needed my wrist and thumb immobilized. But a couple people said to me, "Oh, I'm so sorry." And told me their story of tendonitis. Most people haven't had tendonitis. Not to mention the common names for tendonitis are the activities that cause it - tennis elbow, trigger finger, and mommy thumb. So it's understandable that most people aren't familiar with it. Which means many more people don't know how to minimize it. Here are 3 things I wish I had done differently.

1. I wish I had changed positions when picking up my children. That being said, it's impossible to NOT pick up your children and pretty hard to even modify it. Using the "L" position under a child's arms puts  a lot of pressure on the thumb and wrist and is the biggest contributor to the pain. Still today, I find it's automatic to pick my children up in this fashion so I have to stop and think before I pick them up. Now, I use one forearm under my baby's tush and the other on her upper back. If they are on the floor I kneel down first before picking them up. And when they're laying down (especially when babies are very young and without head control) I slide both forearms under their body to pick them up. Many times, I also curl my thumb in and use my fist for support.

2.  I wish I hadn't held my Kindle in my hand when reading e-books. I didn't think that little thing could put that much pressure on my wrist but it definitely contributed. 

3. I wish I had paid more attention and gone to the doctor sooner. The swelling and hormonal changes during pregnancy can cause both carpal tunnel syndrome and tendonitis. I was unfortunate enough to get both. I had hand pain for so long that I didn't realize that one kind of pain had gone away and a new one had started. I'm normally really good at listening to my body but this time I just wasn't. I remember saying at the time I was too busy taking care of my kids to notice. While that was true, it's important to remember my own health was also important. My midwife had been right that it went away and if I had paid attention that something new was happening, I may just have avoided a lot of this. 

Unfortunately, I can't go back in time and have a do-over. This story may come off as if I'm whining and complaining. I don't mean for it to sound this way. But it was tough. I was unable to dress my baby or change her diapers without pain for months. My husband did most of the dressing, diapering and bathing. While I know that might sound like a dream, being that dependent was extremely difficult. I couldn't really be home alone with my baby. I often had to have her handed to me to breastfeed her. I relied on my friend (where the kids go to day care) to put my kids in their car seats. My husband even had to take over cleaning my pumping supplies. I have had many moms tell me that is not something that they could have let their husbands do. I had no choice. I had to go to work so I had to pump. It was that or not breastfeed.  I had to let go of many things during this time. It was challenging to feel so helpless. But I was fortunate to have the help I needed. 

In the end I used heat therapy, an economy size bottle of ibuprofen, had steroid cream administered through an electrical current (called iontophoresis) and regular occupational therapy. I wore my splint on my right wrist for the recommended 6 weeks and was relieved that the pain was minimized after that time. Unfortunately, while "resting" my right side my left side was doing everything and got significantly worse. It became painful to open a door, turn a key or cut my food. I got a cortisone injection and continued the above treatment and splinting for an additional 4 months. Still, I could see my tendon popping under my skin. So I reluctantly had surgery. There was some improvement after that but the pain remained. I had a total of 10 months of occupational therapy and 11 months of splinting. To augment traditional treatments I also had 12 sessions of acupuncture and wear magnetic bracelets on my wrist every day. I am beyond grateful to my friend who recommended acupuncture which provided the most pain relief. A year later I am finally starting to feel better. I still have to be careful with how I lift the kids. I can't use my left thumb to type. I have only knitted twice in the last year and the time I did it for more than 20 minutes, I felt it for 3 days after. Not a day goes by that I don't hurt.

But I am almost back to normal now. And my hope of all hopes is that I can share this story and prevent at least one new mom from experiencing mommy tendonitis. My occupational therapist urged me to share my story to help other moms. I had no idea at the time how I would do that. But I'm hoping that writing this is at least a start.

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