the front of my mind (by which I mean the back of my mind) is on the middle of my mind

by Michael S. Kaplan, published on 2008/06/13 03:01 -04:00, original URI:

This blog represents an arid squallor of non-technical associative linkage, written by somebody who may as well have been stoned the whole time (or at least some part of it) though in reality he (by which I mean I) wasn't, an it wouldn't have actually changed any of it anyway. You have been warned...

It started a few days ago.

And when I say few, I mean three.

Some tingling in my fingers.

The fingers on the left side.

Not all the fingers, mind you.

But the pinky and half of the ring finger.

An ulnar nerve distribution, they call it.

Image:Nerves of the left upper extremity.gif

(It's the nerve over on the left side that heads down to those two fingers.)

Now I did not think much about it, as the dysesthesias, tingling, and numbness? It's kind of par for the course. It comes and goes all the time.

Then a couple of days ago, it was moving up my arm, too.

Again, just in an ulnar sort of a distribution.

This was less common thing, but hardly unprecedented.

I let the day go on, and in the back of my mind I followed the progress.

Which I found funny, since the actual nervous impulses were eventually going to my brain of course.

But hardly to the back of it -- more like the middle, somewhere on the right side.

And the thinking about it?

That goes on more closer to the front.

Which is also going on here.

And maybe I zone out and stop paying attention to whatever is in front of me for a moment, so I can concentrate on how far up it has traveled.

At which point I am not paying as much heed to what is happening in those visual centers that are in that occipital lobe, posteriorly.

So the front of my brain is thinking about the middle of my brain, and paying less attention to the bit in the back.

And I call that the things going on in the back of my mind.

It's kind of crazy, but clearly my mind has no idea what my brain is up to.

And then yesterday it was all the way up my arm, and something new was going on in the other fingers.

On the other half, the median nerve half.

By the end of the day, I couldn't feel my left hand at all.

This was much less common, but it too was not entirely unprecedented.

I have had MS exacerbations that started just this way before, of course.

And maybe I was having one again.

Wait a minute.

Could I be having an exacerbation?

This would be very cool, for reasons that only Now experiencing what is *almost* a pleasant exacerbation and Quando Dio vuole castigarci ci manda quello che desideriamo could provide sufficient context for.

I could try to do it again but maybe you could just skim them, instead? Thanks, I'd appreciate it. :-)

It would be cool because it would mean that things aren't as bad as they seemed to be, at all.

By today, as I was typing out my annual review, and with the strange interactions between Dragon Dictate and InfoPath forcing me type it, the front of my mind (which is to say the back of my mind) was really on the middle of my mind, and what effect would this have on the exacerbation I seemed to be having.

Of course in the old days nothing I did to speed up or slow down me had much effect on the course of a pure exacerbation with no underlying discernible cause.

Typing my review was a lot harder with me not being able to feel my left hand, but I don't think one gets extra credit for that. In fact, if it makes one write less it can have quite the opposite effect. So I decide not to hold back.

I won't talk about the review's content at all, but as a meta-point I will say that in finishing it, and finishing it early, I exceeded at least one personal expectation (one that was not in my commitments, except the implicit commitment to finish the bleedding thing and I could check with the generalist if you wanted me to but I don't think that counts!

I took the rest of the day off when I was done. Just walked into my manager's office, said

I've submitted my review, and I can't feel my left hand. I'm going to leave now and take the rest of the day off.

He blinked for a moment at the three possible non sequiturs (presumably trying to determine if he was supposed to connect any two or all three of them), and then just nodded and said okay.

I can't imagine that managing me is the easiest thing to do. The random statements alone would fell a lesser person, certainly anyone for whom English is a second language.

My managers are made of sterner stuff; too bad that category is not in the manager feedback, even worse I don't know how to free form it in a way that makes it sound helpful!

I wanted to talk to someone about all this MS stuff that was happening, for reasons I can't really explain.

Ironically my six month appointment with my neurologist is tomorrow morning, howze that for timing?

But I want to talk to someone now.

Unfortunately, all of the someones who I would talk to are nine hours away or in meetings or working or unavailable or deceased or something. And all of the living, available people I had in mind would certainly stop to talk for an emergency, but it really isn't an emergency and I'm not even sure what I want to say anyway. Or why.

And if people start urgently calling you saying they need to talk but have nothing to say then you might inspire a whole different kind of worry.

Now, half a day later, I could actually talk to all sorts of different people (mostly the ones who ar available and/or awake) but I don't feel a pressing need to like I did half a day ago.

It's just an exacerbation, I've had tons of them before. What's the big deal?

It's weird.

When I first started having exacerbations, I was married around the beginning and had good friends throughout, But I didn't talk much about it then either either, since no one understood. Hell, I didn't understand.

But there is a strange comfort in knowing that I am not so jaded and cynical about the MS.

You know, knowing that an exacerbation can still fuck me up this way.

And THAT thought makes me smile.

And maybe you too, if you have the same kind of sense of humor that I do. :-)


This blog brought to you by(U+a196, aka YI SYLLABLE NUR)

# Barfieldmv on 13 Jun 2008 8:47 AM:

So you say going numb isnt really a bad thing. You post kinda scared me till i understood it was a normal thing.

So now we got a foreign mind thinking about your frontal mind thinking about your back mind thinking about your numb fingers, hmmmm strange kinda humor you can find around on the internet.

Anyway enjoy your day and good health.

# John Cowan on 13 Jun 2008 10:45 AM:

Well, there's no reason why the back of your mind should be implemented in the back of your brain.  CPUs don't do background processing with their back sides, after all.

Or as Doug Hofstadter puts it:  "I think, therefore I have no access to the level where I sum."

But if you were a Windows system, I'd recommend a reboot about now....

# orcmid on 13 Jun 2008 12:52 PM:

The interesting thing about those symptoms is that they are also associated with carpal tunnel problems and also arm position (sleeping position of the arms matters, according to my physician), as I know when it wakes me up and I need to unfold my arm and have it relaxed at my side.

Of course, at my age, and male, the symptoms could be anything, including medication side-effects, so I have to just keep my head on straight, not go all hypochondriac, and notice that I can alleviate the symptoms that I recognize by adjusting arm position and repetitive movements.

Except now you have me thinking about it and I am not sure that is helpful since it has me be aware of the tingling and not alleviating it.

So, did you know that, in medical terminology, exacerbation and acerbation mean the same thing?  I didn't until now.

# Michael S. Kaplan on 13 Jun 2008 3:01 PM:

Hey Barfieldmv  -- I wouldn't go sof ar as to call it "normal", though at this point it is expected...

Thnks for the postive thoughts, in any case! :-)

# Michael S. Kaplan on 13 Jun 2008 3:03 PM:

Hey John -- a Windows system? Well, I do WiNCE now and then, so perhaps I am running under Windows CE?

I had a reboot of sort -- The Novantrone. It was also given its destructive nature kind of a BSOD, and as a chemotherapy agent, it is something of a Blue Substance Of Death (BSOD)....

# Michael S. Kaplan on 13 Jun 2008 3:12 PM:

Hey orcmid -- Well, most of my symptoms would be a Guyon's Tunnel thing (that is the ulnar nerve's equivalent of the median nerve's Carpal Tunnel), but the principles are the same -- it does not have problems as often, but "Guyon's tunnel syndrome" is not completely unheard of, either.

I knew about the acerbation/exacerbation thing -- I think the former is actually a relatively recent back formation (like the last 150 years or so?). Interestingly, they are often used in different contexts -- like certain diseases they prefer one term, others prefer the other term. With no logic as to which one is best in each case, either!

# Si on 14 Jun 2008 12:08 AM:

"the strange interactions between Dragon Dictate and InfoPath forcing me type it"

InfoPath is lovely and everything, but no one (at least no one below a 59) "types" their review into InfoPath. ;-)

Word is actually a much better tool for creative writing, and with the marvels of cut and paste, there's no need to have the intern transcribe it for you.

# Si on 14 Jun 2008 12:10 AM:

Doh! that should be "above a 59" - there goes my exceed. ;-)

# Michael S. Kaplan on 14 Jun 2008 2:48 AM:

Hmmmm.... I guess they might have to relevel me soon, in that case.... that never even occurred to me, I was just so eager to get it done and move on!

# Russ C. on 19 Jun 2008 10:02 AM:

I don't know if this helps you, but I get this same problem in my left arm; with me in particular its brought on my the angle of my keyboard.  

Since I badgered my employers into buying me the Microsoft Ergonomic 4000 I've had a lot less trouble with this condition as I use the provided plastic to tip the keyboard backwards.

When I first started getting this problem I went to my Doctor and he told me that it was cause by an inflammation in the wrist that causes this nerve to be squashed, because of strenuous activity (typing :P) in a bad position.

My doctor advised I wear a wrist strap when the condition flairs up - the particular one I use extends down my forearm and has a dogleg shaped piece of flat metal that keeps my hand and wrist in an open position which relieves the pressure on the nerve.

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