Ulnar Nerve Transposition – Recovery

On March 25th I had Ulnar Nerve Transposition surgery. I wrote about it, one handed mind, a few day after. (Wow, I just realized I posted that on April 1. No, that post was not an April Fools joke, but I digress.)

I hit the four week mark on Tuesday, April 22, and my recovery is ahead of schedule. My range of motion is at about 99% in my estimation. Fully straightening it is still accompanied with a bit of pain, but it’s not bad. Overall the incision has healed nicely, no infections, or other troubles.

The 'smile' cut

I love modern medicine. Surgery was on a Tuesday. I left the hospital with gigantic cast-like wrapping on my arm. I couldn’t move it, it was fixed in a 90 degree angle because your ulnar nerve likes that relaxed position and would allow the nerve to cool down. The first couple days were the most challenging, my nerve was not a happy camper, and I’ll be honest, at times I wanted to cut my hand off. By Friday I was feeling pretty darned good and visited the hand therapist for my first session.

Session One

I didn’t know what to expect on my first visit. I’d already gone through therapy with this group in an attempt to fix my issue without surgery. I couldn’t imagine doing nerve glides just yet. The arm was a bit too tender and swollen for that. Session one was all about getting the bulky wrapping off my arm and replacing it was a much lighter version I could remove if necessary. They even used a nice removable wrist brace because anything touching my hand could cause the nerve to go crazy. By using this removable brace I could seek relief when the nerve flared by removing the brace. It was quite nice. That was all for the first day.

The 'smile' cut

Session Two – Crumpling Paper

My second session was at the seven day mark. We took the brace off the arm and I received a massage just above my elbow on my triceps muscle, which was surprisingly nice. Then we moved on to some simple exercise to make sure scar tissue didn’t form around my newly relocated nerve and prevent it from moving properly. The first exercise was to move my arm downward from its 90 degree angle to 45 degrees and move my open palm left and right, without pain. The second exercise was to make sure my head was properly aligned over my shoulders and tilt it to the right, which pulls on the nerve from the other direction. Done for the day, sent home with homework to do these exercises throughout the day. Pain free movement was the operative word.

Crumple that paper!

One Week + One Day

At just over a week I visited the surgeon for a check-up. The doc removed the soft cast and said “Take that thing off, but wear it to bed.” So, that’s what I did. I was able to do some light typing after that, but couldn’t push too hard or I’d anger the nerves in my palm. It was really nice to have it off. Unfortunately I didn’t think to grab any pictures of the different cast setups.

Session Three and Beyond

By the end of my second week my arm was feeling really great. When we hit session three I was able to do all sorts of “advanced” stuff. I think you’d be surprised how much your ulnar nerve is isolated and used doing very simple things. I got to crumple paper, play with coins, use the rainbow arch, and rub my elbow in rice. Yes, rice, it’s a texture thing. The nerves around my elbow didn’t like to touch things after surgery. It was actually quite unpleasant when I rubbed up against something. Moving the rice around with my elbow allowed the area to become accustomed to being touched again. I was also instructed to rub the area throughout the day with various different textures to help with the process.

Playing with my food

I’ve been doing so well the therapists have decided to cut me lose until after the six week mark. At that point we’ll begin strengthening.

Coins and Puzzle

Lately, as in the last few days, I’ve experienced a sensation I’ve never experienced before. I’m not sure this has anything to do with the surgery, but I’ll run it by my doc. I’ve been getting a strange sensation at the base of my neck, then it spreads out and down both arms, almost like a cramp. My arms become very weak and I get sick to my stomach. It’s not a pleasant experience. Knowing my body it’s a stress thing, but I guess we’ll find out.

Rainbow Arc

Oh, One More Thing

I started this process in hopes I’d get feeling back in my left hand and fingers (pinkie and ring finger, and half of my palm.) That hasn’t happened, yet. According to the doc feeling may never return. It will take six months to a year to know for sure.

In the meantime I need to get back to writing software.

By Rob Fahrni

Husband / Father / Developer