No one warned me about Carpal Tunnel Syndrome. Or maybe I didn’t listen. Like most people, I pay close attention only to things that affect me personally. Carpal Tunnel Syndrome had been in the news, of course, and I was aware that it afflicted keyboard operators. I considered myself a writer though, not a keyboard operator. It couldn’t happen to me.
Writing was just my hobby. At least that’s what my husband called it. Long before I’d ever touched a computer keyboard, I was writing stories in longhand on notebook paper and preparing final drafts on an electric typewriter. The speed of the keys and the carriage return were great improvements over my old manual typewriter. I thought I had all the technology I’d ever need until my husband brought home a PC.
At first, I did not embrace it. But after months of my husband’s badgering that I was “resistant to change,” I sat down and learned how to use the word processing program. Once I got the hang of it, I wondered why I’d been so stubborn. Words were easy to move around, and copies were always clean.
Soon I was connecting to the Internet, too. It opened up a whole new world to me. There was no end to links connecting me to writers’ associations, clubs and bulletin boards. I read online literary magazines and scanned their classified ads for current markets. I found submission guidelines on web pages or got them fast and free via e-mail, rather than sending SASE’s snail mail and waiting for them to come back. Electronic submissions also eliminated trips to the post office. The greatest thrill of all was launching a story into cyberspace and receiving a reply a few hours later. I don’t know what pleased me more—the quick response or the fact that the editor wanted to publish my work!
That day I was so ecstatic I would have testified in court that technology had improved my life immensely. Yet at the same time, I was experiencing its dark side without even knowing it. I’d begun to wake up in the middle of the night with a pins-and-needles sensation in my fingers and hands. Sometimes they felt numb, as if they belonged to someone else. For weeks I put up with my hands falling asleep at night like this. Then the tingles turned to sharp pains shooting like electricity through my hands and arms. I’d shake my hands urgently and hang my arms over the side of the bed. As soon as I got back to sleep, I’d wake up in pain again. What was wrong with me?
I made an appointment to see my doctor, but I avoided telling him that I was a writer. I knew from experience that the next question would be “What have you published?” At that point, I’d had only the one story published, and it was in a magazine few people had ever heard of.
The doctor listened to my symptoms and frowned. “What do you do with your hands?” he asked, as if I were an old lady who knitted all day. “It sounds like a repetitive motion disorder, perhaps Carpal Tunnel Syndrome.”
I was sure this diagnosis was wrong. My hands and arms bothered me at night, not when I typed at the keyboard. The doctor said that this was common in the early stage, that I had the classic symptoms. Once I stopped denying the obvious, my first concern wasn’t how Carpal Tunnel Syndrome might interfere with the general use of my hands. Instead, I was afraid the doctor would tell me I should stay away from the computer. But he didn’t. He advised me to get a wrist rest and to take frequent breaks. He said that the wrist braces sold in drugstores might help, and then he showed me some stretching exercises to do with my hands.
When I got home from the doctor’s office, I e-mailed my sister, who’s a nurse, and asked her if she knew anything about Carpal Tunnel Syndrome. Then I logged onto the library’s card catalog, found several books about the subject on the shelves, and with a click of the mouse had them placed on hold and sent to the nearest branch. It wasn’t until I was scrolling down the results of a search engine that I realized my life was now centered on the keyboard, and every minute I spent on it was making my Carpal Tunnel Syndrome worse!
I didn’t want to give up using the computer, so I tried to understand what caused the problem. The books I read explained that eight bones called the carpals form a tunnel in each wrist. Through this tunnel pass tendons that control the movement of the fingers. The median nerve competes for space in there as it runs down the arm and into the wrist on its way to the hand and fingers. Hours of pushing down on keys and then releasing them causes the tendons to swell from overuse. If the wrist is bent at an unnatural angle, the tendons rub constantly against the carpals, aggravating the situation even more. The swollen tendons then press on the median nerve, causing pain. I didn’t notice discomfort during the day, but when I slept blood flowed slower through my body, enlarging the blood vessels in the tunnels, putting more pressure on the nerves and waking me up. That’s stage one of Carpal Tunnel Syndrome, CTS for short.
I had inadvertently done everything I could to give myself CTS. My keyboard sat so high on the desktop that I worked with my wrists bent backward, a position that caused the tendons to rub against the carpals with every flick of the wrists. I was not only jerking my wrists up and down but also twisting them from side to side as my little fingers stretched to reach outer keys. I spent several hours a day repeating these movements in this awkward posture. My speed increased; I didn’t have to stop to wait for a carriage return or to roll in a clean sheet of paper.
Through my reading I discovered that an endless list of jobs created the injury. I shared CTS with sign-language interpreters, musicians, hair stylists, supermarket checkers, postal sorters and assembly-line workers. The condition progresses rapidly if no changes are made in work habits. Besides being responsible for sensory feedback, the median nerve acts like a computer cable relaying motor messages from the brain to the hand and fingers. You know you are in stage two when the motor part is involved. Your hands become weak; you lose your grip and drop things. Simple tasks like buttoning a button or tying your shoes are difficult.
Some of the experiences I read about sounded very familiar. Perhaps I wasn’t in the first stage, after all. I had told the doctor that my case was limited to night episodes, but now I made connections between CTS and my daily routines. I remembered a bag falling while I unloaded groceries from the car, broken glass and spaghetti sauce splattering all over the driveway. When I set the table, a plate slipped out of my hands and smashed on the kitchen floor into a hundred pieces. Both accidents I’d blamed on clumsiness. I began to question why it was impossible to get jar lids off, and why every turn of a manual can opener was a struggle. A gallon of milk was hard to carry; even my purse seemed heavy. The CTS was affecting parts of my life that I’d always taken for granted, and it scared me.
So I did what the doctor said and more. I not only bought a flat padded wrist rest, but I invested in an ergonomic keyboard. The key layout was split halfway down the middle and turned toward the center, so that my wrists didn’t have to twist toward my little fingers. Legs on the front edge of the board tilted it back slightly, which forced me to hold my wrists straighter. My husband installed a pullout drawer on the underside of the desk that positioned the keyboard lower than the desktop. That way my arms weren’t poised up all the time. Instead, they made right angles at my elbows when I typed, a posture that was supposed to be best.
Forget about stopping often for breaks though; I’m the kind of writer who has periods of “lost time” as those abducted from UFOs claim to have. I’d look up at the clock and four hours would have passed. So I temporarily quit writing long manuscripts and composed poems, which required less typing. I managed to get four poems published in journals, although I didn’t feel I was doing what I should be doing.
To prevent my wrists from curling at night, I wore braces, which immobilized them while I slept and held the carpal tunnel open as wide as possible. Each morning there were indentations in my forearms from the snug Velcro tabs. I used the wrist rest all the time, too, and exercised my hands the way the doctor had showed me. Yet now my hands hurt during the day! Had I damaged the nerves permanently, or was I doing something wrong? I went back to the books on CTS. Don’t secure the braces too tightly, one author warned. Use the wrist rest during pauses, not while you’re typing, another said. It’s important to wait until your wrists are healed before you start exercises, still another cautioned. I followed all of this advice and within a few weeks noticed an improvement. I also experimented on my own, removing the curved metal splints from the braces and replacing them with two six-inch wooden rulers. I can’t be sure exactly what made my wrists get better, but over time they did.
Some nights I still wake up with tingling hands, and then I know I have to stay away from the keyboard for a little while. I often wonder whether I should be using a keyboard at all. There’s no guarantee that an alternative design will prevent CTS, even if it’s labeled ergonomic. It’s a chance I take simply because this technology made being a writer so much easier. I don’t want to live without it, yet I can, and I must, if it threatens to ruin the normal functioning of my hands. In the world of literary arts—where workers’ compensation is nonexistent, where payment is usually in copies—a writer already pays an extraordinary price. So when I have symptoms of Carpal Tunnel Syndrome, I don’t turn on the computer. I remind myself that I survived for years without a word processing program and without the World Wide Web. Then I take out some lined paper and write the old-fashioned way—with a pen. An ergonomic pen, of course.