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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 25, 2009 - 12:16am PT
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Bwahahaha, LOL hugely. Moosie, TB and Gordo still have the grate sense of humor !!!! Feels sehr gut to laugh.
Bocce, cerveza and my own personal Guido...what more could a gal ask for. (Darn, if I'd held the can face forward Modelo said they would have given us a job..!)
EDIT: We all raise a fist and a beer to Tuckers Feet. (Could be a grate name for the next best Knarly Climb :)))))
Double EDIT: New knarly beer called Tuckers Feet ...with his very own on the label. WoooHeeee, what do you think ? Pro a DARK malt !?
Triple Edit: Along with the kin of double dog dare you....laughter is sometimes the best medicine. Jess sayin'. Bet Jingy would agree.
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healyje
Trad climber
Portland, Oregon
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Feb 25, 2009 - 12:31am PT
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Tar,
Hmmm, mystery upon mystery, your symptoms are quite elusive relative to known syndromes / conditions. Stepping back yet again - still ruling out parasites and general [nutritional] deficiencies such vitamin D - and also for the moment excluding degenerative neuromuscular disease (and systemic autonomic conditions) which would likely present broad ranging symptoms on multiple fronts, it still seems to me you're down to three possibilities:
a) forearm-local neuro/vascular/muscular problem
b) problem related to the neurological pathways somewhere going on back as far as the spine
c) vascular pathway problems going back to the thorasic.
And I suppose any of those three could also easily be combined with both exertional/repetitive injury (work & climbing), and, this many years later, with more localized autonomic responses. Seems to me if the pathways from spine and thorasic do in fact check out (spinal stenosis, TOS, etc.) then, regardless of the symptom mismatch, you're down to something f#cked up locally in your forearms and it can only be so many things in that case. I suppose a rheumotologist could catch something systemic in all that lab work that somehow only presents in your forearms, but I still seriously doubt it.
I'd say take Callie up on her offer, go with Collier (haven't heard back yet) - bundle all your records up along with this thread and ship it to him a good month in advance with a good summary cover letter (I would, or maybe Ezra might be willing, to help with it).
[ EDIT: Ha! Ezra - you beat me to the same conclusion. Sometimes I wish I hadn't discovered climbing in the midst of pre-med studies... ]
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Tarbuster
climber
right here, right now
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Feb 25, 2009 - 01:20am PT
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Vascular insufficiency seems the most likely culprit to me.
Remember, that doesn't just present locally in the forearms with me, there is systemic precedent.
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healyje
Trad climber
Portland, Oregon
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Feb 25, 2009 - 04:34am PT
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Just sent Dr. David Nelson a short note with link to this thread. He may or may not want to dive in here. He's certainly been more than generous with his time and advisory comments here on ST in the past (even with an old uncorrected finger break of mine), but as Ezra can probably testify, it can be a fine line of propriety and a sticky wicket doing medicine online so we probably shouldn't necessarily have expectations either way, but you never know...
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Tarbuster
climber
right here, right now
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Feb 25, 2009 - 12:30pm PT
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PAD peripheral artery disease
Yes granite climber: that PAD is some pretty nasty stuff.
Nice diligence on your part with the links; I’m reading all of it. I have more or less reviewed this material on peripheral artery disease before. From what I understand it’s fairly progressive and I should be really wiped out by now with some of those end stage symptoms.
”Buerger’s disease, an inflammation of the small blood vessels and nerves in your hands and feet that usually affects male smokers”.
Descriptively, this Buegers disease seems like some sort of corner case worth looking at.
”Rarely, frostbite, radiation therapy for breast cancer, and repeated injury, for example, to the pad of your hand, or other forms of injury, can cause arm artery disease.”
I’ve had frostbite to my hands: if in some bizarre way, damage to the capillaries in my fingers contributes to some upstream resistance in the forearms, then this could be a player. I conjectured this earlier up thread.
Severe second-degree frostbite circa 1984:
Today:
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Prod
Trad climber
A place w/o Avitars apparently
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Feb 25, 2009 - 01:45pm PT
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Never saw the frost bite pics, looks awful.
Prod.
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Rick A
climber
Boulder, Colorado
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Topic Author's Reply - Feb 25, 2009 - 02:58pm PT
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Roy,
Looks like you had been using the knuckle-bashing Terrordachtyls discussed in recent threads. (Just trying to lighten up this discussion a little)
Rick
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Tarbuster
climber
right here, right now
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Feb 25, 2009 - 06:43pm PT
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Yes Riley,
I have taken extended breaks from climbing.
And most importantly, I have lowered the periodicity and intensity of what little climbing I do for a very long time.
I've done so little climbing over the last 12 years, that climbing hurts me the least of all activities currently. Simple daily chores and computering are the worst, riding a bicycle with drop bars is out, skiing with poles is out.
This doesn't mean you are wrong in shooting from the hip and suggesting I am just plain old worn-out.
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graniteclimber
Trad climber
Nowhere
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Feb 25, 2009 - 07:14pm PT
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Roy, going back the trouble you have using a mouse -- have you tried using a touchpad instead of a mouse?
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 25, 2009 - 07:24pm PT
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Yikes ! Could someone give me a Short take on how frostbite to the hands to that degree feels, how long it takes to heal and does one have residual effects. Was thinking about getting more involved in the winter white buttttt...... lrl
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Tarbuster
climber
right here, right now
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Feb 25, 2009 - 07:28pm PT
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Didn't feel like throwing the money at a touch pad.
I can simply lay my hand on the table and start tapping my fingers and that will hurt the elbow tendons.
Doesn't mean that if I had a touch pad I couldn't throw it into the mix though.
As with voice-activated software, I still need to use the keys and occasionally the mouse.
So for instance, the keys on a laptop have a diminished stroke, and that switches up the strain enough to get by sometimes for a few minutes on a laptop, typing some sentences, without voice activation, where it would be more troublesome on a regular keyboard.
We are not talking about buying much time here though on the switch outs from say a mouse to a touchpad, or soft to hard keys. This is why I am unable to work: even this daily Q&A, as persistent as it is, puts me over the edge.
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ron gomez
Trad climber
fallbrook,ca
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Feb 25, 2009 - 08:45pm PT
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Don't EVEN think of it Lynnie. Stay with the warm weather climbing, is my advice. Looky what happened to Roy! If yo wants to know how it feels...go stick yer hands in an ice bucket for a couple hours, then yer half way there.
Peace
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Tarbuster
climber
right here, right now
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Feb 25, 2009 - 09:11pm PT
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Lynne,
You don't necessarily feel anything when frostbite happens, because sometimes, say if it's from acute exposure instead of lowered core temp, the external nerves can get numbed just so that you don't feel the deep freeze happening, as with me.
It's the rewarming that is painful.
Rapid rewarming is ill advised, as in the warm water of a shower. I didn't have any discoloration or other signs other than numbness, so of course went for rapid rewarming, which brought on a feeling of hammers and vice grips, which was quite painful.
I went to sleep in pain and was visited with swollen fingers and blisters upon waking.
Recovery varies from person to person; as I no doubt entertained rockclimbing too early in my recovery, my joints and tendons have never been the same. That meant I could resume after a few years to again lead 5.11, but hard bouldering was pretty much out for many years.
I ice climb some now in fact; more as a bizarre form of testing my coping responses than anything else. Facing the demon as it were... I'm bundled up face hands and feet beyond what most people would put up with in order to engage in "recreation".
Went out last week in fact.
These are token affairs really; some top roping, maybe an easy lead, taking pride in fiddling the screws in with my giant gloves on.
I go with a guy who is 67 years old and very conservative with any risk scenario.
Didn't go at all last year, because I could never recover from waxing the skate skis for Lisa and myself. This year, we decided for obvious economic reasons not to buy a pass for the Nordic tracks, so I found I had a little bit more "arm" left in me...
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Ezra
Social climber
WA, NC, Idaho Falls
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Feb 25, 2009 - 10:00pm PT
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Healy,
I discovered climbing in my 2nd year of med school. Wouldn't have completed medicine with out the community and outlet for normalcy it created (docs can be an odd bunch). You're happier for having discovered climbing earlier, trust me...;)
Tar,
There is a fair bit on pub med about autonomic dysfunction following frost bite in animal models. Also on Myointimal hyperplasia (vascular narrowing due to artery growth, essentially).
Vasa. 2001 Jul;30(3):176-83.Links
Myointimal hyperplasia and sympathetic reinnervation following local cold injury and rapid rewarming in the rabbit central ear artery.
Arvesen A, Maehlen J, Rosén L, Aas P.
Division for Environmental Toxicology, Norwegian Defence Research Establishment, Kjeller, Norway.
BACKGROUND: Functional and pathological improvements following rapid rewarming in 42 degrees C water was compared with alterations following slow thawing at room temperature (22 degrees C) after frostbite (-9 degrees C, 15 minutes) in vivo of the rabbit central ear artery. METHODS: Following two to ten weeks of in vivo regeneration, vascular segments were tested in vitro. Maximal and dose-dependent isometric contractions were induced by exogenous noradrenaline. Sympathetic nerves in the vascular wall were stained with glyoxylic acid. Vascular ring segments were stained with haematoxylin and eosin. RESULTS: Following slow thawing, the total uptake, the K+ evoked and the spontaneous release of [3H]noradrenaline in the sympathetic nervous system were strongly reduced two weeks after freezing, with a subsequent increase to control level within 3-4 weeks. After rapid rewarming the total uptake, the spontaneous release and the K+ evoked release of [3H]noradrenaline commenced earlier such that after ten weeks the level was twice as high as following slow rewarming. The glyoxylic acid induced catecholamine fluorescence in sympathetic nerves, revealed an earlier regeneration after rapid rewarming. Haematoxylin and eosin-stained segments revealed less intimal hyperplasia three to 20 weeks after rapid rewarming than after slow thawing. CONCLUSION: Rapid rewarming of in vivo frozen arteries in warm water (42 degrees C) did not prevent immediate vasoparalysis and degeneration of sympathetic nerves. However, nerve regeneration occurred earlier and with higher tissue nerve densities as compared to tissue that had been slowly rewarmed. Myointimal hyperplasia was less pronounced after rapid rewarming. Abnormal sympathetic nerve function and myointimal hyperplasia, as observed in this study, may contribute to a greater understanding of sequelae in the human body following frostbite.
Best,
-e
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Ezra
Social climber
WA, NC, Idaho Falls
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Feb 25, 2009 - 10:41pm PT
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I agree,
Sounds like a compartment syndrome,
Doppler flows are good, weighs against a vascular bypass being effective. So many variables in this problem, like a continuously repeating puzzle.
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Todd Gordon
Trad climber
Joshua Tree, Cal
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Feb 25, 2009 - 10:51pm PT
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Party, wiener dude....
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 25, 2009 - 11:56pm PT
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Well, that rock, Todd is more descriptive than words can ever be! :D Leavin' it at that.
Is the band in, will the Cactus "bloom"? Which one of them is tan pants ? They rocked at Stephanie's Birthday !! Smiles lrl
Edit: limiting my winter wonderland protocol
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