You are not my doctor. But neither is anyone else within 5000 miles.
October 1, 2011 12:02 AM   Subscribe

Smashed my elbow, and have some numbness in my hand. Challenging part: I'm a long way from home.

I fell off of the ladder on a night train the evening of the 28th. I hit my arm on a bunk on the way down. Now the last two fingers on my left hand (the ring and the pinky) feel like they are asleep. Not tingling so much as just dull and heavy. They will move, not gracefully but probably not much worse than their counterparts on the uninjured arm. No pain, just the lack of sensation. It sort of feels like my hand is really swollen, except it isn't. Kind of like hitting your funnybone. Speaking of which, that part of my elbow is now supersensitive - resting my arm wrong sends shocks down to my hand. The only bruising is about 2/3 the way to the armpit - there is otherwise no external sign.

The catch is that I'm traveling right now, in Venice right now but soon (i.e. Sunday) to continue on through Slovenia, Croatia and beyond, at a four city per week kind of pace. I don't want to take a lot of time in medical clinics, can't afford to spend a lot more time in Venice, and am unsure about the state of Balkan health care. (I'm sure Slovenia is fine, but is Albania, for instance?)

The other catch is that this arm has an AV fistula, put in for dialysis but never used. I still feel a strong thrill on the site, and the hand seems to have bloodflow.

Any advice? Will this just clear up eventually? Can it wait the three weeks until I get back to Canada? Are there any warning signs I should be looking for to indicate things are getting worse or I should otherwise see a doctor?
posted by Homeboy Trouble to Health & Fitness (10 answers total)
See a doctor unless you are willing to risk permanent nerve damage. Go back to Canada if you have to. It doesn't make sense to risk a lifelong medical issue just to finish a vacation.
posted by twblalock at 12:35 AM on October 1, 2011

Worth taking the time to see someone in Venice. I'm sure you can get some decent care in the Balkan regions, just be prepared to have to hunt around and wait a bit.

We had good luck with doctors and dentists overseas. Sometimes the offices didn't look the best, but you couldn't beat the health care and the providers were very caring. (I had a major surgery in a Turkish hospital.)
posted by BlueHorse at 12:43 AM on October 1, 2011

Not advice, but I had the same thing happen a few years ago (blame it on drunken college antics and a misplaced high five). The numbing in the ring and pinky finger, the super-sensitive funny bone, though no bruising if I recall.

I waited about three weeks before seeing the school nurse, during which the numbness and sensitivity dulled slightly but didn't go away. They took an x-ray and didn't find anything, and the nurse told me I'd probably just pinched a nerve and to wait and see what happened.

It took a few more weeks, but my arm feels fine now except I still get that sharp twinge whenever I knock my funny bone even slightly. I take it as a reminder of a lesson learned.
posted by datapoint at 1:00 AM on October 1, 2011 [1 favorite]

IANAD, but it sounds like you've bruised your ulnar nerve on the under side of your upper arm. The same nerve is in your "funny bone" spot, and it's connected to the little finger and the ring finger. You don't seem to be describing any issues that implicate anything else.

If I were in your place and googling what I've googled, I'd put my arm in a sling, not move it in a way that causes the shocky feeling, and expect these symptoms to last a while--weeks and even months seem possible. But you're you and feeling that pain and worrying about that AV fistula deal that I have no clue how to assess.
posted by Monsieur Caution at 1:08 AM on October 1, 2011 [1 favorite]

I did something similar as a kid. Whacked the outside of my elbow really hard on a metal post. The same side of my hand went numb for a while, although not as long as yours has. It was a very weird sensation, and made me feel a bit nauseous.

For years, on an off, I'd get that shock through my hand that you describe. And the slightest knock would cause temporary numbness in the side of my hand. It was probably ten or fifteen years before the effects went away altogether.

On the whole, I'd say get it checked by a doctor, or at least only wait if the symptoms aren't getting any worse. It's probably just a pinched/bashed nerve, but you might have damaged your elbow in other ways.
posted by le morte de bea arthur at 1:30 AM on October 1, 2011

Nerve pain is weird so it could clear up or it couldn't on it's own, but if I were you I'd be a little concerned about the stay of your fistula in the bang up. Where on your arm exactly is it located in reerwnce to the bruising?
posted by takoukla at 3:17 AM on October 1, 2011

I am not a doctor but I am a person with a damaged ulnar nerve in my left arm from elbow trauma. And so are you. If you check, you'll probably notice that your ring finger is numb only on the side facing the pinky.

I truly don't know whether it's OK for you to wait three weeks to have this checked out. From the above comments, it sounds like other people had this problem go away by itself. My only concern here is the clumsiness in the hand. My general sense from the doctors was that weakness is worse than numbness, clumsiness is worse than weakness, restricted motion is worse than clumsiness, muscle atrophy is worse than restricted motion.

The good news is, you don't have a mysterious tropical disease -- what's wrong with you will be diagnosed by any doctor in 10 seconds. If it were me, it would be worth it to spend a couple of hours in a Croatian clinic to hear an MD say "yeah, just watch and wait."

By the way, a physical therapist, especially an occupational/hand therapist, can also help you with this (both helping the symptoms and helping you figure out whether you need to see a doctor.)

What to look for:

Have a friend try to pull your pinky finger apart from your ring finger, while you try to hold the two fingers together. That's a muscle likely to be weakened by ulnar nerve damage. Do this with each hand. Can you still provide substantial resistance with your left hand? If not, that slightly inclines me to push you a little harder to see a doctor. If so, that makes me more inclined to tell you to wait.

If your fingers start clawing towards the palm, I would definitely see a doctor, wherever you are.
posted by escabeche at 5:41 AM on October 1, 2011

It's weird to have a stranger describe your symptoms exactly. Escabeche, that's exactly what I needed - the ladder of symptoms. I definitely make it through numbness and weakness, not sure about clumsiness - I wasn't exactly playing virtuoso piano before. Logistically, I have both transportation and accomodation booked tomorrow, but once I get to Ljublijana, I'm exploring the Slovenian healthcare system.

Thanks everybody, including la morte de bea and the eponyrrific Monsieur Caution, your answers were all helpful, and I'll update in a couple of days.
posted by Homeboy Trouble at 1:08 PM on October 1, 2011

I had this same exact thing: smacked my elbow, and then my pinky and half of my ring finger was numb.

It was pretty freaky, but I read online about the ulnar nerve, and it said that it would go away on its own.

It did, but it took many days to do so.

I wouldn't worry about it much; as I understand it, this is a pretty common thing that almost always resolves on its own.
posted by teatime at 5:41 PM on October 1, 2011

I visited the fine folks at Univerzitetni Klinični Center Ljubljana; three hours and €106.14 later, the good doctor confirmed that the x-rays showed nothing broken, just an "insulted" ulnar nerve, as predicted. They gave me a sling, and suggested icing the elbow. I wasn't too worried, but it's nice to know that there's not much medical science can do for me beyond trying to take it easy.Thanks again, everybody.

And by the way, Ljubljana is pretty goddamn pleasant.
posted by Homeboy Trouble at 1:12 PM on October 3, 2011 [2 favorites]

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