The Adventures of Arganoid and Bongle Twonker

I have used computers since the age of four, when I learnt to use a Sinclair ZX Spectrum. As well as using it to play games, I learnt how to write programs - such as ones that made farting noises (a purpose for which the Spectrum's internal speaker was well-suited). After about 20 years of intensive computer use I got a job as a a game programmer - a job that sometimes involves working excessive hours. During one project, I had no days off (not even weekends) for about three months, and often worked for more than 10 hours a day. But even during more normal times, I would often work for 8 hours, then go home and get straight onto the computer for most of the evening.

I first noticed that something was wrong on 4th June 2007 at around 4pm. There was a strange ache in my right forearm and wrist which persisted for the next two days. I had never experienced anything like this, but I had recently heard a colleague mention his RSI problem, so I considered the possibility that this could be RSI.

A week later, the symptoms returned and did not go away. I started using my left hand to control the mouse some of the time, but very soon the same symptoms started occurring in my left arm. I also experienced tingling and weakness in both arms. Suddenly my productivity at work was reduced to perhaps a quarter of what it had been before. I didn't just have problems using PCs either - even a simple thing like reaching for the TV remote control would usually give me a jolt of pain. I knew that I had a serious problem which could not be ignored. I ordered voice recognition software (Dragon NaturallySpeaking 9.5) to see I could use it to reduce my dependence on the keyboard and mouse. I also ordered a book on RSI and made an appointment to see my GP.

Here are some quotes from online chat sessions in which I had mentioned my problems at that time:

(I soon learnt that treatment was possible, thanks to the book "It's Not Carpal Tunnel Syndrome!")

(I went on to have several more episodes of serious weakness, including difficulty buttering bread and lifting my toothbrush. Although it never reached the point where I couldn't perform a particular function, it came close)

When I spoke to my GP about my problem, I didn't find him to be very useful. Even though by this point my symptoms were considerably worse than they had been initially (such as the weakness mentioned above), his advice was simply to "try using a wrist rest" and to try taking Ibuprofen (an anti-inflammatory medication). Given that my symptoms persisted all the time, using a wrist rest seemed to be completely inadequate advice. I did try the Ibuprofen, but it made no difference to my symptoms. Even if it had, it would just have been relieving the pain, without having any impact on the underlying causes. Indeed, it could have made things worse overall since damage to my body could have continued to build up with no pain stimulus to make me change my ways.

In the last week of June, I went on holiday. Despite barely doing any typing at all (just a small amount of texting on my phone, and checking my emails a few times), my symptoms improved only marginally. During the holiday I was able to finish reading "It's Not Carpal Tunnel Syndrome", and gained a much greater understanding of RSI - for example, that bad posture and persistent muscle tension are major causes of it.

After my holiday, I returned to work and continued to work at the aforementioned reduced speed. However, I soon noticed that my symptoms seemed to be getting worse. On the 8th of July I made an appointment to see a physiotherapist, since that was the recommended course of action given in the book I had read.

From this point until mid-August, I received ongoing physiotherapy. This consisted of massage on the muscles of my back and shoulders, which it turned out were in a constant state of tension. I was also given some stretches to do during each day. I started to see improvements in my condition - it was still bad, but not as bad as it had been. I started returning to more normal levels of work, and reduced my use of speech recognition software. Under normal circumstances I might have been more cautious about increasing my workload, but our project was approaching its end and I wanted to ensure that the parts of it I was responsible for were as good as possible. I also felt encouraged by the improvements I had seen following the physiotherapy - I felt like I was on the path to recovery, so could manage a bit more work again.

From mid-August till early September, my symptoms gradually got worse again. The project at work was now in its final weeks and I had to work more evenings and weekends. My symptoms weren't quite as bad as when they had been at their worst, but it wasn't far off. When it became apparent that things were getting worse, I started using speech recognition at work, getting help with some tasks, and stopped working extended hours. However, even after these changes my symptoms did not improve. For a number of reasons, I didn't receive any physiotherapy during this time.

From September until the end of the year, I resumed regular physiotherapy sessions. I also had to change the what I did at work, from programming to design, since the speech recognition software was much better suited to writing sentences in plain English rather than entering program code. Over this period I saw very gradual improvements. I might even have had one or two days with no symptoms. It was during this period that my physiotherapist recommended that I start going swimming regularly. I hadn't swum for years, and when I started I found that I couldn't even manage half a length without stopping. When I did get to the point where I could manage a whole length, I had to stop for about 5 minutes before I could do another one. However, my swimming ability gradually improved - after a few months, I could do 15 lengths in 15 minutes.

From November until January, I continued to have physiotherapy. However, the rate of improvement seemed to slow, and overall the symptoms seemed somewhat 'up and down' - the road to recovery was clearly a bumpy one. Things were definitely better than they had been a few months ago, but I now started to increasingly notice problems with my voice. In February these problems became so bad that I had to stop working, and had to completely abandon my use of speech recognition. The consequences of this development on my RSI will be covered in the next part.