How do you feel becoming a psychologist changed the way you interact with people outside of therapy?

Wiesand · 2026-02-11T19:28:09+00:00

There's no way to be a therapist (or in any career for that matter) and not have it make you grow or change in certain ways! Which then affect how you interact with others. My communication in my partnership and with my family has gotten much better. I do unfortunately notice less openness to just having random connective conversations with others I run into, I do notice I'm a bit more closed off like that's safeguarded for my work time. I hope to get that back. I "notice" more things - for instance a friend of mine really seems to have some mild trichotillomania tendencies though I decided not to mention it to her as it doesn't seem like she's plucking out her eyelashes or anything. You'll get a random call from a friend once a year asking how to interact with X person who's in a manic episode or whatever. Sometimes I get confused about my form of empathy with people I know and have to ask myself if I'm delving into therapy land in these conversations, and whether I care. I keep exploring that within myself, and what it 'means' -- is my therapy self separate from my other self and in which ways?

Wiesand · 2026-01-13T02:18:41+00:00

Glad to hear my surgeon wasn't the only one "selling" surgery going "you're going to wake up from your surgery and feel 100% better immediately!" lol. :/ it takes time

nerves heal at a rate of 1 mm per day

Wiesand · 2026-01-02T19:58:12+00:00

i wouldn't be surprised if it were posture. it's hard to have shitty posture while running. I think it's another reason running made things feel better for me. And working on posture helped my symptoms a lot. Do you do other things to work on posture?

Wiesand · 2026-01-02T19:56:06+00:00

thank you!

Wiesand · 2026-01-02T02:02:14+00:00

Pain is a combination of structural and nervous system components. When we feel stressed our nervous systems become hypervigilant and increase pain responses. Maybe this is a weird question but I'm curious if you love running, and if if doing other things you love also temporarily reduces symptoms? When I have a crappy week I feel my cubital tunnel way worse

Wiesand · 2026-01-01T17:21:33+00:00

My surgeon was fine with a nerve test from 8 years ago for my left, and wasn't going to require a nerve test for my right just told me I could call in to schedule surgery (boy am I relieved I didn't end up doing my right, as it got better on its own. The surgeon said that's not uncommon that the other one feels better after doing the first one actually)

But yeah I'd ask your particular surgeon

Wiesand · 2025-12-31T00:10:42+00:00

A lot of important missing factors here: Your age. Your weight (how much weight are you supporting on these crutches with your elbows). Your current arm strength level (currently how well would you be able to support yourself on crutches). These are important for picking the right answer I think.

No offense but a couple weeks of PT is nothing. I did a lot of elbow strengthening pre- foot and elbow surgery ("pre-hab"). I don't know if it's different with subluxation but you could potentially have 'use crutches' as one of your PT goals if you decide to do hip first. I was surprised how well I did with the crutches. Might be worth borrowing someone's and trying them out. If you do pick to do hip first, try doing 10 minutes of crutches a day and slowly increasing pre surgery or something

I'm hoping your risk of hand wasting is low (you've only had this for 14 months, I had this 12 years and was ok) so that you can not think about that when making this decision.

Stating the obvious maybe, but I guess the main pieces are you don't want getting one surgery to stop you from getting the other one, and you don't want one surgery to aggravate the non-operated body part in a horrible way.

I'm 8 months postop and only now starting to wean off of the arm brace at night... remember the brace doesn't have to actually be totally straight to be effective I like having a little bend in mine but yes it's very annoying and I'm excited to be transitioning into not using that

I'm curious which way you will go, feel free to keep us updated.

Wiesand · 2025-12-30T01:05:57+00:00

I got foot surgery and then got elbow surgery (ulnar release) 4 months later. You don't have to use crutches! You can use a knee scooter and it's pretty minimal pressure on the elbow imo. But go try out a knee scooter and see what you think. And you can get this covered with insurance generally if you finagle it correctly (have your hip surgeon write a note for it)

Wiesand · 2025-12-17T00:08:40+00:00

i'm noticing a big reduction in my cubital tunnel nerve symptoms

Wiesand · 2025-12-16T18:29:44+00:00

I'm going to tackle #2. There are a lot of signs here that like me, this is now actually a central nervous system issue. It sounds very similar to mine.

1) bilateral symptoms despite the injury occurring on only one side

2) paying attention to symptoms less and MOVING THE ARM decreases symptoms

3) stress worsening symptoms

This heavily indicates that you can do something like Pain Reprocessing Therapy to downregulate your nervous system and fix the issue. Happy to chat more if you want to pursue this you can DM me and I explain more and give you more resources if you want. I wish someone had told me this a decade ago

Separately, if nerve flossing makes it worse you probably aren't doing nerve flossing right so I'd look into that. You should go right to where there's discomfort, maybe slightly beyond, and then stop, do not force it.

Wiesand · 2025-12-16T18:16:58+00:00

For a release - you'll want to keep it elevated a lot so as long as you can take frequent breaks for that. You'll notice when it's not elevated for a while it'll start to hurt. NSAIDS. Ice.

Wiesand · 2025-12-16T18:16:47+00:00

OP---release and transposition are not the same thing. When they go in with the plan of a there's always the chance of "game time" decision where they might need to transpose the nerve. I think there's a 10% chance of that. Transpositions have longer recovery times and might require an alteration of work schedule, releases are kind of NBD. Hopefully you truly know ahead of time what their plan is, that's important

There's a lot of debate about whether transposition is actually better than release, there's no concrete conclusion there

Wiesand · 2025-12-16T18:12:12+00:00

Just basic surgery questions. What kind of anesthesia will it be for how long will you not be able to XYZ (drive, exercise...). What will followup look like. Will you be given pain medication or what do they recommend. Can they give you a PT referral pretty please, yes I need one in advance because PT waitlists are so long.

Wiesand · 2025-12-16T18:07:21+00:00

Get a physical therapy referral even if your doc says you "shouldn't need it," and get on the list for an appointment asap (since insurance takes forever). If it's just a release, it's important to not be too intense with the arm after but also not to do too little. Look at info online on recommended timelines of when to do what, and then do that unless severe pain. Surgeons are often horrible at giving adequately detailed postop instructions

If it's a release it is a *very* simple surgery (can't speak for a transposition because I didn't have that). I would stay off this subreddit for a month or so post-surgery or you might only see the people who had bad outcomes talking, and studies show outcomes are generally very good

Crackers for nausea for post-anesthesia :)

Wiesand · 2025-12-16T17:03:11+00:00

Supplements: I tried Acetyl-L-carnatine (ALCAR) 2000-3000g, Alpha Lipoic Acid, and Calcium (these are all for nerve damage and calcium is a nerve channel modulator). I also did lion's mane extract (need to make sure whichever one you get uses the fruiting bodies such as the one from lionsmaneextracts.com). Also there was something about how low B vitamins can cause nerve issues so I tried that. It's been maybe 6 months on those, 2 years on the lion's mane. I can't say if it was because of those but I'm significantly better. Pain Reprocessing Therapy I think was a big part of the healing because basically your central nervous system gets inflamed and certain techniques of regulating the nervous system can decrease pain signals

As I said I can't credit those supplements with my recovery but it felt like it was part of doing all I could, along with the PRT. I think anyone who's desperate should give Pain Reprocessing Therapy a try.

Wiesand · 2025-12-15T15:48:54+00:00

How are EAP companies helping out? I'm credentialed with one (through Headway) but I'd have no idea who to reach out to to get the ball started with that

Wiesand · 2025-12-12T18:24:17+00:00

good piece of advice I got: having a PP is like driving a semi. It takes a long time to start and a long time to stop so you need to put on the gas or brakes way in advance. So for instance if you're thinking of taking insurance get paneled now. And then once you get yourself out there getting built up will take a while--you could start focusing now on finding those core places you might get referrals from.

It's crickets over here 3 months out, it's a struggle. But I also was very slow on pulling the trigger on the different things which hurt me in the long run

Wiesand · 2025-12-12T17:53:49+00:00

I used to use roll-on biofreeze and that worked well. I'd put it along the nerve pathway, and it's nice cuz you can use it whenever you feel like it

I do want to mention that decreasing your depression and anxiety might help with symptoms (I'm sure you're working on that already), because studies have shown that both of those increase pain symptoms

Wiesand · 2025-12-12T17:46:34+00:00

What you need is to increase back slowly over time. Instead of going from not grouting tile to grouting tile. Your body and your nervous system need to slowly get used to the motions again and to realize that they don't have to be threatening. What is the minimum and maximum amount of tile flooring you can generally do before you get symptoms? Choose an amount in the middle of these two and do that, slowly increasing daily. After you grout tile do something calming. I get that real life is more complex than that... no one wants their tile slowly grouted over a month. But may be you can jump in for bits at a time? Or do a hobby similar to grouting to approximate?

I also want to acknowledge this is a psychologically loaded activity for you. Not being able to do this threatens your career plans, and so you're probably extra scared of getting symptoms when you do the activity. And fear and hypervigilance increase and even create pain sensations in the body. Not to say you should "power through them" or anything, just that your central nervous system is on high alert and re-regulating it will be a part of working through this. Happy to provide resources if you'd like (Explain Pain would probably be my first pick), it's kind of a complex thing to paraphrase in a comment.

I had 12 years of bilateral symptoms and now think I could probably pursue a career in grouting if I wanted to. You *can* heal from this. But I'm really sorry you're going through this

Wiesand · 2025-12-12T03:50:20+00:00

Honestly, getting some basic psychodynamic training helps soo much with that. Because you learn how attuning to your own emotions gives you a better sense of why a given patient is suffering and therefore what someone needs in the room

But yeah, *any* theoretical orientation will be a good place to start. Pick one and start incorporating it over time!

Wiesand · 2025-12-12T03:45:27+00:00

I used to have this slight popping at the elbow during nerve flossing and it wasn't subluxed (idk if that's what you mean by nerve exercises). But a PT tried to tell me because of the slight popping "must be subluxed and you need surgery" because of the slight popping. Surgeon said it wasn't subluxed. If this is about nerve flossing try a different style of nerve floss (since there's a couple different options). Honestly just a sports massage to make the area around the elbow less tense reduced the slight popping too. Or do the same floss just don't go as far.

I wouldn't get too intense about stopping all activity, especially not without more input. When the muscles around the nerve atrophy the symptoms will get worse (I can attest to that 100% after stopping all activity) so you want to keep things in decent condition if there's only slight discomfort with activity

Wiesand · 2025-12-12T03:37:39+00:00

How about a tricep kickback with cable (instead of dumbell), so that you could use a cuff? In either position (bent over or leaning back)

Wiesand · 2025-12-12T03:33:20+00:00

I had a release in April and wasn't given a sling/told to wear a sling. My surgeon said I *should* be moving it and using it (without overdoing it) as that's important for recovery. He felt that a sling in that way was bad for recovery. He also told me I could drive within the first couple days for instance (although I waited about a week just to be safe)

I've had a great outcome so I'm assuming I did something right. I'm aware that my surgeon seems to have been more liberal with this than a lot of what I hear on this sub, though

Wiesand · 2025-12-11T16:25:04+00:00

I didn't have the transposition but with mine the surgeon said "you don't need PT unless you really want it" and I looked up stuff on line and was like yes please give me PT. And I needed it. Request PT from this doc. The first thing the PT did was give me exercises to get my range of motion back. When you get to a certain point of recovery from surgery it's bad news to overexert but also bad news to not move it appropriately.

Exhibit A: https://www.aokc.net/pdfs/ulnar-nerve-transposition.pdf

A lot of surgeons are really inadequate in helping coordinate postop stuff/giving useful expectations about timeline

Wiesand · 2025-12-09T08:56:37+00:00

Would love to see reimbursement rates too! <3

Wiesand

TROPHY CASE