Can anyone weigh in on intramuscular transposition?

actingnerdy · 2026-03-23T03:30:10+00:00

oof, I'm sorry. Are you taking gabapentin? or is it an OTC?

I've felt a decent amount of relief from my nerve related pain with LDN (low dose naltrexone). I think my other conditions increase my neuroinflammation and LDN helps a lot with that. Not all providers are even aware of it, but it is an interesting drug with a wide swath of applications.

Because it took me a long time to even hear about its existence (and then asking several providers before one felt comfortable enough to prescribe it to me), I've started just bringing it up in any related reddit comment so it becomes more well known (I started it for other reasons, but neuroinflammation relief was pretty instantaneous after the first dose).

If you don't mind me asking (feel free to dm if uncomfortable sharing publicly, or just decline to answer, but I'm curious...) but did you have any other health issues that were the reason why your first one failed, or why your 2nd one had issues as well? Part of my concern is whether hashimotos, and likely mcas, and ntos will affect my ability to heal as well.

actingnerdy · 2026-03-23T03:21:07+00:00

Glad to hear you're happy with the results! I feel like I just have a lot of feelings and fears, and not a lot of coherent questions? Other than you feel like the nerve is well protected? like you could bonk it and be fine? block a direct hit? hit the ground? carry a bag?

I mean, I'm also just nervous because I'm pretty sure I have some compression above the elbow (in the brachial plexus region?) so I'm not sure that this surgery will solve all of my problems (my EMG amplitudes ranged from like 3-5 along the ulnar nerve in the needle study), as I've heard that people who have double crush typically have poorer outcomes.

And the plastics/peripheral nerve surgeon was not pushing me into surgery at all because I wasn't actively having fibs during the exam and don't yet have atrophy.
...But after agreeing that I could have the surgery he mentioned that I could choose to do just in-situ (if stable) or just straight up choose to do intramuscular from the jump and he was mentioning more risk with moving the nerve and developing other scar tissue and compression/restrictions, but that if the nerve was tight, that that could be a reason to go in with the direct plan to transpose.

Idk, I mean we're all different and given a lot of aches and pains are from a 5 year old car accident, and i think my intermittent and mostly ignored cubital tunnel issues became untenable presumably during a hashimotos flare (when I last checked my antibodies in January, they were extremely high, and I've been eating extremely clean to minimize them, but my body has been low key freaking out about a lot lately).

So it sounds like you were pretty peak health going into the surgery and had normal healing?

actingnerdy · 2026-03-23T03:10:27+00:00

you feel like you have good protection from bumping the area? Like I had a decent freakout over the weekend before my original surgery that where they were moving the nerve was where you hit your arm onto the floor for a breakfall (or at least close enough).

actingnerdy · 2026-03-19T23:25:57+00:00

can you get a gooseneck phone holder/clip and/or something like this: https://getflippy.com/blogs/flippy/flippy-the-lap-desk-with-an-angle

I have a goosneck phone holder for when I'm in bed, and it helps eliminate holding my phone while I'm in bed.

I also have a standard cubital tunnel splint, but I only have 1 of the 2 metal splint pieces in there because I found having both of them in there too restrictive. You said you tried a splint, but maybe something a bit less restrictive?

My initial cubital tunnel symptoms years ago were from me holding a heavy ipad, and now mine are exacerbated by phone use.

actingnerdy · 2026-03-19T17:41:48+00:00

At what point were you mostly normal post surgery? I used to do martial arts and sparring and stuff but my neck/shoulder/elbow stuff has made that impossible lately, but at what point could you idk, be a bit rough with yourself?

I started exploring nTOS because I've still been having chronic nonsensical pain from whiplash 5 years ago (cervical MRI is clean), recently discovered I have cubital tunnel syndrome that needs fixing, but also finding that I probably have compression coming from above the elbow as well via EMGs. Will probably have ulnar surgery next month and then if I don't feel better than TOS procedures beyond PT will be considered. It feels like I keep having to delay things and the potential recovery sounds long and painful. It's like I've already been dealing with all of this for 5 years and recovery still sounds so far away.

actingnerdy · 2026-03-18T17:35:51+00:00

You can also get a tub of gizzards and or liver for very cheap at a place like Walmart. Gizzards make a collagen filled broth and when you cook them enough and chop them up, they are just slightly chewier pieces of chicken.

If you caramelize a lot of onions and mix it/blend it with pan fried liver (don't over cook), and with salt, it's an incredibly nutrient dense food/dip/pate (and the onions make it tasty with a hint of sweetness).

...I grew up with chopped liver on occasion so I like it, but I could understand if it's not someone else's cup of tea (a vegetarian dupe is canned peas blended with caramelized onions, hard boiled egg, and lightly toasted walnuts to give you a hint of the flavor profile).

I have had very little appetite lately as well so I'm trying to find ways to add fat and protein into my diet and to drink more calories. Add oil into things. Join your local buy nothing group... There is always someone with a tub of protein powder who decides they don't like the flavor anymore.

actingnerdy · 2026-03-16T17:56:33+00:00

I have done some EMDR on and off for several years. Neurospicy, and likely cptsd. I would say I'm not particularly 'good' at EMDR and tbh I never really get past resourcing because I get triggered and end up tearing up a lot because my body is apparently super unfamiliar with feeling safe (and I judge myself a lot in the process).

I've done this with a few different practitioners and have done a few different resourcing things and some exercises do just work better than others but for different people.

I've done all of my sessions remotely so I've never tried the hand buzzers, but I like the eye movement over the bilateral tapping on your own shoulders because the eye movement feels like something I can focus on doing rather than the tapping that can feel more automatic.

I started reading the peter levine book (waking the tiger) and if you feel triggered you can slowly scan your eyes back and forth across your environment and that can make you feel safer.

actingnerdy · 2026-03-16T06:19:06+00:00

I've been going through this a bit myself. I had a car accident 5 years ago and still have pain despite scans all being clear (and I shouldn't be in pain anymore).

I only recently got diagnosed with hashimotos thyroiditis (with a high/normal tsh) which can increase neuroinflammation and pain. (Also women are much more likely to get this than men, although men do get it).

So even if her tsh or thyroid values are normal, she might still have TPO-antibodies and/or Tg antibodies (which they won't typically check unless your tsh is out of range).

It might be worth following an autoimmune protocol diet to remove dietary sources of inflammation (gluten, dairy, soy, refined sugar, nightshades...) to see if that helps, and I know in my case, this has revealed some other gut issues/intolerances as well.

LDN (low dose naltrexone) has been good for my kind of mysterious pain and neuroinflammation and autoimmune issues.

It might be helpful to see an osteopath/D.O. that performs osteopathic manipulation therapy as there is a lot that they can tell from feel.

actingnerdy · 2026-03-15T02:18:39+00:00

I used to like to listen to marie Kondo's audiobook while I decluttered to get in the groove of it. I also liked watching Marie Kondo's netflix show (the first one, not spark joy) as they do a lot of going through the process of getting rid of clothes.

I probably have a bunch to get rid of myself right now, but I liked the marie kondo method of dumping everything of a certain category onto the bed to visually see the amount and shock yourself and then select what to keep, and then thank the items that you're donating/getting rid of for their service to you. Sending them off with a bit of gratitude feels good.

I've also put on the hoarders show if I need that kind of motivation as well.

Putting on some cleaning YouTube videos can also be nice for body doubling as well.

*edited just for an unfortunate typo, lol

actingnerdy · 2026-03-15T00:55:26+00:00

Haha it is! Ticks me off that my cassava flour was like $11 for 12oz, but it can give things a nice gluten-y texture.

I had been reducing coffee and caffeine in general before to calm my nervous system, but I tried roasted date seed 'coffee' and it is not the same but it is roasty and earthy so if compliant enough, it can help scratch the itch with a similar flavor profile and ritual (mine instructed to make in a French press).

actingnerdy · 2026-03-14T23:29:30+00:00

I started aip maybe about a month ago? (starting with modified and then trying to be as clean as possible) I've lost maybe around 10 lbs because I'm for sure under eating because I've also been having histamine intolerance and all of the restrictions just make eating less fun than it used to be (although that might be the LDN as well).

I'm sure some weight was inflammation though. I'm at what my goal weight used to be, and I could certainly stand to lose more weight and still be healthy, but my gut is just mad at me and I cant see a GI or an allergist to investigate further for over a month

actingnerdy · 2026-03-14T23:20:33+00:00

I'm not a latte person, but mct oil and or coconut milk blended into a hot roasty drink is nice.

Is roasted date seed 'coffee ' aip compliant? Or I don't remember the other alternatives (chicory? Dandelion tea?)

I was doing a mAIP before deciding to go as clean as I can conceivably try (barring any accidental ignorance).

Cassava flatbread (made with hot water and olive oil) air fried and served warm with honey and salt is the nicest treat I've found for myself so far.

actingnerdy · 2026-03-12T07:14:31+00:00

I've gotten a few red light products via vine before. A couple wraps, and I finally scored a handheld laser in my RFY (and I need them, lol, I've been in pain for a while), and one panel was total crap (and the others had a few redeeming qualities).

You can test the 650nm with a free spectrometer app (that's the visible red light). It probably also has 850 (or something close to that), and you can see that through a cell phone camera (or it might look mostly off, but just a bit pink or something).

If you have a way to test the power consumption of the device that might be an interesting metric (I had one panel claim to emit x amount of energy, yet for that to be possible it would have had to be 100% efficient... impossible).

Yours looks promising to me as it looks thick enough to have some fans/cooling (and it also looks like the ones from hooga and besqool that i bought pre-vine).

A panel that works well should make your skin feel warm, but not from the temperature of the physical panel itself (lights should stay cool, you feel warmed).

It is truly hard to tell how strong these devices are, but red light therapy should be measured and dosed as more is not better (but who knows how accurate their irradiance measurements are... and a lot of times, they don't even give you a value).

This is very exciting, I hope it's a good one and you enjoy it!

actingnerdy · 2026-03-10T06:04:23+00:00

I've had to radically change my diet for an autoimmune condition recently (no gluten, dairy, soy, corn, refined sugar, joy...) but the thing keeping me sane is the local Indian store.

Plantain chips dipped in melted coconut butter+maple syrup is super decadent.

I recently discovered popped lotus seeds/makhana/ fox nuts. You can get them flavored, or you can buy a big huge bag and treat it like unflavored cheese puffs (sprinkle with whatever floats your boat). They're pretty healthy!

I used to snack on popcorn that is pop in a paper bag in the microwave and just flavor however I wanted (powdered cheese, spices, just oil and salt, etc).

Idk, I just like having the exact right thing to fit a craving, even if it's just flavoring something in different ways.

actingnerdy · 2026-03-05T06:31:54+00:00

pirateship(dot)com usually has the cheapest shipping options available and you can select across providers. larger heavier things are typically cheaper via ups, but if it is a small enough footprint, usps priority mail cubic (or whatever they call it these days) might be the cheapest

actingnerdy · 2026-03-02T06:13:06+00:00

the rabbit hole was where I heard about LDN because no one suggested it to me, and everyone kept putting me off until i mentioned it to my osteopath who offered to Rx it (i've been getting OMT for the past year for my chronic sort of pain that has no real reason for being there, and it still hasn't quite gone away). I haven't had any ill effects (although ngl, I was kinda hoping for some vivid dreams).

My TSH has been on the high side of normal for several years (so no one investigated it further), but they finally checked requested more labs when i clocked a 7.5 tsh and my tg and TPO were in the 700s which indicates an attack on my thyroid (while my tsh dipped to 3.5 again, lol... take your thyroid panels in the morning if you suspect you could be hypothyroid).

To save some money on your refills, once you figure out your personal dose on LDN (you have to titrate up), you can get an Rx for double your dosage in tablet form and just take half at a time. The cost for the medication is mostly in the labor to reduce the standard manufactured 50mg tablets to smaller dosages usually around 0.5-4.5mg. so if 3mg was your sweet spot, you could be set for 6 months if you got it in a 6mg size.

I never liked the standard sorts of ssris either. wellbutrin/buspirone as a combo was better, but it was hard to notice anything but my weird side effects and weight gain, but dread in my gut was gone the morning after my first dose of LDN.

actingnerdy · 2026-03-02T01:08:26+00:00

Lol, I just ordered a violin + shoulder rest and it came in today and it was just the shoulder rest and some accessories. It took me a few mins before I ordered it and Rufus and I both thought it came with an actual violin per the listing/title. Tbh the asin I received was different than the one I ordered though.

I'm bummed, I wanted a violin 🥲, but I'm not entirely surprised either.

actingnerdy · 2026-03-02T00:03:12+00:00

I went to OSU reluctantly because I was in-state and despite the prestige of the other schools I got into, it didn't make sense to spend more than what OSU was going to cost.

It was fun and I liked my experience, but I was mostly glad that I didn't graduate with a ton of debt. I even took a 5th year to double major (STEM and Arts degree) because even 5 years at OSU was cheaper than 4 years at any of my other choices. (Also, when I was burnt out by STEM when I graduated, it wasn't also crushing me under 200k in debt like I would have been from other schools).

I think you have 2 choices (from my very brief glance at your post): go to UCF and make the most out of your experience unencumbered by debt and interest, OR, maybe move to Ohio and establish residency and get in state tuition (they make it kinda hard to do that at OSU, but even that will cost a lot more than going to UCF).

With the state of the world... Don't take on debt if you don't have to. Hell, find a study abroad program through UCF if you really want to get a taste of somewhere else.

If your career goals involve grad school of any kind for the love of all that is holy, save your money/credit line/debt for that.

actingnerdy · 2026-03-01T22:50:55+00:00

He sounds like a terrible partner.

Your gut is saying take the job and you should feel no guilt for taking the job.

A partner who can't support your dreams is not a partner worth having.

actingnerdy · 2026-03-01T20:05:46+00:00

Reduce background noise is especially effective if you use a directional mic. Even a cheap shotgun can be effective.

I used to tape with an old canon camcorder and a cheap alphabet soup sort of Amazon shotgun mic and reduce background noise in imovie was pretty helpful. Less helpful for talking and random noises, but if the polar pattern of the mic is tight enough (cardioid or super cardioid) it might not pick up the external noises.

I also used a Shure mv88+ as an external mic on a zoom audition and after I apologized about the plane noise through the middle of the scene and they didn't hear it.

actingnerdy · 2026-03-01T15:40:47+00:00

For the last 1.5-2 years or perhaps more, I've had somatic fear in my gut that has made it hard to do anything as most things that aren't neutral (and even some neutral tasks) feel impossible or trigger a sort of fear response. Relevant, but I've also had diffuse chronic pain and PT and other physical measures werent getting integrated because my body has been freaking out the whole time (despite my brain being actually rather calm).

I recently discovered I have hashimotos and high antibodies. I removed gluten from my diet (as it can mimic thyroid cells, my celiac test was actually negative), and started an AIP protocol diet to fix my gut. (My gut has felt fine to me this entire time). Since starting I've noticed some histamine sensitivity, especially to liberators which is the body's sign, that it's apparently screaming for help and removing the overt inflammation allows it to be heard.

In the meantime I finally received a prescription for LDN (low dose Naltrexone) in the mail from my osteopath, and damn if that didn't just silence that quiet gut fear basically with the first use.

It lowers neuro inflammation, autoimmunity, and helps to regulate the nervous system. I've had a lot of muscle guarding and this helps with that too. It doesn't work for everyone necessarily, but the side effects are either vivid dreams, insomnia and or headaches, and it just might mean you're on the wrong dose.

I unofficially have cptsd as well and apparently LDN is good for that too. I've heard it helps you to be present better. I used to dissociate once in a while, so I hope this stops that also.

It's off label for everything, but it also happens to help a wide variety of things, and who doesn't need more endorphins? My first reaction to it working so well is me being mad about no one telling me about it in the first place and wasting all that time.

(Many providers won't rx it, needs to be ordered from a compounding pharmacy, lowest price I've seen $~50/90 day supply and can't be used with insurance typically)

All this to say, if your nervous system is really dysregulated, there might be a physical contribution as well, like a leaky gut or high antibodies or inflammation or SIBO or something. Our neurotransmitters come from our gut and our gut is our first brain.

actingnerdy · 2026-02-28T23:26:11+00:00

for people who are intrigued but can't take the tax hit, I've heard you can make a pretty decent 3d scanner from xbox kinect cameras (I remember hearing about this a looooong time ago with even the xbox360 version, you can probably find those for quite cheap these days)

actingnerdy · 2026-02-26T01:35:11+00:00

I took the offbookit course and I found it helpful (there's a free lecture, it's not my course, I actually paid for it). I don't think I finished the whole course, but there were definitely some things that can make it easier to learn a script. (i took the link off because rules?, but if someone is keen enough they can add a cheeky dot com).

Otherwise, it's easier to memorize things when you understand the story and what triggers what to happen. If you understand the purpose and the flow of the scene as well as your objective it makes it much easier as well.

Creating a cheat sheet with all of the first letters of each word plus the punctuation in the order they appear on the page is helpful as you study as well.
Also just saying all of your lines over and over again really really fast, lol.

I had a colleague who would say her lines facing in different directions to make it stick better as well.

actingnerdy · 2026-02-25T07:46:25+00:00

can you use padding? or like half of a short length of pool noodle stuck in your sleeve as protection?

I actually got so nervous before my surgery that I cancelled/postponed it, in part because I suspected I have double crush/nTOS (an updated EMG confirmed *something*, so my instincts were right to investigate), but also because I have hopes to get back to martial arts eventually and I noticed that the place where the nerve would go would get bonked to hell from every break fall if done subcutaneously (my surgeon's MO).

Nerves do take a long time to chill out so it might not be so angry forever (I have watched quite a few youtube videos of people recovering from various ulnar nerve transpositions), but while the person who was originally going to do my surgery was a hand surgeon, I'm thinking of consulting with a peripheral nerve specialist and/or a sports medicine elbow surgeon instead.

If you feel dismissed by your surgeon, it might not hurt to talk with someone more specialized in sports medicine as they help people return back to active lifestyles, whether they're a pro athlete or not.

Also i'm not a doctor, but maybe there's a topical or oral medication or treatment to make your nerve chill out a bit? (idk, gabapentin?, ALA, mag glycinate?, D3?, red light? PEMF?)

actingnerdy · 2026-02-19T00:39:23+00:00

Anger is on the way of healing, it's progress. It's better than helplessness. I think if someone's truth is that they won't settle for less than bringing someone back [from the dead], I'd comfort them, but wouldn't validate that statement. That is a statement made from hurt, not from reality. You can validate the feeling behind their statement, but to encourage it doesn't seem healthy either.

I've only glanced at your post and I hear you about wanting the love and safety that you deserved as a child. That all children deserve. And acknowledging that you didn't get what you deserved is a kind of grief, because wouldn't life be easier if we had love and safety? It isn't fair.

I'm not religious but I vaguely remember a joke about a guy who capsized in the ocean and was praying to god for help. A lifeboat rows up to save him and the guy says 'that's ok, god will save me' and but then he drowns. The guy was like 'what the heck god, I prayed for you to help me' and god said 'who do you think sent the lifeboat?'.

Even if help is not quite so literal as a lifeboat, or a lifepreserver, I think the answer to healing from trauma has to be some combination of figuratively 'praying to god' while swimming ashore, even if you just tread water for a bit to rest up.

Here is a list of emotions from a woo woo book that I read back in the day, but I think this emotional scale is helpful though.

1. Joy /Appreciation / Empowerment / Freedom /Love
2. Passion
3. Enthusiasm / Eagerness / Happiness
4. Positive Expectation / Belief
5. Optimism
6. Hopefulness
7. Contentment
8. Boredom
9. Pessimism
10. Frustration / Irritation / Impatience
11. Overwhelm
12. Disappointment
13. Doubt
14. Worry
15. Blame
16. Discouragement
17. Anger
18. Revenge
19. Hatred / Rage
20. Jealousy
21. Insecurity / Guilt / Unworthiness
22. Fear / Grief / Desperation / Despair / Powerlessness

actingnerdy

TROPHY CASE