By Marie Havenga, Spectrum Health Beat
Photos (except where noted) by Chris Clark, Spectrum Health Beat
With the wind in her face and the reins in her hands, Shanna Ruffner guides Jag, her quarter horse, through corkscrew-like barrel racing drills at a farm near her Otsego, Michigan, home.
Ruffner, 39, has been steering horses through barrels since age 2.
She’s always felt freedom and exhilaration aboard a horse’s back. Until last year.
After many repetitive motions at work, she felt pain.
The pain in her hands started like a slow walk, waking her up at night about this time last year. By November, the sensation had galloped into her daily life, affecting just about everything she attempted to do.
Taking a toll
Ruffner has worked for years for General Motors in the Lansing Delta plant, assembling Traverse and Enclave vehicles.
“I do a lot with the main wiring harness for the motor, plugging in different things and bolting things to it,” Ruffner said. “I also torque down the strut, tie bar and hub on the front end and attach radiators to the undercarriage before it gets married to the body.”
It’s important work, but repetitive work. And it eventually took a toll on her.
“I started experiencing numbness in my fingers about a year ago,” she said. “It finally got to the point in November that I could no longer sleep because it was waking me up. My hands would completely go numb in the middle of the night. They would go numb and they would burn. It was just unbearable.”
It became increasingly more difficult to work, and also risky to ride.
“It made it difficult to ride a strong, powerful horse because my hands would go numb while I was riding,” Ruffner said. “I ride a very powerful gelding. It’s a good thing we have a good bond because if it were any other horse, I don’t think I’d be able to ride.”
Still, the pain sometimes outweighed the fun. It was a crushing blow for Ruffner, who followed in her dad’s hoofprints so many years ago.
Her dad, George, who died in 1996, rode competitively and taught his daughter all he knew about barrel racing.
As a child, Ruffner competed in Michigan, Indiana, Ohio and Texas.
But in the last year, she felt like her condition was holding her over the barrels.
“It made it hard to pull and made it hard to hang on,” she said. “It just didn’t feel quite right. I didn’t have as much control as I would have liked to have.”
A horse wasn’t the only thing that became difficult to steer. She experienced trouble driving a car.
Ruffner’s commute from Otsego to Lansing spans an hour and 15 minutes. About 10 minutes into her drive, her hands would go numb. And eventually, they’d be numb before she even turned on the ignition.
She enjoyed taking her sons, Trenton, 18, and Brady, 15, to the movie theater for family outings. But the numbness closed the curtain on those outings, too.
“I got to the point I didn’t want to go to the movie theater because I knew my hands would bother me by the time I got there,” she said.
‘It was simple’
Last spring, with pain and numbness continuing to canter, Ruffner saw a specialist in Lansing for a nerve test.
“They basically hooked up different electrodes to see how the nerves react,” she said. “The nerve testing came back that I needed surgery on both my hands.”
In June, she consulted with Peter Jebson, MD, a Spectrum Health Medical Group orthopedic hand and upper extremity surgeon.
Within 10 days of first seeing Dr. Jebson, on June 27, she underwent carpal tunnel release surgery in his office.
“It was simple,” Ruffner said. “I felt a little pressure when they were cutting (the ligament), but as far as anything else goes, the worst part of it was the shot of the local (anesthetic) to numb my hand. It was a piece of cake.”
Ruffner needed only Tylenol to keep the pain at bay.
“It’s felt really good,” she said.
Dr. Jebson said he’s pleased with Ruffner’s progress.
“With carpal tunnel, you have pain, particularly at night,” he said. “You can have bothersome numbness and tingling and also functional loss. She had the entire constellation of symptoms. But she’s already experiencing 100 percent pain relief and 90 percent of the tingling has improved. She is doing very well and the incision looks good.”
Dr. Jebson said carpal tunnel release surgery has come a long way in recent years. It used to be performed in an operating room in a hospital or outpatient surgery facility, under general anesthesia, which is significantly more expensive. The new technique, developed in Canada, saves patients money, pain and healing time.
“It also used to be a larger incision,” he said. “The patient used to be casted or splinted after surgery. We’ve progressed to where we now do minimally invasive incisions.”
Dr. Jebson and his Spectrum Health Medical Group team of hand specialists—Drs. Kevin Chan, Randy Lovell and Levi Hinkelman—perform about 750 in-office hand surgeries each year, including carpal tunnel release, trigger finger, trigger thumb, De Quervain’s tendonitis release, simple tendon laceration repairs and ganglion cyst excisions.
Dr. Jebson estimates performing procedures in the office suite saves patients and health care insurers $2,000, “which is significant with the increasing shift of financial responsibility to patients with higher co-pays and deductibles,” he said.
“Not only does it save patients a significant amount of out-of-pocket expense because they’re not using anesthesia and they’re not at a surgical center, patients don’t have to go for any preoperative testing, which saves them a lot of time,” Dr. Jebson said. “And this doesn’t require IV antibiotics.”
Office-based surgery is also environmentally friendly, producing only one bag of waste for a day’s worth of surgeries versus one bag for every procedure.
“It’s a significant savings to society in general,” he said. “It’s a multiple win and provides true value for patients. It’s the future—it will be the standard of care in three to five years across the country. We’ve been doing it for four years now and happen to be a nationally recognized program.”
Ruffner is pleased—especially that she’ll be able to return to work soon.
“I’m a self-admitted workaholic,” she said. “Being home all the time is difficult for me.”
It may be a bit before she bounces back to barrel racing—her saddle weighs 19 pounds and she has a 5-pound weight restriction.
But she has plans beyond lifting saddles. She aims to have surgery on her left hand, too.
“By the time this journey is all said and done, I will have had surgery on both hands,” Ruffner said. “I want to get it done and over with and be pain-free and resume a normal life.”
She hopes to be running barrels again by mid-September, with both hands healed and weight restrictions lifted.
“It’s a rush,” she said of barrel racing. “I love the adrenaline. You get to go out and run as fast as you can around three barrels without hitting them on a 1,000-pound animal that has a mind of their own. They have a personality and temperament all their own. You learn the true meaning of teamwork. It’s one thing to be a team with another human. It’s entirely different to be a team with an animal.”
But Ruffner said she truly appreciates the teamwork with Dr. Jebson and other Spectrum Health staff, in getting her back to where she wants to be.
“Anybody that is fearful of having carpal tunnel release surgery done should know, the way Dr. Jebson does it, they shouldn’t be fearful,” Ruffner said. “Have the surgery and take care of it as opposed to waiting until your hands are completely numb all the time. This experience has been so easy.”