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Solve the Medical Riddle: Her Left Arm Is Painful and Her Fingers Tingle, First Week

Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.

We’ll start this week by letting you know what the patient told the doctor and how the doctor proceeded with the examination. Next week, a specialist will continue to look for clues to the medical riddle. The third week, we’ll let you know what some people have suggested as possible diagnoses. The fourth week, the specialist will reveal the actual diagnosis. Then we’ll move on to a new riddle for the following month!

The Patient Reports Her Symptoms

Diane, a 59-year-old divorced empty nester, woke up one morning with pain in her left arm plus a tingling sensation in the fingers of her left hand.

As always in ThirdAge Medical Riddles, the doctor uses the classic S-O-A-P notes as follows:

S=Symptoms or Chief Complaint

O=Objective Findings

A=Assessment or Analysis

P=Treatment Plan or Recommendations

This week, we’ll learn what Diane told the doctor:

“Thank you for fitting me into your schedule on such short notice. The reason I walked in without an appointment is that I’ve heard that having pain in your left arm can be a symptom of a heart attack. I thought I’d better see you right away. I live alone now that I’m divorced and the kids are grown so I kind of panicked at the thought of being in the house by myself and having a heart attack. I don’t really think that would have happened, though. I’m left-handed and I started taking tennis lessons for the first time in my life three weeks ago. I might have pulled something. I hope that’s all that’s wrong and that the pain goes away soon! Right now, I can’t lift my arm over my head or anywhere close to that height. This morning I couldn’t get my coffee mug off the shelf with my left hand. I had to use my right hand.

“That’s not the end of the world, I know, but being unable to use my dominant arm and hand normally really is a nuisance. I had trouble putting on my clothes when I was getting ready to come here, and I can’t carry my purse on my left shoulder the way I usually do.

“Also, my job as an elementary school secretary involves a lot of typing on a computer. I called in sick today so I haven’t tried to type yet but I’m pretty sure it will be difficult. Did I mention that the fingers of my left hand feel tingly and cold off and on? I’m usually a very fast touch typist but this condition, whatever it is, will surely slow me down. Do you have any idea what might be wrong with me?”

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