To speak or not to speak, that is the question

To speak or not to speak, that is the question

Summary: Carpal Tunnel Syndrome has me exploring the feasibility of leaving the keyboard behind for my writing.

TOPICS: Mobility
Wrist brace

Carpal Tunnel Syndrome (CTS) is an evil condition. It can reduce the strength of your wrist and hand. It can make it difficult to do simple things like grip objects. It can reduce you to tears with severe pain when you do things like move your hand. Worst of all, if you are a writer, it can make typing on a keyboard an exercise in painful futility.

I've had CTS for years. That's not surprising given the amount of typing I've done the last decade. I suspect my years of using 5+ pound Tablet PCs for taking ink notes in my previous career played a role, too. In fact, I experienced symptoms of CTS more often back then than in recent years after leaving the heavy tablets behind.

The CTS symptoms start all at once. First, there is alternating numbness and tingling in my left hand. Then the pain in the wrist and hand appears, triggered by simply moving my wrist. It progressively gets worse until I do something about it.

Several years ago, a doctor recommended a wrist brace to wear when the symptoms appear. That suggestion was golden, as wearing the brace for a week or two has always caused the symptoms to go away.

Thinking about the future and the impact that CTS will have on my ability to type, I've been giving serious thought about using speech input for my writing.

The brace holds my wrist and hand in a rigid position, making it clumsy to do simple things. It's worth putting up with the brace though, as it stops the progression of CTS and gets my hand back to normal. I then put the brace away until the next time symptoms appear, usually months later.

This time, CTS is back with a vengeance. My left hand started tingling a week ago. Then the numbness started, followed by the pain. When I started paying close attention to the problem, I noticed something I've never seen before — the muscles in my left hand have atrophied. It's no wonder my left hand's strength is markedly reduced compared to my right hand.

Unfortunately, my trusty wrist brace didn't make the move last year with my other important stuff. I have no idea where it is, and I really need it to arrest the progression of the CTS.

Thankfully, Amazon has me covered, and a new brace will be here today. I'm concerned that my symptoms are worse than they've been in the past, and the brace may not work as well as it has previously. If that's the case, then surgery will be in my future.

Even if the brace is able to reverse my symptoms, it will take a few weeks. Typing will be difficult while wearing the brace, and given how severe these symptoms are, I will be reluctant to return to the keyboard even if they disappear in the future. It's clear that the CTS is getting progressively worse.

Thinking about the future and the impact that CTS will have on my ability to type, I've been giving serious thought about using speech input for my writing. It's a scary thought but it may be unavoidable.

I'm a mobile guy, and all my gear is of the mobile variety. That's what I use, and that's what I have to work with to use speech recognition for writing. This leads me to wonder how different platforms and devices will handle the speech recognition.

Next: Speech recognition doesn't scare me; what devices I will test

Topic: Mobility

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  • Why not...

    ...just get the surgery? Slice, recover, good as new.
    • Probably will

      If the doctor recommends it. He wants me to try less invasive methods first. Even if I end up going that route I will end up having a period where typing won't be a good option so this test is valid.
      • Ah, I see

        I have CTS as well. The doc has me wearing that stupid brace until I can't stand the pain any more.
    • Get the Surgery

      With all due respect, your doctor is not giving you good advice. There is no way you should have been suffering for 5 YEARS!! I am a hand surgeon. I perform this surgery multiple times per week. I do this endoscopically. My patients are typing again in sometimes under a week. The surgery takes about 15 minutes, is outpatient, and involves a half inch incision in the wrist that often requires noting more than Motrin for pain.
      Again, you are getting BAD advice. You will feel better the next day after this surgery and your numbness (if you have any residual) will go away over about 5-6 months. No more suffering and no more splints.
      If you wait too long, you can have permanent damage and your recovery will be both harder and longer. Skip your doctor and find a hand surgeon that uses the endoscope.
  • Sorry for your pain.

    I have also used speech recognition tech for a long time, it can be tricky sometimes, especially with spelling grammar and punctuation. Key things for a writer. I look forward to hearing about your tests and methods in this area. Hope the impact on your work is negligible.
  • dogs

    I used to have something CTS-like.
    It got worse and worse but for some reason over the past 3 years it's getting better.
    I don't know what did it but 3 things pop to my mind :
    1) I'm not using a mouse anymore bot a multi-touch trackpad
    2) I'm now on a clicklet keyboard thorughout the day
    3) I've got dogs which I walk about an hour and a half on a leash per day
    My best guess is that 'walking the dogs' is what cured it because it means having to use all the musles in my hand while they sometimes rip my arm off in vain attempts to regain their freedom :-D
  • Short story

    I wrote a short story (for a friend) last month using iOS speech recognition in Evernote. It worked, but it was quite tedious. I'd like to find something that (a) is more accurate, and (b) more interactive. But the fact was, a 1K+ word story did get written. I did have to do a hand edit after, though.
    David Gewirtz
    • The rain in Spain falls mainly on the plain.

      Or where is Professor Henry Higgins when you need him. Don't blame Siri for your poor speech patterns, David! It must be that crazy New England/Floridian accent mashup of yours that is causing all that extra editing. Grin.
  • Headset

    A good headset with noise cancelling sounds like an ideal pairing to speech dictation.
  • Sorry to hear that James

    While you and I clearly have our differences, I would never wish anyone to be in pain like that. I hope you find a solution that clears this up for you.

    I'm glad you will be testing out Windows 8 speech recognition on your Thinkpad. Please keep in mind, dear ZDNet readers, that while MS has done absolutely nothing to advertise this, the Surface RT contains the full Windows 8 speech recognition platform. Well, probably not right to call it "Windows 8 speech recognition" since as far as I can tell, absolutely nothing has changed from Windows 7. I tried it for a bit on the Surface RT and it seemed to be able to keep up perfectly well. I must admit though that I didn't use it for long since there isn't any need for it in my use cases.
  • glove

    The best glove I ever used was a bowling glove with steel stays in the palm and back. Totaly ridgid yet not too tight. Good luck with it.
  • James, muscle atrophy is not good

    If you have muscle atrophy, that means you have nerve damage. That is a strong indication for surgery, and you still may not recover that muscle strength. Any doctor that continues to tell you to try non-invasive methods when you have muscle atrophy is of questionable judgement.
    Nevertheless, you should have been using speech recognition years ago. I have been using it since 1998. It is a really great now. Even if you just use the software that comes with Windows 8, it is great. Dragon is very affordable now as well.
  • surgery

    I had hand surgery last summer, though not for carpal tunnel. Surgery will help with pain, etc.. but it will cause stiffness, which will have some of the same affect that you get from wearing a brace. Plus, if you continue the same tasks that caused the CTS in the first place, you'll end up back in a brace anyway.

    While my hand was non functional before the surgery, and in various casts, splints, and braces after, I used Dragon Speaking. It's an awesome tool, but you get out of it what you put into it. You really need to make the effort to learn to use it to its full potential. If you do, it's an amazing tool.

    Luckily, I'm back to typing, though with some modifications to work around the stiffness and immobility I have in one thumb.

    Good Luck!
  • And this is why I use a Microsoft Natural keyboard.

    And this is why you'll pry my Microsoft Natural keyboard out of my cold, dead hands.

    As much as you guys *love* to tout these fancy new Chromebooks and such - they're horrific ergonomics.
  • your speaking trek...

    Looking forward to hearing about this endeavor, surgery or not, I agree, it is worth the effort and time.

    Another idea - recording into a digital recorder, then using something like Dragon Naturally Speaking to do the conversion. I've done this with reasonably good results overall. I used to drive 2 hours each way to work for about 18 months, so I began podcasting, then did a little bit of using Dragon to convert my yammering into text. With a good digital recorder, it worked OK - more of an experiment for me...

    Wishing you less pain and happy un-typing.

    -- James
  • Speech Recognition

    I have had CTS for years and I use Dragon NaturallySpeaking on a Windows laptop for writing longer text. I still use keyboard for final editing, shorter emails and basic computing. For heavy duty writing, Dragon works great. I wouldn't be able to type longer texts without it. It has also been good for my kids (5th and 7th grade), they can not type fast, so being able to speak their writing assignments is much faster. I recommend you include Dragon in your tests.
    • Speech-recognition s/w helps a lot

      Absolutely. After ensuring CTS-like symptoms for a while, I started using Dragon NaturallySpeaking Professional on my laptop (Win 7) and found it eased my writing activity a lot. It's quite accurate, though one has to edit their write-ups. Barring small writing activities like responding to email in brief, I use the s/w which greatly benefited me. Wonder why Microsoft and other OS makers can't integrate a good speech-recognition s/w in-built in the OS. Guess, the Star Trek days are a long way off....
  • The dictation experience

    I've covered speech recognition for more than a decade as an analyst. I write constantly, having published over 200 monthly issues of my newsletter, Speech Strategy News (a typical issue runs over 20,000 words), and a book, The Software Society, just recently. I don't have RSI problems, in part because I use speech recognition to do rough drafts. The trick in using speech recognition isn't the accuracy; the technology is very good, gets better as it adapts to your particular voice and vocabulary, and the error rate is dropping 18% per year, and will continue to do so indefinitely, according to Nuance Communications' CTO ("Vlad's Law"). The difficulty most people have is that dictation of something one wants to appear in print is an acquired skill. We aren't used to talking the same way we write. It takes a bit of patience to learn to pause to formulate a sentence, rather than stopping in mid-sentence and repeating a different version, for example. The key for me was thinking of it as a way to create a rough draft, to get all my ideas down, and then edit by keyboard. If you worry about each word as you dictate, it isn't very effective for creating large amounts of text. Editing is much less of a strain than the original writing.
  • Nice thought but .....

    Most jobs and job tasks do not lend themselves well to the use of this tech. Add to that the need to seriously edit what you have done. Unless you have a job that fits well (site and structure) you are better off tippity tapping away.
  • Create a lexicon

    As you undoubtedly know - but other readers might not - creating a lexicon upfront and updating it as you go makes the recognition a lot more accurate. The idea is to speak common terms and phrases ahead of dictation (and correct the text that it generated) to make it easier for the software/platform to recognise and transcribe more accurately. This is especially relevant if you're writing in a field that has it's own terms and acronyms.

    It's similar to "training" the software to recognise your voice and speaking style, while you train yourself to speak in a way that the software can recognise easily. Different applications use different methods for doing this, of course.