Look ma! No hands on the keyboard!

Once again, I’m the break-apart woman. A few months ago, my shoulder started hurting. I thought I was just sleeping funny. Eventually, the pain got worse and now I’ve lost some mobility in the arm. I can’t touch the middle of my back, and I can’t raise my arm straight in the air. I am also experiencing weakness in what was once my dominant hand. I know. I know. I should have dealt with it sooner. But I kept thinking that if I took it easy it would fix itself. From my Googling, it’s a very likely that I have a rotator cuff tear. Since it’s my left shoulder and I’m left handed and I don’t remember injuring myself, I’m sure it’s a repetitive stress injury from spending a lot of time with my hand on a mouse.

I was hoping that the week away would help in which case I would come back and make sure that my desk was more ergonomic. But it didn’t help. If anything the pain is worse, and I’m not sleeping well.

So this week I finally went to the doctor. That’s a whole other story in itself. I made the mistake of going to a general doctor first, even though my insurance doesn’t require it. I was hoping to get an initial assessment and get the MRI ordered so I knew where to go for treatment. Unfortunately, my regular doctor is on vacation so I had to see his partner. The guy starts prescribing pills for me even though I told him that I have a stomach condition that makes it difficult for me to take anti-inflammatory medication. Suffice to say we did not hit it off. He ordered the x-ray, (which shows minor arthritis… not really the cause of the problem considering the fact that I’m only 40 years old and minor arthritis wouldn’t cause the lack of mobility that I have) and insisted that my insurance company wouldn’t pay for an MRI until after I’ve had treatment. Sure that makes sense. Aetna wants to pay for treatment with no diagnosis. Yesterday, he called to see how I was doing. I asked again for the MRI since that appears to be standard operating procedure for this kind of injury. We argued. I hung up on him. Then I did what I should have done in the first place and I have an appointment with an orthopedist next week. Times have changed from the days that I would blindly do what a doctor told me to do. He can write all the prescriptions he wants, it is still my decision whether or not to fill them. Believe me, I’m not looking for surgery. I’m hoping I can fix the problem with either cortisone or physical therapy. If I do go on medication for this, I’d want to know that it’s something that will work on the specific problem that I have so it’s worth messing with my tummy.

In the meantime, I’m trying to minimize my mousing time. Goodness forbid I actually take more time off, so I bought Dragon NaturallySpeaking 9, which is voice recognition software. David Pogue had wrist problems and has sworn by this program for years. Verdict? It’s interesting. I’m getting much better at it. I didn’t get near the accuracy that Pogue did, but I am finding the more I’m correcting (and I’m correcting a lot) the more accurate this is getting. I’m learning to think ahead about what I want to say and I’m working on minimizing any extra vocal sounds when I talk. I’m a very fast typist, so it’s slow going. Some of the mistakes it makes are hysterical, so I’m being very careful about my proofreading on e-mails. This very blog entry was done without my hands ever touching the keyboard or mouse. Even though you can control everything about the computer with your voice, it would be very difficult to rely on voice commands exclusively. Still, I’m glad I bought this, as it’s cutting my mousing and keyboard time in half. It’s amazing how much harder it is to think through your mouth as compared to thinking through your fingers. Unfortunately, I couldn’t afford to buy the software for both Mac and PC and I’ve heard that the Mac version is not as good. So when I have to work on the Mac I rearranged my desk to get better position on the mouse. I’m also experimenting with using my right hand for mousing, but that won’t help me if I injure that shoulder too.

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13 responses to “Look ma! No hands on the keyboard!”

  1. I’m older than you, I had a shoulder problem a few years ago, I could not raise my right arm (i’m right handed) above my head. Diagnosed as some kind of age related rotator cuff related thing. Very specific eh? Physical therapy and time healed it. My wife who is slightly younger had the classic “frozen shoulder” (which you may hear from the orthopedist) which again with physical therapy, anti inflammatorys, ice, cortisone shot, and exercises healed, but it takes a looong time. Surgery is an option but usually a last resort. We both use computers in our jobs but I don’t know how much we can blame that.

    Would a track mouse/rollerball help?
    Good luck

  2. A few years ago when I was still in the student affairs world we had a quadraplegic student. We bought Dragon Naturally Speaking for him, which worked well enough without a whole lot of corrections. Version 9 is eons more advanced than whatever we had back in 2000, so I’m glad it works for you. The other device the student had was a mouth-stick (difficult to manuveur and hard on your teeth but is nevertheless another option if you want to avoid typing on the keyboard).

    Rick in a previous comment mentioned a track mouse/roller ball. I’ve been using a roller ball mouse (only for my home computer; I take whatever they give me at work) for almost 3 years now because I started having a wierd tingling in my right index finger and began worrying about repetitive disorder. I haven’t had any more wierd tingling since then but kept the roller ball mouse because I actually like it better.


  3. Thanks, Grace. And Rick. I’d say the accuracy of NaturallySpeaking is around 95% now. Most of its mistakes are me tripping over my tongue, can’t blame the software. Years ago, when I worked at the ad agency I tried a trackball mouse and I really hated it. Since the problem is in my shoulder I don’t think a trackball will help. The problem is having to reach for it and keeping my hand in that position for a long time. So I do still use the mouse but being able to dictate helps me take my hand off of the mouse more often.

  4. Not necessarily rotator cuff — last winter, well before the accident, I was in physical therapy because bad posture at the keyboard was causing radial-nerve compression in both arms and hands.

    I wish you luck finding someone who’ll help, and battling with your insurance over it!

  5. A colleague at work is trying a mouse that I’ll try to get the name of. She also has a shoulder condition. It sits below the spacebar and has a roller on the left and right, separated by left click and right click buttons. She doesn’t have to move her hand/shoulder to the right, just straight down. It seems to help.

  6. Judi, if you can justify the cost, a USB headset will give you significantly better recognition with Dragon than the basic audio-line-in headset that comes with the software. The one I’m using is about $60 CDN, but I know they’ve come down in price since I got mine over a year ago.

    If you’ve got time, read some extra training into it. It’s not the most scintillating reading, but it does improve both the speed and accuracy of the recognition.

    There’s a slider setting in the options (sorry, can’t remember where offhand, and I don’t have it set up on this new laptop yet) that lets you push it to higher quality recognition. It’s a tradeoff against speed/processor consumption, but I’ve found I can definitely bump it up from it’s mid-range default to better accuracy without driving myself crazy with lag as long as it’s on a fairly strong machine. A lot of folks don’t know the option is there, so I thought I’d mention it in case you hadn’t come across it.


  7. Thanks, Paul!

    I had already read about USB microphones being better at this. I’m seriously considering it. Specifically which one are you using? I also found the slider you mentioned, but I am noticing the performance hit so I’m constantly trying to find the right balance.

  8. Judi: Here’s some info on the roller type mouse my colleague is using. But it’s not cheap- approx $185 -but maybe a cheaper alternative exists.



    some text: Traditional mice force you to take one hand away from the keyboard to use them and cause shoulder tension by putting you in an awkward position. For a radical and very successful rethinking of the mouse, look to the RollerMouse PRO. It cleverly builds a pointer control, scroll wheel, and five buttons into a Lycra-covered, gel-filled wrist rest that sits below your keyboard—a solution that’s both comfortable and efficient. The RollerMouse PRO lets you keep your hand in place, for better productivity and a more relaxed posture. Its best feature is the roller bar, which sits just above the buttons and lets you precisely control your cursor with only slight finger movements. Download the driver to customize the five buttons.

  9. Judi, the set I’m using is from Plantronics. I’ve long since lost the model info, but it’s a fairly basic set that was at the lower end of their USB offerings a year or so ago. They completely revamped their product line so I can’t point you to them, but these look like they’re pretty much the same quality level. One of the really nice features is the built-in mic on/off switch. I find it more convenient than turning it on and off at the keyboard through NatSpeak.

    I chose mine purely for voice recognition, but if you want them to double as good stereo headphones, you might want to go a little higher in the product line.

    The “quality” slider definitely takes some tweaking to balance lag with accuracy. Even on my dual Athlon system with loads of ram, I can’t move it all the way up. Since NatSpeak isn’t multi threaded, it’s one app that probably would have been better on a superfast single processor rather than the slightly slower dual. Ah well, it’s more than accurate enough for me now after sufficient training.

    Unless you’re on a dual system, do knock down any unneeded apps and processes when dictating for any significant period of time – the more CPU cycles available the better. I used to shut down Norton on my older slower system and that made a noticeable difference, because Norton was such a resource hog anyway. (Won’t use any Norton stuff anymore – I and clients have just had too many problems with their newer stuff.)

    Oh, and keep a log of the funniest of your misrecognition goofs – it can be great fun to go back and see them all together.

    Lastly, do back up your voice config files periodically in a secure off-machine manner. You’d hate to have to retrain from scratch if something were to corrupt or fail.


    PS Hmmm… something strange with your comment preview form. When I preview a comment, it shows the preview, but there’s nothing in the comment submission box on the preview page so there’s no way to post the comment from there unless I copy the preview and past it back into the comment box, then re-enter commenter info (or else go back to the original comment page and hit submit instead of preview). Just thought you’d want to know.


  10. I picked up a Logitech USB 350 microphone. Only $50 and very comfortable. So far, I definitely see the difference from the plug-in microphone I was using before. I’m now correcting one or two words every five sentences or so, instead of the every fifth word that I was doing before.

    I’ll check out what you were talking about in the preview window. It may be something that got messed up in the template when I upgraded to Movable Type 3.3. Thanks for letting me know and thanks for all the great tips.

  11. Glad to hear the new mic is such an improvement. If it was requiring that much correcting before, I suspect it needs more training. Did you let it train itself on your documents and email when you set it up? And have you done at least half an hour or 45 minutes of reading from the training scripts? I know NatSpeak 9 claims not to need any training, but it performs vastly better if you do. (You’ll only see the after-training improvement right away if you let it re-process its voice files right after you’re done.)

    It’s a very different way to “write”, but boy is ever faster for lousy typist like me, and much easier on the anatomy – although I have heard of people harming their voice from excessive use.

    One of the things I like most about it is that, since my headset has a long cord, I can get up and walk around a little as I’m dictating. Ergonomically healthier to be able to get out of the chair periodically too!

    Have fun with it.


  12. I did do the training. I did the basic training first, and then a little later I read from Dilbert, I believe. Don’t know if it was 45 minutes but it certainly felt like at least that long. What I’m finding most annoying is the fact that when it gets it wrong, and I say “correct (whatever)” almost invariably the first or second choice is exactly what I want. Why doesn’t it just pick that in the first place? Obviously it heard me correctly if it’s able to make the right phrase an option. 🙂

  13. judi,

    i have the issue, i’m wondering how you are doing now? did you ever get your mri? are you back on the mouse?