It's been about a year now since my wrists got really bad. Unfortunately, it's no longer limited to just my wrists: I'm having similar issues with my hands. Last time I wrote about how my doctor thought that this was likely due to ganglion cysts, but since then we've done more imaging and that looks like it probably isn't the problem. After talking to a rheumatologist, it looks like [1] it's probably a kind of inflammatory arthritis, which is a chronic autoimmune disease.

So far, the only things that have helped have been minimizing use and icing (flexible wrist packs are nice!). I've tried two nonsteroidal anti-inflammatory drugs (NSAIDs), Ibuprofen and Naproxen Sodium, without effect. I'm about to start on the immunosuppressant methotrexate, which I have mixed feelings about, but positive on balance.

I'm still doing lots of dictation, but I haven't needed to continue with voice control. When using the computer/phone, as long as I dictate words, I've been able to still use my hands for navigation. The biggest problem is when I have substantial tasks that aren't just reading and writing, such as spreadsheet work or green-field coding. Luckily this is only a very small portion of my regular work, and I've been doing fine there, though I'm not sure what dictation will look like once I'm back in the office. I'm back to playing music, which I'm really happy about, but no jammer or fast melody.

[1] My understanding is that the diagnosis is primarily based on the appearance of my hand and wrist bones under x-ray. My joint spacing is narrow and my bone density has decreased, especially in my wrist. Comparing x-rays from 2020 and 2018, it is most apparent in 2020 but 2018 also showed the issues. They ran a lot of blood tests, which were all normal, including testing negative for rheumatoid factor, cyclic citrullinated peptide antibodies, sedimentation rate, and c-reactive protein. No visible swelling, but substantial stiffness in the morning—I initially didn't report this is a symptom, because I'd assumed this is just the way hands are in the morning. Since I also have some persistent dry scaly patches of skin, they thought most likely psoriatic arthritis. Possibly something I've had since a kid, since some kinds of juvenile arthritis can cause tendonitis-like symptoms.