Peripheral Nueropathy and Gaming

Warning: if you're at all squeamish about descriptions of surgery/internal body workings, you might not want to read this post.

I've been away from these forums for a while (that is - if anyone noticed, as I'm not exactly the most prolific poster here). This is unfortunately due to some severe medical issues I've had.

I have cervical spinal stenosis. For the uninitiated, this means that my spinal cord is being squeezed in my neck area, particularly around C4 to C6. The cause was two extruded discs.

The case was severe, enough so that the doctors told me I could be paralyzed if I didn't get surgery - my spinal cord was VERY compressed, and even has myelopathy (bleeding/localized injury to spinal cord).

So two weeks ago tomorrow, I had ACDF (Anterior Cervical Disc and Fusion) neck surgery - they basically opened up the front of my neck, dissected down and extracted the faulty discs, then inserted implants with bone cells from a cadaver donor. Secure these in with titanium screws, and the hope is that the bone grows into the affected spine segments, thereby fusing them together and re-instating stability in my cervical spine.

I'm well into recovery but most of my symptoms have not gone away. Among these are a severe burning in my left foot (worsened by sciatica), arm and shoulder pain, and the worst part - peripheral nueropathy in both hands. Depending on painkillers/how I'm feeling on any given day, the effect this has varies. Sometimes I feel a slight tingling that is just irritating. At other times it is extremely painful and difficult to pick things up and manipulate a keyboard. I have a feeling that by now this condition is permanent due to nerve damage.

So that brings me to the point of this post. I'm finding my experience when playing PC games has degraded quite a bit. In particular I find it difficult to manipulate my pinky with my middle finger as I'm playing first person games. I tried, for example, to replay Mass Effect and my game was WAY off - oftentimes hitting the wrong key because my sense of touch is no longer as sensitive as it was and the tingling/pain is distracting. Running in FPSs is particularly difficult.

My question is - has anyone had a similar experience? Any advice they can give to perhaps retrain my brain and how I manipulate my hands? How about any tips for lowering the pain intensity?

Yikes. Well, let's begin with I sure hope the recovery is successful and you are able to get your feeling entirely back along with the sciatica going away.

As far as my suggestion, well, it's kind of stupid, but how about a controller? Specifically something like a Steam controller. I have one and I don't like it, but it seems like it would be a great thing for you.

I'll follow garion's stupid (but good) advice with some more.

Re-map your keys to avoid the problematic movements?

Map problematic commands to voice-controls? I've used VoiceAttack to offload keyboard controls for Elite Dangerous in VR (cos I can't see where the bloody keys are with a nerd helmet on), and it works really well.

I second the voice control thing, I've got peripheral nephropathy and I've successfully played Dark Souls with the combination of a controller and voice commands. (I use Dragon Naturally Speaking + the Dragonfly Python app, but that's just because I like to be able to run arbitrary Python code in response to voice input.)

Other things that help:

- Switching control schemes periodically: sometimes a mouse feels better than a controller, sometimes its the other way around. Varying the input devices helps me reduce fatigue from any one device.

- Combining input devices: like I said, I play Dark Souls with voice and controller: the controller is fine for basic movement, and then when I want to do something I can't quite pull off like a kick, I use the voice commands. For Elite, it's a HOTAS plus voice.

- Having good quality, ergonomic devices (and workspace). Doesn't have to be super expensive, but using a decent mouse or keyboard is way better than crappy lowest-rung ones.

- I've always tended toward fewer action games with precise timing and more turn-based strategy games. But that's aligned with my personal preferences anyway.

- Microsoft is actually getting really good at making customized accessibility controllers.

- If you have a large budget there's more exotic stuff like eye tracking that I've never tried but is an option.

That sounds incredibly rough to deal with. I hope you get a shift in a positive direction as you recover!

Eye tracking is a good pull. Maybe even integrating a foot pedal into your setup for one or two of the more problematic commands may help. I know flight sim and racing sim folks use them, but you should be able to program them to match all kinds of inputs.

Yes the controller is the obvious approach - I like and use my Xbox one controller a fair amount.

I still like the precision of mouse + keyboard though, and it depends on the mood I'm in - controller has always felt like a more lean back "rookie" experience vs mouse +keyboard an armchair general strategic experience. I don't plan on playing RTSs with controller.

But I could be weird like that. Sorry to get all PC master race on ya.

I hadn't thought of the voice command stuff, it's something I may look into. I may get strange looks from my wife every time I yell "KILL" into a microphone

I think I will look into a foot pedal as a run toggle since that's my main issue right now.