@fairestmoss Ah, I see! That certainly helps, thanks! Have you tried rotating it around so the buttons aren’t being pressed by any fingers? Since it sounds like there’s an issue with the buttons anyway, essentially making them useless, it’s less critical for you to be able to access the buttons.
I tend to hold mine like in this image with the top finger pointing out along the pen and the thumb slightly under the buttons. Maybe give that a try to help relieve some of that choking up. Keep experimenting and find a way that suits you better.
Sorry to hear about your carpal tunnel! I hope it heals soon, or enough that it won’t hinder you.