Question for Dr Bland

progballs
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I came to see you on December 14. You may recall that in 2003 I consulted you and, after tests, I was told I had CTS in my right wrist but at that time I declined surgery. In December having had an initial Consultation and impressive Tests with one of your colleagues, followed by one with you, I learned that my CTS condition was 75% better than in 2003. You advised that one option was an injection. This is not an option I wish to pursue. I was both impressed and overjoyed with this consultation, but continue to be surprised that at no time has there been any practical test/examination to assess the restricted movement in the right wrist with a view to Physiotherapy. I would welcome such a test/examination, followed by bespoke Physiotherapy. I would welcome your help.

jeremydpbland
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The original consultation was in 2001 so it's a long gap from then to last December. Carpal tunnel syndrome itself does not cause restriction of wrist movement, though other disorders which do affect wrist movement may be predispoding factors for the development of CTS. My clinic is very much focussed on CTS and although we do recognise some other conditions we are not experts in the treatment of everything that can happen to the hand and wrist so we tend to keep our noses out of things we do not feel fully competent to diagnose and treat. I did write in my notes in December that I thought a significant part of your problem might not be the CTS. Local steroid injection is one way of trying to disentangle which symptoms might be related to the CTS and which not. Physiotherapy does not really help CTS (or at least has not clearly been shown to do so) but may help other things. I can arrange for you to be seen in the hand clinic to see if they have any ideas as to the cause of limited movement - that will probably take a few weeks - will that help? JB

Incidentally I will move this to the Canterbury patients forum in a few days as that is where it belongs.

progballs
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Thank you so much for your prompt and detailed reply, much appreciated. I'm afraid that my memory is not as accurate as your records!
I had no idea that there may be so many causes to my wrist condition.
I am not in favour of steroid injections but I would be very grateful if you would be kind enough to arrange for me to visit a hand clinic.

Sorry I used the wrong avenue to contact you, but I did not find it easy to access to correct one.

Again, thank you for your response.

jeremydpbland
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OK We'll arrange a hand clinic referral to begin with and see what their thougts on other diagnoses are. JB

progballs
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Dear Dr Bland

I had been hoping to have received an appointment to visit the hand clinic as it is two and a half months since your last message!
Fingers crossed
Thankyou

jeremydpbland
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They are a bit overloaded but I would have hoped something would have come through by now. We'll see if we can trace where the referral has got to. JB

progballs
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Much Appreciated

progballs
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Dear Dr Bland

It is now a year since your kind offer to assist.

Still no news about an Appointment with a Hand Clinic?
I would be so grateful if you could wave your magic wand and make it happen

jeremydpbland
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I'll try again. It seems likely that last year;s attempt to arrange that went astray somehow. Has there been any great change in symptoms in the last year? JB

jeremydpbland
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I've now looked at the previous records and I think the easiest thing would be for us to see you again to start with, as so much time has passed. Could you make it in to see me this Friday morning (12th May), JB

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