What if I don't do ANYTHING?

Eelizabeth
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Having mild attacks over 10yrs ago and my GP's partner giving me splints - which worked .. wearing for 2 wks managing without for 2 mths - in the last 6 mths, things have gone downhill, attacks so bad that I've dreaded going to bed - crying with pain, splints not working, tried Bowen therapy, worked for a few months, went to my GP and he sent me to a consultant (North of England!) I've had a Nerve Conduction test and they say it is serious .... Okay, so I'm due to go and see the consultant again, I know he's wanting me to have the "op" BUT what happens if I don't? The worst hand according to tests is my right and my nerve responses and muscle are zero - I can still garden, walk my two very large, strong (pulling!) dogs, I can open jars, I can carry 20lb bags, I can drive, I can drink etc and I'm now not getting the pain in my right hand..... My left hand, accordingly is going downhill fast (severe pain at night at present!). If I get over this period of pain, and will it eventually go away, what is the long term outcome? Is it safe to put off surgery for, say 6 - 8 months (winter life style, selfish I know!)

jeremydpbland
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Hard to be sure without seeing the results but it is certainly possible that the right hand is now at the top end of my severity scale (grade 6) and unlikely to deteriorate further. Once the nerve fibres have died they become unable to carry pain signals so the fingers can become numb instead of painful. If that is the case in your right hand then one would expect the fingertips to be markedly less sensitive to touch, pinprick, hot and cold etc. Once it has advanced to that stage one could argue that the main reason for surgery is to relieve pain and if there is no pain then that justification seems a bit doubtful. The other hand may well be going the same way and you presumably have some chance to catch it before it ends up like the right side. In end stage CTS when the main functional change is loss of sensation the thing to watch out for is inadvertent injuries because of the loss of pain sensation - there is a photograph on the site here of some burnt fingers like this. Get the surgeon to discuss with you exactly what you are trying to achieve by surgery. JB

Eelizabeth
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Many thanks! I'm seeing the Consultant for the 2nd time - (is a consultant, a surgeon as well, or are they usually 2 different people? )in just over a fortnight (I always thought these things took forever!?!) I will try and speak to him - during the day, mostly I feel a fraud, hands are working as ever... when I visit Specialists, I always feel as though I'm wasting their time - there must be people in more pain than myself and I do spend a lot of time trying to convince myself that I'm not a hypochondriac - Sorry, I'm wittering but I am grateful for your reply and as yet all responses "markedly less sensitive to touch, pinprick, hot and cold etc" are, as they always have been!! so onwards and forwards and I'll try and get the consultant/surgeon to talk and not "give orders!!" Thank you.
ps Visibly - if I hold my hands flat in front of me with thumbs streched out, the left hand, the thumb is approx at four o'clock & the right is at approx two o'clock ..... BOTH hands/wrists have had "interesting" seperate breaks 20 odd years ago (ski-ing... dry slopes!!)

jeremydpbland
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The terms 'consultant' and 'surgeon' have become rather blurred in recent years and I feel sorry for patients who can have great difficulty understanding the qualifications of the people they see. A 'consultant' nowadays may be a qualified doctor of considerable seniority (which is what the term used to signify) but we now also have 'consultant nurses', 'consultant physiotherapists' and a profusion of others who are not medically qualified (though they do have qualifications in their own profession of course). 'Surgeon' just means someone who carries out surgery and again this is not confined to people who have been to medical school as some surgery is now carried out by nurses and others. In cases of uncertainty, as long as you have grasped the name of whoever you saw, they can at least be looked up easily on the medical register to see what medical qualifications they hold (if any).

For reaching a rational decision about whether to go ahead with surgery in your case you would be best off talking to a consultant hand surgeon - ie a medically qualified doctor who has specialised in surgery of the hand. Such a person could be expected to have extensive experience of carpal tunnel syndrome and a good understanding of what surgery can achieve. That can be difficult in busy out-patient clinics however where many patients are seen by junior doctors in training. JB

Eelizabeth
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Once again, many thanks for your response. Thankfully my GP recommended "my" Consultant, my "other half" looked him up and a retired radiographer and retired A&E Doctor have all sung his praises, so I must be in good hands (excuse the pun!) I think it is just me being unsure and not in control of my own body that scares me somewhat!!
I will let you know what is to be done and the outcome - it must be so frustrating, just having a very quick snapshot of peoples lives, but how wonderful for "us" having a second opinion at the other end of an electronic device!
Best Regards Elizabeth
p.s. turning out to be a beautiful sunny day .... WHEN the op happens, I'm going to get white arms.... argh!!

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