Follow-up arrangements
After 20 years of studying CTS patients to arrive at the information presented in this site there are still many unanswered questions about the disease and we remain interested in what happens subsequently to EVERY patient who we see in Canterbury who is suspected of having carpal tunnel syndrome. We are however a relatively small team with no research funding to systematically follow up our patients and we are therefore dependent on the goodwill of our patients in keeping us informed. The formal follow-up arrangements for patients who have been referred for management to the East Kent CTS protocol are as follows:
AFTER INJECTION - a follow up assessment will be performed after about 6 weeks, usually by the same general practitioner who performed the injection(s). These are mostly done in person but a few are done by telephone. We will ask you to complete the symptoms severity scale and functional status scale again so that we can see how your answers have changed. As an alternative to this follow up you can now 'do it yourself' on this web-site provided you register with us. This new method has the advantage that you tell us repeatedly how your symptoms are doing over time and we can build up a much fuller picture of how your CTS is evolving. HOWEVER YOU DO IT, PLEASE GIVE US SOME FOLLOW UP INFORMATION. Beyond 6 weeks it is up to you to get in touch with us if and when you have further problems.
AFTER SURGERY IN PRIMARY CARE - We will write to you approximately 3 months after surgery, by which time the wound should be fully healed. At this point we will ask you to visit your general practitioner so that he/she can examine the hand. The paperwork we send you at this time has sections to be completed by you, like the symptom severity and functional status scales, and also a section for completion by your GP. When you have both filled in your parts of the form it should be returned to us in the post.
It is important to note that we do not generally expect it to take as long as three months for your symptoms to improve after surgery, indeed many patients observe that they feel markedly better within 24 hours of surgery and any deterioration of symptoms should be reported promptly to either the surgeon who performed the operation, your GP, or to the Canterbury neurophysiology department. Our surgeons generally remove their own stitches 2 weeks after surgery so there is also an opportunity for review of the initial results then.
The three month follow-up forms also include space for you to tell us what is happening to the other hand - the one that has not had surgery - and to let us know whether you would like anything doing with it. If you had severe bilateral symptoms and the first operation has obviously been successful and healed satisfactorily then you can also contact the neurophysiology department before the three month follow up to make arrangements for treatment of the second hand.
PATIENTS WITH NORMAL NERVE CONDUCTION STUDIES - We do not routinely arrange to see these patients again but we do recommend to the referring general practitioner that a second test may be advisable if symptoms persist for three months and still sound likely to be CTS. You can see exactly how likely your symptoms are to be CTS by completing the questionnaire on this site and if the score is very low then it is probably more useful to look for other causes of the symptoms rather than repeating the nerve conduction studies. Experience shows that many patients with suspected CTS and normal nerve conduction studies spontaneously recover within three months anyway - whatever the right diagnosis was.
IN ALL CASES - the person who is most concerned about your symptoms and most responsible for doing something about it is YOU. If you have severe (and especially worsening) symptoms from your CTS, don't grin and bear it - TELL US! We do not guarantee to cure you but we are just as interested in our 'failures' as our 'successes'
