Enter page title here Update on treatment
Good morning Dr
I came to see you sometime ago and as directed wore splints for about a month until I had injections on 22nd August. During this time there was a gradual improvement at night although the condition was never painful. Since the injection I have noticed - but not immediately - improvement particularly at night. Indeed the left hand shows no symptons at all day or night. Although this was the poorer hand in your tests it never gave me much of a problem. The right hand 3 fingers are still slightly numb to the touch and tingle a bit in the day but is generally free of any symptons at all at night.
I am awaiting a date for a follow up appointment with Dr Miles which, 6 weeks after the injection, will be about the same time as my first appontment -1st Oct - with Dr Rine.
So I need some advice.
If surgery will prevent the condition getting worse in the future then fine. But if it is likely to improve or stay the same anyway then I wonder if it is worth doing.
My right hand continues to be cold most of the time - would the surgery also improve the circulation?
I really do need your advice on the best thing to do - please don't say "it is of course up to you!
thanks for your help
Andrew
First of all you might look back at the discussion on here headed 'steroid injection while waiting for surgery' which concerns exactly this problem of whether to proceed with surgery when CTS has apparently responded well to injection Many orthopaedic surgeons would go ahead with surgery in these circumstances on the basis that "it is inevitably going to come back". I am less sure, but the worse the original NCS results were the more inclined I am to be aggressive about treating it. Your CTS grading was 5 on the right and 4 on the left so it is the neurophysiologically more severe hand which is more of a problem now. I think the best course of action here would be to test them again to check whether there really has been a significant change in nerve function, especially in the right hand. If it has come down to grade 3 or below I would defer surgery, otherwise I would go ahead I think. I could fit you in a quick test on Monday 26th September at 4:30pm which would be well timed in terms of making a decision whether to go ahead with surgery. JB