Bilateral carpal tunnel release surgery two weeks post op
I had my surgery done two weeks ago today. I was badly bruised but since I am a diabetic I figured that was probably par for the course. I am also 56 years old which adds to that issue. I felt as though the surgery went well and I had help for several days and so I felt like it was easier than I expected to be. However the last couple days I have been experiencing the same amount of pain that I had pre-op. The pain is keeping me up at night and there is extreme numbness in both arms and hands. I am not taking the pain pills I was given I took them for about the first week to 10 days. I really expected that I would feel this kind of pain. Am I where I'm supposed to be? Or should I be concerned? I don't see my doctor until the end of next week. Your advice would be very much appreciated. Thank you so much :-)
Thank you. That's excellent information. Yes, I have all the numb feet :-( They said it was really bad in one hand and severe (maybe unfixable) in the other. The pain and numbness in my hands and arms is pretty much the same as it was pre-op. I did take Tramadol CR yesterday evening and so this morning I at least feel OK. But, there is still numbness in my palm wrist. I may have babied this too much. I don't know. I have been doing post op exercises more about 10 days. It sounds like I am correct in thinking I shouldn't be having this sort of pain. I did worry that what I was experiencing beforehand could have something to do with my diabetes (type 2, totally under control). Unfortunately Lyrica is not an option for me. I have wanted to stay away from pain meds so I would have a clear idea of what and where the pain was when I see the doctor. Thank you for your information. It really helps.
As you obviously have diabetic nerve problems too I suspect that pre-and post-operative nerve conduction studies will be even more important than usual here if symptoms continue. JB
Thank you again for your advice. How long should I wait before having the nerve conduction test? Symptoms continue. 2 nights in a row up most the night having the same pain I had pre-op. I've tried to be positive but it's hard because it's almost 3 weeks post-op.
I am seeing my surgeon tomorrow. My first follow-up appointment. I don't plan on going back to him because I've decided I need a specialist in Carpal Tunnel. But, I really don't know what questions to ask him. I don't see him until early afternoon our time. If you see this in time, can you please give me some advice as to what questions I should ask him that may not seem obvious to me?
Thank you again,
Chris
At 3 weeks post-op the original symptoms of CTS, at least pain and tingling, should have improved at least a little. It would help me if we knew what your pre-operative nerve coduction studies looked like. The obvious question is "why am I not feling any better". Although the commonest single reason for failure of symptoms to improve is not fully cutting the ligament most surgeons at this stage will feel pretty certain that they have done so, so asking if they might not have done will get a fairly predictable answer I think. Knowing when to repeat the NCS is difficult. Most surgeons seem to be inclined to delay much longer than I would. My general feeling is that you can never have too much information in this situation and if one of my patients says they are no better two weeks after surgery I will usually try to take a look at the NCS and ultrasound imaging as soon as I can. It's worth remembering that the person who did the operation is the only one who has had a chance to look at the interior of your wrist so they are in a unique position to give an opinion on what the problem may be and I would not abandon your initial surgeon too precipitately. JB
Thank you for your advice. I saw my surgeon today. Going to another doctor isn't a reflection on him. I have other issues that are likely nerve related and I think it's time to see exactly what is going on with my body. The doctor who performed the surgery is a plastic surgeon. I feel as though I need to see a neurologist.
The doctor seemed to think it wasn't time to say this didn't work and said I am pretty much where I might expect to be. I realize everyone is so different and predictions really can't be made with any amount of accuracy. He wants to see me in 6 weeks and I'll go back but I hope to get into a neurologist before then. He said he won't do a nerve conduction test for a year because even if the tests shows no improvement, there could actually be improvement the test isn't picking up on. I had moderate/severe results in both hands from my initial nerve conduction test. I never had any sort of ultrasound.
I forgot to ask if I should worry about straining my hands, can I use the computer without causing more damage and how much? Is it okay to vacuum and mop or am I making things worse? Everything hurts so if I stop because it hurts I will do nothing. :-( I also am unsure about the amount I should be lifting. I forgot to write these questions down. He is a nice doctor and spent a lot of time with me answering other questions.
You should be OK typing and carrying out everyday tasks like dressing/eating etc. I would be more wary of long bouts of strenous activity. Plastic surgeons are usually fine for CTS, quite a few of them specialise in hands, but like most surgeons I am afraid he clearly does not understand nerve conduction studies. If your NCS results were not grade 6 before surgery then failure to improve by about 3 months post-op is almost always an indicator of incomplete decompression. Depending on who did them, seeing the person who did the NCS may well be a useful tactic. AANEM members who carry out NCS will have a better understanding of how to interpret the results than the surgeon and in many cases will have seen vastly more cases of CTS than the average surgeon too so they are a useful resource. JB
Are these essentially the same symptoms you had before surgery, or is it a different kind of pain? It also helps to know how bad your CTS was before surgery (NCS?) and whether you have any evidence of diabetic neuropathy - numb feet? Moderate CTS should respond very quickly to surgery in most cases. You may find it useful to to read the When Surgery Fails page to get a grasp of the sort of infomration that is needed in trying to analyse post operative symptoms. JB