Numbness

We reckon you have had 6 in the left wrist and 2 in the right. You are nothing like our record holder who is on number 14! Of course whenever you get fed up of the cycle we can always send you for surgery but your CTS has always been physiologically fairly mild so there is no great urgency for that. JB

Yes, thank you. As a wheelchair user the surgery recovery time would be horrendous as I only rely on hands. So far I have been so pleased with the relief coming from injections, I could lead a normal life for 1-2 years each time after them. I will report back next week and ask to see you if splinting is not helping me. Regards

Is it possible to be sent an appointment for a steroid injection? many thanks

I've added you to the list. As more than a year has passed I will want to test them again to check that there has not been a marked deterioration. They have always been pretty mild or normal in the past. JB

Ok, I guess I will check back in here or wait for a letter in the post; is it long waiting times atm? Thanks

Waiting times are a bit haphazard. I'm not operating a first in first out queue but prioritising patients according to what I know about them - so someone who I already know has grade 5 CTS with severe symptoms is probably going to get seen next week whereas a patient with very mild symptoms that are probably not due to CTS may well wait 3 months. JB

I understand. Sounds fair. Just an update on me: atm the numbness in left hand is painful and affecting me using my chair. Also in the mornings, I have to take breaks or wait for 10-15 mins until I can attempt washing my hair etc. I was hoping splinting will take the edge off it and nights seem ok with it, but mornings are v bad with painful pins and needles and thumb numbness. Also, bit of pain radiating up the arm to elbow again like last time. The right wrist has had some symptoms too lately, but I wonder if it is also from overcompensating for the left that I am not trying to put so much strain on. IM

I'll do what I can. We do have the prospect of being able to run some extra clinics over the next few weeks as long as we don't get a huge new outbreak of COVID in East Kent. The Kent COVID figures seem to be a bit higher than average for the country at the moment so I hope that's not a bad sign. JB

Yes I saw that, very concerning... thank you Dr B

Dear Dr B,
Things have got worse over the last week, I seem to get numbness, tingling and pain in my left hand now even when wheeling myself round the house, basic chores that require bending my wrist automatically trigger symptoms. Was wondering if there was any chance to be seen, I am worried if I leave it too long the injection may not work anymore, if that is possible to happen?! Many thanks again for you time. IM

It's a bit late now so I'll take a look at the situation in the office in the morning. JB

Thanks for that ))

I've moved you up the priority list a bit. We should get to this in a couple of weeks I think. JB

Thank you v much

Reaching me by my yahoo email is probably best . Worried of missing your call as working from home and phones mostly busy. Thanks

We'll try everything eventually, email, post, carrier pigeon :-). Mostly however we're finding that the phone is best as most appointments are being made at short notice. JB

In that case, I will keep the window open for the carrier pigeon at all times! :-) Failing that, plz leave a voice message on my mobile and will get right back to you! Many thanks for all your hard work.

Hi , just a new update here. The left wrist seems worse at the end of this week. Now it is problematic pulling my jeans on or holding my mobile in the morning especially with painful pins and then numbness in hand. I have to stop driving my daughter to school as I don't trust my hand not to go numb. At night while wearing the splint seems ok as long as I don't move it at all. Once I bend the wrist or it gets pressed, numbness sets it. I need to dangle it all the time downwards to get feeling back into it. If waiting times are long, can I ask my GP for steroids? Starting to get real worried about the winter ahead. My hands are all I rely on as a wheelchair user. Many thanks again.

We should be able to get you in next week I think. JB

An early update after my latest injection in my left hand two days ago. Thank you very much for seeing me as the discomfort was really getting to me this time. Possibly because it was left 3 months after symptoms re-emerged and I really forced my hand in this time, I had the worst reading in the nerve conduction test so far:3. Thanks to Emma injecting me, I now have about an 80% improvement and decrease in discomfort symptoms, no pain at all anymore , but still remnants of tingling and pins and needles when driving longer distance in tip of index finger and palm. It felt very nice being able to have two uninterrupted nights of sleep. I am weary of how long the effect of this injection will now last considering it was a high grade reading, but I will put more effort into splinting, which I hadn't the previous year.
Emma explained that it was grade 3 because of the reading in the thumb muscle but I didn't understand exactly, do you think it is because of the carpal nerve being trapped and is there loss of muscle mass? Can I do anything to reverse this? I am hoping it is all because I really strained that hand the period before coming to get tested.

Many thanks again.

There isn't usually any loss of muscle at grade 3, it's just that the signal from the brain to the muscle to make it move is taking a bit longer to get there. You wouldn't notice that but we can measure it. We don't fully understand the reason why the different changes in nerve conduction happen in a particular order in CTS but it does seem to be mostly consistent from patient to patient. Grade 3 cases sometimes show longer responses to steroids than grade 2 or 1 - the reasons for that aren't clear either. JB

Many thanks for the explanation Dr B

Today is 6 weeks since my latest left wrist injection. So far, luckily no numbness, tingling has returned. Occasionally wrist pain when exerting it, but not major. I have left an updated assessment questionnaire online. Many thanks.

Thanks very much. I've imported thos new scores into the hospital records. It looks as though the rihght hand has improved too! JB