Mixed Aeitiology
Thank you for your prompt reply.
Yes I saw Dr Withrington and had physiotherapy at that time with hot /cold therapy and if I remember correctly a TENS machine was used , neither helped so I had injections in both wrists. Symptomatically they were excruciatingly painful at that time whenever I relaxed , I could not hold anything properly,could not pick up anything with one hand, could not grip the steering wheel , could not even cut up my food so things were very different to this time. The Injections worked very well and I had no real problem for many years.
Thank you, there is certainly a lot to be considered. I am keen to get to the bottom of it andfind out why I am having so many problems that may or maynot be related. I really need to get some sort of diagnosis. I really wonder how I will continue in my current job for another 9 years.
Would it be worth having another test as the symptoms are gradually getting worse. ?
The weakness is a real problem, especially with 2 young grandchildren, struggling with collapsing and putting up a pushchair and securing car seats etc, .At work, cytology results are often' insufficient' now bordering on unacceptable levels as I have little stregnth and dexterity is compromised.
As there are so many other symptoms, maybe a referal would be the right option at this point.
If you think the injections should be done maybe Emla creama application would be helpful.
Looking forward to your opinion .
GM
We could certainly test again out of curiosity and that would give us another chance to discuss it face to face as well. I'm not a fan of EMLA cream for steroid injection. It's useful for superficial anaesthesia of the skin but it's not passing the needle through the skin that hurts when doing CTS injections. The people who get severe pain seem to get it on injection of the steroid and EMLA won't reach anywhere near where the injection goes. I'll send out another appointment. JB
Thank you for the appointment in a few weeks time. The pain in my hands and wrists are now, both changing and worsening, My fingers are very swollen in the morning, I cannot clench my hands and I have very little grip.I am now unable to grip the steering wheel in the mornings. My MCP joints are swollen and painful, worse in the right hand. My wrists are also swollen and today have been quite warm to touch,
Would it be wise now,do you think, to go back to my GP or be referred to Rhumatology. If I am to be referred by yourself could Iplease be seen in QEQMH. As t would mean less time off work .
Many Thanks
GM
If we need a rheumatology opinion it will probably get an earlier appointment if the referral is made by your GP rather than me. The finger and joint swelling does sound rather suspect. JB
Well in your current circumstances I would generally recommend injection. We know that it has worked well for you in the past and where we are uncertain how much of your problem is CTS the response to injection (if any) will help to clarify how much of it is coming from the wrist. I appreciate that you found them very unpleasant in 1992 but that does not mean they would necessarily be the same if done again now. I can understand if you don't want to try it again though. So far as the possible CTS goes the only other real alternative would be surgery and with normal test results last time and rather odd symptoms I would be a little wary of the knife. The other way to proceed here is to ignore the CTS diagnosis for a bit and get Dr Withrington to see you again in rheumatology. JB