Post injection results
Dr Bland, Following my injection of both wrists 7 weeks ago symptoms in both hands seem to have disappeared, I can still get numbness if the wrist is bent back for a period of time, ie resting my head on my wrists which is an avoidable action,but otherwise both wrists are considerably better, both the numbness & pain.
How often can steroid injections be done safely? As my first injection lasted approx 4 yrs but my second only 6 months, is it possible to contact the clinic without seeing my G P again if my symptoms return?
Mrs Clark
Dr Bland, following my appointment yesterday, I rang Minor surgery Admin this afternoon to make an appointment for steroid injections, unfortunately i will have to go to a surgery in Wye to have the injections done, but as they said i cannot drive afterwards & would therefore have to get someone to take me there, I wondered if it is possible to have them done at your clinic, as I already have to come back to Canterbury hospital on Tues 29th October for another appointment at 12 o clock. Please let me know if this can be arranged.
Also regarding the fact that you said my Median nerves are both enlarged, but you did not know why, I am a little concerned that Steroid injections are only treating the symptoms, without knowing the cause, Is it possible that it is because of my overactive thyroid & if so should I mention it when i see the Endocrrinologist on that date? If not is there someone else you can refer me to try to establish the cause? I would appreciate your advice.
PC
We can do them here in Canterbury but only on a Monday morning at present I'm afraid. In fact the chances are quite good that would be able to drive after injection but it is not guaranteed - how were they last time?
The median nerves become enlarged because of carpal tunnel syndrome - what we don't know is what the mechanism of that enlargement is. Some people believe that it is local accumulation of water in the nerve which causes it to swell but there are other theories too. Carpal tunnel syndrome is associated with having an underactive thyroid (again the mechanism is unclear) but not generally with an overactive thyroid. If steroids work for you, and they do not work for every CTS patient, then it is clear that they do more than suppress the symptoms because objective measures of nerve function do improve. It is probably worth reading the sections of the website relating to the aetiology of CTS and on treatment by injection for a much more detailed explanation of some of these concepts. JB
Thank you, Canterbury would be much easier to get to. I did not drive last time, so better not to take the chance. Would i be able to come next Monday Please? preferably 10 o clock or after as I will come on the bus.
PC
Yes we should be able to do that, just get to us before 12:00 noon. Can you let the SIPC office know you are coming to us please. JB
Hi Dr Bland, following succesful steroid injections in both wrists in October, my symptoms have now returned again but at present in my right wrist only. The pain returned a couple of months ago, but is now severe, making everyday tasks difficult because of the pain & weakness in my wrist. I have also had some numbness in recent weeks. Would it be possible to return for assessment/ treatment? PC
Yes I'm sure we can arrange that. I'll arrange something after the bank holiday. JB
Hi, Dr Bland,
When would it be possible to come back? What do you think is necessary now? just another injection or further tests. The previous injection only lasted around 3 months before the pain started to return in my right wrist. I have a small amount of pain in my left wrist, but at least the injection in that one has lasted 6 months. Should i wait until the left one is more painful to have it injected again? PC
Looking back at the records I think that, on the whole, I would prefer the chance to see you again and have a full new set of investigations. I've found a space next Thursday and put an appointment letter in the post. JB
Hi Dr Bland, I am happy to have another consultation with you, I would prefer that option. I really appreciate you fitting me in so soon. However I seem to remember from last time that it is not possible to have injections on a Thursday, if you decide they are the best option. Therefore as i would have to return another day for injections & would have to rearrange my work schedule for a Thursday appointment, I wonder if it would be possible to come on a Monday as before? Assuming you work on Monday & injections are still given then? If however this would mean I had to wait much longer, I would rather keep the appointment you have made for Thursday. PC
We can inject any day now (well not usually bank holiday and weekends). JB
At least for the moment you can contact me through this website whenever you like. What I am able to do is sometimes dictated by the NHS's administrative and contracting systems but for the most part I am assuming for now that once your are officially my patient I can carry on treating you indefinitely.
The rule we are currently working to regarding repeat injections is basically not more than an average of once every 6 months for each hand. Recurrence times after serial injections seem to be essentially random - ie there is not a convincing overall trend to progressively shorter (or progressively longer) intervals in most patients. JB