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Dear doctor bland have been trying to get in contact with you for months now as injections all though verry sucessful ,as previously were,it has taken so long to get a reply to my enquires, that my apparent carple tunnel has properly flared up and am now at the point where i am nearly unable to work.{ carpenter &joiner}. my rist almost feels as if broken ,so tender ,all the usual numbness, fingers both hands dead at night wakeing up every hour, NEW ONE acheing like tooth ache going up arm to elbow constently 24 hrs. I was eventually given an appointment for re-testing ,even though wealready know what it is , was told have to after six months , well if someone had bothered to contact me after one of my many calls it would have been within the time scale for repeat injections.last time we met you told me to contact you direct to save time for every one involved but here i am .please could youtell me if i could deal with this a lot sooner,as i cant afford to be out of work ,with this its bad enough having to take time of to be tested again. the injections by the way were briliant not a sign of anything , including arthritus.
Sorry for the moaning im sure youre very busy.
regards Dom p
Thankyou very much for the swift reply to my notes,this is definetly the best form of contact.
I would like to take up the offer of re-injecting on Thursday morning,and so will be at youre surgery first thing.
many thanks.
That's fine. If you turn up between about 8:45 and 10:00 we will fit you in amongst all the other CTS patients - it may involve hanging around for a few minutes until we have a room free. JB
I'm sorry it's been difficult to contact me. Messages left in the office do not always get to me and I tend to accumulate a pile of answerphone and paper messages which I get around to trying to deal with once every few weeks - usually on a Sunday afternoon nowadays when I can hope to find most people who I call at home. The forum here, I have to say, is by far the most efficient way of communicating with me for those who can use it. Your last injections were in May 12 though I note that you failed to attend the follow-up assessment so that I do not have a contemporaneous record of how good the respose was - but I gather it was as good as the earlier ones.
If we re-inject now that will be the fourth time in each hand and one has to appreciate that this is no longer evidence based medicine - there are no published studies of repeated injection and there is no evidence to say that it is safe to continue injecting. On the other hand there are some theoretical risks - of rupture of the flexor tendons mainly. I am therefore rather wary of giving many injections but we are prepared to do it provided the patient fully appreciates the potential risks and provided we check on the nerve conduction studies from time to time - hence the requirement for repeat tests. I am also happier when patients keep in fairly close touch for follow-up so that I know what is going on with them - essentially one has to view this as an experimental treatment once you get past the second injection.
If you want them re-injected on that basis, and you are not willing to contemplate surgery for work reasons, then we can re-inject them for you on Thursday mornning if you can make it to my office at the start of the clinic. If I can find time we will-re-test them too and spare you the visit currently planned for the 22nd April. JB