Getting worse

Nikkibear
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Hi Dr Bland

I have been wearing my splints since I saw you. However recently both hands and wrists have been getting a lot worse. Can I come back in to see you to see and talk about other options?

jeremydpbland
Online

We should probably test again as it's nearly a year since we last saw you. The next obvious step in the way of treatment would be to try local steroid injection. We could probably do an injection for you on one of the next two Mondays if symptoms are very troublesome but I can't fit in a re-test for a few weeks I'm afraid. JB

Nikkibear
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I didn't realise it has been so long.
I think I'm going to have to try the injections, I remember you saying when I saw you, that would be the next thing to try. Even if I wait for another test you will probably recommend them anyway. Like you said, it is the next step and this is the worst they have been.
I am away next week, so would it be possible to book in for the second Monday? and will I still need to book in for another test even after the injections?

jeremydpbland
Online

I think 'probably' is likely to be the right word regarding recommedning injection. Ideally I would like to see how much your nerve conduction studies have deteriorated in a year before deciding. We started out at grade 1 and I think if they had slipped as far as grade 3 I might think about surgery. However there is a fairly low chance that it has actually gone that far in a year. As I cannot fit in nerve conduction studies for a few weeks however the more important issue is what can we do about your symptoms and if they are very severe then injection is likely to provide a quick fix - whatever has happened to the nerve conduction studies, and we can do that next Monday I think (5th August). I'll just need to check with Nick - who would be the person doing it. JB

Nikkibear
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I am happy to wait a few weeks and have the test done, although I am suffering I would rather have the test done first so we can see how far it has gone. I wouldn't be able to make the 5th as I am away until the 11th. So can we please book in for the test instead.

jeremydpbland
Online

Test booked - there should be a letter going out in tomorrow's post. JB

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