RETURNING SYMPTOMS
Dear Dr Bland
I had an appt with you on 17 June after I had been given coristone injections on 2 June by Dr Bull at Dover. Even with the injections I scored a 3 in the test you gave me on that day and you advised me to contact you after the injections had worn off.
The pain is now starting to return though not as badly as before I had the injections. However, the strength in my hands and wrists is getting worse and at night I am woken up about 2-3 times as my arms are stiff and painful (the pain is not bad enough or long enough to warrant painkillers) and occasionally the pins and needles are back in my right hand but not as bad as it was before the injection. My wrists also seem to be swollen. Some of my fingers hurt when I try to bend them in morning but this does soon get better after a while. I still have a numbness/tingling sensation in my middle finger on my right hand and this is also mildly present in my index finger.
I have filled in another diagnostic questionnaire online and have scored worse than before though do find it hard to answer the questions about pain as it is not constant (for example my wrists hurt when I put pressure on them, ie when I lean on them to get up from a seat but otherwise there is no pain). I cannot clench my fists fully nor can I click my fingers at all.
I am not really sure that all these symptoms are part of CTS but may be due in some part to arthritis and do not know where to go from here and would really appreciate some advice from you.
I am sorry to bore you with a running commentary of my symptoms but I wanted to give you as clear a picture as possible.
KIND REGARDS
Ann Goodwin
Dear Dr Bland
Thank you for your prompt reply, much appreciated. After taking time to think about my options I think I would like to go down the surgery route as although the injections worked in as far as they alleviated the pain, they did not improve the strength and grip in my hands and this is what I am finding frustrating. I think the CTS symptoms were bad before any real arthritis set in and am hoping that surgery rather than more injections will be the most beneficial. If you are happy for me to go down this route, can you please tell me how long I would have to wait for surgery?
Thank you.
Kind Regards
ANN GOODWIN
PS I shall be away from 26th Aug until 2nd September
Unfortunately strength and grip sometimes get worse after surgery so I have to warn you against expecting too much. Cutting the transverse carpal ligament is a bit of an assault on the normal structure of the wrist! We probably can't arrange surgery until November so it will be after your return from holiday - do you want them injected as a temporary measure while you go away? JB
Dear Dr Bland
I did assume that if I were not one of the unlucky 5% for whom the surgery did not work, I would get the strength and grip back in my hands or at least most of it. However, I do think surgery is the best option and I would like to go on the list for this. If a second lot of injections will help the strength and grip (which is now worse than when first diagnosed) I would appreciate having them again as a temporary measure. Please could you arrange this upon my return after 2nd September?
Many thanks and kind regards
ANN GOODWIN
Surgery booked for early November. Letter in post. If you need an injection in the meantime just call the SIPC office to arrange it. JB
Don't worry about the running commmentary - the more information the better. There are really only two options here - try another injection or go for surgery. As there may some element of arthritis too I might be inclined to give it one more injection now before resorting to surgery but you can head straight for surgery if you wish. JB