Greetings once again all …

I write to you as a surgical skeptic. The water of Carpal Tunnel Syndrome or “RSI” release surgery is very muddy water for me.

At the very least, I am as scared. My situation, unfortunately, was industrial in nature and the care rendered thus far quite poor with no continuity. One thing though; they sure were quick to want to cut! And, every surgeon I talked to wanted to do surgery, imagine that???

Within six weeks of first reporting symptoms and six P.T. visits, I was referred to a rather aggressive surgeon with a “make a quick buck attitude” (I was not impressed and actually filed a complaint with his board). I bailed from that scene and explored Chiropractic, which I was very impressed with. There are some outstanding Chiropractors out there. I was a naysayer, a nonbeliever, then the feeling and sensation began returning to my thumb and gradually to my fingers, Acupuncture was also used. Anyway, I honestly believe that if this injury was on my personal time and I had access to my private health provider, I would have had a serious regiment of P.T. and O.T.; and I of course believe this would have halted the progress and changed everything. I probably would have been pulled from my job before my fingers triggered also!

As stated above it was industrial and my treatment on again, off again. This California reform and a vindictive employer have turned this into a living nightmare, and now I am officially in a very uncomfortable and tenuous position.

My left two fingers and thumb have various degrees of numbness returning, and if the arm is unwittingly over used, my forearm will flare up with moderate pain. My fingers triggered bi-laterally, but were released by Cortisone injections. My right wrist seems to have some mystery ailment underneath, the ulnar nerve region. It hurts like hell when at certain and sometimes un-determined angles. The feeling started as a shock type feeling and then after time settled into a burning pain. My small right finger now feels much like the fingers on my left hand.

I am due to see a Neurologist in the near future.

My dilemma is this; my vocation requires me to restrain people sometimes, actually physically (with assistance) take patients to the floor, then transport and restrain. A 230 lbs. male with no grip strength is just a big target. In order to remain in the occupation I gave blood, sweat and tears to achieve, is hanging in the balance of the decisions made about these paws of mine, coupled with quite a bit of lady luck.

I’ve heard this story and that story about the typist or admin or business type person going right back to work, like having your tonsils removed. If you have a job like mine, or the construction trade or any job that requires reasonable torque/strength, having the stabilizing ligament of your palm voluntarily cut has the very real possibility of ruining a career.

I have two questions;

1. Is there anyone in a trade that requires reasonable strength and grip that has had this procedure and how are you fairing after this procedure?

2. What are the realistic options to surgery besides the obvious? Are there realistic options? Especially as I advance/deteriorate?

There just has to be a better mouse trap!?!?


Peace,

JD




:confused:

JD:
I also spent almost 2 years trying everything before deciding to give in to surgery. I agree with you with regard to the aggressiveness of the hand surgeons. But I have to tell you - the surgery was quick and the recovery went well. I have absolutely no pain in my wrist and the numbness is gone. I'm very happy I decided to have the surgery. I am sorry I didn't decide to have it sooner. Good luck with your decision and I wish you relief from pain! Beebs. :)

sigman. Well, I had ct release in 1993 on my right hand. I'd had ct problem for approximately 20 years....starting with doing repetitive work in a canning factory for summer job between college semesters.....and used my hands a lot because of art major. It let up some when I got married and had children...different type of work. But then I got some goats and was milking them by hand. that really did a number on my hands so I opted for surgery on my right hand. That surgery went well. I didn't do left hand because of needle in the armpit to administer regional block. My right hand has been good despite continuing with farm work....I can lift 50-110 pound bales of hay ( I weigh 130 and am 52yrs now), not to mention carrying buckets of grain and water around. I currently milk around 100 goats...by machine, not by hand, but do do a lot of gripping.
I did try chiropractic....my brother is a chiropractor. I tried vitamin B too.
I finally had my left hand done two years ago. Had complications following that surgery done by orthopedic surgeon. I had it redone almost a year ago, and had some improvement. (I'd tried accupuncture between the surgeries, to no avail) I had that surgery done by a hand surgeon that was voted top doctor in his field by other doctors ( like who would they go to if they had to have surgery done on hands/wrists) So I would say, I had a good outcome for my right hand....not my left. I wasn't able to do what I needed to do last year in some areas because of complications. I just completed a cna course and did clinicals in a nursing home.

Maybe check around a little more for a surgeon that seems to fit for you....see who some healthcare workers and other docs would go to if they had to have it done.

JD,

I definitely understand your concern, especially considering that the use of your hand strength is your livelihood, income and also your self-defense.

To make a long story as short as possible, I had cubital (ulnar nerve) decompression and transposition surgery on my elbow on August 29th. The surgery was a success. In fact, it was a piece of cake. I just wish I had my surgery sooner. If I had surgery sooner the small intrinsic muscles at the base of my thumb would not have wasted (atrophied). Wasted muscles do NOT fully recover. This is something for you to really think about in terms of waiting in hopes you recover without surgery...

I was a skeptic about having surgery too, just like you. I just knew my condition would get better in-time and I'd be as good as new. That is why I waited four months before having a nerve conduction test and ultimately seeing a specialist, which led to me having the surgery I needed. During the four months I waited to heal on my own (before having surgery) I did a lot of research to learn exactly what my problem was all about. It didn't take long for me to know exactly what my problem really was and what the surgeon would do if I did have surgery. When I eventually came to the conclusion I was not going to heal without surgery I sought out the very best, most experienced, specialist I could find in my area. The doctor I chose is a specialist in micro-nerve this and micro-nerve that, plus he is an assistant professor at a major medical center...and is the specialist that would take care of a major university's athletes if they had nerve related injuries of the hand, arm or shoulder.

After having the preliminary nerve conduction test done I visited the specialist. Like you, I was concerned because within five minutes of meeting him he told me I needed surgery. Man, that was quick I thought! There was no beating around the bush with this guy - he gave me no hope of an alternative to surgery... The first thing that crossed my mind of course was that he just wanted to operate, because operating meant money in his pocket. I soon learned that mind-thought was an ill-fated theory on my part, and I needed his expertise far more than he needed me as an outpatient customer/client. I asked lots of questions...and he gave me answers. I corresponded with him again via email to ask a few more questions I had come up with...and he gave me answers. The tail-of-the-tape was really very simple for him to explain why he KNEW I needed surgery - he had seen hundreds of patients with my exact problem, had performed hundreds of these surgeries...and had seen the results of those people who elected not to have surgery, and those people who did. The man eats, sleeps, dreams, teaches and is fully consumed with his medical training and expertise. He re-attaches nerves for trama victims that have been in serious accidents...and he's seen it all. What he was recommending that I have done was routine and known (by him) to be the right thing to do. Well, he was right!

The surgery took care of my nerve problem beautifully. For what's it's worth, my hobby is playing golf. I have been playing golf for decades and have a very low (scratch to -3) handicap, so having strong hands is important. Having surgery concerned me because I didn't want to have the surgery mess up my golf game, but I knew that not having surgery was an even worse choice. I was hitting golf balls at the driving range 14 days after surgery, which is the day my sutures were removed...and taking full swings with no problem. The next day I was trimming large tree limbs with a chain saw, and dragging them away. My grip strength in my non-dominate hand, which is the arm in which I had the surgery, was tested and found to be stronger than my dominate hand (because of the strength built-up from playing golf for many years). So, I did not lose any grip strength. Needless to say, I am pleased...but like I said, I wish I had elected to have the surgery sooner. My grip (using the last three fingers and my palm pad) is as strong as ever, but my ability to pinch (using the forefinger and thumb) is very weak due to muscle wasting or atrophy at the base of my thumb (in the web between my thumb and forefinger). This wasted muscle is my own fault because I waited so long before having the surgery. You do not want that to happen to you! I'm hopeful I can regain some reasonable pinching strength as the nerve continues to heal, which happens at the rate of about 1" per month...and since my cubital surgery was done at my elbow it will take about a year or so to find out, but I'm told not to expect much improvement [because I waited so long before having surgery]. Without the surgery my problem would have only gotten worse, and eventually my hand would have had no strength at all and been useless, and looked like 100 year-old person's hand with skin draped over bones. Muscles that do not have healthy nerves "firing" to them become wasted and wither away...forever.

My suggestion to you would be to talk with the best specialist you can find. Ask him how many procedures like you need he has done. Tell him what you do for a living and how important it is that you fully recover. In other words, talk to him and let him know how concerned you are...and why. He'll understand and give you answers, and will tell you what to expect concerning your strength and recovery time after surgery. He'll also tell you what to expect if you elect not to have surgery, and I can assure you that you will not like hearing what he will tell you!

If the specialist tells you that you need surgery to take care of your problem, knowing what I know from my own experience, I would set the surgery date just as soon as he can schedule it...........

Best of luck to you...

Koot

PS - As you will see, I was also a skeptic: http://www.healthboards.com/boards/showthread.php?t=417704