Vent: To Have Surgery for CTS or Not - Carpal Tunnel Syndrome Message Board

sivyaleah · 10-31-2005, 03:08 PM

After 6 months of testing, retesting, orthopedist and neurologist visits (including 1 neurosurgeon) I am at a loss about whether or not surgery is warranted.

I have CTS in both arms (and, mild CT in my right hand). Quite the annoyance. While certain activities set it off - for the most part daytime hours are bearable and I've modified my activities to a degree where it really isn't much of an issue. For instance, I've stopped using my PDA and cellphone indiscriminately, took the arms off my desk chair so I wouldn't be tempted to lean my elbows on them, have my husband do long distance driving, take breaks during days of heavy typing (I work on a computer all day), etc.

But - nighttime remains a huge problem. My hands go numb all night long to the point where I get little sleep because of it. I was on Ambien for about 3 months (2 actually - I was able to stretch it to 3 when I discovered 1/2 a 10 mg pill was as effective for me so I started cutting them in half - wish I'd done that sooner). Ambien works wonders - I sleep well, have no side effects at all, not even that much dreaded rebound insommnia.

At this point - my orthopedist can't help me other than surgery. Same for the neurologist. So, neither will prescribe the Ambien. I was referred back to my regular doctor, who I know for a fact is very conservative and will never let me stay on it even tho it's been approved for long term use.

My point is - is surgery called for when the worst aspect of it is not being able to sleep? It seems like a stupid reason to have surgery, you know? But on the other hand, it's kind of ruining my quality of life - not being able to get a sound night's sleep wrecks havoc with your daily life. Tired, cranky, moody, make small errors, etc. And yet, who on earth would chose to have surgery if your entire life isn't be effected severely by it?

If I go ahead w/surgery I'm leaning towards the neurosurgeon, who I believe is more qualified than my orthopedist to do this type of work. I love my orthopedist, and trust him (he did surgery on my knee last year and it went well) but when it comes to nerve problems, somehow I think it's better left to the expert in those issues. So, the neurosurgeon (whom I like too) said my case, while annoying and complicated by it being both arms, isn't in a severe stage yet and perhaps waiting a few months to reassess would be a good idea. He's not pushing me into surgery at all but did make mention that while my case is mild now, that doing surgery now would also have better results than waiting until there is more nerve damage and other associated problems that come with it.

Anyway, I'm venting more than anything but if anyone wants to respond or put in their 2 cents I'm happy to hear your opinions!

Thanks!

Taimse · 10-31-2005, 04:45 PM

You always run the risk of complications....did any of the doctors promoting surgery tell you about complications?
I have had complication following CT release in Feb. I am scheduled for hand surgery at an unrelated hand surgery facility next month to, hopefully fix or correct what is wrong. I was told last month, my a doctor in physical medicine and rehabilitation to go home and live with my pain ....that remodeling could be taking place. The surgeon I saw last week, was pretty concerned about EMG results done last month showing very little improvement and thinks it is probably nerve entrapment still... not totally released from Feb surgery.

sivyaleah · 11-01-2005, 09:38 AM

Yep, complication possibilities another reason why I don't want to have the surgery. As of now - I have pretty good use of the hand - it's the darn numbness which is my biggest complaint. Just doesn't seem like a good enough reason to slice open my arm(s) - you know?

CDauthier · 11-01-2005, 09:08 PM

Sivyaleah,

Just had the ulnar nerve decompression and carpral tunnel release done on my left arm on Oct. 24th. I don't regret it a bit. I knew I had made the right decision in the recovery room as I felt I had my hand back again...it felt like it belonged to someone else before!

My coordination, pain, numbness and tingling were distinctly better right after the surgery (the pain from the surgery itself is different...you just have to experience it to know what I mean). I had the same feelings in getting a neurosurgeon to do these proceedures. My GP set me up with an ortho hand specialist, but I cancelled and went to my neurosurgeon who had performed back surgery on me several years ago. If it was a broken hand, that's different, but neurosurgeons are more knowledgeable about the nerves...that's what they studied for years and years to become a neurosurgeon.

You will know when it's the right time for the surgery. I was told the feeling in the two fingers may not come back...but that's o'kay even if it doesn't...the motor skills are definitely better and that's what I was afraid of loosing. The tingling and pain associated with both the ulnar nerve and carpal tunnel are gone. There is some very slight discomfort left in the wrist that should be gone in a couple of days. The long cut on the arm at the elbow is very sensitive but it's getting better every day. When it gets too aggravating I just take a pain pill and don't even notice it.

Since I had both done at the same, it was done under general anesthesia. I had the ace banage removed on the arm two days after surgery and the soft gause protecting the wrist removed at that time also. Was told I didn't have to wear the sling unless I was somewhere where I felt vuneral and needed the protection. The wrist and the incision on the arm had terry strips...the kind they put on to protect incisions. I have two stitches on the wrist will which be removed Tuesday unless I decided to remove them myself sooner. The arm had a combination of dissolvable stitches and glue. The terry strips over the incision were the only thing that gave me fits, but as the doctor told me that I could start showering that day and they would come off by themself, I just showered and showered until they came off. Then it was heaven after that...still sensitive, but no scratchey tape strips blistering the arm.

Just be careful and not wait until it's too late to have a good outcome. Sleeping is a third of your life that effects the other 2/3 's of your life while you are awake. It's awesome to get a good night sleep now! Good luck with whatever you decide!

Cathy

sivyaleah · 11-02-2005, 07:19 AM

Cathy,

Thanks for the long, informative and encouraging post. And yes - sleep is an issue, my orthopedist said that too - how long can you go without a good night's sleep? It's funny - last year at my annual work review both of my bosses mentioned that they thought I seemed annoyed a lot of the time w/them. I told them that wasn't true (mind you - I've been here 18 years and since it's a small office I have a remarkably good relationship with both of them) and told them they were misreading me. I didn't elaborate as I didn't think it necessary to complain at the time but in retrospect I should have just told them the truth - I was in pain, exhausted and frankly, yes, occassionally cranky in general because of the lack of sleep (this was before my orthopedist took pity on me and prescribed the Ambien). Since then, I have been more vocal about my problems because it does effect my job to a small degree and they've been great about trying to help figure out ways to make it easier for me on the job.

I've decided to wait a few more months, reassess then. By the way, how did you ever go about daily activities having done both arms at the same time? That seems rather daunting to me - I guess you must have had to have someone help you do literally everything for at least a few days. What a misery. The neurosurgeon I went to said he would do them separately, which I prefer anyway.

Thanks again for your encouragment - it's highly appreciated!