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    Old 01-18-2004, 08:08 AM   #1
    1Ageless
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    Carpal Tunnel Syndrome

    I have posted this reply on another board. As I read through some of these posts, I have to disagree with the person that said Ambien is not addictive. That is not true. Over the counter sleep aids contain Benadryl for sleep, such as Tylenol PM, etc... Having worked for a Board Certified Microvascular Hand Surgeon who had a Fellow in the field of hands; very highly regarded in his field, I have some knowledge of this problem. I have firsthand knowledge in fact. Please see my posts below...
    I worked for a Board Certified Hand Surgeon as Surgical Technician for many years. If you understand the anatomy of carpal tunnel, perhaps you can better understand the situation of the problem. There are rows of carpal bones in your wrist. Your median and ulnar nerves, along with arteries, tendons, ligaments etc also run in and between the carpal bones (through the carpal tunnel) of the wrist. The median nerve gives power to the thumb, index, and partial long finger, and the ulnar nerve gives power to the fifth finger, ring finger, and usually ulnar side of the long finger. An EMG / nerve conduction study will confirm carpal tunnel syndrome, cubital tunnel syndrome, or other syndromes, such as thoracic outlet, deQuervain's syndrome, brachioradialis problem etc. The more time you spend at your computer doing keyboarding or any type of repetitive motion, without any sort of intervention, this carpal tunnel situation can progress. Some of the major symptoms of carpal tunnel syndrome are numbness and / or tingling of one or both of the nerve distributions (median or ulnar nerve distribution), dropping items you are trying to carry, numbness or tingling of your hand that can awaken you at night, weakness of the hand. The nerve is the softest and finest of the anatomy (tendon, arteries, nerves, etc...) that goes through the carpal tunnel, therefore, the swelling compresses the nerve which causes the symptoms. There are two surgical options; open carpal tunnel release, or endoscopic carpal tunnel release that relieves the pressure on the affected nerve. It can be done as an out-patient with a local anesthetic and you would probably be in a cast or splint for two weeks with sutures, and then on to hand therapy. I have had experience with steroid injections, which have many side effects, and I feel should never be used unless absolutely necessary. Splinting and "resting the nerve" and cutting back on repetitive motions can help. An EMG / nerve conduction study is not terribly painful; it measures the amplitude and velocity of your nerve(s) that is affected and will give you your diagnosis. As I said above, this could be a problem other than carpal tunnel, such as cubital tunnel, thoracic outlet, etc... I would highly recommend a BOARD CERTIFIED hand specialist, which is usually an Orthopedic Surgeon, or Plastic and Reconstructive Surgeon with a Fellow in Hand Surgery, a very specialized field of medicine. Just remember how important your hands are to you, and keep yourself as ergonomically correct during work as possible, including neck position, head position, height of monitor, height of your desk, etc... GOOD LUCK.

    Last edited by 1Ageless; 03-22-2004 at 11:58 AM.

     
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    Old 01-18-2004, 08:11 AM   #2
    1Ageless
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    Re: Carpal Tunnel Syndrome

    Quote:
    --------------------------------------------------------------------------------
    Originally Posted by Tasha2003
    1Ageless: Thanks for the reply. I have actually tried to cut back on computer time, started doing stretching exercises and taking B6 vitamins. I'm seeing a chiropractor with Kinesiology background on Thursday in hopes of gaining more info.
    I have thyroid disease and type I diabetes, which can further complicate CTS. So far, I do not have weakness or problems during the day, but do have at night.
    we'll see how it goes.
    Btw, if you have hand surgery and it is your right hand, and you're right handed, what in the world do you do? I wear an insulin pump and need my hands to change out pump supplies etc. I have no clue how I would get by with my left hand?
    --------------------------------------------------------------------------------


    Tasha ~
    Cutting back or completely laying off your computer or doing any repetitive motion for a while can help the swelling. An anti-inflammtory, such as Aleve, may be of some help. You have stated that you know your thyroid and diabetes problems can cause complications. Most of the CTS symptoms are at night, with numbness and tingling awakening you. Many people sleep with their wrists flexed, and this will cause pressure on the nerve. Unfortuntately, I was misdiagnosed with traumatic carpal tunnel after an airbag injured me. I challenged the surgeon's diagnosis and told him "I feel like there is a fracture." I also reminded him that I had worked for one of the finest microvascular hand surgeons in the large metro area of a large city, and I watched him clench his jaw. He continued to insist that I have surgery, which I opted not to do, since I was certainly convinced his diagnosis was not correct. He chose to inject my wrist area with steroids "indefinitely." Unfotunately, at that time, I did not know the severe risks with steroids, and I found out the hard way. The surgeon insisted I undergo the surgery, and I reluctantly did so via the endoscopic route. His surgery failed! I still had the same symptoms that were not at all consistent with carpal tunnel syndrome symptoms. He again began to inject me with steroids until my hand withered, bled under the skin, turned my carpal bones to mush, and the thenar eminence (the fat part of your thumb on the palm side) had withered. I immediately sought a second opinion with a second Board Certified Hand Surgeon that only specialized in "hands. After three years, an x-ray was taken, and my suspicion of a fracture was very correct. I had walked around with a wrist fracture for three years and it was never x-rayed prior to that! The second surgeon tried to save my hand, but the damage had been done. A DEXA-scan revealed that I also had osteoporosis in my left hand and forearm, showing about three carpal bones scattered up into my hand. An arthrogram revealed torn ligaments. I now have the use of only my right hand and arm. I really do miss my left upper extremity ~ I fall much easier now since I don't have two hands and arms to break my falls if I should trip, and I cannot catch myself, therefore, causing further injuries. Now I get to learn to be a handicap ~ I would strongly urge anyone not to put this off ~ Make sure your surgeon has a very good reputation by checking out certain websites that patient advocate, Sydney Wolfe, MD, can supply for you if you key in that name in your search engine. Don't believe everything your doctor tells you. Get a second opinion. If you have a phsician that you truly trust, ask him who HE would send his wife to for the absolute best care. Many of the medical education hospital facilities have some of the finest surgeons, since they are "teaching physicians" and they are not in it for the cash or a quick cure, or unfortunate misdiagosis and false trust from patients. ALSO, make sure you have an EMG / nerve conduction study with a good firm diagnosis prior to undergoing this surgery! Mine showed "possible mild early unsymptomatic" carpal tunnel syndrome, and the doctor doing the EMG agreed that my symptoms were not consistent with carpal tunnel syndrome. If I can attempt to get by with only one hand and arm the rest of my life, I think two weeks out of your life to save your hands is definitely worth it!!!

     
    Old 01-18-2004, 11:02 AM   #3
    lidia09
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    Re: Carpal Tunnel Syndrome

    I also reminded him that I had worked for one of the finest microvascular hand surgeons in the large metro area of a large city, and I watched him clench his jaw. He continued to insist that I have surgery, which I opted not to do, since I was certainly convinced his diagnosis was not correct. He chose to inject my wrist area with steroids "indefinitely." Unfotunately, at that time, I did not know the severe risks with steroids, and I found out the hard way. The surgeon insisted I undergo the surgery, and I reluctantly did so via the endoscopic route. His surgery failed! I still had the same symptoms that were not at all consistent with carpal tunnel syndrome symptoms. He again began to inject me with steroids until my hand withered, bled under the skin, turned my carpal bones to mush, and the thenar eminence (the fat part of your thumb on the palm side) had withered. [/QUOTE]

    Ageless
    I'm completely confused as to why you allowed this surgeon to continue treating you when you were so sure in the first place that he had misdiagnosed your medical condition. If you worked for the finest hand surgeon in town, why the heck didn't you go see him in the first place? You seem like a well-informed person when it comes to medical matters. I just can't understand why you would continue to allow someone to inject you with steroids to the point where your hand was withering away? That sort of thing doesn't happen overnight. Didn't you try to find out about the side effects of cortisone when you were being injected with so much of the stuff?

    Lidia

     
    Old 01-18-2004, 11:43 AM   #4
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    Re: Carpal Tunnel Syndrome

    Quote:
    Originally Posted by lidiajamjar
    I also reminded him that I had worked for one of the finest microvascular hand surgeons in the large metro area of a large city, and I watched him clench his jaw. He continued to insist that I have surgery, which I opted not to do, since I was certainly convinced his diagnosis was not correct. He chose to inject my wrist area with steroids "indefinitely." Unfotunately, at that time, I did not know the severe risks with steroids, and I found out the hard way. The surgeon insisted I undergo the surgery, and I reluctantly did so via the endoscopic route. His surgery failed! I still had the same symptoms that were not at all consistent with carpal tunnel syndrome symptoms. He again began to inject me with steroids until my hand withered, bled under the skin, turned my carpal bones to mush, and the thenar eminence (the fat part of your thumb on the palm side) had withered.
    Ageless
    I'm completely confused as to why you allowed this surgeon to continue treating you when you were so sure in the first place that he had misdiagnosed your medical condition. If you worked for the finest hand surgeon in town, why the heck didn't you go see him in the first place? You seem like a well-informed person when it comes to medical matters. I just can't understand why you would continue to allow someone to inject you with steroids to the point where your hand was withering away? That sort of thing doesn't happen overnight. Didn't you try to find out about the side effects of cortisone when you were being injected with so much of the stuff?

    Lidia [/QUOTE]

    Lidia ~
    Unfortunately, my old boss, the microvascular hand surgeon became extremely ill and had to close his practice. After that, I had a medical business, and hand surgeon #1 was one of my clients. I THOUGHT I trusted his expertise, and perhaps, since I do not have MD after my name, that I could be wrong. After all, he did use the word "Traumatic" in my diagnosis. Yes, the airbags were a very traumatic indicent with multiple surgeries and terrible injuries that I was dealing with on top of my hand, and in physical therapy and rehabilitation. I had many surgical repairs for many injuries ~ I was not ONLY DEALING WITH MY HAND. I was dealing with severe injuries, surgical procedures, post op rehabilitation, pain, etc... My first question to surgeon #1 was "Will this cause atrophy?" (that was the ONLY possible side effect I knew at the time of his first injection.) His reply was "Nah." I am very well informed NOW about the side effects of steroids. YES, my symptoms of bleeding, withering (atrophy) DID appear overnight! The steroid injections masked the pain and enabled me to continue to use my hand until the petechiae, atrophy appeared. I awoke one morning to see a bloody hand after washing my hands and toweling dry. I immediately showed my hand to that surgeon that I had put my trust in. That was when I read of the side effects of corticosteroids ~ unfortunately, after it was too late. You have to realize I was in and out of the hospital more than a dozen times for procedures, surgery, as well as numerous events of physical therapy and rehabilitation, on top of trying to keep a business going and raising children. Yes, I had to learn the hard way.

     
    Old 01-18-2004, 12:07 PM   #5
    1Ageless
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    Re: Carpal Tunnel Syndrome

    Lidia ~
    I had also lost consciousness when the airbags deployed. I never saw them coming. Also, I had moved aaway from that city. I had so many injuries to deal with and surgeries ~ Let's just say it was a horrible experience, and my hand was only a part of it.

    Last edited by 1Ageless; 03-22-2004 at 11:55 AM.

     
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