Post operation

bettya
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Have just received the telephone pre-assessment. That went fine. Having given the matter further thought however, I would like to ask a question related to the post-operation period. I understand I must self isolate for 7 days. Given that I am near 91 years old with osteoarthritis, to what extent should I be able to use my right hand - the hand which will be operated on ? I’m wondering how will I manage alone with: a) getting upstairs at bedtime - I use banisters on both sides of my staircase ? b) dressing/undressing ? c) all matters concerning toileting and personal hygiene ? d) cooking, washing up etc etc ? I have at this time no information on what to expect post operation but feel I need to know now so that I can think about alternative arrangements if that’s possible during the 7 day isolation period and possibly beyond ! Can you advise or point me in the right direction for some advice ? Betty A

jeremydpbland
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Most people are able to use the fingers of the operated hand for light manipulative tasks (helping to eat/dress etc)  within 48h or so of surgery. It varies a little depending on the policy of the individual surgeon. Some like you to keep a bulky dressing on the hand for longer than others. If you are listed for surgery with Michael Nicholas I can get him to discuss things like this with you in adfvance I think. JB

bettya
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Thanks for the feedback. I'm listed with Mr A Smith. However today, after giving it a lot of thought (bearing in mind I'm 91 years old and awaiting right hip replacement), as I am very shaky on my feet at the moment and prone to falling, I have decided to postpone the carpal tunnel surgery until such time as I have my right hip replaced. The thought of loosing the use of my right hand even if only for a couple of days, is a bit frightening at this time, but if my legs were stronger, I wouldn't need my right hand so much to keep me upright and stable. Also, postponing to a period when a week of (covid related) isolation post surgery isn't needed, will also be beneficial.

My son has left such a voice message with Mr Smiths Wait List Co-ordinator.

Incidentally the throbbing and aching I used to get in my right hand, seems to have diminished, so at this time, I'm back to severe numbness in the tips of my right thumb and two adjacent fingers.

jeremydpbland
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OK. If we are definitely not operating for the moment you could, if you wish, try giving it another injection. Occasionally two in quick succession do work and they are fairly trivial to do. JB

bettya
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Hi..Yes, happy to try a 2nd injection..Can you arrange ?

jeremydpbland
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We shoud be able to do Monday at 9:00am if you can make that? JB

bettya
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Yes can do..I’ll be there for 9am then..Thanks

jeremydpbland
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OK. I'll put it in the diary this morning. JB

bettya
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It's now exactly 6 weeks since I received the 2nd injection. Have to say it has had zero effect.

I will still need the carpal tunnel operation, but as mentioned before, I would rather defer that until such time as I have received and recovered from a hip operation (replacement right hip due in 8 days time - 27 Oct 2020 - if I meet all pre-assessment criteria).

Wish me luck !

jeremydpbland
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Good luck with the hip. I'll try to check what the waiting list office have done with you regarding hand surgery. JB

bettya
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Hi Jeremy..I had the replacement 'hip' operation 27 Oct 20 and am making great progress (though I say so myself)..Although I still have some way to go regards recovery, I'd like to start planning for a carpal tunnel operation..Could you give me some idea as to lead/wait times ? Best guess at the moment is that I'll probably be in a position to go for a carpal tunnel operation say Feb 2021 onwards..Look forward to hearing from you !

jeremydpbland
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The orthopaedic surgeons migth get around to it about then if COVID comes back under control. We could currently arrange surgery in primary care provisionally in January but again that may be disrupted by COVID yet. I would sit tight and see what happens to the epidemic until Xmas and then think aout it again. JB

bettya
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Hi. I have been offered (and accepted) a carpal tunnel operation which has been scheduled for Fri 29 Jan 2021 at Herne Bay hospital. I forgot to mention to the admissions officer that called me, that I’m currently taking blood thinning tablets - Apixaban 5mg 2x per day. I assume that's not a problem as it wasn’t in relation to my very recent (Nov 2020) major surgery (replacement hip operation).

jeremydpbland
Online

They will want to know about the Apixaban. I think they do a pre-op assessment by phone so you should get a chance to mention it before surgery. I'm wondering whether COVID is going to disrupte those Herne Bay lists by making staff unavailable - did they say anything when offering the booking? JB

bettya
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The date of the operation was set for exactly 14 days after my 2nd covid vaccination (which is scheduled for 14 Jan 2021). I was told to then "stay indoors" - which I take to mean 'isolate' - for the next 14 days and to then go to Herne Bay hospital on 29th Jan 2021 for the carpal tunnel operation. I was also told 'paperwork' would be sent explaining everything and that I should also receive a covid 'home test' kit. The latter has subsequently changed to a 'drive through' test at Canterbury hospital after I thought about it, and informed the admissions chap that in hindsight I'd prefer a drive through test.

The paperwork has not yet arrived.

The Admissions Officer that rang me said his name was Adam, and could be reached on 01843 235080.

NB: In Aug/Sep this year I was due to have the carpal-tunnel operation, but cancelled as I preferred to have my replacement hip operation first, then the carpal-tunnel operation - in that order. I still have the paperwork for that aborted operation and I did indeed have a carpal-tunnel Pre-Op Assessment. I will mention the Apixaban at the upcoming Pre-Op assessment !

jeremydpbland
Online

Yes that's Adam Chaloner - he's pretty efficient at organising things and can probably answer any questions about ongoing changes to procedures as the COVID crisis continues. JB

bettya
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A point of interest - Friday next week I’ll be undergoing a carpal tunnel operation on my right hand. Since covid lockdown first started, I have been struggling to operate my first ever ipad. My son noticed that I always seemed to struggle to get my ipad to respond whenever I used a finger from my RIGHT HAND on the touch screen. He suggested I try using my ‘good’ left hand. Oddly, my ipad responds when using fingers on my left hand. It seems the carpal tunnel problem in my right hand has somehow affected my ability to operate a touch sensitive screen. Bizarre, or is this a know side effect ?

jeremydpbland
Online

Not a known side effect but a very interesting observation. Amongst other things the median nerve controls the sweat glands in the affected part of the hand and how dry your hand is will affect the electrical conductivity of the skin, which might be a factor in operating a touch screen I guess. Can you try a little experiment - see if the effect is the same if you use the little finger to touch the screen - that one is not controlled by the median nerve. JB 

bettya
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My apologies. My observations were made when attempting to operate a specific application known as Google Duo. As an experiment, I tried opening other apps with my thumb, and each finger including my little finger, on my right hand - one at a time of course. At every attempt those other apps opened, so my earlier conclusion was false.. actually 'inconclusive'. Thought I'd made a weird discovery for a minute there !

bettya
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So tomorrow I have my carpal tunnel operation on my right hand. I stopped taking my Apixaban tablets yesterday evening (last tablet) but it struck me nobody has told me when I should resume this medication. Just in case I forget to ask, are you able to advise when I should resume taking these tablets ?

jeremydpbland
Online

Probably a day or so after surgery but the doctor doing the surgery will advise. JB

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