Return of CTS symptons

MalD
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Dr. Bland:

You asked me to contact you if / when CTS symptons returned post-steroid treatment received at Faversham on 9 February 2012 .

Regret to say that they have returned within the past week - brought on by some home decorating I think.

The 'pins and needles' and pain in the right hand are now quite strong, along with stiffness in my right thumb and index finger.
Also there is a return of the 'associated problem' of pain in my right shoulder/ upper arm; and my sleep is being disturbed. once again.

Would greatly appreciate your help and advice.

Kindest regards.

jeremydpbland
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When I saw you in January we were uncertain whether there was a problem at the shoulder as well as CTS but it sounds from the follow-up records I have here as though all of the symptoms improved after injection - is that right? If so then it seems fairly likely that it was all coming from the wrist. It was grade 5 on the NCS in January so if the response to injection was really good and it is recurring after only 3 months then surgery will probably effect a long-lasting improvement . However, ultimately it is your hand and therefore your choice regarding surgery or re-injection. Either way I think we should test it again so that we know what we dealing with - if it has actually improved from grade 5 I might be more inclined to try another dose of steroids, whereas if it is the same or worse then surgery would probably be better. I have just come back from a conference and while I have been away a few cancellation slots seem to have appeared in the diary for testing so if you are free over the next week or two we may be able to fit in a quick re-test. JB

MalD
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Dr Bland:

Thanks so much for your prompt reply.

Yes- all of the symptons, including the discomfort in my right shoulder, did improve greatly after the steroid injection. They have only returned with a vengeance within the past couple of weeks whilst decorating.

I'm more than happy to attend your clinic for a re-test, if you would please suggest some dates for an appointment.

I can't make Wednesday 6th June through to Friday 8th June inclusive (+ weekend) - other than then should be okay for me.

I'm more or less settled that CTS surgery would probably be the best option for me in the future. Others I know have all experienced continuing good outcomes after surgery - so I would hope for the same.

Once again, many thanks for your help.

jeremydpbland
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I can fit you in tomorrow morning (Tuesday) or Thursday morning this week - your choice. JB

MalD
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Dr Bland:

Thursday morning appointment, please - what time?

regards, MD

jeremydpbland
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About 11:00am - if you've been to the Thursday morning clinic before you will know it can be a little hectic but we try not to keep people hanging around too much. JB

MalD
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Thank you Dr Bland - see you 11.00 ish on Thursday.
regards, MD.

MalD
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Dr Bland:

Re: Consultation - 31 May 2012. Feedback as requested.

Pleased to let you know that the second steroid injection has done the trick as you suggested.
My right hand/right shoulder are quite comfortable now. Minor pins & needles only when carrying shopping etc. for awhile: apart from that - no problems.

Really appreciated having a consultation and being treated by your colleague in one go - excellent arrangement.

Once again, many thanks.
MD

jeremydpbland
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I wonder how long it will last this time - perhaps until you start another frenzied bout of decorating! You know how to contact me now anyway so let me know if and when it starts to become a problem again. JB

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