2 completely separate issues...but seeking advice

[nscrbug]

Thanks for all the responses, everyone! I meet with the doctor on Jan. 4th. I have MANY questions to ask, and one of them will be in regards to my neck. I do experience quite a bit of neck pain and stiffness in the last few years, so I too, have also wondered about that.

I have researched the endoscopic version of the surgery, as well. My doctor does the "open" variety, unfortunately. But, I suppose it would not be out of the question for me to find one that does endoscopic. There are a few that I did find. The downside to that, is having to go through all the preliminary evaluations all over again with a new doctor...which means more time wasted. I was really hoping to have this done sometime in January, so that I would be ready to go once riding season is in full swing. I have spoken to one gal at my gym, who had the open surgery back in August on both hands, and she is doing very well. She is a plumber (so she uses her hands for her work everyday) and says she was back at work the very next day and hasn't had any recurrence so far. Her outcome gives me a lot of hope.

A recumbent bike is not an option for me. For one, I just purchased my current bike - a custom Ti that was VERY expensive, back in February. There is simply no way I can afford another bike, nor do I want one. The stationary recumbent bikes at the gym hurt my back after riding it for just 10 minutes. I need to ride the bike I have.

Can anyone suggest some good questions to ask the doctor when I meet with him next week? I don't want to forget anything. Thanks!

Linda

[goldfinch]

My husband swapped surgeons. He did not have to do a bunch of retesting, he looked at the reports for the EMG and nerve conduction tests. Spouse switched because he did not want the open procedure and given that he had substantial nerve damage he wanted the best doctor we could find. We spent some time looking for such a person.

I would ask you doctor about recovery time and about whether the procedure he does will be entirely suitable for you, given that bike riding is extremely important to you.

[nscrbug]

My husband swapped surgeons. He did not have to do a bunch of retesting, he looked at the reports for the EMG and nerve conduction tests. Spouse switched because he did not want the open procedure and given that he had substantial nerve damage he wanted the best doctor we could find. We spent some time looking for such a person.

I would ask you doctor about recovery time and about whether the procedure he does will be entirely suitable for you, given that bike riding is extremely important to you.

Just curious...does your husband ride? How long ago did he have his endoscopic surgery and how are his hands doing now? I understand that you said he does have permanent damage, but aside from that...is he happy with the outcome of the surgery?

I am checking into a few other Chicago-area hand surgeons that specialize in endoscopic carpel tunnel release. Are there any downsides to going with the endoscopic route, that you are aware of?

Linda

[tulip]

Just thinking...someone mentioned the possibility of neck issues that might be casing hand problems. I'm not sure that a hand specialist will necessarily take that possibility very seriously given their focus on hands. Doctors can be surprisingly un-systems oriented. If it is a neck issue, hand surgery won't likely help.

Take care and get the whole picture before you go the hand surgery route. I might be inclined to try less invasive options forest, including acupuncture and chiropractic. But that's just me and you know your situation best.

[OakLeaf]

I really don't know much about EMGs, but isn't one of the things they're supposed to be good at sorting out is whether something is a nerve root (spinal) or branch (peripheral) issue? Is that why the hand surgeon wasn't convinced it was entirely CTS?

I am so impressed with the osteopathic manipulation I've been receiving. It's so different from any treatment I've ever had before, very effective, extremely non-threatening and side effect free. Basically by gentle pressure on the ligaments, they realign the skeleton. That would be another thing to consider. Not all DOs do OMM, but if your surgeon is a DO he might be able to refer you. Otherwise try the Cranial Academy website.

[goldfinch]

Just curious...does your husband ride? How long ago did he have his endoscopic surgery and how are his hands doing now? I understand that you said he does have permanent damage, but aside from that...is he happy with the outcome of the surgery?

I am checking into a few other Chicago-area hand surgeons that specialize in endoscopic carpel tunnel release. Are there any downsides to going with the endoscopic route, that you are aware of?

Linda

My husband had very serious nerve damage, to the extent that his hands lost a fair amount of muscle. He rides but does not ride a lot. He cannot use drop bars and has to use a very upright position. However, he is very satisfied. The doc was very upfront about the fact that he had permanent damage that he would not recover from but that they could stop further damage. The damage has stopped and in fact he has less nerve pain. His recovery from the serious nerve pain took almost a year. He is a special case though, type 1 diabetes for 50 years which is not only a risk factor for carpal tunnel syndrome but increased the likelihood of permanent nerve damage due to neuropathy.

I do know that there are generally less risks with the endoscopic procedure as compared with the open procedure. However, when looking for a surgeon we learned that endoscopic hand surgery is highly specialized and it is important to get someone with experience. That is why we ended up going to Minneapolis for the surgery.

I just wish he would have had the surgery sooner. He was stubborn and waited too long.

[nscrbug]

I was unable to find a hand surgeon in the Chicago area that does endoscopic, but I did find a highly reputable hand surgeon from Midwest Orthopaedics at Rush, that does what is referred to as "mini-incision" carpal tunnel release. I booked an appointment for a consult with him on January 9th, so we shall see what he has to say. This doctor has some pretty impressive credentials:

Mark S. Cohen, MD (Midwest Orthopaedics at Rush, Chicago). Dr. Cohen is the director of the section of hand and elbow surgery at Rush University Medical Center in Chicago and a consultant for the Chicago White Sox and Chicago Bulls. He has an expertise in performing minimally invasive surgery, mini-incision carpal tunnel release, wrist and elbow arthroscopy and using bone cement for treating wrist fractures. In addition to his clinical practice, Dr. Cohen regularly conducts research on topics such as wrist fractures, elbow trauma and arthritis and wrist ligament tears. He has written more than 80 professional articles and written a text book on hand and wrist injuries. Dr. Cohen has been recognized by the Society for Surgery of the Hand for having the best scientific paper at the 2009 annual meeting. Dr. Cohen earned his medical degree from Harvard Medical School in Boston and completed his residency in orthopedic surgery at the University of California San Diego Medical Center. He also completed a hand, upper extremity and microvascular fellowship at the Indiana Hand Center in Indianapolis.