Where to start. I guess by explaining what it is. The NHS website has this simple explanation:
Carpal tunnel syndrome (CTS) is pressure on a nerve in your wrist. It causes tingling, numbness and pain in your hand and fingers. You can often treat it yourself, but it can take months to get better.
But of course, things aren’t always that simple. It’s something that builds over time rather than appearing overnight, and for me, something that I didn’t really think about until it got much worse. For me much worse was last summer when I was waking up with numb hands, which was quite scary and concerning. At first shaking and flexing my hands would relieve the symptoms and I put it down to the weather, then a change in my medication and I thought it would improve. But when it didn’t, and it was taking longer to bring my hands back to life I realised it was bad enough to speak to my GP.
His initial instinct was that it was CTS, though at the time I was less convinced still thinking it was down to a change in my medication. However I went with his diagnosis - he’s the one that’s medically trained after all - and took up the offer of seeing the physio. She agreed with the doctor, and having experienced CTS herself, she told me it was curable either through exercises, a steroid injection or for worst cases an operation.
I left with daily exercises to do, information sheets and instructions to buy myself some splints to wear overnight to help keep the pressure off the nerve while I slept, and preventing waking up with numb hands. I still wasn’t convinced, but I had nothing to lose, and for the next couple of months or so I followed the routine.
And things did improve massively, so I was starting to think they were probably right. But while it was improving, it wasn’t better. I went for my follow-up physio appointment before Christmas and reported my progress. My next steps were to continue with the exercises, and reduce wearing the splints overnight to avoid becoming dependant on them. It all made sense, and I left with the advice from the physio to ‘not leave it too long’ if things didn’t continue to get better, or got worse.
Things didn’t really get better, and Christmas and life got in the way of the daily stretching exercises which were a little more sporadic than before. But even after resuming my previously regular routine in the New Year it was more on the side of getting worse, so I resolved to go back and see the physio. Before this though for about a fortnight I kept a log of when and what seemed to cause the tingling, which fingers on which hands etc, and while I probably didn’t get them all - remembering that I’d woken two or three times a night with tingling in fingers on my left or right - and sometimes both - hands was enough evidence for me to realise I needed to make that appointment.
While this was quite an OTT exercise, it was useful in that I learnt what types of activities set it off. And quite mundane activities at that - sleeping was the big one (and I wasn’t stopping doing that) but also smaller things like holding the toothbrush, putting on my make-up, holding a knife or fork (and I wasn’t giving up eating either), holding a needle for cross stitch or sewing crochet squares together, holding my phone and/or iPad (though the latter was eased with one of those bean bag mini cushions) and at times holding the steering wheel. So quite a wide range of everyday activities but thankfully being aware and knowing which of the exercises helped me most, the tingling was now more often short-lived, so that was something.
But it was still there.
I saw the physio again in the first week of February and she agreed that things had plateaued and she was also concerned about some muscle wastage under the thumb on my right hand. I’m not sure if this had worsened since my earlier visits as I don’t remember it being mentioned before, but it didn’t sound good.
Anyway, I was to be referred.
The next day the referral came though, and setting expectations it said the deadline for it to be reviewed was the second week of April, but I thought at least I am in the queue. Less than two weeks later, thanks to being able to take up a cancelled appointment offered at a day’s notice, I was being assessed by a consultant. He’d asked how long this had been happening and I’d since found the notes from my endocrinologist when my hyperactive thyroid and Graves Disease was diagnosed back in 2012 and I’d mentioned tingling in my fingers occasionally then, so was able to say ‘quite a while’. He asked what symptoms and mitigations I’d had/taken etc. etc. and I left with him saying that it was likely that more tests would be needed before confirming which course of treatment I’d need, and an appointment would follow.
So I was back in the queue, but at the next stage.
This all seemed fine, though I remember coming home and saying to MOH that I wasn’t sure the consultant 100% believed me, but I’d see what happens. To be fair there was nothing in his demeanour or manner that said outright that it wasn’t true or as serious, but well, you know how things are, sometimes it takes a couple of visits to the doctors to be heard, and it just felt like that.
What I wasn’t expecting was a phone call the same afternoon from the consultant saying that he’d reviewed my notes again, and on reflection he could refer me immediately to my local private hospital as an NHS patient, if I was ok with that. So that was quite out of the blue, and my perception of the earlier appointment was completely off the mark, no doubt he was considering the avalanche of information presented to him in a short time slot which must be hard for anyone to process and deliver an on the spot solution.
The next referral appointment was booked for the end of March, but for one reason or another it took place by phone a week ahead of that. That was a shock to me too, but during the conversation I learnt that my case had been marked urgent, and that an operation was likely to be the outcome. A face to face appointment was booked for the middle of April, which has now taken place.
Last week I saw the surgeon and we booked in an operation for the second week of June for my right hand, and once again I was able to benefit from another cancellation. I’m waiting for the specific details, but I know where the op will be and obviously have met the surgeon who’ll be performing what he assures me is a simple procedure. It takes place under a local anaesthetic, which while I’m not exactly looking forward to that, avoiding a general anaesthetic is always good. After the op I will need two weeks rest - so no driving - and it should take between six to nine months to heal completely.
Resting my right hand for two weeks sounds sensible but challenging, but it is what it is and I’m sure we’ll make things work. The challenge is getting to and from the hospital as it’s not a direct route on public transport and MOH doesn’t drive - but we’ll manage.
So it’s all been quite a whirlwind (relatively) and I seem to have benefitted greatly from cancellations. Of course, the symptoms are still there (in both hands) but I’m hoping for my right hand to make a full recovery as quickly as it can. And I’ve promised my surgeon that I’ll try to look less worried about the whole thing, which is easier said than done.