CARPAL TUNNEL SYNDROME
This is a condition where a ligament protecting the peripheral nerve going into your hand (carpal tunnel) has become thickened, causing entrapment or compression of the nerve. This may cause pain, numbness and tingling of the hand and fingers. This condition is often found in people who do repetitive hand motions such as typing, using tools, working on an assembly line, etc.
WHAT IS THE PROCEDURE?
Surgery involves putting you to sleep under general anesthesia. An incision will be made from mid palm to your wrist. The ligament entrapping the nerve will be clipped. Your incision will be closed with skin sutures and a sterile dressing will be applied. Your surgery will be scheduled in the morning time and should last less than half an hour. After surgery, you will be transferred to the recovery room until discharge.
Your admission will be registered with the hospital by our office. We will contact your insurance company for precertification requirements. You will be responsible for inquiring whether or not a second surgical opinion is required by your insurance.
The evening before your surgery – Do not eat or drink anything after 10:00pm. This includes gum, mints, cigarettes, and your morning coffee. The anesthesiologist will not administer anesthesia if you have had anything by mouth after midnight, and your surgery will have to be postponed. If you are on any blood thinners, steroids or NSAIDS (aspirin, Coumadin, ibuprofen, Aleve, BC, Goody powders, etc), these must be discontinued one week prior to surgery. Steroids must be discontinued in tapering doses. You also need to stop taking over the counter vitamins and supplements one week prior to surgery. If you are not sure about your medication, please contact our office. Please notify our office if your medical condition has changed since your last office visit, or if you develop a fever, rash, vomiting, diarrhea or productive cough.
The morning of your surgery – Do not eat or drink anything! Do not wear make-up, contact lenses, hair pins, etc. Leave all jewelry and valuables at home. Please remove any body piercings and dark fingernail polish. Arrive promptly at your scheduled time. If you are late, your surgery may have to be cancelled or delayed. Bring your daily medications with you or bring a list that includes the names of the medication, dosage and when you take them. If you have a living will, please bring a copy to go with your chart. You will be given a hospital gown to change into, however, after surgery you may change into your own pajamas or clothes.
Each patient undergoing a surgical procedure is required to have preoperative blood work, including an HIV screen and a hepatitis panel, drawn before surgery. This must be done at least one week before surgery, but no greater than two weeks. Please call Brookwood PAT at (205) 877-1980 to schedule your pre-admit testing if you have not been given an appointment time and date already. You will need to bring your driver’s license and insurance cards to your appointment.
After your surgery is finished, you will be moved to the recovery room inside the surgical area. Your stay in recovery will be approximately one hour. During this time, you will be closely monitored by nurses and anesthesia staff. Friends and family are not allowed to visit in the recovery room. You will be allowed to eat small snacks and drink fluids. After you are awake, stable and have used the restroom, you may be discharged home.
You will have an incision that is closed with skin sutures and you will have a dressing fully covering it. You should avoid getting the dressing wet, therefore, sponge bathe or otherwise wrap your hand well with plastic while bathing until you come back to the office for your follow-up appointment. Your incision should remain covered. If the original dressing should come off, or if your skin becomes irritated from the tape, apply a new dressing. The dressing and sutures will be removed at your office visit approximately two weeks after surgery. After your sutures are removed, you may get your incision wet. Your incision will no longer have a dressing on it after this visit. It is normal for your incision to be sensitive for a few days. If you notice any excessive redness, discharge or have a fever greater than 102°, please contact the office.
LEAVING THE HOSPITAL
Upon discharge from the hospital you will be given instructions on activities and restrictions for the following week. You must call the office at (205) 949-1800 to set up your appointment to have your sutures removed 12 to 14 days from surgery if you have not been given an appointment already. Prescriptions for pain medication and antibiotics will also be given to you upon discharge. You need to make arrangements for transportation home, as you will not be allowed to drive yourself.
Although the nerve compression has been corrected with surgery, it will take time for the nerve to heal, and the tissue around the area will go through a healing process. Therefore, you may experience symptoms very similar to your preoperative condition. After suture removal, you may soak your hand in warm water for 15 to 20 minutes up to four times per day and begin exercising your hand by squeezing a small rubber ball. Numbness is usually the last symptom to resolve. Generally, most of your pain should resolve over a period of about four weeks. If you continue to have problems postoperatively, you may be prescribed a form of conservative treatment such as steroids or physical therapy.
RETURN TO DAILY ACTIVITIES
Use the following as a guideline:
- Driving. Avoid driving if at all possible while you still have your sutures. You must absolutely avoid driving a manual transmission for four weeks after surgery.
- Working. If your job involves manual labor, you should not plan to return to work for four to six weeks following surgery. At your return office visit, the doctor will assess you and determine at what point you may return to work. If you have a predominantly sedentary job, you can plan to return to work, most likely part time, after two to three weeks. Caution and common sense should be used to determine whether or not you should engage in any activity.
PRE AND POSTOPERATIVE QUESTIONS
If you have further questions regarding your scheduled procedure, please contact our office Monday through Thursday between 8:00am and 4:00pm.
If you experience any signs or symptoms which cause you concern, please contact our office at (205) 949-1800 during office hours. After-hours calls will be directed to the answering service. This document should be used as a general information guide only and should not be used in lieu of medical treatment. As individual conditions vary, always contact your doctor regarding your health care.