I am a 60 yr old dentist and have cuts diagnosed by clinical exam and EMG's. I have significant muscle atropy of the intrinsic muscles of both hands and weakness in the hands. Due to sleeping with bent elbows, I have numbness upon getting up but it quickly goes away. EMG's show a bilateral 70% loss of ulner nerve function with most of the loss occuring at the elbows. I have little to no pain and never have. I have carpal and cubital surgery scheduled in one month but am very concerned over when I will be back to work. The surgeon says 3 weeks but that seems very optomistic. If I don't have the surgery I guess I could end up with a claw hand. Tuff decision. Any comments of suggestions. Thanks, David

Hi David,

I'm pretty new to the CuTS and Carpal world too. What type of cubicle tunnel surgery is your Dr. recommending?

There are a lot of people on this site who are back to work in four weeks. I think it really just depends on your Dr., the type of surgery you have, and how bad the damage is to start off with which will determine how fast you go back to work.

Have you tried any splits during the nighttime to keep your elbows and wrist straight?

Cindy

Cindy, Thanks for your reply. I use both wrist and elbow splints most nights but I don't sleep that well with them. They really help. Now if I don't use them, the numbness seems much worse. I guess my condition has progressed more the last few months.
The surgeon is planning to do the transpositional surgery but I asked him about the "in sito". He clearly felt the open approach was much better.
My surgeon is a well respected Neurosurgeon and seemed to feel this was basically a routine and easy surgery.

As it is now, I can continue to work and I really wanted to work for a few more years and considering on backing out of surgery but am afraid that might not be an option.
Thanks, David

Hi David,

My personal opinion is if your condition is progressing, in light of your continued conservative efforts, is to go ahead with surgery. This is coming from a person who is very conservative (I tried everything before opting surgery!) However, there comes a point when the nerve is too damaged in which it will never come back. The offce who did my surgery explained that nobody can predict when that day will be - when the damage is to much. It's kind of a gamble of how long is too long to wait. I think that if your doctor is sure what your problem is that it was better to get the surgery now in order to avoid risking any long-term permanent damage to your arms.

I feel bad for you that you are having problems sleeping with your splints. Do you have a hard elbow splint? Have you tried any of them homemade remedies for splints? Have you seen the YouTube video posted by Phyllis? She has some good recommendations for splinting.

Cindy

dsh263 wrote:
I am a 60 yr old dentist and have cuts diagnosed by clinical exam and EMG's. I have significant muscle atropy of the intrinsic muscles of both hands and weakness in the hands. Due to sleeping with bent elbows, I have numbness upon getting up but it quickly goes away. EMG's show a bilateral 70% loss of ulner nerve function with most of the loss occuring at the elbows. I have little to no pain and never have. I have carpal and cubital surgery scheduled in one month but am very concerned over when I will be back to work. The surgeon says 3 weeks but that seems very optomistic. If I don't have the surgery I guess I could end up with a claw hand. Tuff decision. Any comments of suggestions. Thanks, David

Howdy David!,

Sorry I missed your post and questions! From what you are describing, your surgeon is either going to transpose your nerve under fat (subcutaneous) or under muscle (submuscular). As a Dentist (general?) you *should* be able to go back to work comfortably in around 4-5 weeks. If he just decompresses your nerve, 3 weeks... The way mine progressed, the intrinsic muscles of my hand were badly affected, and I had atrophy in my arm. I got pretty much ALL of it back after physical therapy.

Yes sir, it *is* a tough decision, but let me put this bug in your ear (again, based on my own situation) if you can't say "cross" your fingers, you NEED to get intervention of some sort! That is a clue that you are "losing your hand" if you will! The surgery is not that bad believe it or not. I would NOT recommend doing both at the same time unless you have someone to ummm errr take care of private business if you know what I mean. <G>

Cindy is a zillion percent right on her suggestion of restricting your elbows as you sleep. The more you can do to take the stress off your elbows, the better. Please let us know what you decide and how it goes. Surgery will most likely let you continue as you wish as a Dentist. *HUG* Oh, and WELCOME to the site!!!!

Brenda

Cindy and Brenda, Thanks for your replies. Cindy, I will definitely check out the Utube video and maybe can improve the situation. One thing I wonder, if you decrease the stress on the nerve will it delay the progression?
Brenda, the information on crossing your fingers was very informative. I can't with my right hand but I can still cross my left fingers. I am glad to know that because from the EMG, the left was worse but apparently there has been more atropy on the right.
Actually I am an oral surgeon which may be a little may demanding as far as strength is concerned.
Another thing I am not sure about is that although most of my loss of ulner function is at the elbow, the surgeon wants to do the carpal tunnel at the same time. I can understand this from a recovery standpoint but am not sure why I need the CTS. I have not medial nerve involvement that I know of.
Thanks, David