If you have any concerns, contact your neurosurgeon or the hospital and ask for the neurosurgical registrar on-call: Prince of Wales Hospital & Community Services 9382 2222 St George Hospital & Community Services 9113 1111 St George Private Hospital 9598 5385 or 9598 5386 St Vincent s Hospital 8382 1111 Wollongong Hospital 4222 5000 CARPAL TUNNEL A guide for patients and their family members. Developed by: Catherine Fulham, CNC Neurosurgery POWH and the SESIH Neurosurgical Nurses Network. CARPAL TUNNEL Median nerve Flexor tendons A guide for patients and their family members Transverse carpal ligament Tendon sheath Carpal bones
This information booklet is to assist patients and their family members prepare for surgery. This is a guide only and the information included can vary depending on your individual circumstances. If you still have any questions or concerns regarding this procedure after reading this guide, please discuss them with your neurosurgeon. NOTES 9
What is the carpal tunnel? The Carpal tunnel is a small tunnel in the area of the wrist. It is made up of bones and covered by a strong tough tissue. What is carpal tunnel syndrome? Carpal tunnel syndrome is caused when the carpal tunnel puts pressure on the median nerve as the nerve passes through the tunnel. How will I know if I have carpal tunnel syndrome? If you have Carpal Tunnel Syndrome: You may lose some or all feeling in your fingers. Your fingers may feel numb or tingle. You may have pain in your fingers, which at night can wake you from sleep. You may drop things because your hand is weak. What is carpal tunnel surgery? Carpal tunnel surgery involves making a cut down the middle of the palm of the hand. The tough tissue covering the carpal bones is then split. This reduces the pressure on the median nerve and helps to relieve your symptoms. 8 1
Before your admission Pre-operative clinic You may be required to attend a pre-operative clinic before your operation. What should I bring to the clinic? Any recent x-rays. Any recent blood tests or other test results. The names of any medications you are taking. Please bring them with you to the clinic. The staff at the preoperative clinic will ask you whether you would like an interpreter. This service is free of charge. Before the operation W ho will you meet? A doctor - Will talk to you about the operation. - Will ask you to sign a consent form, which says that you request the operation. - Will admit you, which means he/she will ask you about your illness and your general health. - Will talk to you about how to care for your hand after the operation. 2 7
When do I see my specialist? Make an appointment to see your specialist in weeks. Phone no Ask the nurse for the Doctors phone number if you don t have it. IMPORTANT See your local doctor OR Contact your local Hospital (see back page) and ask for the neurosurgical registrar if: There is bleeding from the wound. The wound is red, swollen, and warm. The wound smells, or leaks fluid. Your arm is still weak and numb 24 hours after the operation. A nurse - Will help you get ready for your operation. - Will ask you to put on a gown, take your blood pressure, heart rate and weight. - Will talk to you about your care after the operation. An anaesthetist (doctor) - Will talk to you about your anaesthetic After the operation You will return to the Perioperative unit. The nurse will take your blood pressure, heart rate, check your breathing and the sensation and movement of your hand. Your hand will be bandaged and may be elevated in a sling. Your arm may feel numb and weak. This may last for several hours. 6 You develop a temperature higher than 38 Celsius. The pain in your wound is getting worse not better. You have any questions or concerns. When can I go home? You may go home when you are fully awake and your blood pressure; heart rate and breathing are stable. A responsible adult, who is over 18 years of age can either drive you home or travel with you, must take you home. Please make sure that this person 3
will be at the hospital when you can leave, and that you and they have talked about how you will get home. Homecare It is important to: Stop your wrist and arm from becoming stiff by performing the hand exercises at the end of this booklet. Use your hand as normally as possible. Massage your scar after the stitches have been removed when the wound is completely healed and free of infection. How do I massage my scar? After surgery, the scar can become hard and stuck down. Rubbing cream into the scar will help stop this from happening. The scar may feel tender at first. Wash your hands. Using Vitamin E or Sorbolene cream, which you can buy at a chemist or supermarket. Massage the scar 6 times a day or approximately every 4 hours for 5 minutes each time. How can I manage my pain? Take the pain relief tablets as ordered by your doctor. Elevate your arm in a sling to lessen swelling - this should only be required for one day. How do I look after my wound? Remove the outer bandage after 24 hours. Keep the dressing dry and clean. Cover your hand with a plastic bag when you shower. See your local doctor 2-3 days after surgery. He/she will remove the dressing, look at the wound and put on a new dressing. See your local doctor to remove your stitches in 10 days. Rub the scar in a circular motion with the tip of your finger. You must use enough pressure to make the nail of the finger you are rubbing with go white. 4 5