July 21, 2008
A Rush to Surgery for Carpal Tunnel is Unusual
DEAR DR. DONOHUE: I fell against an end table and broke my left arm almost at the shoulder. During my visits to the orthopedic doctor, I complained of tingling in my left hand. I continued to complain all during treatment, but no one listened.
On my last visit, the doctor suggested a test for carpal tunnel syndrome. The test was positive, and my doctor said surgery is necessary.
I have looked on the Internet and in several other places, and I have only tingling as a symptom - no pain or swelling.
Do you think the test results are correct? Should I go through with surgery? Should I get a second opinion? - D.S.
ANSWER: I believe you can trust the validity of the test, but I don't see why you have to rush to surgery. Carpal tunnel syndrome is a compression of a large wrist nerve as it passes through a tunnel of ligament and bone on its way from the forearm to the hand. Compression of the nerve brings on pain, numbness or tingling.
Anti-inflammatory medicines, like ibuprofen, taken for a week to 10 days often can relieve symptoms if a person can tolerate those medicines. A wrist splint is another way to get pressure off the nerve. Sometimes you need to wear the splint only at night, but in other cases it's a 24-hour necessity.
If medicines or the splint make no headway, the doctor can inject a cortisone drug to reduce pressure on the nerve.
If none of these measures work, then thoughts turn to surgical correction.
A second opinion is always a wise move.
DEAR DR. DONOHUE: My grandchildren have warts on both hands. What causes them? Someone said they're a vitamin deficiency. What is your opinion? We are applying wart remover, and it works after a while. What can we do to prevent them? - E.P.
ANSWER: The human papillomavirus causes warts. That's not an opinion; it's a fact. There's not a lot to do for prevention, but there is a lot available for treatment.
Over-the-counter preparations found in all drugstores often work well. Many of them contain salicylic acid. It comes as a gel, cream or liquid.
Sometimes ignoring them can be an accepted treatment. Most warts disappear on their own, but that can take some time.
If the warts don't yield to commercial remedies, a doctor can remove them in a number of ways. One popular way is freezing them.
DEAR DR. DONOHUE: When I was in my 20s, I had genital warts, and they were excised. No one told me they were contagious. In the ensuing 20 years, I had multiple partners. I feel like Typhoid Mary. I am not concerned about cervical cancer, because I had a total hysterectomy. Since age 41, I have been celibate. If I decide to marry (I am now 63), should I have my husband use a condom to protect him from infection? - C.T.
ANSWER: Genital warts are caused by papillomavirus - different strains from the ones causing hand warts. Some strains of papillomaviruses cause cervical cancer. At least half of the sexually active population has been infected with a papillomavirus at some time in their life. Most infected people clear the infection in two years. With no outbreaks in the past 40 years, it's unlikely you are still infected, and the need for a condom is not great.
The papillomavirus story is told in the booklet on genital warts and herpes infection. To obtain a copy, write: Dr. Donohue - No. 1202, Box 536475, Orlando, FL 32853-6475. Include a check or money order for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475. Readers may also order health newsletters from www.rbmamall.com
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