Dialysis and Carpal Tunnel Surgery

Last Wednesday was another trolley ride, this time for a “Carpal Tunnel Release”.  Julie and I turned up at the appointed hour – 0630 – at Cabrini Hospital’s Outpatient Clinic ready for the day’s work.  Like all appointments related to doctors, the 0630 start was to ensure that I would be ready and waiting for their 8am start.  About 0715 a nurse came for me.  She told Julie it would be about 4 hours, so she could go home and they would call. Off I went through the No Admittance doors into the bowels of Outpatients, first answering identity and allergy questions, then changing into disposable undies, paper slippers, gown and robe.  I put my clothes and my book (who knows, I might have time to read when I wake up…) into a locker.

Then to an interview room the same questions (I like to know that they want to be sure, so I was happy to repeat everything).  I was labelled, had a pink band (no blood pressure, bloods, etc.) placed around my fistula arm, then onto a trolley to await the anaesthetist.  He asked questions, old and new, double-checked the answers and departed with “I’ll see you soon.”

About 15 minutes later I was wheeled to the operating theatre: up two floors and straight ahead.  I will never get used to being wheeled to theatre: watching the ceiling lights come and go, heading inexorably towards another roller coaster ride.

Being the first of “five Carpal tunnels” for the day, all the players were still arriving, but all were fresh and friendly.  The anaesthetist appeared and after a moment inserted a tube into a vein on the back of my hand and we were ready.  At 0805 the surgeon arrived. He double checked that the surgery was on my right wrist, that there was plenty of room between the Carpal Tunnel site and my fistula, and that the bandage would leave enough room for me to access the fistula later that day for dialysis.  Then the process began.

The only good bit of the whole deal is when they inject the anaesthetic and tell you to “You’ll be asleep in 20 seconds.”  I was to have a light anaesthetic, just enough “to calm my nerves”.  Ok…  Just to check, I started counting the seconds. I got to 20 and was still awake. First I thought “Hah, it takes more than 20 seconds!” then I thought “Hmm, maybe I counted too fast.”  Then I didn’t think anything. I wish it was that easy at home.

About half an hour later I started to wake up. My right arm was outstretched and much of my head was under a green sheet.  I looked through a crack and could vaguely see a couple of people working on my wrist.  I could feel some poking and pulling, then I lay back and thought of nothing again.

I remember being wheeled from the theatre and to the recovery ward.  I dozed for a few minutes, then began to wake up properly.  I had a drink of nice cold water, rested a while more, then I was guided off the trolley to a seat in the discharge area.

All was well, nothing hurt.  I was a little hungry, and the sandwich and cup of tea were very welcome.  The staff rang Julie, brought me my clothes and my book (I didn’t feel like reading).  I got dressed and walked back into the waiting room.  There was Julie, and home we went.  It was about 1130.

I was due to dialyse at 3pm, so I had some lunch and relaxed for a while.  Gradually I could feel my wrist and definitely some pain.  Eventually, the throbbing got the better of me and I took some of the strong painkillers the surgeon subscribed in my discharge pack.

Dialysis was OK.  I felt a little unwell and sore, but the needles went in Ok and the run was fine. I slept for a couple of hours and read for the rest of the time.  That night I was pretty sore and sorry, but with the painkillers, I mostly slept.

The next day was standard for me. For some reason, I always feel lousy the day after surgery.  Maybe the anaesthetic has gone from my system and I can feel the impact fully, or maybe it is a bit of shock. I don’t know, but I didn’t improve until after my second dialysis session. I slept for a couple of hours again and felt much better.

I was very impressed with Cabrini.  They phoned me the next day to check that I was Ok and to see if I needed anything.  I was in bed at the time, dozing, but I appreciated the call.  They said the pain was normal, to take my pain killers and that it would pass eventually.

It’s day three now, and I am pretty much recovered.  I spent the day back at work. My wrist hurts if I lift things or type too fast (joke), but otherwise, I’m on the mend.

With regard to the result, I have heard from several people that you can feel the benefit of a Carpal Tunnel release almost immediately.  While my fingers can move more easily, they still have that pins and needles feeling and are not yet normal.  However, people on dialysis don’t always get the full benefit because the cause may be damage to nerve linings or accumulations around the nerves, both due to the BigD.  Still every little helps, and my hand definitely feels better.

If you are considering Carpal Tunnel surgery, I can recommend (most of) it.

Picture next week, when the bandages are off.

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