Navigating a Lifetime with Carpal Tunnel Symptoms
As someone who has dealt with carpal tunnel syndrome since birth, I find myself in a unique situation. Though tests have returned negative results, an electromyography (EMG) has indicated otherwise. Medical professionals have recommended surgical intervention, cautioning that if I delay, I may eventually struggle with simple tasks like zipping and buttoning clothing. From a young age, specifically as early as second grade, teachers noted my symptoms, yet they haven't significantly worsened over the years. My experiences with these symptoms aren't constant; they mainly affect my functionality. I notice that my fingers lack speed and agility, and my grip strength is markedly below average—while most people manage around 90 pounds, I only muster about 30. While the sensations I feel in my hands are bothersome, they are manageable; a brief rest usually alleviates the discomfort. Overall, my main concern revolves around whether undergoing surgery would substantially enhance my strength and dexterity. Additionally, I wonder what the expected success rate for such a procedure might be. Before making any decisions about seeking a second opinion or continuing to live with my current limitations, I'm interested in hearing from those with knowledge and firsthand experience. Despite my dexterity and strength challenges, I have adapted by relying on a basic hunt-and-peck method for my daily tasks and work.
Answers (1)
3/27/2025, 2:00:52 PM
OpenHealth AI
It's important to recognize the significant impact carpal tunnel syndrome can have on your daily life and functionality, especially since you have been managing symptoms for such a long time. You’ve already shown great resilience, and understanding your options moving forward is crucial.
Explanation
Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist, leading to symptoms like numbness, tingling, weakness, and reduced dexterity in the hand. Since you've experienced symptoms since childhood and they have not worsened significantly, it could indicate that you've developed some adaptive strategies. However, the mention of potential surgical intervention suggests that your current limitations could become more pronounced over time, especially if everyday tasks are at risk.
The success rate for carpal tunnel release surgery, when indicated, is quite favorable. Many patients report significant improvements in symptoms such as pain relief and increased strength/dexterity after the procedure. It might not restore full function for everyone, but many do experience a positive change.
Next Steps
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Educate Yourself: Research what the surgery entails, including recovery times and possible outcomes. Understanding what to expect can help you feel more confident in your decision-making.
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Consult with a Specialist: Before progressing to surgery, it’s wise to seek a second opinion from a hand specialist who can assess your unique situation and discuss other treatment options. This will ensure all conservative approaches (like splinting, physical therapy, or ergonomic adjustments) have been adequately considered.
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Evaluate Your Daily Function: Consider keeping a journal of your symptoms and daily tasks to assess how they impact your life regularly. This will help you (and your doctor) understand the significance of your limitations and how surgery may help.
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Assess Goals: Reflect on what your personal goals are for your hand function. If improving grip strength and dexterity is a priority for you, surgery might be a more attractive option.
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Discuss with Others: If possible, talk to individuals who have undergone similar surgery. Hearing their experiences can provide personal insights that may help you make your decision.
Your concerns are valid, and taking the time to explore them thoroughly before making a decision is commendable. If you have further questions or need clarification on any medical terms, feel free to reach out.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.