Exceptional Patient No.3

ST consults an orthopedic surgeon in a private medical clinic in the Montreal region for carpal tunnel syndrome. The surgeon examines the wrist briefly and takes a look at his EMG results, before confirming that a surgery is necessary. The consultation lasts for about 10 minutes.

The day of the surgery, he is informed that he will be operated on by another doctor because his surgeon no longer works at the clinic. This new doctor does not examine or ask the patient about his symptoms and proceeds to do an open carpal tunnel release of the right wrist, in very rudimentary sterile conditions, which surprises ST. ST describes feeling an electric shock during the procedure, but the surgeon reassures him that everything is normal. He leaves the clinic that day with a scheduled follow-up in 10 days.

At his postoperative follow-up appointment, ST informs the nurse who removes the stitches that his symptoms have worsened. He has more pain and electric shocks. The nurse assures him that these will improve. His surgeon was not on site and therefore could not assess ST’s condition.

A few weeks later, his condition worsens, and he calls the clinic to see the doctor again. The doctor was not available. He decided to consult Exception MD. His initial assessment took 45 minutes and revealed that his right carpal tunnel was still blocked, and electrical tests showed that the condition of the median nerve in his right wrist had deteriorated. In addition, a complete examination of his left upper extremity shows carpal tunnel syndrome and compression of the same nerve higher up in the elbow. The phenomenon of double compression of the nerve (like a garden hose in the garden is rarely blocked in one place), is very common and should be investigated for optimal results.

ST was then operated on for an endoscopic revision of the right carpal tunnel, an endoscopic decompression of the left carpal tunnel and a decompression of the left lacertus (at the elbow), in one session, under Walant-type local anesthesia (without tourniquet on the arm). He is delighted with the result and regrets having had the first surgery elsewhere.