Carpal Tunnel Release

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before Surgery:
• You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
• Your doctor will tell you whether you need to have blood drawn.
• The Night Before Surgery:
• Your physician may suggest you take a sleeping pill.
• Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.
• Call Your Doctor If...
• You have a cold or flu or are running a high temperature. The operation may need to be postponed.
• The problems for which you are having the operation get any worse.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: The doctor will check this picture of your lungs and heart to make sure they can handle the stress of surgery.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Anesthesia: You'll need a pain-killer during the operation. For this type of surgery, the following options are available:
• General Anesthesia: This alternative puts you completely to sleep throughout the operation. The anesthetic is given either as a liquid in your IV or as a gas through a face mask or endotracheal (END-o-TRA-kee-ull) tube placed in your mouth and throat.
• Local Anesthesia: This is simply a pain-killing injection at the site of the operation. You'll remain awake, and may feel some painless pressure or pushing.
• Intravenous Regional Anesthesia: This approach can be used on an arm or leg. A pressure cuff is first put on the limb, then painkillers are given through an IV. The cuff keeps the medication in the affected limb.

After Surgery:

• Oxygen: After the operation, your body may need extra oxygen. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• Deep Breathing and Coughing: These exercises help prevent a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
• Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Incentive spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Drains: If the operation is performed through an open incision, thin rubber tubes may be put into the area around the surgery to drain off excess fluid. They will be taken out when no longer needed.
• Medicines:
• Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
• Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take it at the same time as your pain medicine, which sometimes upsets the stomach.
• Anti-Inflammatory Medicines: These medications, including steroids such as cortisone shots, will help reduce swelling and redness at the site of the surgery.
• Vitamin B:si6:ks : This vitamin can relieve pain and numbness.

After You Leave

• For pain or swelling, you may put ice in a plastic bag, cover it with a towel, and place it over the incision for 15 to 20 minutes out of every hour as long as necessary. Do not sleep on the ice pack. Treatment with ice is most effective when started right after the operation and used for 24 to 48 hours.
• After the first 24 to 48 hours you may use heat for pain or swelling. Apply a heating pad (turned on low) or a hot water bottle, or soak your arm in a warm water bath for 15 to 20 minutes out of every hour as long as you need relief. Do not sleep on the heating pad or hot water bottle. Heat brings blood to the area of the operation and helps it heal faster.
• When you are allowed to bathe or shower, carefully wash your stitches with soap and water, then put on a clean, new bandage. Change the bandage any time it gets wet or dirty.
• Rest your hand for 2 weeks after surgery. Then ask your doctor about exercises to strengthen the hand.
• Eat healthy meals from all 5 food groups: fruits, vegetables, breads, dairy products, and meat. This will increase your energy level and promote faster healing.
• Unless instructed otherwise, drink 6 to 8 large glasses of liquid, such as water, juices, and milk, each day. Limit caffeinated beverages, such as coffee, tea, and soda.
• Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• To keep from getting carpal tunnel syndrome in your other hand once you return to work:
• • Take a break every hour. Rub your wrist or shake and dangle your arms for a few minutes.
  • Wear a brace to support your wrist if your doctor recommends it.
  • Look into getting an ergonomic keyboard if you do a great deal of work on a computer. These keyboards are designed especially to prevent carpal tunnel syndrome.

Call Your Doctor If...

• Your incision is swollen and red, or you see any pus. These are signs of infection.
• Your stitches come apart.
• Your bandage becomes soaked with blood.
• You develop a high temperature.
• You get itchy, swollen skin or a rash. You may be allergic to your medicine.