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Thread: carpal tunnel rehab

  1. #1

    carpal tunnel rehab

    I've been diagnosed with bilateral CTS and need surgery on both hands. The consensus is that this will require 4-6 weeks of inpatient rehab. I'm a non-ambulatory T11-L1 para. I will need to have two separate surgeries requiring a minimum of 3 months in rehab. Has any para had this surgery and done rehab at home? If so, what kind of assistance did you use; people, equipment, etc. If there is some way to avoid being away from home and family, I would like to try it.

  2. #2
    Bump. I need to make some difficult decisions soon.

  3. #3
    We almost always had the person come for inpatient rehab care, but that is going back a few years now. I am not sue if your insurance will cover rehab for the reason that you are needing it. That would be my first recommendation. Check with your insurance and see what they are obligated to pay for. Find out if they are willing to give you home care for the amount of time that you may need it. Include both nursing and therapy care in your request. Find out if they are willing to pay for rental equipment that may make it easier to stay at home.
    CKF

  4. #4
    The early indication is that my insurance will pay for inpatient, but this presents problems for me and the entire family. I'm trying to determine if anyone has done this rehab at home and the resources that were used to accomplish it. Was it successful? How did you manage transfers to the w/c, bed, john, shower? Did the incision hold up?

  5. #5
    Senior Member WM's Avatar
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    Hi tasty,

    My husband had CT surgery on both hands (at different times). He did not have any rehab at all. It was never suggested. He came home the day of the surgery and still transferred as normal but with my help. The doctor told him to be sure to not press down on his palm when he transferred, and to use his fist instead. He normally uses his fist anyway. Even so, he kept transferring down to a minimum. For one, it hurt to do it, and for two, trying to protect the incision. The incision did come apart some toward the time for him to get his stitches out, but it was healed on the inside by then. He did wear a glove and pad on the incision when moving about to try to protect it. When he had the first hand done he could still do his own bowel program, but when he had the second hand done, I had to do it for him because he has a huge curve in his spine and because of that can only reach to do his BP with the one hand. I was able to take care of him at home because other than doing the BP for him with the second hand, the only thing he required was more assistance like getting food, helping him dress, etc. Things that any sick person would require. So, if your surgery does not affect your ability to do your BP, I would think that family and friends should be able to help you out at home. Since he did not have any rehab at all, I can't advise you on that. Your situation may call for rehab. It was never suggested to him. He just proceeded as usual once his hands healed. The place where the incision was did bother him for a long time, but went away after a while. Nothing like the pain and numbness he went through before the surgery so worth it. I'm not suggesting no rehab for you though. Since it was advised, there must be a reason you need it. Every case is different. Good luck with it!
    "I just want you to know, it was the best time ever." J.F.F.

  6. #6
    For our CTS surgery patients, we nearly always keep them inpatient for the entire 6-8 weeks of recovery. Limitations will include absolutely no weight bearing on the involved hand for at least 6 weeks. This means no transfers without a lift, no pushing a manual wheelchair, no long or short sitting bearing weight on your hands, no self bowel care, etc. We have done both hands at once since the limitations are the same for one as they are for both.

    If you have sufficient family and attendant support to be dependent in virtually all your self care and mobility at home, and can get a power wheelchair and mechanical lift for all transfers and mobility for that time period you may be able to manage this at home. Most of our clients do not have that much support at home. I know people in the private sector who have had to stay in a nursing home until they can start their real rehab program (which can be inpatient or outpatient) with OT, which is usually delayed until the first 6 weeks of healing is completed.

    (KLD)

  7. #7
    Senior Member ChesBay's Avatar
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    I was diagnosed about 2 years ago and my doctor wanted me to have surgery. I still haven't had surgery, partially for the kinds of concerns you raise. I am sure each outcome and circumstance is the different.

    Here is a thread where I posted similar questions and the replies recieved.
    Wish you well.

    http://sci.rutgers.edu/forum/showthread.php?t=84281

  8. #8
    Senior Member WM's Avatar
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    KLD, I am interested in what rehab and OT involve for CT surgery. Since my husband did not have anything like that, I am just interested, not disputing the need for it. And not trying to hijack your thread tasty! Again, good luck! Hope it goes well for you!

    Quote Originally Posted by SCI-Nurse View Post
    For our CTS surgery patients, we nearly always keep them inpatient for the entire 6-8 weeks of recovery. Limitations will include absolutely no weight bearing on the involved hand for at least 6 weeks. This means no transfers without a lift, no pushing a manual wheelchair, no long or short sitting bearing weight on your hands, no self bowel care, etc. We have done both hands at once since the limitations are the same for one as they are for both.

    If you have sufficient family and attendant support to be dependent in virtually all your self care and mobility at home, and can get a power wheelchair and mechanical lift for all transfers and mobility for that time period you may be able to manage this at home. Most of our clients do not have that much support at home. I know people in the private sector who have had to stay in a nursing home until they can start their real rehab program (which can be inpatient or outpatient) with OT, which is usually delayed until the first 6 weeks of healing is completed.

    (KLD)
    "I just want you to know, it was the best time ever." J.F.F.

  9. #9
    Therapy for CTS surgery is a specialty by a hand therapist, usually an OT, but sometimes a PT. There are exercises to both strengthen the hands and arms after the forced rest, as well as teaching regarding techniques for ADLs, mobility, etc. that will avoid the person developing CTS again in the future (often unlearning bad habits) which can occur in people with SCI due to the way they use their hands. This is not something you would get or even be approved for admission to an inpatient acute comprehensive rehab program, although you might find an inpatient subacute (nursing home level) rehab program that has a hand specialist therapist (but this is rare). Mostly it is done outpatient.

    (KLD)

  10. #10
    Thanks for the responses. I'm dealing with the insurance to see what they will cover in regard to rehab. I'm also going to get a second opinion to determine if a less invasive procedure can be done. (I doubt it, but it's worth the effort.) The situation is what it is. If there is some way to do this at home, I'll give it a try. Another question: Can the repaired hand still be used to assist in the BP? How extensive is the bandaging? Will the rubber glove cover it? Will I still be able to manipulate my fingers? I've never used my L. hand for the BP, but I think I'll be able to get it done, if the R. is incapacitated. However, you don't know until you try. I guess the wise thing is to try it now before surgery.

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