How to prepare for carpal tunnel surgery & recovery: a patient's perspective

Me, post op. Best animal crackers I ever had!

How did I get here?

Me, stressing those medial and ulnar nerves

Do online research to generate questions, not for answers

This guy’s video inspired me to write this blog post

Picking a physician

My surgeon

Questions you can ask your doctor

  1. What surgical procedures am I getting done?
  2. How many of these surgical procedures have you done in your career?
  3. How many of these procedures do you do per week?
  4. What is your success rate with these procedures?
  5. When a surgery isn't a success, what are some typical outcomes? How to remedy them?
  6. How many surgeries do you typically do in a day? Do you do them in parallel, or one at a time?
  7. What painkillers will you prescribe? When do you anticipate that I will be able to shift to over-the-counter painkillers? What about alternative painkillers like CBD?
  8. What surgery center will you work perform the operation at? How often do you work there? What is their address, phone, and email?
  9. What anesthesiologist will you work with? How often do you work with them? What is their address, phone, and email?
  10. After surgery, what physical therapist will I work with? When will that start? What is their address, phone, and email?
  11. Before surgery, will you mark the arm to be operated on and the incisions to make? Will this be before the IV is inserted?
  12. Will I have a nerve block during surgery, and if so, how long after surgery should I anticipate that block wearing off and me starting on painkillers?
  13. Can we schedule the follow up appointments now, before I go into surgery?
  14. My phone blocks unknown callers. Could you please share with me the phone number that or their assistant will be calling from I can ensure that it is not blocked?
  15. After surgery, what finger mobilization should I do to promote healing?
  16. Who do you recommend that I use for physical therapy? A few choices would be good so I can ensure that I find somebody in network.
  17. When should I schedule my first physical therapy appointment? Can I book that before surgery?
  18. How long should I keep the sling on?
  19. How long should I keep the splint on?
  20. When will I be able to type?
  21. When can I remove the bandage from the I.V.?
  22. How long should I do ice for?
  23. How long should I keep my arm elevated?
  24. Is there a time when I can start to safely drink coffee again?
  25. When is it OK to drink alcohol in moderation, along the lines of a glass of wine with dinner?
  26. How many people in your not office have not been vaccinated against Covid?
  27. How many people in the surgical center have not been vaccinated against Covid?
  28. What are your covid vaccination requirements for patients?
  29. What are your covid vaccination requirements for caregivers who drop off and pick up patients?
  30. Where can my caregiver park when they’re dropping me off for surgery? Can they stay at the facility during surgery?
  31. After surgery, will I be in a wheelchair to my caregiver’s car? How far is the trip to their car? Is it covered in case of rain or snow?
  32. What is my current grip strength in both hands? (You’ll want to know this to measure your recovery progress after surgery.)

Big things to line up beforehand

Confirming insurance: CPT codes

Confirming insurance: NPI numbers

Confirming insurance: building a paper trail

Confirming insurance: what you actually pay

Insurance coverage questions

  1. What surgical procedures am I definitely getting done? What are their CPT codes?
  2. What surgical procedures am I possibly getting done? What are their CPT codes?
  3. What physical therapy activities will I need post-therapy? What are their CPT codes?
  4. What is the NPI number, taxpayer ID number, billing phone number, and billing email of the surgeon that I am using?
  5. What is the NPI number, taxpayer ID number, billing phone number, and billing email of the surgery center that I am using?
  6. What is the NPI number, taxpayer ID number, billing phone number, and billing email of the anesthesiologist that I am using?
  7. What is the NPI number, taxpayer ID number, billing phone number, and billing email of the physical therapist that I am using?
  8. Are these NPI numbers in-network for my insurance plan?
  9. Are these CPT codes covered by my insurance plan?
  10. Do I have authorization for all possible CPT codes, performed by the NPI numbers and taxpayer ID numbers of my surgeon, anesthesiologist, surgery center, and physical therapist? What is the authorization number and authorization date?
  11. What is my unused deductible?
  12. Can I use my FSA to pay this unused deductible?
  13. What amount will be billed by the surgeon, surgery center, and anesthesiologist to the insurance company? What portion of this will the insurance company cover, and what portion of that is coinsurance to be paid by me?

Preparing yourself and your home

Pain management

https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
  • midnight: Motrin/ibuprofen
  • 4 am: Tylenol/acetaminophen
  • 8 am: ibuprofen
  • noon: Motrin
  • 4 pm: Tylenol
  • 8 pm: Motrin

Build a project plan

The fact that this is a best seller means you need to take surgical project management into your own hands

Week before surgery

Day of surgery

Unintentionally morbid message to read before surgery…

After surgery: day one

After surgery: day two

After surgery: day three

My arm, all bundled up

After surgery: day four

After surgery: day five

After surgery: day six

After surgery: day 13

After surgery: day 22

Hot pad
Cover for hot pad
Theraputty, tan, xx-soft

After surgery: day 23

After surgery: day 24

After surgery: day 25

Graduation: day 99

Complex Regional Pain Syndrome

Tendonitis

Back in the saddle

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Occasional thoughts on tech, sailing, and San Francisco

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Al Sargent

Al Sargent

Occasional thoughts on tech, sailing, and San Francisco

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