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One-visit Treatment

Your plan of treatment:

Before the operation you need to improve condition of your skin on the hand. For this you can use moisturizing and nourishing hand cream.

Step 1

Online Consultation.

You send to us a photo of the arm and answers to the questions. We send you the plan of medical check and the treatment.

Step 2

Online Consultation.

Choose a convenient date. Visit to our clinic.

Step 3

The operation and the bandaging are conducted the next day.

If postoperative recovery is favourable supervision is possible to conduct domiciliary.


What is necessary for one-visit treatment?

With the help of modern technologies, the treatment of CTS is possible in a day.

For this you just need to send photos of hands via email handcenter@sogaz-clinic.ru or whatsapp (+7-996-766-76-08), describe your complains and answer our questions. Our specialists will study the information you provide and create an individual treatment plan.

For a diagnosis proof you will have to go through the check with EMG (electroneuromyography). This study will help to discover the place of pressure or nerve damage. EMG can be conducted at a neurologist in an ordinary clinic and send us the results. In conclusion the doctor who conducted EMG the level and the degree of the nerve damage should be indicated.


In the letter is it desirable to point out:

  • Surname, name, patronymic and date of birth.
  • Contact phone number and the city of living.
  • Do you have numbness in your wrist or do you loose feeling in your arm?
  • Do you have pain in the wrist, especially during night?
  • How long do you have the illness? Who made a diagnosis?
  • Did you have injections in your wrist? Duration of the effect after it.
  • Did you have operations before? If yes then where and when (it is recommended to send the copy of postoperational epicrisis and in the picture with an arm to highlight postoperational scar).
  • Was EMG conducted over you? If yes send the copy of conclusion.
  • Attach the photos of the arm with highlighted area of numbness and pain.

Examples of the arm photos

Examples of the arm photos and letter text:

«Dear Doctor!
1) My name is Ivanov Ivan Ivanovich. I am 45 years old. 

2) I live in Samara. Contact phone number is 8-931-323-32-32. 

3) I have periodical hand numbness for around 3 years. Left hand suffers the most. 

4) For the last two months I can see that my condition is worsening. I wake up during nights because of pain and numbness.

5) The diagnosis was made by the local surgeon at the clinic. 

6) Injections in the wrist were not made. 

7) Operations on hands were not conducted as well.

8) Went through EMG and ultrasound. 

9) Photo of the arm is attached to the letter. The area of numbness, ultrasound and EMG is highlighted».»

You have sent the photo of the arm, EMG and/or ultrasound results and answered questions. Now its our turn to act. Our specialists will send you the list of tests you can undergo domiciliary or in our clinic in the day of the operation. Possible dates of the operation will be agreed via email or phone.


Tests before the operation*?

  • Blood Cell Count (valid for 10 days).
  • Blood Biochemistry– glucose (valid for 10 days)*.
  • Risk factors – tests for hepatitis В, С; RW; HIV (valid for 3 months).
  • If you have chronic therapeutic diseases or older than 70 years, you will need the approval of your GP to conduct minimally-invasive ambulatory technique under the local anaesthesia.

Test results are better to be send in advance via email Handcenter@sogaz-clinic.ru

* In the case of tests changes the treatment plan can be corrected.
** Patients with the level of glucose over 10 will need correction at endocrinologist.

Food?

No food restrictions before or after operation.


How to prepare the hand to the operation?

Before the operation you need to improve condition of your skin on the hand. For this you can use moisturizing and nourishing hand cream.


How will it be happening at the clinic?

You have sent us the letter with answers to the questions, photos of your arm, results of ENG and ultrasound and you are now at the clinic. You will be welcomed by the administrator at the reception, the documents will be filled and the number of the consultation room will be named*. Next:

EXAMINATION BEFORE THE OPERATION

15-30 min

OPERATION

10-20 min

POSTOPERATIVE EXAMINATION

10-15 min

DISCHARGE FROM THE CLINIC

5-10 min


Examination before the operation.

Usually, the examination lasts for 30 minutes.
The aim of this examination is to inform you about the illness, possible variants of surgical treatment and possible postoperative complications. Furthermore, the surgeon will evaluate your state of health and will study results of the medical tests recommended during the online consultation.


What you should inform your doctor about:

Medicines you take.
If you take any medicines you need to inform your doctor.
Allergies.
Inform your doctor in case local anaesthetics (lidocaine, novocaine) or any other medicines give you allergic reactions.
Other illnesses.
You should inform your doctor about your health state, especially of you have diabetes (it is not a contra-indication for conducting the operation but requires special technique of conducting the operation). It is contraindication to the surgery if you have exacerbation of chronic diseases (ex. problems with heart, lungs, digestive tract, urinary system, nerve system and endocrine disorders). In addition to that, if you have viral and bacterial diseases in its acute stage including common cold or wounds or inflammations in the damaged area, surgery can’t be conducted as well.

What will be happening during the operation?

Surgery is conducted when the patient is lying, damaged arm is on the side table.

Arm is treated with antiseptics and the skin is anesthetized with local anaesthetic (lidocaine or ultracain). Anaesthetic injection is the only painful and unpleasant feeling you will have during the operation. However it is not more painful than an intramuscular shot. After this the surgeon will apply a tourniquet to exclude the bleeding.
After the anaesthetic works, the surgeon will make a small puncture in the wrist, through which he will dissect the carpal ligament pressed by the median nerve. All procedure is going on with the usage of ultrasound navigation. With the help of the new instrument, the carpal hook, the skin is minimally damaged, the operation time is reduced, which allows to avoid hospitalization.


Postoperative examination.

Usually the examination lasts for about 20 minutes. After the operation, the surgeon will invite you to the examination room where he will inform you about the specificity of the operation. In addition, the doctor will evaluate your general condition and give recommendations for the entire postoperative period. At the end of the conversation you will be given the reference in which it will be the information about the performed manipulations. Postoperative procedures (if necessary) will also be described in detail.


What you should do after the operation:

  • On the first day after the surgery, the restriction of physical activity is recommended. After 1-2 days, the operated hand can be used within the limits of household load (eating, dressing, personal hygiene, etc.). However, it is important not to wet or soil the dressing. It is necessary to protect your hand and do not overload it during the first 7-10 days.
  • The pain after surgery is usually insignificant, but in case it is getting worse, you can take any pain killer you have at home (Ketorol, Meloxicam, Ibuprofen, etc.). Usually we recommend taking ARCOXIA 60mg tablets (1 tablet 2 times per day if you have pain, duration 1-2 days).
  • You can also use ice and to put your arm to the higher position to prevent swelling and reduce pain. Do not use ice for more than 10-20 minutes during 1 hour (preferably 2-3 repetitions of the procedure per day).
  • Sometimes immobilization of an arm with an orthese or with a plastic bandage is required.
  • In the postoperative period, it is recommended to take Group B drugs (Neuromultivit, 1 tablet, 3 times per day, during 30 days).
  • Keep in mind that acute pain goes away immediately after surgery. Numbness can last up to a year. It depends on the duration and advance of the disease.
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