This is the 5th nerve conduction test I've typed up this week for patients who are all 80 or older. The ages are 80, 80, 85, 86, and 90. These patients, all but one, insist they're too old to have surgery, but the one 80-year-old patient's parents both lived until their mid 90s and her only medicines are as needed for arthritis. She wants to have carpal tunnel releases done so she can keep knitting and crocheting. That, to me, is a perfectly valid reason. I'd go crazy without my crafting after two months.
For the others, however, who are not going to have surgery: All of the four had very distinct symptoms of carpal tunnel syndrome. In other words, they need to shake out their hands if they sleep on them wrong. All had thenar wasting. All had decreased sensation in the median nerve distribution. All had the thumb, index finger, and middle finger affected. Hello, carpal tunnel syndrome.
Again, they insisted that they did not want anything done for the condition.
So, why did their physicians get the testing done?
Not only did they have nerve conduction testing done, but they also went with the extra step of an EMG, looking for evidence of cord compression, radiculopathy, etc.
Hello...if they weren't going to have carpal tunnel releases done, a relatively common and safe procedure, why waste the extra money for another more extensive surgery that they're not going to have done, either?
I tried to do a quick check about the cost of nerve testing and EMG testing, one side or both. Minimum figure for the nerve testing alone, both sides, was $800. Add it up, just for this week. This is a very regular occurrence.
If all the physical exam findings are there, for goodness' sake, just give the patients the wrist splints and send them home! If all this crap is just for documentation purposes...
Makes me want to scream.
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