Telephone Consultation Letter

Copy to: GP 1 November 2024 at 14:30 Sarah Johnson Hospital Number: SJ789012 Dear Sarah, This letter follows our telephone conversation which I will summarise below. I explained that we discussed your recent symptoms of tingling and numbness in your left arm and hand, which you have been experiencing intermittently over the past few weeks. You mentioned that these symptoms tend to worsen with certain activities, such as typing or prolonged computer use. We also talked about your medical history, specifically your previous carpal tunnel syndrome diagnosis on the right side, and how these new symptoms differ slightly in their presentation. The reason for our telephone call was to review the results of your recent nerve conduction studies and electromyography, which were performed last week. We aimed to determine the underlying cause of your current neurological symptoms and to formulate an appropriate management plan. During our discussion, I informed you that the nerve conduction studies show evidence of mild to moderate median nerve compression at the wrist on your left side, consistent with carpal tunnel syndrome. The electromyography did not reveal any significant signs of nerve damage or other neuropathic conditions. We explored the possibility of conservative management given the mild-to-moderate nature of the compression, and you expressed a preference to try non-surgical options first. Based on these findings, I advised you to continue with regular wrist splinting, particularly at night and during activities that exacerbate your symptoms. I also recommended trying a course of anti-inflammatory medication, such as ibuprofen, as needed for pain relief. We discussed occupational adjustments, suggesting frequent breaks during computer use and maintaining an ergonomic workspace. Additionally, I provided you with information on specific hand and wrist exercises that can help improve flexibility and reduce nerve irritation. We agreed that we would review your progress in approximately six weeks. I have scheduled a follow-up appointment for you at the clinic on 13 December 2024 at 10:00 AM. If your symptoms worsen significantly or if you develop new concerns before this appointment, please do not hesitate to contact my secretary to arrange an earlier review. Yours sincerely, Dr. Eleanor Vance, MBBS, FRCP Consultant Neurologist