Ship of Fools: Cyberchondria, Googly diagnosis and treatment

Thread: Cyberchondria, Googly diagnosis and treatment Board: Purgatory / Ship of Fools.

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Posted by no prophet's flag is set so... (# 15560) on :

Do you suffer from this ailment? Looking up every little thing health related on the internet. I have bouts of it. It makes for reassurance sometimes, but more often anxiety for me. Is it those who've had health disasters who tend to share more on the internet?

Posted by Brenda Clough (# 18061) on :

Health issues is just a subset of the vast ocean of knowledge now available to us. How to thread a sewing machine. Tools to change a spark plug. How to format footnotes to MLS format. The filioque clause, history and significance. How to divide bearded irises. All, all are available by searching, with copious discussion, informative videos and often news sites in which different techniques are bitterly contested and lead to flamewars.

So, no -- it is not that sick people pour it all out on the net, especially. Health is part of a huge flood. I hold that more knowledge is always better than less. Now you don't need someone to show you how to thread a bobbin; you can just google it up. And it is a writers' paradise; I can inflict horrid diseases upon characters, with fully accurate symptoms and sequelae, without having to chat up microbiologists in bars.

Posted by mdijon (# 8520) on :

quote:
Originally posted by Brenda Clough:
I can inflict horrid diseases upon characters, with fully accurate symptoms and sequelae, without having to chat up microbiologists in bars.

It sounds like the internet has even more collateral damage than I first suspected. Pity the benighted microbiologists, timidly emerging from darkened laboratories, lacking in outgoing elan and suave chat-up lines, who now lose their last outside-chance of meeting interesting and transforming female authors in bars.

Posted by Sioni Sais (# 5713) on :

Eldest Son, who has a biochemistry degree, might not know everything in that field but he can sort the wheat (ie the reputable, peer-reviewed materiel) from the chaff. It's best to find someone who knows their way around the subject because a lot of people post some dangerous crap in this and other areas.

Posted by Bishops Finger (# 5430) on :

Maybe, but the microbiologists can themselves resort to the internet chatrooms, dating sites etc. where they may still be able to meet interesting female authors.

As regards Googling one's health issues, I have Secondary Adrenal Insufficiency (SAI), and have found various websites both interesting and informative. It whiles away the time between infrequent hospital appointments, anyhow!

IJ

Posted by Ohher (# 18607) on :

quote:
Originally posted by mdijon:

quote:
Originally posted by Brenda Clough:
I can inflict horrid diseases upon characters, with fully accurate symptoms and sequelae, without having to chat up microbiologists in bars.
It sounds like the internet has even more collateral damage than I first suspected. Pity the benighted microbiologists, timidly emerging from darkened laboratories, lacking in outgoing elan and suave chat-up lines, who now lose their last outside-chance of meeting interesting and transforming female authors in bars.

We needn't assume that microbiologists are heterosexual or male, either. Nor that interesting authors must be female.

Posted by Amanda B. Reckondwythe (# 5521) on :

quote:
Originally posted by mdijon:
Pity the benighted microbiologists, timidly emerging from darkened laboratories, lacking in outgoing elan and suave chat-up lines, who now lose their last outside-chance of meeting interesting and transforming female authors in bars.

There's always church.

Posted by Sandemaniac (# 12829) on :

How apt that I googled Googly to get a link. Not easy to diagnose at all when bowled well.

AG

Posted by Dafyd (# 5549) on :

On health questions I feel the internet is like Borges's Library of Babel that contains every possible text. So it contains the correct catalogue of the library as well as every possible incorrect catalogue. The internet contains accurate helpful advice and every possible variety of inaccurate advice.

Posted by Bishops Finger (# 5430) on :

True. Discretion, and large pinches of salt, are required.

IJ

Posted by Nicolemr (# 28) on :

It's not a new problem. Back in the 1800s, in Jerome K Jerome's Three Men in a Boat, he writes about reading a medical dictionary and becoming convinced he had every ailment in the book. His doctor prescribed a good steak dinner, and to stop reading medical books.

Posted by Bishops Finger (# 5430) on :

JKJ actually found that there was one ailment - just one - that he didn't have, to wit, Housemaid's Knee. He felt quite cross about this at first, but decided to be unselfish about it, considering that he had Everything Else.

IJ

Posted by Nicolemr (# 28) on :

Ah yes, I had forgotten that.

Posted by Brenda Clough (# 18061) on :

I have a tendon issue in my hip, a long Latinate name which I have already forgotten. My doctor said that I could undergo a complex and time-consuming regimen of physical therapy, or Google it. I did, and immediately discovered the simple stretching exercise 9with YouTube video demonstrations) that my PT therapist would charge me $40 an hour to rehearse me in. Works fine and I am cured, as long as I keep up my stretchings.

No, there is no substitute for finding a boffin and pumping him in a bar. But, for the basics, you want to dig around on line first. Then you may approach your expert and ask him the questions you really need answered without waste of time. It is idle to ask a doctor, "How do I ensure that the hero doesn't die, but is bedridden for weeks?" Better to refine your question until you can demand straight out, "How long does it take a grown man to recover from having his throat cut with a straight razor in poor repair if it is 1871?"

Posted by mdijon (# 8520) on :

quote:
Originally posted by Ohher:
We needn't assume that microbiologists are heterosexual or male, either. Nor that interesting authors must be female.

No, but I did, I guess based on the specific instance at hand.

Posted by mdijon (# 8520) on :

quote:
Originally posted by Brenda Clough:
No, there is no substitute for finding a boffin and pumping him in a bar.

Probably works for the boffin too.

quote:
Originally posted by Brenda Clough:
...until you can demand straight out, "How long does it take a grown man to recover from having his throat cut with a straight razor in poor repair if it is 1871?"

I must say that whatever pumping I thought might be just round the corner I'd find that a sobering line in the conversation.

Posted by Bishops Finger (# 5430) on :

Only if you were having the conversation in 1871, surely? Modern medical techniques, and all that...

[Paranoid]

Posted by Brenda Clough (# 18061) on :

History of medicine is a subspecialty. (It is a problem, quizzing ordinary doctors.)

Posted by HCH (# 14313) on :

A similar thread could explore rumors about investments.

Posted by Ian Climacus (# 944) on :

I was put on anxiety medication and forgot to ask the pharmacist for the fact sheet, which includes side effects.

So I got home and googled the medication. In my highly anxious and moderately depressed state.

Forum upon forum about the evils of this medication and the *drug pushers* who inflict it on unwilling victims. It seemed as if Satan and his minions personally developed this treatment given the effects people reported. Finally searched for the manufacturer and found what I needed. Went to the pharmacist and spoke to them, who reassured me and told me to report back if I had side effects.

But I still think it is an overwhelming good thing we have it. Yes, confused and not-thinking-straight people may get led astray, but the good outweighs the bad in my view.

Posted by Brenda Clough (# 18061) on :

One no longer needs to painstakingly save the manual for the phone, the iron, the device. You can always google the manual up, in PDF form, from the manufacturer.
Nor do tedious and possibly useless debates have to be gone into, about whether there are peanuts in Chex cereal or whether shampoo is acidic. You don't have to know things any more, just how to ask.

Posted by mousethief (# 953) on :

There are even cartoons about it. (The "expensive" part is of course applicable to America, where we still live in the 19th century as regards availability of medical care. Sigh.)

Posted by Pigwidgeon (# 10192) on :

quote:
Originally posted by mousethief:
There are even cartoons about it. (The "expensive" part is of course applicable to America, where we still live in the 19th century as regards availability of medical care. Sigh.)

They forgot one of the pros: the internet doesn't make you take your clothes off.
[Biased]

Posted by no prophet's flag is set so... (# 15560) on :

quote:
Originally posted by Pigwidgeon:
They forgot one of the pros: the internet doesn't make you take your clothes off.

This is true, you take off your clothes if YOU want to on the internet. Man with three buttocks (Monty Python - script)

Posted by mousethief (# 953) on :

quote:
Originally posted by Pigwidgeon:

quote:
Originally posted by mousethief:
There are even cartoons about it. (The "expensive" part is of course applicable to America, where we still live in the 19th century as regards availability of medical care. Sigh.)
They forgot one of the pros: the internet doesn't make you take your clothes off.

Well, dating sites.

Posted by Golden Key (# 1468) on :

I have a bunch of health problems. If I need info, I usually start with WebMD.com, which IIRC is both written and vetted by doctors. Used to use About.com for basic info about conditions and perspective on having them. Their health/medical info has split off into VeryWell.com.

With a new med, I usually check for contraindications and side-effects. There are lots of both; docs and pharmacists don't always get things right; and I often have some of the rare-but-not-lethal side-effects.

It often takes docs a long time--if ever--to correctly diagnose a condition. Meanwhile, you have to live with it, so looking online can be a huge help. Just be sure to start with a couple of actual medical sites. Then you can move on to other people discussing their experiences with with the condition.

As far as developing hypochondria from what you read: I understand that's a normal stage for medical students.

Posted by mdijon (# 8520) on :

There were a couple of medical students I knew who had just about every disease they studied by the end of the lecture. But most people seem to get through that stage.

I really appreciate a novelist that gets the history of medicine right. The book "Cutting for stone" was completely ruined for me because of the ludicrous turns that the medical background took, a key part of the book. It's perfectly fair game to have a few improbable events (after all improbable things do happen) but somehow lumping together an early 20th century ship's doctor with a rural African Mission surgeon with a US transplant surgeon's career was too surreal for me to cope with.

If a book is magical realism from the start I'm fine with that, it's the apparent historical setting gone surreal that removes my enjoyment.

Posted by mdijon (# 8520) on :

quote:
Originally posted by Ian Climacus:
But I still think it is an overwhelming good thing we have it. Yes, confused and not-thinking-straight people may get led astray, but the good outweighs the bad in my view.

Yes. Anything else is a vote for paternalism and control of information, which generally ends badly.

Posted by Baptist Trainfan (# 15128) on :

Two dangers of cyberchondria that I have encountered:

1. Presuming to give the doctor one's diagnosis. Of course it's OK to say, "I wonder if it might be ..." but some people are much more assertive.

2. Being convinced that conventional medical practice is all a big conspiracy, that you have a rare condition that doctors deliberately ignore and demanding completely unproven (but expensive) wild-and-whacky treatments.

Having said that, I must tell you a story against myself. Some years ago I was diagnosed as having high cholesterol and prescribed statins. I made the mistake one morning of going onto the NHS website - hardly the most drama-laden site on the web! - to read about possible side-effects. As I read through them, I started feeling woozy and fainted - although not without managing to close the laptop first!

When I came round I heard my wife dialling for an ambulance. I asked her why. "Because you've had a stroke", she said. Although that's indeed what it looked like, I managed to convince her that I had only fainted - as has happened before when reading medical facts (don't ask me why). She didn't know whether to laugh or scold me!

By the way, I've had no side-effects at all!

Posted by mdijon (# 8520) on :

You might be interested in this account of side effects of statins originating from a nocebo effect (i.e. the opposite of placebo).

Posted by Baptist Trainfan (# 15128) on :

Very interesting - thanks!

Posted by Ian Climacus (# 944) on :

quote:
Originally posted by Baptist Trainfan:
Two dangers of cyberchondria that I have encountered:

1. Presuming to give the doctor one's diagnosis. Of course it's OK to say, "I wonder if it might be ..." but some people are much more assertive.

This is what worries me about the American(*) habit of allowing medication to be advertised. People decide they want Brand X to solve their problems and off they go. I have heard of people being asked by doctors what they want -- I hope that is not widespread.

(*) may be elsewhere too...I have not seen it.

Posted by mdijon (# 8520) on :

quote:
Originally posted by Ian Climacus:
I have heard of people being asked by doctors what they want -- I hope that is not widespread.

I'm guessing it must be - otherwise why would the companies spend their shareholders' cash on it?

Posted by North East Quine (# 13049) on :

I remember way back in the dark ages before the internet answered everything (1999). I had had a scan and a diagnosis of my (subsequently stillborn) unborn son's condition. Unfortunately the penny didn't drop that "your baby is a dwarf" was an actual medical thing and not just another was of saying "your baby is small for dates" until the following Saturday, at which point I had no-one medical to ask.

A desparate search through the public library and Waterstones ensued. The library card index showed that there were books on dwarf conifers, dwarf lop-eared rabbits and other assorted non-human dwarfs.

The only fact I knew about dwarfism was that the actor inside R2D2 had the condition. So that's where I started. In the Star Wars section. Which, as it turned out, was a good place to start, because Kenny Baker had a good life, was married, had children etc, and wasn't a scary example for the mother-of-a-dwarf-to-be.

But Google would have been so much better.

ETA One day I will write a black comedy about that pregnancy!

[ 20. June 2017, 11:51: Message edited by: North East Quine ]

Posted by Golden Key (# 1468) on :

{{{{{NEQ}}}}}

Clever to look up Kenny Baker!

Posted by Adeodatus (# 4992) on :

quote:
Originally posted by Baptist Trainfan:
2. Being convinced that conventional medical practice is all a big conspiracy, that you have a rare condition that doctors deliberately ignore and demanding completely unproven (but expensive) wild-and-whacky treatments.

I've known several people die because they did this. When I worked in healthcare, it was always an inward-groan moment when we were told the patient had been researching their condition on the internet. I guess about 20% of the time it was a good thing - we had an informed patient who co-operated intelligently in the treatment options open to them. Most of the time it meant we'd encounter some degree of cyberchondria or wackiness that would be tedious to work through. And rarely - but not that rarely - we'd find someone who believed, say, that a diet exclusively of curly kale would cure their condition, if and only if the person also gave up all reliance on "conventional" medicine.

You can argue, persuade, and even cajole, of course, but in the end the patient can't normally be forced to undergo the treatment you're offering. It was sad and desperately frustrating to see someone reject treatment that might have worked for them, in exchange for some utter nutjob nonsense that didn't stand a chance. And it made me very angry about snake-oil salespeople in general.

Posted by Huia (# 3473) on :

quote:
Originally posted by Ian Climacus:
[QUOTE]This is what worries me about the American(*) habit of allowing medication to be advertised. People decide they want Brand X to solve their problems and off they go. I have heard of people being asked by doctors what they want -- I hope that is not widespread.

(*) may be elsewhere too...I have not seen it.

NZ allows some advertising of medication, but as I don't watch TV and seldom read magazines I don't know how widespread it is.

Golden Key mentioned only using internet sites that were medically reviewed, or had some official standing, which is what I do also, having self-diagnosed with a tropical disease as a child [Hot and Hormonal]

(my mother laughed, then told me about the bloke who didn't have housemaid's knee). Having said that, a suggestion made to someone else on a message board recently has resolved the annoying problem of skin peeling alongside fingernails, so I don't discount advice given altogether.

Huia

Posted by cliffdweller (# 13338) on :

quote:
Originally posted by Huia:

Golden Key mentioned only using internet sites that were medically reviewed, or had some official standing, which is what I do also, having self-diagnosed with a tropical disease as a child (my mother laughed, then told me about the bloke who didn't have housemaid's knee). Having said that, a suggestion made to someone else on a message board recently has resolved the annoying problem of skin peeling alongside fingernails, so I don't discount advice given altogether.

Huia

It was actually a random, offhand comment by a Shipmate on this very board that led to self-diagnosis of my son's condition, one for which there is more awareness in the UK than in the US.

Posted by Lamb Chopped (# 5528) on :

I self-diagnosed after having my mother scare the crap out of me suggesting Marfan's. Google and a whole lot of research later, and it turned out to be garden variety Ehlers-Danlos (hypermobility type), which sucks but generally doesn't kill. A geneticist confirmed the diagnosis a few years later.

I'm just glad I can google to find out crap, since I'm more or less the go-to person in our community for "What the hell does this diagnosis mean?" But then, I went to grad school and I learned how to evaluate sources and avoid the bad ones. I wouldn't want to see a lot of my friends let loose with no help on the Internet to self diagnose--they'd get scared silly. I suppose the only remedy is to teach everybody how to evaluate sources and stay skeptical--but that's a tall order.

Posted by cliffdweller (# 13338) on :

Yes google is a mixed bag.

My daughter and SIL received a devastating diagnosis for my then-unborn granddaughter on a Friday afternoon of a rare and very serious heart defect. They were given a referral to a top prenatal cardiologist-- but, it was a Friday. We all spent the weekend googling the daylights out of that diagnosis. We certainly got better info from the cardiologist later the following week-- as well as a more refined diagnosis. But I was grateful for some online information, parent blogs and support groups to get thru those initial 4 or 5 days. It was also helpful when they did meet with the cardiologist to have some basic understanding of a very complex condition and come up with a list of questions

Posted by bib (# 13074) on :

I've seen my own GP consult Dr Google to find me some extra information on something [Big Grin]

Posted by Curiosity killed ... (# 11770) on :

Last time I had something major enough to require investigation the ultrasound lady told me what the problem was (no, she shouldn't have, but there were staff shortages and I and the other lady in the queue had been waiting an extra hour and a half with full bladders), and I googled. So when I had the follow up appointment with the GP I wandered in saying, I know what this is and I know what the options are, I'd rather not have the surgery if you're OK with that. Her expression was a bit concerned when I admitted to looking it up online, but relaxed when I accurately described the realistic treatments, because it made her job much easier and she didn't have to discuss surgery with someone not expecting it as an option.

Now, if I'd googled earlier I'd have saved myself possibly ten years of quite unpleasant discomfort and quite probably have had a less invasive surgical option available (I'm not sure if this surgery was available ten years before.)

The consultant told us to look at the help boards for Hypermobility when my daughter (and I, by genetic inference) was (were) diagnosed with Ehlers-Danlos Syndrome (Hypermobility) (hEDs), but not to Google Ehlers-Danlos because there are other versions which are serious.

Posted by Jane R (# 331) on :

mdijon:

quote:
Pity the benighted microbiologists, timidly emerging from darkened laboratories, lacking in outgoing elan and suave chat-up lines, who now lose their last outside-chance of meeting interesting and transforming female authors in bars.

Brenda: you don't just have to know 'how to ask', you also have to know how to evaluate the trustworthiness of the sources you find.

This is now in the National Curriculum (for England and Wales, Scotland and Northern Ireland have different educational systems) which means younger people (those who were paying attention in class) are equipped with the skills to find out what politicians are really talking about when they use words like Marxism.

I shall pause here, to allow everyone to enjoy the spectacle of Nigel Farrago encouraging the nation's youth to go and read Karl Marx.

Posted by Leorning Cniht (# 17564) on :

quote:
Originally posted by Ian Climacus:
I have heard of people being asked by doctors what they want -- I hope that is not widespread.

Mrs. C had a bizarre conversation with her doctor not long after we moved to the US. I can't even remember what it was about (nothing terribly serious), but Mrs. C was waiting for the doctor to tell her what the best course of action was, and the doctor was busy saying "we could do this. Or we could do this."

It took her quite some effort to get the doctor to produce an actual opinion on the best course of action, rather than a menu of choices.

Posted by Brenda Clough (# 18061) on :

Googling, within my lifetime, has now begun to almost approach the usefulness of poking around in a well-catalogued library, or sitting with a boffin in a bar. The trick is not only to know what to ask (and how to evaluate the answer you get). A very important secondary feature is serendipity -- the sudden mention of some angle that had never occurred to you. (You do this in libraries by looking at all the books on the shelf that you are interested in.) A scientist with a couple of beers in him will be chatty, and the conversation will take a left turn into thrilling new territory. You can't quite yet get Google to do this.

Posted by Jane R (# 331) on :

<to Brenda> Yes, you can't always get the information you want from interviewing a human being either... I remember one of my lecturers at library school gave the example of a conversation about pesticide residues in artichokes that he overheard which caused him to resolve never to eat a non-organic artichoke again. He'd never even thought about the issue before, so if he hadn't overheard two other people talking about it he would never have known (of course, being a librarian he went away to check their information was accurate before giving up regular artichokes).

So there's information you have; information you know you need to find out; information that people you consult might give you if they think you'd find it useful; and information that you actually need but would never think to ask for.

Serendipity is a wonderful thing.

Posted by Lamb Chopped (# 5528) on :

quote:
Originally posted by Brenda Clough:
Googling, within my lifetime, has now begun to almost approach the usefulness of poking around in a well-catalogued library, or sitting with a boffin in a bar. The trick is not only to know what to ask (and how to evaluate the answer you get). A very important secondary feature is serendipity -- the sudden mention of some angle that had never occurred to you. (You do this in libraries by looking at all the books on the shelf that you are interested in.) A scientist with a couple of beers in him will be chatty, and the conversation will take a left turn into thrilling new territory. You can't quite yet get Google to do this.

Actually, you sort of can. Do your basic Google so you have the background, baseline data--but then go back and retype your search, putting in your search terms one at a time and checking to see what random things auto-complete comes up with. This has often steered me in wild and wonderful directions I never would have thought of. To be sure, "here be dragons" and have your bullshit meter calibrated.

Posted by mdijon (# 8520) on :

quote:
Originally posted by Leorning Cniht:
It took her quite some effort to get the doctor to produce an actual opinion on the best course of action, rather than a menu of choices.

Interesting feedback. Most medical teaching now, based on lots of patient feedback, is that people prefer to be presented with options, particularly when there isn't an obvious right answer. Often these options depend on how one feels about risk, how one balances disability against long life, and what side effects one is prepared to tolerate. Obviously it doesn't work for everyone though.

Posted by Lamb Chopped (# 5528) on :

Yeah, but what's frustrating is when you know,
and they know,
and you know that they know that you know,
that only one of the pair of you in the room has anything like an informed opinion--

and that person refuses to spit it out.

I've been forced to say rather rudely, "Well, you're the doctor, what do YOU think..." whereupon they finally (wo)man up and spit out what they think we ought to do.

How can I have an opinion on something I don't know diddlysquat about?

(don't answer that, legions of voters have shown me already)

Posted by cliffdweller (# 13338) on :

I'm with Lamb. It's the flip side of our sharp slide in valuing the expert opinion-- the false equivalency of "all opinions are equally valid". For the patient it's the suggestion that they would know as much as someone with decades of training. For the medical professional, it's an unwillingness to take on the risk of making even an expert opinion that may turn out to be wrong, so passing that risk on to a vulnerable patient with far less resources for making that call.

There's definitely a happy medium. One can go over the options, listing the pros and cons of each, but still finish up with an expert recommendation-- "this is the one I would choose & why"-- while still giving the patient the autonomy we crave. But to hold back that expert opinion seems to me to be a cowardly dereliction of duty.

Posted by Jane R (# 331) on :

It's not a new idea though; as mdijon pointed out earlier, the idea that patients should have control over what happens to their own bodies and must consent to treatment is a cornerstone of medical ethics.

Explaining all the options available and asking the patient to choose is just the latest way of doing this.

Posted by cliffdweller (# 13338) on :

quote:
Originally posted by Jane R:
It's not a new idea though; as mdijon pointed out earlier, the idea that patients should have control over what happens to their own bodies and must consent to treatment is a cornerstone of medical ethics.

Explaining all the options available and asking the patient to choose is just the latest way of doing this.

Sure, but some medical professionals are better st this than others. There's a reason why they get the big bucks. If all they're going to do is offer a bewildering array of options without giving any professional recommendation they're no more useful than Dr Google

Posted by Jane R (# 331) on :

True. I believe medical schools are now providing courses on communicating with patients... which is great until you run up against a language barrier. My Other Half recently suffered an injury whilst working (temporarily) in France. He managed to understand most of what the doctor said (especially the important bit, that his arm wasn't broken), but failed to realise that he'd been given a prescription for heavy-duty painkillers until he got home and I translated the paperwork from the French hospital for him...

[ 06. July 2017, 10:42: Message edited by: Jane R ]

Posted by mdijon (# 8520) on :

Some aspects of the decision aren't to do with expert opinion, but to do with values. And here the doctor really needs to hear the values of the patient.

For instance, take an elderly patient, somewhat prone to falling and housebound, but with an irregular heart beat that carries a risk of stroke. The risk of stroke can be dealt with by warfarin, by aspirin, or by nothing.

Warfarin is best able to reduce the risk, but carries the greatest risk of bleeding complications, and requires frequent blood tests.

The doctor can't decide on the best course of action without knowing how badly the patient detests being carted out of the house, how the patient values risk of death versus risk of disability, whether the patient fears bleeding more than stroke for emotional reasons, and how the patient feels about risk in general.

Answers to those questions are very context specific. The doctor can't simply ask the patient for a scale of 1 to 10 on each then make a decision.

In old paternalistic days the doctor would have just decided since they know best, but if the patient can absorb the information then once they have grasped the risks they know everything the doctor knows. The difficult part of the decision is the trade-off of very different kinds of risks and the patient is the expert in how they feel about that.

Posted by Jane R (# 331) on :

Yes, and there may be practical reasons for preferring one course of action over another. I refused an operation for my carpal tunnel syndrome on the grounds that the recovery time was too long. I might have been more enthusiastic if the doctor had been able to guarantee an improvement in the symptoms... but she couldn't. So we went with the second option of physiotherapy and painkillers, which improved it well enough. And I didn't have to spend weeks off work trying to do everything one-handed.

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