Full Transcript Show Introduction and Guest Welcome 0:00 Welcome to the coalition. 0:02 This is a talk show dedicated to discussing health, wellness 0:06 and inspiration. 0:07 I'm your host, Doctor Shani Belgrave. 0:11 Hello, everyone. 0:13 Thank you so much for joining the coalition. 0:16 I'm your host, Doctor Shani Belgrave. 0:18 I am a bariatric and minimally invasive surgeon in Atlanta, Georgia. 0:23 I'm also the founder and CEO of Omega Bariatric and Wellness. 0:27 You can learn more about me and get connected at that 0:31 doctor shiny belgrave.com. I am related to. 0:34 Welcome to the show today. 0:35 Doctor Opeyemi Lami Kamara. 0:38 Doctor Lami Kamara is an orthopedic surgeon with a specialty in hand surgery. 0:43 She joins the show today to let us know the key things 0:45 we should know about our hands. 0:48 Doctor Opeyemi Lami 0:50 Kamara thank you so much for joining the coalition. 0:53 Hi doctor Belgrave how are you. 0:56 I'm good I'm good. 0:57 And so I am so excited to jump right in because a hand surgeon 1:02 you know I think there's a lot of people that may not know all the intricacies 1:05 and things about why hand surgery is important. 1:09 So can you please 1:10 get us started by telling us a little bit about who you are and what you do? 1:14 Absolutely. Well, I'm Doctor Obi. 1:17 I mean, let me Canara. I'm an orthopedic surgeon. 1:19 So what that means is that I specialize in bones, muscles, 1:23 and kind of the soft tissues and the area of the hand versus an elbow. 1:28 I'm here in Atlanta, Georgia. 1:30 I've been here since 2016, over nine years in practice. 1:35 And, I just started my practice to, 1:39 it's current surgery in orthopedics. 1:42 So currently in Vining, care space. 1:45 And then I'll be at, Sandy Springs, the end of the year. 1:50 Wow. Well, we definitely have a parallel journey.
Doctor Kamara's Background and Practice 1:53 You can a sweet sandy spring location kind of thing. Yes. 1:58 Patients. 1:59 Introduction of your practice and to you as well. 2:03 That's a big deal. 2:04 Thank you so much. 2:06 And so, I figured a good thing to chat about 2:10 would be some common conditions that you treat. 2:12 So I'm just going to list the condition, 2:14 and then you can kind of let me know what we should know. 2:17 So the first one is one that I think a lot of people 2:19 have heard about carpal tunnel. 2:20 What should people know about carpal tunnel? 2:23 So carpal tunnel is, 2:25 so it's one of those diagnoses that people always think they have. 2:30 Just because, you know, it is actually the most common condition 2:34 that I treat, and it's essentially numbness of the fingers. 2:37 The nerve passes underneath a band here, 2:41 and that forms the roof of the carpal tunnel. 2:44 So the nerves sitting inside the carpal tunnel as it passes underneath 2:47 that band, it goes to these fingers, half of this finger. 2:51 So you wake up with. 2:53 So I immediately started doing this because if you see somebody kind of 2:57 shaking their hand like this, I'm thinking carpal tunnel until proven otherwise. 3:01 It's a feeling like your hand has fallen asleep. 3:03 It wakes you up in the middle of the night. 3:05 Just kind of. 3:06 When you're touching things, I feel prickly. 3:09 That's carpal tunnel syndrome. 3:11 So tell me about that. 3:12 Like, can it come and go? 3:14 Or if you're having any of that, is it going to require treatment? 3:17 So a lot most carpal tunnel will kind of come and go. 3:21 Especially in the beginning. 3:23 It will you'll kind of wake up with numb hands, shake them off 3:27 and then keep it moving. Right. 3:28 And so if that's the situation 3:30 where you kind of wake up with it slightly numb and it goes away, 3:33 I wouldn't think too much about it.
Carpal Tunnel Symptoms and Risk Factors 3:34 If it gets a little bit worse, it usually suggests 3:37 sleeping in a brace at night and just wearing it a little bit 3:40 loose helps to kind of keep the hand from going into this position. 3:44 I know we love sleeping like this, but this is the worst position 3:47 for the hand and elbow. 3:50 So usually I recommend just starting with a brace at night. 3:53 Now, once things become disruptive 3:56 to your sleep, you know, you're noticing symptoms throughout the day. 3:59 It's starting to limit your ability to do things, 4:02 and especially if you're starting to drop objects that needs treatment, 4:06 those those are the kind of progressing signs. 4:09 So a little bit of numbness in the morning goes away wearing a brace. 4:13 Not too much. Once that becomes more frequent, 4:15 you really need to at least see somebody for it. 4:18 And so what are kind of some of the risk factors. 4:21 Can you get it from repetitive motions like using a keyboard? 4:24 Or are there things you can do to decrease the likelihood of getting it? 4:27 So one of the biggest things is your sleep position at night. 4:30 This is terrible. 4:32 Like I said, so just kind of keeping the elbow 4:36 at least 90 degrees and then keeping the hand if you can. 4:39 Straighter is better. 4:41 Yes. 4:42 Repetitive motion can exacerbate it. 4:44 Studies are a little mixed 4:46 as to whether or not it causes it, but it can definitely exacerbate it. 4:50 And then there are things like diabetes, diabetics 4:53 or higher have a higher chance of getting carpal tunnel. 4:56 And really, most of my common, symptoms, including carpal tunnel, trigger 5:01 finger tendonitis, all of those are have a higher association with diabetics. 5:06 And then hormonal shifts with pregnancy, 5:10 can be very triggering for carpal tunnel, just a swelling in general, 5:15 those things can increase pressure in the worse. 5:19 Well, I learned something new there. 5:20 I didn't realize that there was a connection 5:21 between carpal tunnel and diabetes. 5:23 So what are some of the treatment options? 5:26 So just starting with the brace is the first step. 5:28 The second step, there is an injection that can be done. 5:32 And the injection is corticosteroid, which is a strong anti-inflammatory. 5:36 It decreases some of the inflammation around the nerve. 5:39 That injection though, usually only lasts for about 2 to 3 months. 5:43 So it's not one that I recommend for everybody. 5:46 And especially in some diabetics, you really have to consider whether or not 5:50 it's worth the increase in the sugars that can occur with it. 5:53 And then the third option is a carpal tunnel release, 5:56 which is that band that I was talking about. 5:59 I'd go underneath and I just release it a little bit. 6:01 So I do, two different ways of a carpal tunnel release. 6:05 I do a minimally invasive way where I use, like a tiny incision. 6:08 I go underneath with a camera and and release it that way. 6:12 It's a little bit faster getting back and less scarring. 6:15 So less pain initially. 6:18 Or like, especially if there are some people who are older, 6:21 don't want any sort of sedation. 6:22 Anything I can do a local only open carpal tunnel release 6:26 where I numb the area, and then I just release that band that way. 6:30 So that's for my patients who get no sedation at all. 6:34 Wow. Yeah, 6:37 it's pretty cool. 6:41 As you can probably see, I didn't do a ortho rotation. 6:44 Yeah, 6:45 trust me, I geek out on ortho, but, like, other fields are like. 6:50 What is that? You do? 6:52 So then what about kubectl tunnels? 6:56 So keep it all tunnel is a similar process but it's at the elbow. 7:01 So it's the same thing where the nerve kind of passes around here
Carpal Tunnel Treatment and Recovery 7:05 and goes into these fingers. 7:07 So it's a small finger and then half of this finger. 7:10 So if you're going I get that numbness. 7:12 But it's really like these fingers that are most effective. 7:16 That's most likely kubectl tunnel. 7:18 And that's the similar the sleep position. 7:22 I would change that immediately. 7:24 You really don't want to be because if you look if you see here 7:27 I have my elbow extended, I can kind of grab the skin as soon as I do that. 7:32 It's very difficult to grab that skin. 7:34 So that nerve is getting just draped around that area. 7:38 And so there's the sleep position and then not resting on the elbow. 7:42 That's another thing that can aggravate kubectl tunnel. 7:45 So that's the difference between the two. 7:47 So my carpal tunnel patients it's here. 7:50 And then my kubectl tunnel patients it's really always that small finger. 7:53 Now here's the thing. You can have both. 7:56 So sometimes it's the whole hand that's numb. 8:00 And we're dealing with carpal and give it all tunnel. 8:03 How successful are the, surgeries for that? 8:07 Like, if you have the surgery 8:08 that you're pretty guaranteed that the symptoms are going to be improved. 8:11 They're pretty high. 8:12 So no surgery, as you know, is 100%. 8:16 But carpal tunnel, when you have the right diagnosis, it's really 8:20 in the high 90s in terms of satisfaction and good outcomes. 8:23 Hebrew Tunnel is slightly newer. 8:25 I think it's like in the lower 90s. 8:26 But again, there's there's 8:28 a little bit more dissection, but both are really good surgeries. 8:32 And for both of them, I typically would expect that the patient 8:36 is not going to require any sort of secondary, surgery from them. 8:41 What's the recovery like? 8:44 I get a question from carpal tunnel. 8:46 I have my patients wear a dressing for five days after and it's a soft dressing. 8:51 So it comes around the hand like this. 8:53 They're able to use their hand immediately for light activity. 8:56 Eating getting dressed. Driving. 9:00 Most people are driving back to their first post-operative visit. 9:04 And then after five days, they take off the big dressing 9:07 and they go into a Band-Aid to the Band-Aid is on, 9:11 and they start to wash over that area each day and put a Band-Aid over it. 9:15 And at two weeks, I take out the stitches. 9:18 So I tell patients that in the beginning, the light things feel fine to do. 9:22 But then, you know, the heavier things lifting that gallon of milk 9:25 or, you know, like gripping is a little weak in the beginning. 9:29 So, that usually gets better over the first month.
Cubital Tunnel Syndrome Explained 9:33 Now, there are two phases of recovery from carpal tunnel. 9:36 There's the initial kind of nerve decompression. 9:40 So that's the, my hand's not falling asleep at night 9:43 and waking me up from sleep and like, those, like, dramatic effects. 9:47 But over the next six months, you start to get more sensation in your fingers. 9:52 And those, like the numbness starts to improve. 9:55 So really, you know, you're 9:57 kind of limited in terms of activity in that first 2 to 4 weeks. 10:01 But then after that, you start to notice you still notice improvements. 10:06 Wonderful. 10:08 So trauma, what can you tell us about fractures and lacerations? 10:14 And one thing 10:15 that I want to make sure we talked about is when someone needs an orthopedic hands 10:19 or if they've sustained a laceration or fracture. 10:23 Yeah. It's. 10:24 So, I'll talk about kind of the fractures first. 10:28 It's. 10:28 If you can't move a joint properly, you need to get seen. 10:32 The thing that, comes up the most for me as a hand surgeon is, 10:37 Oh, I jam my finger and, 10:40 you know, it's just jammed, and they never come in. 10:44 That can actually be a fracture 10:46 that needs to be treated immediately within the first three weeks. 10:51 Your outcomes are so much better. 10:52 So there you can get, So the jam finger is like 10:56 your jam, your finger, and then it kind of comes down a little bit 10:59 and you can't bend through that joint that needs to be sent out. 11:04 That's like worst case scenario. 11:06 If you've hurt yourself and it's been, you know, everything is moving time. 11:10 But it's been like a couple of days and it's still really hurts. 11:13 Let's get an x ray. Come see us, you know.
Fractures and Hand Lacerations 11:15 If you're if you've had a bad fall 11:20 and your wrist like your outstretched on the wrist, 11:23 that needs to be seen to, if it's, you know, you wear a brace for, 11:26 like, a day or two, and it's like, this still hurts. 11:29 We need an x ray. 11:30 Now, obviously, if it's really painful, then you need to get seen. 11:35 And then cuts. 11:38 I have had. 11:39 So if you have a cut and one, it's gaping open. 11:42 You need to be safe. 11:43 So if there's any sort of gap or anything like that in this area, we need to see 11:48 if there's a let's say 11:50 you had a poke hole and you can't move your finger. 11:54 That needs to be seen. 11:55 If you had a poke hole and you have some numbness like 11:59 I could feel this side, but I can't really feel this side 12:01 that needs to be seen. Why? 12:03 Because even those small, little deep incisions or cuts 12:08 can cut the tendon, which is, you can see, better on the back of your hand, 12:12 the ropes that allow us to move our fingers. 12:14 And then there's also nerves in those areas. 12:17 And most in this area are sensory nerves. 12:20 So it's sensation that you're losing not necessarily function. 12:24 You're going, well, I can move my fingers, but I just can't really feel 12:28 that is potentially a nerve issue and needs to be checked out. 12:32 Perfect. 12:33 Thank you for outlining that. 12:35 I wanted to go back because I skipped over Trigger Finger. 12:37 What I got is 12:40 my second most common diagnosis. 12:42 So trigger finger is one of the things that we don't really learn 12:46 about in med school, interestingly enough. But it's super common. 12:49 It's a tendonitis in the hand, really, 12:52 in these areas, the A1 pulley is what we call it. 12:56 So what it is, is the tendon is passing underneath a band, 13:01 and it goes into kind of a tunnel of pulleys along the finger. 13:06 And as it goes into that area, it can kind of rub in that area 13:10 if you have a little bit of irritation and it leads to people kind of 13:14 having their finger get stuck like this and then like they feel this clicking, 13:18 it's like a triggering, and so that can continue 13:23 if it's not treated or sometimes it can resolve on its itself. 13:27 But that's kind of. 13:29 So I say it's like a belt going into some belt loops,
Trigger Finger Symptoms and Treatment 13:32 and one of those loops is a little too tight, or there's kind of 13:35 a little bump in the belt and it just kind of clicks as it goes. 13:39 So that's the presentation of Trigger Finger. 13:44 And what did you say? How is that treated? 13:46 So the injection. 13:48 So you remember I talked about the injection for carpal tunnel. 13:51 And that usually works for about 2 to 3 months. 13:53 The injection for trigger finger can actually cure it. 13:56 It's, again steroid 13:59 a little bit of an anti-inflammatory, plus lidocaine. 14:03 And I inject it right into that area, 14:05 and, usually within about four weeks, it can get rid of it. 14:08 And up to 80% of people, obviously not 100%. 14:12 So we have the option to do another injection depending 14:16 on your response to the first one or a trigger finger release. 14:20 And that is surgery. It's a small surgery. 14:24 And I make a kind of in the area of the belt 14:28 loop pulley, and then go down and release that belt loop. 14:33 Again. 14:33 You have plenty of other belt loops to keep it, you know, in place. 14:37 But, what it does is it kind of gets rid of that friction point for the patient 14:42 and the kind of the protocol is the same as for my, carpal tunnels. 14:47 Five days and the bandage, take it off. 14:51 Start to wash with soap and water, Band-Aid, stitches out at two weeks 14:56 that they always get this little lump of scar right at the area. 15:02 Things like scar tissue massage starts at about three weeks, 15:04 and you say we're good to go from there. 15:08 Well, thank you so much, doctor Opeyemi Lami of 15:11 what would be the take away message from a hand surgeon, 15:15 what would be one nugget that you'd want everyone to take away from this chat? 15:19 As a hand surgeon, if I could get people to stop sleeping like this 15:23 or that, curled up, 15:26 I would have so many fewer patients. 15:30 So literally just kind of extending 15:32 just a little bit can make a big difference for you. 15:36 All right. 15:37 Well, what is the best way for people to get connected with you? 15:41 Absolutely. 15:41 So my website is Atlanta hand surgeon.com. 15:46 And on there has all of my links to everything else. 15:49 My Instagram is ATL hand surgeon 15:53 and my LinkedIn is OPM e lami camera.
Key Takeaway and Closing Remarks 15:59 Thank you so 16:00 much Doctor Lami Conrad I hope you'll come back another time. 16:03 Absolutely. I would love to. Thank you for having me. 16:05 This is great. 16:06 Well, everybody, thank you 16:09 so much for tuning in to another impactful episode of The Coalition. 16:13 I'm your host, Doctor Shani Belgrave. 16:15 I am a bariatric and minimally invasive surgeon in Atlanta, Georgia. 16:19 I'm also the founder and CEO of Omega Bariatric and Wellness. 16:23 Very special thank you to Doctor Opa Yemi Lami Kamara, 16:27 the Atlanta hand surgeon, for joining the show to share her expertise. 16:31 You can get connected with doctor OPM in Miami. 16:33 Kamara on her website or on her social media. 16:37 Make sure you share this episode with friends and family so we can learn about 16:40 common hand conditions. I'll see you next time.
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