Dr. Sanjay S. Desai's response
I am very sorry to hear of your concerns, and it is unfortunate I do not have more details of your particular events. I cannot determine from your review what type of surgery was performed.

Regarding the request for the surgical report and x-rays, this is handled off-site by our Medical Records Department, and many times our staff here are not notified of the request.

If a patient needs a cast or splint, the physician assistant sees the patient and applies these as necessary. This is standard procedure for my practice, however, I am always available in the event extra consideration or care is needed. Our practice is a team and this team enhances the care of each patient.

We generally ask patients to arrive early for surgery because they need to be interviewed by the anesthesiologist. They also need an IV started as well as a numbing block to numb the arm which can take up to one hour to completely set up. Unfortunately, the surgical facility dictates what time the patient needs to arrive at the facility as there are several variables which can affect this. Surgery is an art and surgical procedures sometimes take longer than originally scheduled. Surgical times are individualized and sometimes delays occur. Each case is given as much time as needed to complete the procedure.

I would be happy to discuss any further concerns you may have. Please feel free to contact our office.

Submitted Sept. 9, 2015

Dr. Sanjay S. Desai's response
Not all hand pain comes from the hand. Some patients have two problems that are unrelated--one in the hand and the other in the neck. Hand pain can come from anywhere in the arm--all the way up to the neck. This is known as “double crush.” (I.e. Imagine your garden hose being kinked in two spots.)

Our first step in addressing hand pain where there is “double crush” is to diagnose and fix the source of the pain in the hand itself. Endoscopic hand procedures are minimally invasive and are an obvious first choice--as opposed to starting with complicated neck surgery.

If the pain doesn't stop, then we move on to resolving any secondary or tertiary problems in the neck or arm that may be contributing to the “double crush.”

If a patient only has one problem that is causing pain, the vast majority of surgeries can cure that one problem. When patients have “double crush,” a procedure on one body part cannot typically fix all problems at once. That’s why a referral to a specialist on that other part of the body is necessary. (I.e. a neck surgeon.)

The patients that I send to “pain management” are usually not sent for the purpose of managing chronic pain. Pain management doctors are able to perform injection procedures that can many times alleviate the symptoms emerging from the neck. Sometimes, injections can be curative. We always try to go with the most minimally invasive route first.

If the injection is not successful, the next step would be a consultation with a spine surgeon.

I understand that it can be very painful. We ask that you have patience through this process and keep an open dialogue with the doctors you are working with.

Submitted Sept. 19, 2014