Scott M., Dr. Fried
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Subjects -> Health, Mind & Body -> Disorders & Diseases -> Musculoskeletal Diseases
Subjects -> Health, Mind & Body -> Disorders & Diseases -> Repetitive Strain Injury
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Customer Reviews:
Total reviews: 7
Average rating: 4.5 of 5
Not perfect, but some valuable insights 3 out of 5 stars.
12 of 13 people found this review helpful.
I really found myself interested in Dr. Scott M. Fried's book, Light at the End of the Carpal Tunnel: A Guide to Understanding and Relief from the Pain of Nerve Problems. (ISBN 0-9659267-5-3) Dr. Fried is an orthopedic surgeon, and compared to the ineffectual and poorly informed medicos often lamented on the SOREHAND e-mail list, he sounds like the doctor we all wish we had. That is, well informed, sympathetic, optimistic, committed to thorough and accurate diagnoses. He also emphasizes the importance of educating the patient, making informed decisions in partnership with the patient, and in not rushing to surgery unless there is a well-established end in doing so. This includes having realistic expectations of the outcome should surgery prove advisable. Although he says that if surgery is done "we have already lost the game," he posits situations where it can be useful.This is where this book is most useful. It is not like many RSI books that discuss the entire gamut of injury and treatment in detail; it is instead the valuable viewpoint of a surgeon who focuses on nerve injuries. As such, it excels, and much of the text is anecdotal accounts of patients, their injuries, decisions, and the outcomes. I learned a lot I did not know or had not considered. While he endorses a number of alternate therapies, he does not elaborate on them.
A couple of themes ran through all of the patient stories, themes we all need to bear in mind. First of all, even when he describes patient outcomes considered successful, he cautions, "This is not a 'normal' arm." That is, patients may regain useful function and minimization of pain but are not "as good as new."
Secondly, he is unflinching about repeating that no treatment can succeed if the patient is not removed from the injurious environment. He acknowledges the practical considerations that drive people to continue employment, but you won't find many details here about ergonomic equipment or such; he sticks with removing the patient from the injurious situation.
Dr. Fried discusses reflexive sympathetic dystrophy (RSD) and its intractability. He suggests that in some cases of RSD or other pain syndromes where patients are relegated to pain management programs, there may well be an identifiable physiological cause underlying the problem that has not been correctly diagnosed. He suggests that in many cases it may be useful to start from the beginning with diagnostic workups.
Dr. Fried is friendly, upbeat, and accessible in his writing. I found the relentless use of anecdotes made the book less focused than it might have been, and it might have done with some better editing. Too, I am not a big fan of Anthony Robbins or Napoleon Hill, whom he quotes on occasion, but I can forgive him that. On balance I think this book is well worth finding. It is NOT a replacement for a comprehensive RSI book like Pascarelli & Quilters Repetitive Strain Injury: A Computer User's Guide, but it is a valuable perspective on nerve problems and surgery and anybody involved with either (or both) should read this before agreeing to surgery.
