During your first appointment you will meet your surgeon in a one-hour consultation. You will review your peripheral nerve problem, medical history, surgical history, allergies, and medications. Then you will undergo a neurological examination, in which many different muscles are tested. In addition, your sensory systems and reflexes will be tested too. Patients who have objective findings on examination, such as muscle atrophy or sensory loss, will have the affected body parts photographed. This is important not only to assist in the diagnostic process, but to have a record so that progression or improvement may be documented.

Any imaging (MRI, CT, X-rays, etc.) or electrodiagnostic studies (EMGs, nerve conduction studies, etc.) will then be reviewed. It is most helpful if you bring the actual films in addition to any radiology reports you may have. In some cases, it is absolutely imperative for your surgeon to review these items prior to making any decisions about whether you need surgery or not. If you are in doubt whether a particular test you’ve had previously might be important, bring it along just in case.

For the remainder of your first visit, you will have a discussion of your peripheral nerve problem, including diagnosis, the need for further tests if necessary, and treatment options. Patients who require further non-operative management may receive prescriptions for physical therapy, medications, braces, or splints.

Patients who require an operation will have a discussion of the risks, benefits, and alternatives of surgery. Once a decision to operate is made, paperwork such as surgery scheduling and consent forms are completed in the office. In some cases patients wish to see what their surgery will look like, including the location and size of the incision(s) as well as the relevant anatomy. Essentially every type of case we perform has undergone an extensive photodocumentation that can be shown to interested patients during their first (or subsequent) visit.