Page 13 - Boca Club News - July '24

Boca Club News, Page 13
Medical Matters: Carpal Tunnel Syndrome

By Richard Nagler, M.D., a member pregnancy and menopause, and particularly frequent bending the wrist all the way up or down avoided. Good
of Broken Sound Club and retired computer keyboard usage all contribute to developing the posture and avoiding cold is recommended.
physician. After graduating from the condition. Treatment consists of simple measures such as taking
University of Pennsylvania and New In addition, it may be associated with amyloidosis, more frequent breaks to rest the hands, avoiding activities
York University’s School of Medicine, diabetes, rheumatoid arthritis, thyroid dysfunction, that worsen symptoms and application of cold packs to
Dr. Nagler served his internship and peripheral neuropathy, an injury to the wrist with ligament reduce swelling. Wrist splinting, which holds the wrist still
residency at Baltimore City Hospital damage and cervical nerve root compression. Carpal Tunnel especially at night while sleeping, is especially helpful.
and Johns Hopkins. He followed that Syndrome must be differentiated from the rarer Quervain NSAIDs can afford some short-term relief. The injection
with a Fellowship in Gastroenterology tenosynovitis involving the tendons that control the thumb. of steroids into the carpal tunnel with the needle under
at Yale University School of Medicine, and was then Chief The diagnosis is made using the Finkelstein test, which ultrasound direction can effectively relieve inflammation,
of Gastroenterology at Fitzimmons General Army Hospital involves bending the thumb across the palm of the hand swelling and pressure on the median nerve.
in Denver. He returned to the Yale Medical School for one and then bending the fingers down over the thumb to make However, ultimately most patients will eventually need
year as an Assistant Professor of Medicine before opening a fist stretching the tendons and causing pain in the wrist. surgery to afford lasting relief. It can be done by one of two
his own successful private practice in Internal Medicine In Carpal Tunnel Syndrome the wrist will often be tender methods. Endoscopic surgery uses a telescope-like device
and Gastroenterology. During that time, he also served for to touch, swollen, warm or discolored. The thumb and three with a tiny camera attached to visualize the interior of the
ten years as Chief of Medicine at Huntington Hospital in fingers should be tested for sensation and strength. A simple carpal tunnel. The ligament pressing on the median nerve
Huntington, N.Y. diagnostic test is often employed using a reflex hammer to can then be cut with one or two small incisions.
Carpal Tunnel Syndrome is a condition where the median tap on the median nerve in the wrist that causes the fingers Open surgery involves making an incision in the palm of
nerve is compressed as it passes through the carpal tunnel to tingle or feel an electric shock. A nerve conduction or the hand over the carpal tunnel and cutting the ligament to
in the wrist. The carpal tunnel is formed by the carpal bones velocity test measures how fast an electrical signal travels free it from the median nerve. The risks in these procedures
at the bottom of the wrist and the transverse carpal ligament along a nerve to muscle. The longer it takes the greater the are incomplete release of the median nerve from the
across the top of the wrist. The median nerve extends the damage to the nerve. For diagnosis, a nerve conduction ligament, wound infection, scar formation and injury to the
entire length of the arm ending in the hand and supplies both study Electro myography (EMG) measures muscle response nerve or surrounding blood vessels.
sensory and motor function to the thumb and middle three to electrical activity in response to a nerve’s stimulation The healing process can take from weeks to several
fingers of the hand, but not to the pinkie. Women are three of the muscle. One or more small electrodes are inserted months where ligament tissue gradually grows back, but
times more likely to have carpal tunnel syndrome than men. through the skin into the muscle and a computer will with more room for the median nerve to function normally.
Symptoms start out slowly, usually at night, but as they translate these signals into graphs or numerical values that Soreness and some weakness usually resolve in time.
inevitably worsen they will be present during the day as well. can determine the degree of damage. Ultrasound x-rays Post-op, the hand and wrist are wrapped and put in a
Included are numbness, tingling, burning, weakness and a cold and an MRI can all reveal a swollen or compressed median splint for a couple of weeks to keep from moving the wrist
sensation even when the hand feels warm to the touch. Difficulty nerve, as well as arthritis or a small previously unrecognized up and down. Patients should sleep with the hand elevated
grasping things due to weakened muscles, trouble buttoning a small fracture. and move fingers to help prevent stiffness. They should
shirt, holding on to the steering wheel of a car, a newspaper or There are some preventive measures that can be avoid forceful hand motions or extreme wrist positions until
a phone, gaming such as golf and racket sports, gardening and helpful. Relax one’s grip as often as possible, especially healing has been achieved.
repetitive workplace tasks are all adversely affected. when involved with a cash register, prolonged typing at With the endoscopic method, return to normal is usually
It usually occurs spontaneously, but certain medications a computer keyboard or even handwriting. The wrist and of shorter duration. How long the median nerve was
(especially chemotherapy), obesity fluid retention in hand should be gently stretched and bent periodically and compressed does adversely affect the time of full recovery.
Legal: New Condominium and HOA Laws

By Michael J Posner, Esq., a partner Several high-profile lawsuits filed by condominium owners sought to take control of the common elements
in Ward Damon P.L., a mid-sized real owners in mixed-use condominiums over who controls the (parking areas, lobbies, elevators and the like) from the
estate and business-oriented law firm building’s common elements led the legislature to adopt a law developer, while the developers argued that they should
serving all of Florida, with offices in that favors developer control. A mixed-use condominium is a control these elements (all along charging the residential
Palm Beach and Lee Counties. They condominium that contains both commercial and residential unit owners for a share of the cost, which many unit owners
specialize in real estate law and units. Unlike a purely residential development where the claim is excessive). The new law clarifies that the developer
can assist buyers and sellers with developer turns over control of the common elements to retains control over the common elements if provided for in
closing and financing of residential the unit owners after selling ninety percent of the units, a the Declaration.
and commercial real estate including mixed-use project frequently has components such as a hotel, The new law clarifies rules regarding a condominium’s
remote closings. They can be reached at (561) 594-1452 or restaurants, retail stores and related uses that the developer official records, including the disclosure of email addresses
at mjposner@warddamon.com runs or leases out to third parties. This means the developer if an owner has consented to electronic transmission of
Several new laws affecting condominiums and (or the developer’s successor) remains involved in the project notice, requires an association to make a good faith effort to
homeowner’s associations will go into effect after Governor long term. locate lost or destroyed records, requires any response to a
DeSantis signed House Bills 1021 and 1203, which went into This has led to lawsuits regarding the maintenance and records request to include a checklist of all records provided
effect July 1st. cost of the shared common elements. The residential unit and lowers the threshold from 150 units to 25 units for an
association to maintain specified records available on the
association’s website or on a mobile device.
in criminal penalties on board members.
In addition, willful action to withhold records can result
ARCHIVE GALLERIES units will now require at least four meetings a year wherein
Board meetings of condominiums with ten or more

members will be able to ask questions concerning the status
of construction or repair projects, revenues and expenditures,
and other condominium issues. Assessment meeting agendas
PAYS HIGHER PRICES FOR FINE ART AND ANTIQUES will now have to include the cost and purpose of proposed
assessments and a copy of any proposed contract.
Suspension of voting rights as a result of nonpayment of a
• Oil Paintings • Sterling Silver • Collectibles fee or other monetary obligation now requires written notice
• Oriental Rugs • Objects of Art • Fine Crystal at least 90 days prior to the election. The new law also allows
• Tapestries • Sculptures • Orientalia for electronic voting in elections by using an electronic means
of consent.
• Fine Furniture • Bronzes • Tiffany Items Finally, on the sale of a condominium unit, the seller
• Service Plates • Porcelain • Clocks must now provide the buyer, in addition to the other required
documents, the annual financial statement and annual budget
of the condominium association.
We Also Purchase Men’s And Ladies’ Items Including: The new homeowner’s association law, which also went
into effect on July 1st, addresses several contentious issues
• Old Watches • Cufflinks • Smoking Items • Coins • Antique Jewelry including parking and fines. Many homeowner’s associations
• Designer Handbags • Fine Modern Jewelry • Vintage Costume Jewelry ban work and pickup trucks from parking on the homeowner’s
driveway. These restrictions will no longer be valid. In
addition, a first responder’s assigned vehicle will not be
One Piece Or Entire Contents Purchased prohibited from parking on public roads or rights-of-way
within the homeowners’ association property.
Directors in homeowner’s associations will now have
CALL NOW FOR A FREE CONSULTATION, NO OBLIGATION to complete an education course within 90 days after being
elected or appointed. In addition, directors will have to
complete four to eight hours of continuing education annually.
CASH 561-498-7536 COURTEOUS With regard to official records, associations with 100 or
PAYMENTS IN HOME more parcels must maintain a digital copy of official records
UPON REQUEST SERVICE for download on the association’s website or through an

Legal on page 14