‘A bit, when I was pregnant.’
He nodded. Rachel would probably know about that. She did all the antenatal appointments at the practice. ‘You often get carpel tunnel syndrome in the last few months of pregnancy.’
‘That’s what Rachel said.’
Rachel, not ‘Dr Bedingfield’, he noticed. Rachel’s style of medicine was very different from his own. ‘Is there a possibility you’re pregnant at the moment?’
Hayley shook her head. ‘Definitely not.’
There were other medical conditions which affected the carpal tunnel, too, including wrist fractures, diabetes, thyroid disease and rheumatoid arthritis. Repeating the same hand movements over and over again could cause it—it was common with people who used computers, assembly-line workers and mechanics and people who played a lot of golf or did a lot of gardening. ‘Have you changed your job lately, or taken up a new hobby, or texted people more than usual on your mobile phone?’
‘I started doing cross-stitch last month,’ Hayley said. ‘But would that cause it?’
‘It’s a repetitive hand movement so, yes, it could be part of the problem,’ Oliver said.
‘But I use my right hand for stitching.’
‘And the left for holding an embroidery ring?’
‘Well, yes.’ Hayley grimaced. ‘My hand’s tingling now.’
‘OK, you can relax your hand.’ He noticed that she flicked her wrist to stop the pins and needles: a characteristic response to carpal tunnel syndrome.
‘What we can start with is a wrist splint at night—that will stop your wrist from moving, but you’ll be able to do pretty much anything you usually do with your hands. Taking some ibuprofen at night, just before you go to bed, can help with the inflammation. You also need to change the way you do needlework—take more breaks, so it gives your wrist and hand a chance to rest. If that doesn’t work, there are a couple of other things we can try.’
‘What sort of things?’
‘An injection of corticosteroids into your wrist often helps.’
She shook her head. ‘I’m not good with needles.’
‘The other option’s minor surgery to release the pressure on the nerve.’
‘You mean, cut my wrist open?’
‘It’ll stop the pain and you’ll get full use of your hand and wrist back within a couple of months.’
Hayley grimaced. ‘I think I’d rather put up with the pins and needles!’
‘Hopefully it won’t come to that. I’ll prescribe you a splint and Rosie—’ the practice nurse ‘—can show you how to put it on. Give it six weeks—around three in four patients find it’s a lot better then. If it’s not any better, come back and have a chat with me.’
‘And have an injection?’
‘Not necessarily. I mean have a chat, see how you’re feeling and discuss what your options are. I promise, no needles unless that’s what you decide you want.’
She almost sagged in relief. ‘Thanks, Dr Bedingfield.’
‘Pleasure.’
The rest of morning surgery flew by, and Oliver definitely needed a cup of coffee at the end of it. Rachel was already in the rest room. He sighed inwardly, hoping that the tension between them from last night would have vanished, but half expecting it would still be there.
‘Hello.’
She spun round and smiled when she saw him. ‘Hi.’ She added milk to the mug of coffee she’d just poured and handed it to him.
Peace offering? He just about stopped himself uttering the words. ‘Thanks.’
‘Had a good morning?’ she asked as she made a second mug of coffee.
‘Average. Though I had a nasty case of carpal tunnel. Hayley Porter.’
‘Mmm, she had it when she was pregnant,’ Rachel said. ‘Poor thing. It’s still giving her gyp, then?’
‘I’ve given her a wrist splint, and told her to take ibuprofen before bed. Hopefully that’ll help. If not, the next step’s a steroid injection.’
‘Which could itself cause problems—apart from making sure you don’t touch the median nerve when you put the needle in, there’s a risk of the patient developing a haematoma,’ Rachel said. ‘Plus she might need a second injection and splints if it doesn’t work. And if that doesn’t work, you’ll have to divide the flexor retinaculum to decompress the nerve.’
‘We can do it by keyhole surgery,’ Oliver said.
She shook her head. ‘I know endoscopic techniques—’ keyhole surgery ‘—mean that patients recover faster, but there’s less risk of a complication with the open technique, and more chance that you’ll release the carpal tunnel fully. Half the time with endoscopic techniques you can’t see well enough and you have to convert it to an open technique anyway.’
His turn for a peace offering. ‘Want me to refer her to you?’ He knew Rachel didn’t get to do as much minor surgery as she’d like.
Rachel nodded. ‘Please. Not that you’re a bad doctor. She’s just really, really scared of needles. Lucy—’ the midwife for Hollybridge and the next village ‘—gave up in the end and sent her to me to do the antenatal blood tests.’
‘Then you’d be the best doctor to calm her down. She’s used to you and she trusts you.’
‘She trusts you, Oliver. Everyone does.’
Did they? He wasn’t so sure. Especially where his wife was concerned. ‘Rach, what you were saying yesterday...’
‘Hmm?’
‘About us. I’ve been thinking.’
She looked nervous; her brown eyes suddenly went very, very dark. ‘What about us?’
‘You’ve got a point. We don’t ever talk about us any more, only about work or the children.’
She nodded. ‘Maybe we should—’
But before she could finish, Rita, the practice receptionist, put her head round the door. ‘Rachel, sorry to interrupt, I’ve got the hospital on the phone. Says it’s urgent.’
‘Hell. I’m expecting some test results. If they’re calling, that means bad news,’ she said. She gave Oliver an apologetic smile. ‘Sorry, I really need to take that call. Catch you later?’
‘Sure.’
Though he couldn’t help wondering. What had she been about to suggest? He had no idea. He didn’t know what Rachel was thinking a lot of the time nowadays. Maybe they could try again and talk tonight when the kids were in bed.
Maybe.
CHAPTER THREE
EXCEPT things didn’t work out quite as Oliver planned. Surgery overran and the florist was closed when he got there, so he had to make do with what was left at the supermarket. Not the ideal choice, but the thought was what counted, wasn’t it?
‘Thank you,’ Rachel said politely when he handed her the huge bunch of carnations. Then she gave him a suspicious look. ‘What are they for?’
What did she mean? He’d bought them because he knew she liked flowers. ‘Do I need an excuse to buy my wife flowers?’ he demanded.
‘No-o.’
But she didn’t sound that sure. He tried to remember when he’d last bought