going to take St John’s wort you’ll need to use an extra method of contraception.’
‘I never thought of that,’ Teresa said, blinking in surprise. ‘It’s a natural remedy. I just assumed it’d be safe to take.’
‘It can be, if you’re not taking any other medications,’ Rachel said. ‘But if you do go into the chemist for a complementary remedy, it’s always worth having a chat with the pharmacist before you buy it, just to check it’s going to suit you and won’t interfere with anything else you’re taking—and also how long you should take it for.’
Teresa nodded. ‘Thanks, Rachel.’
Rachel smiled back. ‘That’s what I’m here for.’
When Teresa left, Rachel waited a while before buzzing her next patient in. Teresa’s worries had made her own doubts resurface. Supposing Oliver was having an affair? Would he agree to see a relationship counsellor? Or would the suggestion be the thing to push him over the edge and make him leave her?
She shook herself. Ridiculous. They had a strong marriage. They’d been together for fourteen years, despite the initial opposition of his family. Two gorgeous children. Oliver wouldn’t walk out on them...would he?
* * *
Oliver buzzed his first patient in. ‘Good morning, Mrs Porter. How are you?’
‘Fine. Well, um, look, I don’t want to waste your time, Dr Bedingfield. It’s a bit silly.’
‘That’s what I’m here for,’ Oliver said with a smile. ‘What’s the problem?’
‘I keep getting pins and needles in my hand. I’ve been waking up in the night and my hand’s just numb until I shake it or rub it.’
‘Do you get it during the day as well?’
‘Not really. It’s a lot worse at night,’ Hayley said.
‘It sounds as if it might be carpal tunnel syndrome,’ Oliver said. ‘The bones in your wrist form a tunnel, called the carpal tunnel, and the main nerve in your hand—the median nerve—goes through it, together with other tendons and ligaments. When the tendons get swollen for any reason, they squash the median nerve and that’s what causes the pain and tingling. May I take a look at your hand?’
‘It’s the left one.’ She held it out for inspection.
‘Does it affect your fingers at all?’
‘My thumb, first finger and middle finger,’ she said.
A textbook case—but he needed to check a couple of things. ‘OK. I’m going to ask you to do a couple of things which will tell me where the problem is.’ He started with Tinel’s test—tapping over the carpal tunnel in the wrist to see if he could reproduce the tingling. ‘How does that feel?’
‘My fingers are tingling,’ Hayley admitted.
Positive: so next he’d try Phalen’s test. ‘I want you to flex your wrist for me, as hard as you can.’ He smiled as she followed his instructions. ‘Yes, that’s perfect.’ He kept half an eye on the second hand of the clock as he spoke. ‘Have you ever had pins and needles in your hand before?’
‘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
