Cally, 44 years of age, is a mother of three children. She is annoyed about the ‘pins and needles’ in her thumb and first three fingers of her right hand. Over the past 4 months she has needed to shake her hand when she gets up in the morning to ‘get it going’. The pins and needles used to go away after shaking, but now persist into mid morning. Cally is also finding it more difficult to use her hands in every day activities such as gardening. In the past fortnight, a similar problem has started in her left hand.
Cally is generally healthy and is not taking any regular medication. Over the past year her weight has increased from 63 to 68 kg (body mass index: 27.2 kg/m2) and she feels she has less energy than previously.
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