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Gene Weingarten: Trigger finger requires a joint resolution

WASHINGTON — This medical adventure1 began, as so many tragic things do, with a man seriously overreaching himself. Trying to be flinty and cool and filled with inscrutable, masculine self-discipline like Clint Eastwood or Mr. Miyagi, I attempted to snatch a mosquito out of the air.

I missed, of course, but as I snapped my fist closed, the middle finger of my right hand locked in place. My other fingers opened back up, but not that middle one. I looked like someone pointedly unflipping the bird. I had to release the stuck finger with my other hand. It popped loudly, like Bubble Wrap.3

Now, this is a fairly dramatic physiological occurrence. A normal individual might take it as a warning to promptly consult a medical professional, particularly when it keeps happening, then starts happening to the middle finger of one's other hand, accompanied by pain and stiffness.

I am not, however, a normal individual. I am a recovered hypochondriac, meaning that medical stoicism has become a matter of honor for me. Many more weeks and months of pain passed before I got around to seeing a doctor, and I did this only after certain essential fine motor skills4 became difficult.

So, here I was in the rheumatologist's waiting room. By then, the Internet had told me what I most likely had: a swelling of tendons called digital tenovaginitis5 or, as it is more colloquially called, "trigger finger."6 The longer this disorder goes untreated, the more aggravated it becomes and the more difficult the treatment. In fact, my left middle finger was now refusing to join its brethren in closing into a fist. My hand was perpetually prepared to deliver a Three Stooges knuckle jab, followed by "nyuk, nyuk, nyuk."

So, finally, I sat across from my doctor and was about to explain my symptoms and apologize for having waited so long when I noticed something odd. Susan Lacks is a sophisticated professional with many advanced degrees, but she was taking my medical history with a pen that she was fisting like a toddler attempting to negotiate a bowl of ice cream with a spoon. I asked her what was wrong.

"It's a condition called trigger finger," she said. "I've been too busy to deal with it, and I let it go too long."

After I held out my hand, and we stopped laughing, Lacks noted that this actually worked out nicely, because effective clinicians value rapport with their patients, and nothing accomplishes this better than commonality of experience.

"Fortunately," she said, "I'm not an oncologist."

Dr. Lacks sent me to a hand specialist. He gave me an injection in each hand, a procedure he said would "burn a little," a three-word phrase that proved to be one-third accurate and that left me, temporarily, with my two middle fingers completely numb. This is an odd sensation, and on the subway home I kept testing it out by poking myself in various parts of my body with my middle fingers, and saying "whoa." People were standing, but, for some reason, no one sat next to me.

Footnotes

1 This is a medical column, ergo it will have footnotes.2

2 As well as terms such as "ergo."

3 The medical term for joint-popping is "crepitation," which also is a term for farting. No one has ever adequately explained this.

4 Nose-picking.

5 A very unnerving name when applied to a Clint Eastwood man such as myself.

6 Much, much better.

Gene Weingarten can be reached at weingarten@washpost.com. Chat with him online at noon Oct. 26 at washingtonpost.com.

Gene Weingarten: Trigger finger requires a joint resolution 10/09/10 [Last modified: Saturday, October 9, 2010 5:31am]

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