Thumb Repair, Step One

     Back on the 28th of March, I went to check that the back door was locked and fell down the three steps that lead from the kitchen to a landing just inside the back door, at the head of the stairs to the basement.  I reached out in the semi-darkness, flailing for the doorknob, and jammed my right thumb against it good and hard.  The immediate reaction was a big blood blister under the thumbnail, and I wrote about it the next day.

     Longer-term, there was some pain and swelling, and my thumb developed a kind of "detent," a click in the motion as I bent it at the knuckle.  I figured it would go away over time, and told my doctor as much at a routine appointment a few days later when she offered a referral to a hand specialist.

     It didn't go away.  It got worse, and affected my grip.  I started using my left hand more, but that thumb has some arthritis from an old injury, and then I had two thumbs aching, keeping me awake at night.

     So I did the grown-up thing, and told my doc I'd better see the hand-doctor after all. It was another two weeks wait for that, but yesterday, the man had a look.

     "Oh," says he, "We see this a lot.  The tendon swells up after an injury and starts sticking in the little tunnel it runs in.  It's like a cable that runs over pulleys.  It comes from muscles in your forearm, up the carpal tunnel, and on into your thumb, and that's where it's sticking.  It's called 'trigger finger.'"

     In fact, the the little "jump" in motion feels a lot like the break of a trigger.  Treatment consists of two stages: first, they shoot you up with -- I think -- cortisone or some corticosteroid.  About half the time that's all it takes.  If that doesn't work,  they do a little outpatient surgery in which they go in and open up the passage in your thumb for the tendon, and that's got a 90% or better success rate. (That's got to take the surgical equivalent of watchmaker's tools.)

     They numbed me up and gave me the shot, leaving my thumb bloated and no more sensitive than a block of wood.  The numbness had mostly worn off by this morning, the residual pain was gone by noon.  It still has the "trigger finger," but much less, and the specialist had said the pain would go away first, and the clickiness would take some time to fade, if it was going to.  I have another appointment next month; if things get better, I can cancel it.  If not, we'll try the surgery.

     The hand specialist was quick, competent, and had the kind of self-confidence that inspires trust: been there, done that, happy to fix one more.