Richard's Festering Nodule

Have You Heard of This Phenomenon?

I've read that as one gets "old," things start to go wrong! Apparently "bodies"—including those of humans—start accumulating defects as they've been around longer. What a nuisance!*

Or more than a nuisance, but I get ahead of myself...

I read an article recently about the concept of the "annual physical exam." I had pooh-poohed the notion of having one for many of my younger years. I was healthy, felt healthy, and saw no need to attempt to prove it to myself or to anyone else. The recent article—by a genuine doctor person—largely verified my intuition. I have campaigned in these phosphors against "annual" rituals; the earth's orbit hardly can be expected to determine, for example, one's fitness to hold a license for transmitting radio signals. Nonetheless, in the past decade or so I've been threatened into periodical medical scrutiny. While it has (so far, of course) yielded nothing but a "keep doing what you're doing" and a literal gold star on lab reports, I did have a recent incident.

My doctor, Torquemada-like in her persistence, refused to accept my repeated assurance that I had not gone defective. "Surely there is something wrong!" she insisted. Wracking my memory, carrying on the metaphor with a slight spelling variant, I realized that I had noticed that my right-hand ring finger had developed a barely noticeable glitch. If I curled and uncurled it, there was a slight resistance to opening at a certain point in the process.

"AHA!"**

"You have trigger finger!"

I didn't have to feign ignorance. Of course I had a trigger finger; I've been shooting guns since summer camp. But this was a medical condition which I had never encountered or even heard of. Turns out it is extremely common. The first few people to whom I mentioned it said they had had it; one even proffered a demonstration of its presence in his own right hand.

Thus educated, we discussed it for a minute or so, got a referral to a doctor who specialized in repairing problems of the manipulative appendage, and I left the office without undue concern.

It got worse. I decided to Do Something about it and went to the doctor, who was very reassuring. He gave me an injection in my palm, which cured the problem until it returned and got even worse.

Doctor: "We could try another injection, but since the first one stopped working in months, the second one likely wouldn't be any better, and due to your age, might not work at all. You need surgery.
Naive Richard: Oh, OK. Go ahead.
Doctor: Do you think my office is set up to do instant surgery? You have to go to a surgery center and I'll do it tomorrow.
Still naive Richard: Oh, OK. See you tomorrow

I should mention at this point that the only "surgery" I have ever had was premeditated dentistry and cataract repair. I have seen dramatizations of surgery on the television set with mock patients connected to tubes and machines while wearing potentially embarrassing costumes. I assumed that this was minor surgery on my hand which would involve a local anesthetic, a little cut, a few minutes work, and I could even watch. I didn't realize I was about to undergo a

Rite of Passage

Let me emphasize, and the photograph should confirm it, that this was surgery on one hand. Nobody bothered to explain why I had to remove all my clothing, put on a backless costume with inadequate closure mechanisms, a plastic item that covered my hair, and funny socks that had little pads on the bottom. All this was done in an area that looked like an execution chamber.*** Rather than a local anesthetic, an IV was inserted in my other arm, and I'm very glad that the anesthetist had a supply of propofol and not pancuronium bromide. Surgery was committed. I barely noticed. When done, they demanded that I take a taxi home instead of walking. (The surgery was expensive; I wasn't keen on spending money on a taxi as well.) I abandoned the taxi when it got stuck in traffic. By far the worst aspect of the experience was the bandage. I'm a rightie, and for the next week I had trouble typing with my bandaged hand. The computer interpreted spurious key presses as directions to Windows to interrupt my work and confirm that I wanted it to do things that I didn't even understand. A week later, I had a "post-op" visit to have the bandage and sutures removed. I was instructed not to look. Perhaps some day I'll be permitted to know why. During the same visit, the doctor told me my tendon had had a "festering nodule."

Today, a couple months later, the palm has healed, the trigger finger is no longer sticking although it is a bit less flexible, and I have a story to tell. Lessons learned?

• Trigger Finger is very common and typically strikes the thumb or ring finger on either hand. It's random.
• Surgery, even with some insurance, is very expensive, and the billing process absurd.
• I am now an elderly person who has had surgery, like many of my ilk.
• Try not to use a computer with an enormous bandage on your hand.
• Surprisingly, other than the cashectomy, the entire procedure was almost completely painless. The worst part was the irritating friction from the bandage.
• Festering Nodules would be a great name for a rock band. I tried it out below.

* I've also read, and evidence has accumulated, that they eventually stop functioning altogether. Word fails me.
**I made her day. That AHA is not at all exaggerated, but it is surely overpunctuated.
***Which I've also seen on the television set but not in person.

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