Trigger whaaaat?

Many of you know I have two dogs, mutts, furry creatures that think they are human. There’s Barkley (who doesn’t get as much attention because she usually behaves — save the unfortunate Tootsie Roll feast where she pretended she didn’t eat anything). And then there’s Lucky, most known as #DevilDog (don’t let the picture fool you.) Lucky is not a bad dog, she just eats everything. (ornaments, bras, shoes, Christmas trees, etc.) Because I live in an apartment, I take my dogs outside as often as I can. We go hiking and we visit the dog park, and sometimes, we just go outside and play — which is exactly what we did on Sept. 17. While we were playing, running and jumping, my hand came down just as Lucky jumped up. Her mouth wrapped around my right thumb and the corner of my hand. She didn’t bite me and the skin didn’t break — it was just your standard hand-to-mouth collision. (wait? what? that doesn’t happen to everyone?)

Needless to say, my hand hurt the next day, as if I had jammed it. It continued to hurt for several more days, but I didn’t go to the doctor. Why? Well, who goes to the doctor because they jammed their finger in their dog’s mouth while playing outside? I mean, really. As my thumb and the joint at its base continued to hurt four weeks later, I decided to call my general practitioner. After seeing me, he prescribed anti-inflammatory meds and scheduled an xray, which came back normal. A week later, I called back because it continued to hurt. (and because WebMD suggested gout and/or Rheumatoid arthritis as possible options).

The next thing I knew, I was at the orthopaedic surgeon’s office. He explained the pain seemed to be coming from my PIP joint at the base of my thumb. Then he said it could turn into trigger finger. (Go ahead, make a gun shape in your hand.) The doctor continued to explain what it was since I was clueless. Apparently the tendons in your fingers, called flexor tendons, are very long. They extend from the muscles through the wrist and attach to the the small bones in the thumb and fingers, which is what controls the movements of our fingers. When you bend or straighten your finger, the flexor tendon slides through a snug tunnel called the tendon sheath which keeps the tendon in place next to the bone. (Credit for that description goes to American Academy Orthopaedic Surgeons.)

So with trigger finger, there is an irritation on the flexor tendon which causes small nodules to form. Those nodules make it difficult to slide through the tendon sheath. And

sometimes, the sheath can get smaller, making it even more difficult for the flexor to pass through. When it’s unable to pass through, the finger gets stuck in a particular position and unable to move… trigger finger. So my doctor gave me a splint to wear at night and stronger anti-inflammatory meds.

While my case wasn’t severe enough for my finger to get “stuck” in a position, it did cause a lot of pain. I couldn’t put pressure on it which made seemingly mundane tasks like opening a bottle of water or twisting a doorknob next to impossible. And I was even having trouble texting, so it was getting serious. About four days after the surgeon visit, I was in the most pain I’d been in since this whole thing started. And to make matters worse, I couldn’t move my thumb backward (picture the L shape) without manually moving it. So I made another appointment.

Monday, (BOO!) I started the day getting a steroid shot. The surgeon was fantastic and explained everything as he did it. He even compared the size of the needle to one a diabetic would use so I could have a better understanding. After numbing it (thank GOD!), in went the really big needle with the steroid. The needle hurt less than him squeezing the sore part. As the medicine went into my thumb, I felt lots of pressure. It felt as though my thumb was about to explode. Before I could say anything, the surgeon looked at me, smiled and said, “Don’t worry, that’s normal and no one’s finger has exploded yet.” (At least he had a sense of humor).

So minutes after arriving, I left with a numb and swollen right thumb. It swelled up something fierce and had it been green, would’ve rivaled that of the Hulk. The surgeon said the steroid may cause additional pain the first day, but after that, I should get some relief. He scheduled me to return in three weeks if it was still bothering me and we would discuss surgery (please, God, no surgery.) He warned me to keep a close watch on my blood sugars all day because of what steroids often do (which is raise them drastically.) I worked a normal day making sure not to use my thumb to do anything involving pressure. I survived trigger finger and only have one small puncture mark as a battle scar.

I did learn a few things from the experience though. For starters, if it hurts after a week (or four), go to the doctor. Secondly, ask questions. I had a wonderful surgeon who explained everything to me, even how the tendons in my hand worked. And thirdly, the DOC rocks. The day I realized I had trigger finger, I sent a tweet which was immediately answered by several of my DOC friends. They had dealt with the same thing and answered all my questions and took away any anxieties I had. I also learned trigger finger is more common among diabetic females. Go figure.

Oh, and I totally rocked that steroid!