Back to the Doctor

In early April I posted a short note about a doctor visit that took place in late March. There wasn’t much travel, but it did involve adventure. Recall that I have Dupuytren’s contracture, also known as Viking Disease. The Mayo Clinic describes Viking disease as a hand deformity, although I choose to view it as a badge from my commitment to bicycle riding. Layers of tissue underneath my left palm have formed a knot that has created a thick cord. The cord is pulling inward on my ring finger. I can no longer straighten that finger, and without some intervention it will continue to worsen. So far, I have no pain but there is discomfort from time-to-time. I have stopped wearing my wedding ring because it exacerbates the odd feeling I have in my hand and finger. Bicycle riding has worsened the condition. I put a lot of pressure on my hands when I ride. The knot in my hand grows larger and is more sensitive during outdoor riding season.

In my previous post, I discussed the process of physically going to see Dr. Tom Ferlic at Nebraska Orthopedic. It was early-on in the COVID-19 safe practice standard setting in the U.S., not in other countries, but a process was in place. Patients were still gathering up in the waiting room, and on that day in March Janet and I met up with 20 or so new friends anticipating a call to go back to an exam room. Janet and I were the only non-staff persons wearing masks. We were asked to don masks because we had traveled away from Omaha over the previous two weeks.

This time, this week, the process was more robust from a COVID-19 safety perspective. My return to see Dr. Tom involved an injection of Xiaflex, a substance designed to assist in dissipating the knot. I arrived early at the parking lot entrance to the clinic. As was the case in March, I drove up to a barrier where I was asked questions about why I was visiting the clinic, who was my doctor, did I have a fever, and when was my appointment. I was also told that I would need to mask-up for the duration of my visit.

I was then told to queue up behind another car that was about 100 feet in front of me. I did. Soon, it was my turn and a masked-up and gloved staff person approached my car. She handed me a set of forms to complete and told me to park my car in the adjacent lot. She also told me that I would receive a phone call when the doctor was ready to see me. The parking lot was the new waiting room, a fact confirmed after I entered the clinic post phone call. With the exception of a staff person who greeted me upon entry, the room was devoid of humans. Just empty chairs waiting for butts to fill them. As I walked into the clinic, my temperature was taken, light beam to the forehead. Quickly, I was escorted to an exam room where the first phase of my “procedure” took place. There were two sets of injections with multiple pricks to the skin. The first set deadens the hand in anticipation of the second, Xiaflex. I do not recommend signing up for getting injections in the hand if you are simply looking for an alternative to binge watching Law and Order Special Victims Unit.

The joy of my “procedure” was not over yet. The Xiaflex injection just started the process, and I had to return to the clinic 72 hours later for a hand manipulation designed to “bust up” the knot. More joy, and more pain, awaited me. There was first a shot, multiple pokings to deaden my hand. Then there was the manipulation, pushing, pulling, and otherwise abusing my hand and fingers. In the end, I could straighten my finger and the knot was much smaller. My hand was very numb for the manipulation, so no pain was realized. As a bonus, I received a Cortisone shot, multiple prickings. Dr. Tom was done. He sent me away with a small set of exercises and information about what I can expect with respect to recovery. He knows that I am itching to ride again.

About 30 hours after my second visit, my finger was still straight, the swelling in my hand and fingers had lessened, and I had no pain, just a bit of discomfort in the center of my hand where the knot once resided. I counted nine small holes, pinpricks, the result of my many injections. They will soon heal. I am optimistic about the future here. My next visit to the clinic is three weeks out, June 8 to be precise. I will be back on my bike again soon.

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