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Wednesday, March 25, 2009

I was recently given a dexamethasone injection for trigger finger tendonitis

I was recently given a dexamethasone injection 1cc for trigger finger-tendonitis, my right thumb is locked open. I think now this was a mistake, but I was trying to avoid the surgery-cutting the sheath of tendon. The surgeon says the surgery is a 99% cure.

Can you give me your opinion on this surgery as the only option for me. The thumb has been stuck open 2-3 mos. I feel really awful about getting the injection now that I now the possible consequences. And is this surgery ususally succesful?

I am 61, my general health is pretty good. I exercise regularly, eat a pretty good diet, mostly vegetarian, probably need to lower my stress and get more sleep.

I do have chronic hepatitis B, but only mildly elevated AST. The doctor said my blood work looked good for someone my age. I am bothered by frequent leg and foot cramps and probably have arthritis in knees and fingers some.

Also, I have heartburn. I'm on no medications, preferring natural-herbs, supplements, homeopathy...
Gary responds:
The injection was probably a waste of time. The surgery may be necessary but you still need to be searching for the reasons behind the condition which surgery will not fix.

The single largest sub-group that approaches me for health advice is female vegetarians, or semi ones. It is not easy to be a good vegetarian and most people - even the most ardent - tend to mess it up. The end result is chronic unusual conditions that fail to respond to medical treatment.

Going by the little information you have given and experiences with similar cases I can make some assumptions:

First of all, it may be the case that you have a very mild case of scleroderma. This condition is far more common than reported in the medical literature - I see a case each month. The chronic stress on your body of the liver ailment and the lack of a number of key nutrients, including minerals, fats, proteins and many vitamins may leave your body in a weak and vulnerable state as the years pass. In particular your immune system gets weak and is easily confused. Please read the many articles here about the link between this and cytokines.

Here is what to do:
  • Ensure your diet is rich in a wide variety of proteins, fats (including animal), all vitamins, including all the fat soluble ones. And do a period of nutrient top up as follows:
  • Take a tissue salt mineral supplement for at least 6 months - Active Elements
  • Take a high strength natural B vitamin and C supplement, plus vitamins D and E for at least 3 months.
  • Take a high strength anti oxidant for at least 3 months (I recommend Astazan in this case)
  • It is recommended that you undergo a liver and digestive tract cleanse - I recommend the Herbal Detox programme which is effective, well established, based on good practice and contains no fads or extremes.
  • Sunbathe as per the many articles on this site about the health benefits of sunlight, especially as applied to immune health.
Cytokine Therapy
This form of therapy uses homeopathic preparations of selected cytokines to help reset the immune system. Please contact me direct if you would like to undergo a course. Generally, it takes from 3-6 months to be sure of a benefit. Highly recommended.

If you follow these recommendations there should be a steady improvement in general health and well-being, less joint pain and reflux and the chances of a recurrence of the tendon problems much less than they might otherwise be.

Please report in how you get on.

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TendonitisExpert said...

Specifically for the trigger thumb, assuming that it is trigger thumb, if it's been stuck open for 3 months, A. The shot never had a chance at doing anything beneficial, and B. the surgery may not be a bad choice.

-IF- it's trigger thumb, meaning you have a huge build up of scar tissue on your thumb tendon and an inflammed tendon sheath, and the tendon can't slide due to the too big scar tissue glob and swollen tendon sheath, surgery may be a not horrible option.

I almost never suggest surgery as a good option, because it's usually not.

Usually there are better, fast, natural solutions.

In your case, because it sounds like you are at the far end of the trigger thumb spectrum, those solutions may not be a viable option for you in the short term.

You're going to get other problems from the thumb being immobile for so long.

If the 'stuck' is because of a huge glob of scar tissue, there's really nothing quick you can do to make it smaller and restore movement, other than surgery.

On the upside, it's a minor surgery. On the downside, surgery has it's dangers.

Gary's the expert in the area of cleaning up your system, I get a lot of benefit from reading his stuff.

Unfortunately, if the trigger thumb you describe is due to classic trigger thumb, cleaning your system is unlikely to help the thumb itself, and definitely not as soon as you need it.

Rarely is surgery a necessary choice. You just may fall into the 'necessary enough' category.

And, it's only a short term fix. Scrape all the extra scar tissue off, give the tendon some room to move again.

Help the surgery heal with icing, extra protein, and appropriate movement.

And then you can deal with getting the area healthy again.

Sorry, this is getting long, but it's an important choice.

A main factor to consider is, how fast will you heal?

You have to balance how much you need that thumb to move considering that it's unlikely to get better on it's own at this point, and how fast you'll heal from the surgery (along with other surgery risks).

Find out if you have a big glob on the tendon, or it's just that the tendon is very very inflammed and swollen.

Make sure the doctor is sure of what it is he's going to be cutting on, and that that's the real problem in the thumb, before cutting.

Surgery or not, do follow Gary's suggestions. Part of the cause of the buildup on the thumb tendon (and certainly the general level of inflammation you are experiencing) could be due to all the extra minerals and such in your system.

Gary Moller said...

Thanks so much for the advice "Tendon Man". Most appreciated. Keep it coming.