Three Is A Magic Number

Out of all the Schoolhouse Rock videos, this is my favorite. (I’m Just A Bill and Elbow Room are runners up.)

There is something magical about the number three. And that song (and the cover done by Blind Melon, too.)

But today, three is not a magic number. It’s the number of trigger finger releases I am supposed to have in a few weeks.

I say supposed to have, because like any empowered patient, I’m going to to do my research about having three fingers done on one hand when only one is actively triggering (although my pinky and my middle finger – hey!). I’ll ask around, look up information in medical journals and perhaps even get a second opinion by another hand surgeon. Why, you ask?

My Appointment Was Not What I Expected

The appointment itself was interesting, because if I had met the surgeon a few years ago, it would have been a different conversation. Here’s how it went (and my thoughts as it happened).

My appointment was for 12:10pm. Brought into a room by Jason with a M.A. on his name tag.

::What does M.A. stand for in this office? Master of Arts? I don’t think so.::

“So, why are you being seen today?”

::Does ANYONE read the reams of paperwork they make me fill out? Anyone? Bueller?::

I give him the lowdown. 

“How do you know that it’s trigger finger?”

::Again, paperwork. Four previous trigger finger release surgeries.::

“You’ll get an x-ray and then the doctor will be in to see you.”

From the time I saw Jason and got two X-rays on my hand, it was another 40 minutes before I saw the doctor.  He breezes in with a guy behind him wheeling a cart with a computer on it. His own personal stenographer for electronic health records.

He knows I have trigger finger. There are no questions. I didn’t get an opening statement in.

Because of my friends, Drs. Sean and Tamara Oser, who present an incredible session at Friends for Life, I know this statistic: 

In a well-known study of the survey phase, Beckman and Frankel found that physicians prevented patients from completing an opening statement 77% of the time. Those who interrupted their patients did so in a mean time of 18 seconds.

He beat this statistic to death.

“Hi, I’m Dr. X (not his real name, although that would be neat, right?). So, let’s see your hand.”

He examines it. Palpitates the area where it hurts. I wince. He keeps asking me to open and close it, telling me to make a fist.

::I can’t make a fist, dude. My finger won’t do that anymore. If it did, I wouldn’t be here.::

He pokes at it again, while I explain that I’ve had trigger release done before, but not here and not for this finger.

“O.K., so I’m going to give you a cortisone shot.”

Options

::Oh, no you aren’t.::Water Punch

::He didn’t even give me options. Ask me if I’ve ever had a cortisone shot in the FOUR other fingers I’ve had trigger finger. Explain that I could choose: physical therapy, cortisone injections, percutaneous release or open surgery release. Four options. I know which one would work for me, for most Type 1 diabetics, but HE DIDN’T GIVE ME OPTIONS.::

“Dr. X, I’m not doing a cortisone shot. It’s been proven and published that it’s not a successful treatment option for individuals like me with Type 1 diabetes. Surgery is almost always done in these cases following a cortisone shot.”

He looks at me, then turns to the steno guy, who is now looking confused.

“I’ve done the research. I am an e-patient.”

He looks at me again. He says:

“I’ve done over 10,000 release surgeries. Most people with diabetes do end up with surgery.”

The steno guy is wide-eyed. Dr. X nods to me, then tells the silent interloper with the computer:

“We’re going to do surgery.”

He turns back to me, starts palpitating my palm again and asks if there is any pain when he presses here or here.

::Yes and yes.::

“You know that you’re already showing signs of triggering in your pinky and it’s only a matter of time before you’ll have to have the pinky and the middle finger done. So, let’s go ahead and do all three while we’re in there doing the ring finger.”

::I am so over this trigger finger thing. Whatever.::

After this brief conversation, he leaves and I schedule surgery, but not before he popped his head in and told me that I would probably want to schedule it at one surgery center over the other he uses, because the anesthesia company he uses does not accept insurance at the one closest to my house.

::In my next life, I’m coming back as an anesthesiologist.::

If this had been a few years ago, I would have blindly accepted the cortisone shot, then floundered for weeks dealing with super high good sugars and staggering amounts of insulin to bring it down, eventually ending up in his office again, this time to schedule surgery.

I have done a lot of research, talked with my friends in the DOC, and had this done four times already, I didn’t go in blind. I just came out angry.

Angry that I wasn’t offered a choice. Angry that I had to state that I was going to have the option he didn’t initially present to me. And then I am angry because I am not even sure I should have three fingers released when I know only one needs to be done right now.

Questions

So, for those of you who have had trigger finger release surgery, has anyone had THREE fingers done at once? What would you do?

And maybe the other question I have is this: Is it wrong to expect doctors to have a conversation with you about options, because right now, I’m as confused as the poor steno guy?