Another diagnosis

It started with a lump. It ended with a diagnosis. The latest affliction to have a starring roll on my medical chart’s problem list is: morbus dupuytren, also known as Dupuytren’s Disease.

I see worried faces. Frowns. What? No one has the courage to ask yet? OK, let me give you some more background on the latest unwelcome guest to set up house in my body.

Apparently it’s more common after the age of 50. My half-centry mark is four months away. Apparenlty it’s more common in men than women. Although I’m not the manliest of men, I do have a Y Chromosome. Apparently people of northern European descent are at higher risk of the disease. Thank you very much, Swedish grandmother. Risk also increases among those who smoke and use alchhol—hang on, this is upsetting me so much I need to go refill my whiskey glass, and step outside for a smoke. And, and of course, you guessed it… Dupuytren’s is more common among people with diabetes, especially those of us dependent on insulin. Is it any wonder I got it? With that many risk factors, there was probably no ducking this particular bullet.

Can it be… cured, you ask? Are you going to be OK? Yeah, not to worry. This one of those things that sounds worse than it is. I was exercising my dramatic literary license again. This newest disease will be an annoyance, but will barely rise to the level of a challenge. Or that’s what I say now. In a year I may be singing a different tune, because one side effect of Dupuytren’s that might prove a minor annoyance to any other person could have a huge impact on me, given one of the ways I earn a living. More about that in a minute.

Let me introduce you to our next lesson in modern diseases. (Doctors learn by studying every disease known to mankind. I learn medicine by “catching” one damn thing after another.) Dupuytren’s starts off as a “knot” of tissue on the palm. It rests below the skin, on top of the muscle. Right now, mine is about as big around as a dime. It feels like a sphere, firm, hard, like I have a small marble trapped under my skin. It isn’t painful. Slowly, over time, I’m told I can expect it to evolve, sprouting like an acorn, growing tree-like roots to become a thick cord, which, like a miniature invading anaconda, will wrap itself around the ligaments of my fingers, pulling them backwards, causing my ring and pinkie fingers to contract more and more and more until it will be impossible for me to do “everyday activities” like placing my hand in my pocket, putting on a glove, shaking hands, or typing. At that point it’s called Dupuytren’s Contracture. And at that point, this harmless little disease could have a major impact on my life. How soon? It’s anyone’s guess. Sometimes it’s a wildfire. Sometimes it’s a snail race in slow motion. We’ll have to wait and see. And resist the temptation to grab a steak knife and cut the little fucker out of there!

No one knows for sure what causes Dupuytren’s, but (naturally) it’s thought to be some sort of autoimmune reaction. According to Mayo Clinic, it can hit other parts of my body too, for instance my feet or my penis.

We’re not going to talk about that. Hell, I’m not even going to think about that.

What can be done? Once it gets bad enough, there are options. A tattoo gun can be used to riddle it full of holes so it loosens its grip. Or maybe they used something more surgical, I forget. I’m too worried about my feet and my, well, you know... They can also cut the cord that’s strangling the ligaments in some cases. And the nuclear option is to open up the hand and try to clean out all the problematic tissue.

But it’s still too early. Right now I have to wait for the seed to sprout. Wait for it to start growing roots that will tangle into cords, and wait to see if the cords or my fingers win the coming tug-of-war.

I’ll write about it for as long as I can.

And that’s what scares me.