Have you ever felt that your palms, especially at the base of your fingers, have little lumps that look like they're forming? At first, it may not seem like much, but over time, the lumps thicken and one or more fingers gradually bend inward. Most people start to think about this when they can't even straighten their hand completely and place it on a table. This is a condition we call Dupuytren's contracture , or Dupuytren's disease . Don't worry, it's not cancer or a life-threatening condition. But it can make it a little difficult to do your daily activities. So, if you have these symptoms, it's best to see a doctor to find out exactly what it is. Let's take a look at what happens when you see a doctor and what you need to know.
Questions you can ask the doctor
When you go to see your doctor, he will ask you a few questions. These questions are to help him understand your condition and determine the best treatment. Don't be afraid to give the most truthful information you know.
Imagine, like our uncle Siripala. He first noticed a small lump on his hand. He thought it was something he had come across while working in Wattepitiya. Over the years, his little finger and ring finger gradually started to bend. He couldn't even hold a cup of tea properly. It was only when he finally found a doctor that he realized it was Dupuytren's. These are some of the questions the doctor asked him.
See the table below to see what questions the doctor asks and what he is looking for in them.
| The question the doctor asks | Why is that important? |
|---|---|
| What are your symptoms? When did they start? | From what you describe, the doctor can get a good idea of the severity of the disease and how quickly it is progressing. |
| Does this hurt? | This condition is usually not painful, but the lumps on the palm can sometimes be a little painful to touch. |
| Has anyone in your family had this disease? | This is a disease that can be passed down through generations. Just like diabetes and cholesterol are said to run in our families, these diseases are also like that. That's why this issue is very important. |
| Do you have diseases like diabetes or seizure disorder? | Although the exact cause is unknown, Dupuytren's is more common among people with both conditions. |
| Does this condition interfere with your daily activities? | Knowing whether you have difficulty with things like shaking hands, working in the garden, or picking up things is very important in deciding whether to start treatment. |
| Can you do a "table-top test"? | This is the easiest and most important diagnostic test. They check to see if you can keep your hand completely flat on a table. If you can't, that's a key sign of Dupuytren's contracture. This usually doesn't require anything like an X-ray or MRI. |
Things you should ask your doctor
Just as the doctor asks you questions, this is the best opportunity to ask and find out the questions that are on your mind. Sometimes when we meet the doctor, we forget the things we want to ask. Therefore, before you go, write down the things you want to know in a book. That way, you won't miss anything. Also write down the answers the doctor gives in the same book.
Here are some important questions you can ask.
How quickly will this disease spread?
It's hard to give a definitive answer to this question because the rate at which the disease progresses varies greatly from person to person. For many people, it progresses very slowly over months or years . But very rarely, some people may experience symptoms that worsen over a period of weeks or months. Your doctor will be able to give you a rough idea of how your symptoms have progressed so far.
How long until I see the doctor again?
If your symptoms are not too severe, meaning they are not interfering with your daily activities, your doctor may suggest waiting a little longer before starting treatment . This is called a 'watch and wait' approach. In this case, you will be asked to monitor your symptoms. You will also be asked to come back for check-ups at regular intervals.
What are the treatment options?
The treatment you receive will depend on the location, stage, and severity of the disease. There are several treatment options.
The most important thing is that you and your doctor decide on treatment together. Talk everything through, understand everything, and then make a decision.
- Enzyme injections: This is a new treatment. Here, a special enzyme is injected to dissolve the thickened, sticky tissue. This is often tried first because it is less invasive than surgery.
- Needle aponeurotomy: In this procedure, a special needle is used to break the thickened tissue into small pieces, allowing the finger to straighten.
- Surgery: If the condition is severe and the toes are severely bent inward, surgery is often recommended. This involves removing the entire joint and thickened tissue.
Can this happen again after treatment?
Yes, this is very important to know. Dupuytren's disease has a high recurrence rate . Therefore, no matter what treatment you use, the condition may recur after a while. If that happens, you will have to undergo treatment again. However, the recurrence rate after surgery is usually lower than with other methods.
Are there places where I can get information and support?
When living with a disease like this, it's a great strength to talk to people who know about it and share information. So, ask your doctor about patient communities or other sources of information.
Take-Home Message
- Dupuytren's contracture is a condition in which the fingers of the hand gradually bend inward. It is not cancer or a contagious disease, so don't be unnecessarily afraid.
- If you feel like your palm is knotted or your fingers are curling inward, definitely see a doctor for advice.
- Diagnosis is usually made through a physical examination and "table-top" tests. Expensive tests such as X-rays are often not necessary.
- Treatment is only necessary if it interferes with daily activities. There are several options, including injections, acupuncture, and surgery.
- When you go to see the doctor, don't forget to make a list of your questions and concerns. It will be a great help to you.
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