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CasinoGirl

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Reply with quote  #1 
For about the last month or so, I've noticed my left thumb will sometimes not straighten unless I manually force it to.  It then "pops" back into place.  I do not recall injuring it.  I have heard women refer to "trigger finger" as a side effect of AIs and wonder if I have trigger thumb?   I have been on Arimidex for 2 years; however recently (Nov '07) took Arimidex holiday.  I started back on Arimidex the first of the year, and have noticed the thumb thing is worse than ever!  So are my knees and elbows, but that's another post!  I thought maybe I had arthritis,  but now suspect it's trigger thumb.  What IS trigger finger/thumb, is it reversible and how can I prevent it?  I'm ready to take permanent Arimidex vacation!  I am a very active (trying to be anyway) 45 year old and feel 80! 

Thanks, NNN.

Donna


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silvergirl9114

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Reply with quote  #2 
donna--

I can save Nicki a little time on this one---have had two of them---a thumb and a ring finger.

Here's the mechanics. We actually have no muscles in our fingers, the muscles that work our fingers are in the palm and work what amounts to a pulley system of a tendon that slides into and out of a tendon sheath when we bend our fingers. The trigger finger is caused when a nodule forms on the tendon and either "pops" into the sheath or gets stuck in there and won't come back out.

My thumb got stuck and wouldn't bend at all by the time I admitted this wasn't anything I could self treat and hauled my butt off to an ortho guy. I'm here to tell you a non-working thumb on your dominant hand is not a good thing.

The nodule cannot be removed but surgery opens the sheath so it has enough room to move as it should. It's outpatient, really fast and your hand is wrapped for a week.

You can try to slow it down by taking NSAIDS, avoiding repetitive hand movements or splinting it---but that will probably just slow it down.

An ortho will offer you cortisone shots to see if that works but I declined. They only work 50-60 percent of the time, the trigger finger usually comes back over time and they can only be done 2 or 3 times and then the tendon becomes too brittle.

The doc will insist AIs have nothing to do with it but it seems to me that, now that they have admitted carpal tunnel is an AI SE and this is basically another tendon problem in the same area, it should be considered. My doc tells me it is more common in women than in men and in diabetics. I am a VERY tightly controlled Type 2 diabetic and almost entirely off medication for that so I'm not buying that as the cause either.

did I forget anything, Nicki?

Just got the stitches out Friday from the ring finger and the finger works fine. About a 1" incision in my palm, three stitches and the scar will be invisible in just a few months.

Let me know if you have any other questions--

Jeannie, the Queen of Trigger Fingers

p.s. The ortho very blithely suggested we still have 8 more fingers to go when I asked him if this was going to keep happening. The thumb was May, 07.
chemoabi

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Reply with quote  #3 
Jeannie the queen of trigger fingers:  You even explained things to me.
 
Hi Donna
 
Nicki

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CherylG

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Reply with quote  #4 
I was told I needed CTS surgery when on Arimidex... so I switched to Tamoxifen and was fine
Hugs
CherylG

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Karen1956

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Reply with quote  #5 

I developed CTS  on Arimidex and had surgery on my right hand before I found out it is a side effect of AI's. I am now on Aromasin for 6 months after a few month break from AI's where all the sed effects went away and the side effects are coming back - CTS is coming back in left hand, sore knees, swollen knuckles (even Craig noticed), elbows and wrists.  The Neurontin is helping a little so I will continue to endure.  Karen

CasinoGirl

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Reply with quote  #6 
Jeanie, Queen of Trigger Finger ~

Thanks for the detailed explanation.  You're definitely right about it not being a good thing to have trigger thumb on your dominate hand.  I was in bed eating a popcicle when my thumb "popped" and the popcicle landed in the middle of my bed!  Guess that's what I get for eating in bed!

Sounds like surgery might be the best answer....do you know if the surgery is generally a lifetime fix?  I don't want cortisone shots.  I wonder how long I'd need to be off work?  I sit in front of a PC all day and type, which probably doesn't help.

Thanks again for the great info!

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silvergirl9114

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Reply with quote  #7 
Donna--

Yup---it's a lifetime fix. I understand the cortisone shots are quite painful but in all honesty the local in the hand is no day at the beach either. I figure why get stabbed in the hand twice when I can fix it for good and only get stabbed once! (I'm assuming the cortisone won't work.)

My ortho guy told me that once the stitches came out I could go back to work (not an issue, I'm retired). That happened a week later so it's no biggy. I still keep a band aid over the incision though---a tad tender and don't want to smack it on anything. Got me out of dishes and laundry for a week because you have to keep the dressing clean and dry----not an entirely bad thing.

If your thumb has gotten hinky enough that you are tossing foodstuffs around your bedroom I'd suggest having someone look at it---it's not going to go away.

Jeannie
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Reply with quote  #8 

Don't want to step on any toes here .... but my doctor who suggested I take the break from Arimidex before opting for surgery told me if I had surgery and stayed on Arimidex it would not be a permanent fix. Once I took the break and all the SE went away he said it would have been a waste to do the surgery. Mind you I have different SE on the Tamoxifen and now Femera but at least I didn't go through another surgery for nothing.


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silvergirl9114

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Reply with quote  #9 
OK Nicki---NOW we need some medical clarification.

I had CT surgery before DX. My understanding of both proceedures is that they are either opening the tendon sheath for the trigger finger, or severing that tendon/ligament/whatever across the carpal tunnel to take the pressure off the nerve. How could that come back?

Or did your doc mean that why put yourself thru surgery if AIs weren't a permanent part of your medical future?

I'm confused. Another example of different docs tell us different things, just like CA treatment?
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