First off, apologies for the lengthy gap since the previous episode – life is what happens to you whilst you’re busy making other plans. The plan had been to let you know how I’d been getting on with Hand Therapy sessions which started in late August and ran continuously once a fortnight till early November when it was decided no more improvement could be made. Also, if anyone out there is suffering a similar infection, I suppose it’s good to know the eventual outcome, or at least my progress after nine months since the operation and eight months into the 2-year course of antibiotics.

So, I can now manage to bend the index finger a little more than I could before I started the hand therapy sessions, though the upper two joints remain weak, whereas the joint nearest the palm is quite strong but is still severely restricted by the bacterial growth which has not really subsided at all in the last few months. To aid the finger in returning to a natural position the hand therapist has  designed me various contraptions to wear mostly overnight (see pic).

‘swan-necking’ prevention brace & trigger thumb brace

One is to prevent the finger from ‘swan-necking’ – this is when it begins to curve upwards from the knuckle because the ligaments have dropped to the bottom of the finger when some of the straps (which wrap around the circumference of the finger) were removed during the original operation. However, I recently lost this finger support and need to get a replacement.

The second contraption is to protect my thumb. Because the thumb had been compensating for the lack of an index finger, I developed trigger thumb – this is when the thumb locks into either a straight or bent position and is painful to move between the two. This can happen with fingers too, as I can testify, having had both a trigger finger on my left hand little finger and trigger thumb on my right hand  quite a few years ago. Both were corrected with surgery under full anaesthetic and are as good as new now. I may eventually have to undergo surgery on the latest trigger thumb if it doesn’t correct itself (unlikely), or I may opt for a cortisone injection as a first call.

Meanwhile, back at the index finger, all the leaks have long since healed up, leaving me with a rather lumpy lowest joint and palm where the two meet (see pic).

If the daily antibiotic regime of tablets does not continue to reduce the swollen section then I may have to undergo further surgery eventually to ‘de-bulk’. A decision will not be taken on this for quite a while until the course of antibiotics is completed in 2015, though there will be a review in March 2014.

The good news is, I am back playing the piano with two hands again, though my left hand is not as good as it was (and may never be) so scales and arpeggios passages are somewhat bumpy where the index finger plays a crucial role. On a day to day use of the finger, I had no choice but to avoid using it when it was unusable, and it is now difficult to break the habit. I must make a more concerted effort to employ the finger in routine tasks such as holding a cup, glass, fork, brushing teeth or simply picking things up (after all, I am left handed!). Funny really, how after decades of ‘normal’ use, just a few months without it and the brain has difficultly in re-assigning the finger some of its previous duties!

The NHS have been efficient as ever with my treatment and most recently with my hand therapy. Since the last appointment with orthopaedics in October, they don’t want to see me again till next May, and I have a 3-monthly visit coming up next month with Infectious Diseases.

If there are any further developments I’ll report back to you. Thanks for all your good wishes and staying with the blog … even demanding this latest update!