Issue link: https://www.epageflip.net/i/42653
Wednesday, September 21, 2011 – Daily News 5C Finicky family frustrating Trigger finger may require surgery DEAR DR. GOTT: I have a Dear Annie: Family get-togeth- ers have turned into a big headache. I understand that some relatives have food allergies. But my siblings have become very picky eaters. One has self- imposed dietary restrictions, another is a semi-vegan, another won't eat beef, another only will eat free-range chicken, and one doesn't eat vegeta- bles of a certain color. Last year I told them that I will make the main dishes, and they can bring side dish- es. They said that would be too difficult, as they live too far away and the food wouldn't be fresh. In order to accommodate everyone, I would have to have a per- sonal chef. Eating out isn't an option since we live in a semi-rural area and there aren't a lot of restaurants. My siblings were not raised like this. Mom always had good, balanced meals. It seems to me they could eat what's on the table as best they can. This is real- ly annoying me. What can I do before the holidays start? — Stressed Out by Picky Eaters Dear Stressed: There is a limit to how accommodat- ing you need to be. Prepare a meal that the majority will eat. Have enough side dish- es so no one will starve. Then tell them you hope they enjoy the meal, but if Annie's Mailbox by Kathy Mitchell and Marcy Sugar not, you will under- stand if they choose to go elsewhere. Smile politely and ignore all negative comments about the food. We sus- pect they will find a way to nibble on something. Dear Annie: We all know that health care is expensive and that finding good, affordable care can be tough. There is a way your readers can avoid unneces- sary heath care bills: by learning what high-quality care looks like. We spend a whopping $700 billion a year on health care in America for tests, procedures, medical appointments, hospital stays and other services that don't improve one's health. As a society, we get an awful lot of health care that helps us feel better — even saves our lives — but also a lot that is unnecessary or wrong and can be dangerous. Some- times we don't receive the care we should be getting to treat our conditions. During the month of September, we are asking Americans to ''Care About Your Care.'' We want peo- ple to understand, identify and receive care that is safe and effective. Your readers can go to www.careabouty- ourcare.org to learn how to recognize — and demand — high-quality care. — Sincerely, John R. Lump- Friday Night Live members will be on hand at the Friday, Sept. 23, Red Bluff High School home football game, cheering on the Spartans and encouraging families to keep alcohol out of kids' hands. Friday Night Live is a youth leadership club focused on the prevention of alcohol, tobacco and kin, M.D., Robert Wood Johnson Foundation Dear Dr. Lumpkin: Thank you for giving us this opportunity to mention your website, which offers sug- gestions for readers to learn how to best manage their health. In this day and age, it is vitally important that we recognize the most effective ways to protect ourselves and stay well. We hope your website will be up and run- ning for a long time. Dear Annie: May I add another story about not get- ting a condolence card from the doctor's office? A few years ago, I received a condolence card addressed to my family from my doctor's office, signed by all the doctors and personnel. They thought I had died. They said many nice things about how I would be missed and how well I was liked. I called the office and said I was still alive and would be in soon for my annual checkup. The recep- tionist checked her records and said, ''Oh, my! It says you are deceased!'' I told her at least I found out what they thought of me. We both had a good laugh over that. I have a fairly common name and understand how it might have happened. My records were changed, and I breathed a sign of relief. — Staying Alive other drugs. The youth will host a booth dedicated to our "Parents Who Host Lose the Most: Don't be a party to teenage drinking" campaign. The youth will offer a parent pledge, encouraging par- ents and guardians to promote this substance free message. Simply taking away the car trigger finger. Three times the doctor has injected it to resolve the problem. He tells me there will be no more injections and that I must have surgery. Is there another solution? If not, can you detail the surgery for me? Thank you. lessen symptoms. A splint might prevent curling at the joint. While massage will not modify the inflammation, it will certainly make it feel bet- ter. DEAR READER: When a fin- ger or thumb catches in a bent position and will straighten only with a popping or snapping simi- lar to the trigger on a gun being pulled and released, the condition is referred to as trigger finger, medically referred to as stenosing tenosynovitis. The condition commonly occurs in the dominant hand, although both hands might be involved. When the condition becomes severe, the finger may remain locked in the bent position. The cause results from a narrowing of the sheath that surrounds the tendon in the affected finger. A tendon is a fibrous cord that attaches muscle to bone. Each tendon is encased by a protective cover- ing lined with a lubricating fluid to help the tendon glide smoothly as the finger is bent and straightened. Because of inflammatory conditions such as rheumatoid arthritis, the space within the tendon covering can narrow. The tendon becomes irritated, causing the digit to catch. The condition is common in individu- als whose work patterns or hobbies require repetitive gripping actions and is more prominent in individuals with a history of rheumatoid arthritis, hypothy- roidism, diabetes and certain infections. Treatment for mild cases might begin with rest of the affected digit for about a month; however, on the flip side, mild finger exercises may help maintain mobility. Since symptoms are more prominent in the morning, when the digit has been dormant for a period of time, soaking it in warm water might keys does not solve all of the prob- lems related to underage drinking. Every day, at least six youth under 21 die from non-driving alcohol- related causes, such as drowning and suicide. You can protect your children Dr. Peter Gott Medication often begins with NSAIDs, non-steroidal, anti-inflammatory drugs, typi- cally those found over-the- counter. From there, prescrip- tion NSAIDs or steroids will given to reduce inflammation. Steroids will not be as effective in those with diabetes or rheumatoid arthritis. Then there's percutaneous trigger fin- ger release performed under local anes- thesia and most effective for the index, middle and ring fingers. During the pro- cedure, a physician will insert a needle and inject steroids to release the locked position of the finger. Finally, surgical release is generally considered to be safe and may be the best solution for cases that don't respond to other forms of therapy. This proce- dure is performed in an operating room. The hand is cleaned and draped, and the surgeon releases the band that restricts the tendon. Two or three sutures will be used to close the incision and a sterile dressing will be applied. The incision should be kept clean and covered for up to two weeks. Motion of the digit during this period is actually encouraged. However, pulling, heavy gripping and pushing are discouraged. You can expect to receive immediate instruction on what specific activity is allowed or discouraged. A hand therapist may become involved. This will be followed with massage of the area of the incision. The incision may remain tender for up to two months, but symptoms will lessen with time. I suggest you be guided by your sur- geon's recommendations. If you have any questions, request a second surgical opinion. 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