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Richard Hayton had always been an active person. He had spent years as a farmer, growing strawberries, blueberries and cucumbers. Then he got a job at an oil refinery, where he had a physically-demanding job.
“I worked with my hands every day,” Richard says. That’s why it was so alarming when he realized that something was happening in his hands and fingers.
The changes had started slowly, when Richard was in his mid-30s. “I didn’t have any pain, but I noticed that I was having problems straightening my fingers out,” he says. “My fingers kept getting more and more bent.”
The problem had started on his little fingers, and then spread to his middle finger on the right hand, giving a claw-like appearance to the hand.
Then one day, about 10 years ago, Richard couldn’t get his work gloves on. He was having trouble doing daily tasks like shaving or washing, and realized that he needed to get help.
Richard went to see his general physician, who diagnosed the condition as Dupuytren’s Contracture, a hand deformity that develops slowly over time. Dupuytren’s Contracture involves a painless thickening of the tissue beneath the skin on the palm of the hand. Hard knots develop under the skin. They eventually form a thick cord pulling one or more fingers into a bent position. Often, it affects the pinky and ring finger. Dupuytren’s Contracture can progress steadily, or start and stop.
No one knows exactly what causes Dupuytren’s Contracture, but some scientists believe that it is an autoimmune response. The condition is most common in those of Northern European heritage.
Although Richard’s general physician did hand surgery, he ultimately said there was nothing more he could do. Richard saw no improvement.
Then last summer, Richard’s girlfriend saw a newspaper ad about a hand doctor who was giving a seminar on the five most common hand problems. Dupuytren’s Contracture was one of those topics.
Dr. Jonathan Shafer, an orthopedic surgeon at Skagit Island Orthopedics, is a hand, shoulder and elbow specialist. In his talk, he spoke about a new injectable prescription medicine called XIAFLEX that had proven very effective in treating Dupuytren’s Contracture, and required little downtime.
XIAFLEX is injected by a physician experienced in giving injections in the hand. XIAFLEX helps to break down the cord that is causing the fingers to bend, allowing the patient to straighten out their fingers once again.
Richard was immediately interested, and went to see Dr. Shafer.
“Each patient is different,” says Dr. Shafer. “My goal is to inform each patient about the options, risks and benefits. Between the two of us, we partner together to make the best decision. For Richard, surgery was an option, but not best for him because he didn’t want downtime. He needed to get back to work.”
Richard was eager to try the XIAFLEX. He came in on a Monday for the procedure on one hand. First, Dr. Shafer numbed Richard’s hand, and then carefully gave him four injections. The XIAFLEX works quickly, and on Tuesday, Dr. Shafer was able to gently straighten out Richard’s fingers.
Richard was sent home in a splint to keep the fingers straightened out. “I went to work that next Monday,” says Richard, “and by week two, you wouldn’t know that anything was ever wrong.”
Richard later returned and had his second hand done. The procedure was done on a Thursday, and Richard was back to work on a Monday. While the Dupuytren’s Contracture can return, future XIAFLEX injections can help to keep it at bay.
“Now my hands look like everyone else’s,” Richard says. “I’m so lucky that my girlfriend saw that ad. Now I have use of my hands again – thanks to Dr. Shafer.”
According to Dr. Shafer, many people put off coming to the doctor for problems because they are afraid they will have to have surgery. However, other treatments are often available.
“Just knowing about your options can bring peace of mind,” says Dr. Shafer. “We have more minimally-invasive treatments available now, which provide for a quick recovery. Our goal is to get you back to your active life.”