The poison worked.
Two weeks ago I wrote of an impending operation in which a surgeon was to inject my hand with Clostridium bacteria – instead of cutting me open and scraping away the bad parts – to relieve me of DePuytrens contracture, or claw hand.
The bacteria, the theory goes, would eat away at – dissolve – the hardened, thickened fascia that made my ring finger curl up.
Two days later the doc would “manipulate” the finger – there’s an ominous-sounding word – the fascia would tear with an audible “Pop!” and I would be all better.
I would not awake from total anesthesia to find my hand full of stitches – this time the anesthesia would be local, and there would be no stitches.
Nor would I be facing six weeks of rehab that were worse than the surgery – as I did in two previous operations. No, after this “procedure,” as they call it, I could go out and play.
Well, it worked.
The Clostridium poison – trade name Xiaflex – has been approved for medical use for just two years. It is extraordinarily expensive.
If you want a doctor to shoot you up with poison, you want it to be really good poison.
My surgeon, the saintly Dr. Liz, thinks it’s the biggest advance in treating DePuytrens contracture in her lifetime. She went through the “procedure” herself.
I have to agree with Dr. Liz.
My previous surgeries were no fun at all. I was stitched and swollen for two weeks, then the stitches came out and I went through the tortures of rehab.
This time, after Dr. Liz manipulated me and we heard the fascia pop, I came home and went for a bike ride, then mowed the lawn.
It wasn’t so much a pop as a rip or a tear. It didn’t hurt – Dr. Liz had shot my hand full of Lidocaine. In fact, the local anesthesia, the shot before the poison injection, and before the manipulation two days later, was the only part of the entire process that hurt.
True, my finger looked like a purple balloon for several days. But as I type this column – using all my fingers – just a week after the poison injection, the swelling has been reduced to the first joint of my ring finger, where the DePuytrens was.
DePuytrens always comes back, Dr. Liz says. There’s no permanent cure. It comes back a little or a lot, and you need to go through the whole process again, or not. But if you don’t go through it, your finger, or fingers, can curl up so far as to be useless. That’s what my little finger did the first time. I could no longer get my hand into a pocket. I could not straighten the finger by force. Pretty soon, Dr. Liz said, the only alternative would have been amputation. She saved my hands twice with surgery, and this time with poison.
The poison was the best.
So that’s my report on the human experiment upon me. I call it a success.
The worst part was battling my insurance company, which I consider a criminal organization, or damn near. I will not tell you its name, but it has the word Blue in it. Also, Cross. And something about an Anthem.
The insurer, whose name I will not tell you, approved the procedure, at first. Then it found out how expensive the poison is, and said, “Wait a minute! We don’t approve it!”
To battle this enormous, evil amoeba, I punched buttons on the phone, seeking a human. Day after day, I punched buttons 60 times or more before slamming down the phone in frustration.
This, I believe, is what the Evil Unnamed Insurer wanted me to do.
The Xiaflex people have programs to help out with the cost. I believe the Xiaflex people – doesn’t that sound like a science fiction movie? – really want to help, but they made me push buttons forever, too.
I gave up. Ecce homo.
Fortunately, I live in Vermont, where even doctors are human. Dr. Liz’s assistant, the divine Holly, took up my lance, and after weeks of battle made the procedure affordable.
I don’t know how she did it. But I would follow Holly or Dr. Liz into the mouth of Hell if they asked me. Not that I think they would, as Hell is so far from Vermont.
The poison worked.