That Boutonnière Deformity Guy

Nine months ago, I injured my finger while roughhousing with my six-year-old son.

(Most of you know this explanation isn't entirely true, but it's my new and improved and truncated account going forward. For the record: NO ONE loves to laugh at himself more than I do, but whenever I've gone into greater detail, the reactions from friends and co-workers has been what can only be called a cross between "skeptical" and "litigious" -- Wait…what? You poked your son with your finger? How hard do you have to poke him to tear a tendon? So, it'll be "roughhousing" from here on out.)

Almost two months ago, I finally had an MRI. In keeping with my new brief, but borderline truth-obfuscating explanations, the MRI went well.

Eleven days ago – some 260 days after the initial injury – a hand specialist spent 20 minutes with me and provided what four doctors before him couldn't: an accurate diagnosis.

(Admittedly, my medical expectations were tempered when my eye caught the unmistakable couch-sized sight of a dot matrix printer behind the desk of the specialist's receptionist. But, this doctor had obviously reallocated funds from 21st century administrative technology to extra night classes at Hollywood Upstairs Medical College.)

I'm the proud owner of a left pinky finger with a Boutonnière deformity – yes, like the flower a man wears on his lapel. And, I'd like to shout out everyone in my office who has brought back so many forced, unfunny floral jokes at my expense. It's been 25 years since Janet Wood last turned off the lights at her flower shop on Three's Company and equally as long since Hightower from Police Academy worked as a florist for strictly ironic reasons.

From the American Academy of Orthopedic Surgeons (AAOS) website:

Boutonnière deformity is an injury to the tendons in your fingers that usually prevents the finger from fully straightening. The result is that the middle joint of the injured finger bends down, while the fingertip bends back. Unless this injury is treated promptly, the deformity may progress, resulting in permanent deformity and impaired functioning.

Or, as my doctor succinctly stated:

"This is a complex injury. I wish we had treated you much sooner."

In fact, the AAOS website recommends treatment no later than three weeks after the injury or development of the deformity, ominously declaring it becomes "much more difficult to treat" after 21 days. I injured my finger in August 2009…am I still within the window?

The specialist didn't want to perform surgery before first sending me to 4-6 weeks of physical therapy. One thing I learned from last year's Samter's Triad Storyline: doctors are determined to exhaust every possible co-pay before considering surgery.

Last Thursday, I went to my first physical therapy session.

Now, I know that I've got some readers in the industry, so try not to retroactively laugh at my ignorance here: I was mildly surprised to find myself sitting in such close proximity to other patients receiving physical therapy. No walls, no curtains, no privacy. I was filling out paperwork while a woman – not more than 15 feet from me – was in tears from the work being done on her neck and shoulder.

My physical therapist walked me through my issues and I appreciated his candor with regards to the previous months of medical missteps ("You were being treated for the wrong injury.") and the likelihood that physical therapy would help me avoid surgery ("At best, it's 50/50.")

One more thing I appreciated: I was required to dip my left hand in paraffin wax and then cover it with a hot towel for 10 minutes. Afterwards, even though my finger still looked rigidly mangled, it temporarily felt loose and free for the first time in forever. Mrs. Bootleg later told me that she pays "good money" (from her part-time job) for paraffin wax treatments. I'm this close to going with her next time, just to resurrect that tired Chris Rock bit ("How much fo' one hand?!").

The physical therapist gave me a series of flexion/extension exercises to "stretch" the tendons and straighten out the finger. Friday morning, I performed these exercises for the first time. Initially, my finger turned purple – a "Black History Month" kind of accomplishment for an African-American – and then, my whole hand swelled like a latex glove filled with water.

The next few days haven't been nearly as bad, but tonight, Mrs. Bootleg had to turn away from the real-time color change that was occurring at the top of my injured digit.

I'm looking forward to holding my surgical scars just inches from her face in a few weeks months whenever.