June 2019
The Two Cent Times
Page 3
www.centralmainetoday.com
Handy tips on hand disease Dupytren’s contracture By Diane Atwood About 12 years ago, Donald Jones ran into a friend who used to be a hand surgeon. When they shook hands, the friend felt a cord in Donald’s palm and told him that he had Dupuytren’s contracture. Dupuytren’s means you can’t straighten some of your fingers, usually the ring and/or the little finger and sometimes the thumb. Donald knew what it was. His father had a contracture in one of his fingers. “He didn’t do anything about it until his finger curled over and grew right into his palm,” said Donald. “He had to have major surgery. They had to cut the cords in his hand to open up his fingers.“ How Dupuytren’s develops Underneath all skin, including on the palm, is a sheet of connective tissue, the fascia. With Dupuytren’s, the fascia becomes diseased. The first sign is usually a small nodule or a bump in the palm, says Dr.
OBITUARY
Youssra Marjoua, a Portland orthopaedic surgeon and hand specialist. “It may feel like a callous,” he said. “There’s no pain, but it continues to evolve into a cord. The cord doesn’t immediately cont ract, but event ually will attach to the skin above. As that happens, it starts to actually bring the skin down and leads to a flexed finger.” The highest prevalence is in senior Caucasian men, mostly of northern European descent. They usually have a family history of the condition. Donald’s progressed slowly in both ring fingers. “I would shake hands and it would feel funny,” he said. “Your finger has curled over and you can’t even force it back. “ In April, he had a procedure to release the cords and his bent fingers, first in one hand and a month later, the other. He could have opted for surgery to remove the diseased fascia, but instead, had an
enzyme, Xiaflex, injected into the cord. The enzyme softens and weakens the cord so that in a day or two it’s possible to break it up by stretching and bending the finger. In one finger, Donald inadvertently did it on his own. “I had the shot one day and the next day I was shopping, I grabbed the door of the bottle return to drop the bottles in and I felt it pull a little bit. When I went in that next day to have it stretched, he said, ‘Oh, you already did it.’ So that pulling already stretched it some and then he did the rest.” Donald says he’s glad he had the procedure done because his fingers are no longer bent. But he still has a bit of trouble opening jars and there’s a chance he’ll have another procedure in the future on his little finger, which has a cord. Deciding how or if to treat Marjoua says it’s difficult to predict the severity
Picture is Donald demonstrating how his father’s finger looked.
How Donald’s finger looked before procedure.
of the disease. Just because there is a nodule, or even a cord, doesn’t mean the finger will bend. To make a diagnosis, in addition to asking questions and examining the hand, the doctor will do a tabletop test, where the patient puts his hand palm down on a table. If all fingers and the entire surface of the palm can be f lat without any gap, it usually means the contraction doesn’t need intervention. If treatment is neces-
sary, two factors should be considered before choosing surgery versus an injection. First: Is there a clear palpable cord that medicine can be safely injected into? The medicine must only go into diseased tissue and not in the tendon or surrounding arteries and nerves. Second: If it’s so severe the patient has a finger and palm deformity and the cord can’t be seen, surgery is an option.
Submitted photos
He’s pointing to the cord in his hand that indicates he MAY develop another contracture.
Some can choose between surgery or injection. In surgery, because the diseased fascia is removed, there is less chance of a recurrence, but it usually can’t be totally removed, so it doesn’t eliminate the risk. Either way, there is no easy way to predict a recurrence. Anyone who suspects he may have Dupuytren’s shouldn’t wait until his finger is curled over before seeing a doctor.
Ellen Roy (Gower) McGregor 1958 -2019
SKOWHEGAN — Ellen McGregor, 60, passed away at home, surrounded by loving family and friends, on May 25, 2019, after bravely battling cancer for the past nine months. Ellen was born Dec. 7, 1958, in Skowhegan, the daughter of Edward J. Roy, Jr. and Verna Dionne Roy. She g radu ated f rom Skowhega n Area High School and the University of Maine. She cherished time spent with her children and grand-children,
loving to cook for all to enjoy. The numerous art pieces cherished by family
members are testament to her artistic flair. She loved gardening and flowers and was proud of her FTD Florist Designer Certificate. In past years, she was employed as a legal secretary, most recently in the office of attorney Stephen Packard in Newport. Ellen was predeceased by her father, Edward J. Roy Jr. Survivors include daughters, Katherine (Michael) Alberico of Topsham and Danielle Gower of Skowhegan; son, Edward
McGregor of Portland; grandchildren Marie, Vincent and Sylvia Alberico of Topsham; former husband and soul-mate, George McGregor of Skowhegan and Livermore Falls, who gave her considerable comfort and support throughout her illness. She is also survived by her mother, Verna D. Lister of Skowhegan; brother, Stephen (Calla) of Falmouth and Madison; brother Eric (Brenda) of Norridgewock; several nieces and nephews and
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greatnieces and greatnephews; Aunt Gen and Uncle Hod Fortier and Uncle Dick Getchell of Skowhegan and numerous cousins. Fondly remembering her are very special family friends, Raelyn, Jessie and Catherine, who also gave her considerable comfort and care throughout her illness. The family wishes to express gratitude to the staff of the Harold Alfond Center for Cancer Care and MaineGenera l Medica l Center Hospital and Home
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Care and Hospice for their compassionate care and support, especially Nurse Brenda. Memorial contributions in Ellen’s memory may be made to Special Olympics of Maine, 125 John Roberts Road, South Portland, ME 04106 or the American Cancer Society, Bowdoin Mill Island, Suite 300, Topsham, ME 04086. Arrangements are by Dan & Scott’s Cremation & Funeral Service, Skowhegan.
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