The injection, as noted in the first section, contains two kinds of numbing medicine, to help prevent it from hurting. The numbing medicine will make the finger or area numb, so don't be surprised. Many patients, after a trigger finger injection, ask me, "Why is my finger numb?" Because I just gave you a numbing shot. Simple, really. The steroid used is a combination of fast-acting and long-acting steroids. This is to try to prevent pain after the numbing medicine has worn off. If you get some increased pain after the numbing medicine has worn off, do not be dismayed. This occurs in about 15% of patients. This does not mean that something has gone wrong.
The care of the hand in the post-operative period is very important in helping to ensure a good result. Initially the aims are comfort and elevation. These are met by keeping the hand up (elevated) especially in the first few days and by use of a long acting local anaesthetic (Bupivicaine). The local anaesthtic lasts at least 12 hours and sometimes 48 hours. Patients should start taking painkillers before the pain starts . on return home and for at least 24 hours from there. This way most of our patients report little or any pain.
The bandage can be removed after 2-7 days, leaving a sticky dressing beneath. The patient or GP practice nurse can do this. If well healed at that stage then the wound can be left open (exposed). If in doubt it can be covered with a light dressing for a few more days. The patient is reviewed in clinic between 2-4 weeks following the operation. Typically dissolvable stitches are used so they should not require to be removed.
The hand can be used for normal activity after the first few days. Most patients can drive after a 2-3 days. Most patients return to work in 2-5 weeks, but this varies with occupation; heavy manual work usually takes about 4 weeks. The wound should be massaged by the patient 3 times a day with a bland soft cream for 3 months once the wound is well healed (typically after 2 weeks). This reduces the scar sensitivity which can be a nuisance. If this is marked a Physio may be organised to help reduce the scar tenderness but this is rarely required. Patients should avoid pressing heavily on the scar for 3 months following the operation as this will be quite painful. Examples of activities to avoid are using the palm to grip/twist a heavy or tight object or use the palm to help get out of a chair.
What are the results of the operation?
At least 85-90% of patients say they have a good result following this operation, with relief of the pain and triggering. If there is already severe stiffness of the finger, then this may not improve. Recurrent symptoms do occur but in our experience in only a 2-3% mainly in patient with more severe symptoms and particularly patients with Diabetes.
His beautiful coat is one of the characteristics that give the Irish Setter his reputation as one of the most beautiful breeds in the dog world. Short and fine on the head and forelegs, the burnished mahogany or rich chestnut red coat is moderately long and straight on the rest of the body, with long, silky feathering on the ears, the backs of the forelegs and thighs, and the tail, and a fringe of hair on the belly and chest. In the show ring, Irish Setters are trimmed to emphasize the lean head and clean neck and to show the natural outline of the foot.
Brush your Irish Setter at least every other day to keep his coat shiny and tangle-free. Check for burrs and other debris any time he's been out in the field or on a hike. Unless he rolls in something stinky, he shouldn't need a bath more than a couple of times a year, as long as you keep him well brushed. You can bathe him more frequently if you want, however, and you'll need to if you plan to show him. Use a shampoo made for dogs to avoid drying out his coat and skin.