March-20-2007

September-15-2007

September-15-2007

October-3-2007, New lump forming under middle finger.

October-3-2007, New lump forming under middle finger.

October-12-2007 was my first Kenalog injection. Lidocaine was injected around the
nodules and Kenalog was injected in the nodules and in the cord. About 3ml of Kenalog
40 was used. Locations can be seen in this picture.

October-13-2007 Lidocaine and Kenalog injection

November-04-2007 3 weeks after the Kenalog. A very small cord is starting to form in line with
the smaller lump. but this may have been there before the injections. During the next few
months, the pain when pressing on a nodule has subsided and the "tightness" when opening my
hand is gone. The skin around this area feels different but does not hurt. This might be from
the Kenalog.

Before this next injection of Kenalog, the nodules were slightly softer and possibly smaller. On
January-2-2008 I had another series of Kenalog 40, 3ml. Here is a picture on January-6-08.
The doc injected less Lidocaine per my request, but this time into the nodules and cord instead of
around it. Per my request, we waited 5 minutes and then the Kenalog was injected into the
nodules and cord. The doctor did comment that the nodules seemed softer than on the
previous injection. The Lidocaine wore off in 6 hours this time and my hand was in more pain
than the previous injection. I'm not sure why at this time but as of this picture, it hurts to completely
open or close it. At this time, my recommendation would be to inject Lidocaine in two locations per
nodule about 50mm towards the wrist, in line with each nodule. Then wait 10 to 15 minutes before
proceeding with the Kenalog. Also, per this article, the Kenalog should be injected into the sides
of the nodules. A bag of raw rice heated in the microwave feels good in the days after the injections.

January-8-2008. My hand is still just a bit sore when opened and closed all the way but improving.
The skin has taken on a smooth texture and is slightly shiny. There is some shrinking of the skin in
the areas around the nodules.

Another image on January-8-2008 showing the shiny skin a bit better and also the shrinking around
the nodules.