Swelling of knuckle joints might not be arthritic in origin

Q. My index finger started to swell at the knuckle, and it hurt. Next, the pain and swelling moved to the base of my wrist on the same hand. The swelling occurred in a direct line and formed a lump. Now I have swelling on the inside of my elbow, and the swelling is greater than the others were. All of them are soft lumps.

My doctor said I was lucky because the swelling eased my pain. He said the swelling was caused by arthritis. Now I have a deformed knuckle. Any opinions?

A. Arthritis causes joint swelling that is not soft. I am suspicious that your problem involves some of the tissues -- such as the lymph glands -- in your arm, perhaps secondary to a finger infection.

I recommend that you see a rheumatologist who will examine you and possibly order some testing and prescribe treatment.

Q. In a past column, you addressed the problem of sleep apnea, and I would appreciate hearing your opinion regarding the following solution.

My husband, who died last June, was diagnosed with sleep apnea after two separate sleep labs tested him. This was more than two years ago. He was prescribed the machine and valiantly slept with it for more than 10 months. He hated it, and so did I, because I had to share the king-size bed.

Last November, he became very ill with double pneumonia and lung bacteria, which resulted in intensive care for weeks, the hospital for 5½ weeks and a nursing facility for rehab for 3½ weeks.

He was under the care of a different pulmonary doctor during this time. When he finally came home, we visited the doctor, who had carefully read the sleep apnea reports. He said that my husband definitely had sleep apnea when he slept on his back but not when he slept on his side. He asked me if I could sew. I do. He told me to take a T-shirt, sew a patch of cloth on the back of it and insert a tennis ball. My husband was to sleep with this shirt.

It solved the sleep apnea problem for him and, incidentally for his 55-year-old son, who had used the machine for a number of years and also had the apnea only when he was on his back.

This is surely a simple solution if a patient has the problem only when he is on his back. I do think it is worth mentioning if you agree.

A. I am publishing this intriguing therapy because it makes sense, is safe and cheap and may save some sleep apnea patients from having to use cumbersome equipment.

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