Sam McBratney’s piano playing was curtailed by Dupuytren’s contracture but thankfully not his writing, explains the best-selling author

Famous in homes around the world due to the international success of Guess How Much I Love You, Sam McBratney has written over 100 books and scripts in all. A keen gardener, musician and family man, Sam is always on the look-out for inspiration for his beautiful stories.Less well known, however, is the fact that a few years ago Sam’s writing career was complicated by Dupuytren’s contracture, a slowly progressing condition that restricts hand function (see boxed text).

“I was very let down by the NHS as it took so long for them to treat it that I ended up going private,” he remembers. “And that delay means I’m now unable to play the piano and the accordion, although I still just about manage the concertina. Dupuytren’s is actually very common – my GP knew what it was immediately – and Margaret Thatcher had it too!

“So six years ago I had surgery to cut away the tendons that were causing the gathering. I wanted to be conscious during the operation but they recommended I go under. I was home the next day and recovered well with some physiotherapy.”

For 30 years, Sam’s bread and butter was his job as a teacher, so he could only find time to write in the evenings, between 8pm and 11pm.

“I’d get home from school shattered and eat, spend time with the family and then get back to work,” he remembers. “Although I have more time to write now, because of the routine I adhered to for all those years my creative juices don’t start flowing until the evening and I really can’t work at any other time of day.”

So whilst he writes by night, during the day 72 year old Sam enjoys his acre of garden and six grandchildren, aged eight to 17 years.

“To my grandchildren I’ve always just been granddad but a couple of them were with me at a book signing the other day where I was treated as a famous author, which made them see me in a different light.

“Authors write for our words to be read, so when a book is a success it’s a wonderful feeling.

“I do dwell on my own experiences when it comes to writing and searching for those tender moments for which the hares in Guess How Much I Love You are celebrated. But imagination is like a well into which you can dip and lift out a bucket… it’s endless.”

What is Dupuytren’s contracture?

Dupuytren’s affects the hands and fingers, causing one or more fingers (or the thumb) to bend into the palm because of a build-up of collagen in the connective tissues.

This might occur in one small area first, forming a small nodule (a hard lump about 0.5–1cm) under the skin of the palm. The nodule may feel a little sore to start with but this usually passes.

The nodules are not cancerous and the condition is not life-threatening. But it can become a nuisance to live with as over time, the nodules can extend and form cords of tissue. These cords can shorten and pull so that a finger or thumb becomes bent towards the palm, getting worse over time.

Why does it happen?

Dupuytren’s is thought to be genetic as it often runs in families. It’s become clear that if you have the gene that causes Dupuytren’s, other factors such as diabetes, smoking and some drugs (for example, medication for epilepsy) may bring it on.

People who are at risk of developing the condition – for example, if you have had it in the past, or if you have a family history of it – stopping smoking helps reduce the risk.

Who is affected?

About 2 million people in the UK are thought to be affected, more men than women. It usually (but not always) occurs in later life in men over 50 years and women over 60 years. The condition seems to be more common in people of North European descent.

Treatment

Many cases of Dupuytren’s are mild and don’t need treatment. But if the condition is interfering with normal functioning of the hand, the following treatments are offered:

• Radiation therapy and injections with collagenase;
• A minor procedure that uses a needle to cut the contracted cord of tissue may be used in the early stages;
• The shortened connective tissue is cut or removed.

Having surgery to remove the first nodule that appears will not stop the condition from progressing, as this will not stop the condition from occurring elsewhere in the palm. So it is usually best to avoid surgery until a contracture that interferes with use of the hand develops. And surgery does not always fully straighten the affected finger or thumb and the problem can come back after surgery.

For more information contact the British Dupuytren’s Society, visit www.dupuytrens-society.org.uk.

First published July 2015

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