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RT in Hamburg by Prof. Seegenschmiedt
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04/09/2016 13:27
meunier 
04/09/2016 13:27
meunier 
Re: RT in Hamburg by Prof. Seegenschmiedt

jimbob0802:
Hello everyone

I have read Alistair Cook's report with much interest, and it has been the document I referred to the most when I went to the GP yesterday to try and put in motion a referral on the NHS for radiotherapy treatment.

The thing is, despite the seemingly obvious DD in my lef hand (spanishbuddha and steffan have seen the photos), I still want to be 100% sure that RT is the way to go. As such, I was wanting to send pictures of the current state of my hands, as per Alistair Cook, to a specialist like Professor Seegenschmiedt. (In an ideal world, I'd like to do the same to the radiotherapists operating in the UK, but I don't know if this would be possible).

Is it still possible to do this, as Alistair Cook did? Or is there any other specialist I can send my photos too?

Final question: do you folks know of the success rates/knowledge of radiotherapists here in the UK? I spoke to the secretaries of quite a few listed from the BDS website and they all seemed confident I would get a referral if the GP could release the funds to have it done in another area. Assuming the GP is able to do so, I would like to visit a renowned specialist in the field - although I know I can't be choosey. Is there anyone in particular within the UK who is considered with the same gravitas as Prof Seegenschmiedt?

Thanks for your help,

Jim

Hi Jim,

A few things in response to yours:

(i) As one UK specialist said to me (as I have seen two of them) the UK led the way with RT and treatement of Dupuytren's in the 50's. That too was under the aegis of the NHS. It was stopped by the National Agency I was told because of (a) cost/resources needed to be given for more immediate cancer concerns given a growing population and (b) the fact that several other beguine difficulties were treated with RT and those therapies proved more troublesome in the longer range given the RT's side effects.

(ii) I don't know if you are in London but the secretary of Dr/Mr Morris (as listed) said that he would happily take referrals and that he was having such a growing DD practice at London Bridge that they thought they were going to open up a separate DD unit UNDER the NHS. This might be a good route to go for you. If nothing else perhaps your GP would allow you an initial consultation should Mr/Dr Morris think it apt (which I'm sure he would.) Then the recommendation for the procedure would at least come from another NHS physician/specialist.

(iii) Don't forget to remember possible alternative routes. There is a massage therapist in South London who has developed a DD speciality. He has treated a member of this Forum for the past two and a half years (after her RT in the UK proved not to be successful) and her DD development has now been contained. I have to say I went to him early this week - just initially for a look see - and have to say that after just one session - one of the small nodules on my right hand appears to have disappeared altogether. Certainly my anxiety has begun to diminish because of it.

Hope the above might help.

Edited 04/09/16 16:46

04/09/2016 13:41
jimbob0802 
04/09/2016 13:41
jimbob0802 
Re: RT in Hamburg by Prof. Seegenschmiedt

Hi meunier

Thanks for this very helpful reply. I would definitely like to go the RT route if an oncologist deems it helpful - at the age of 33, I've got this thing pretty early on, and would like to halt its progression as early as possible. I just hope that my left hand hasn't gone beyond the stage of RT help - after following the techniques used in Alistair Cook's reports, it's clear that I'm got a contracture when doing the adpated table top test - probably of about 10 degrees, so I would still be in N/1...but the nodule and cord I have is huge. So I need to get on with this straight away.

Thanks for the info re Dr Morris. I left my GP with a list which included him, although I wasn't able to get through to his secretary at Guys, his other one at Kings College confirmed he's happy to see NHS patients. I live in Bradford, Yorkshire, so the closest radiotherapy unit listed is Christie Hospital in Manchester - but I'd prefer to go to London if indeed Dr Morris has a background in treating DD.

I haven't considered massage therapists? It's interesting you mention this - all this time, I've just been under the impression that the developing nodule and cord was a just remnant of the trigger finger surgery I had 16 years ago. However I now think it's Dupuytren's because: a) the hand specialist said so; b) my GP said so; and c) turns out my uncle has had surgery for it - twice. So I think I need to go at it head-on. But I am open to other routes. Can you DM some details?

Thanks again

Jim

04/09/2016 23:51
dpjcrfsh 
04/09/2016 23:51
dpjcrfsh 
Re: RT in Hamburg by Prof. Seegenschmiedt

I was treated on both hands by Dr. S in Oct 2015 and Jan 2016. I would say I'm happy with the results. I had general slow but regular progression prior to the treatment, but it seemingly stopped after that with perhaps slight reduction in nodes. I have Ledderhose in both feet as well, but decided not to treat them. They haven't progressed noticably either, but perhaps slightly. No new nodes though. Curiously, I had an interesting effect. Starting at about 1 month after radiation and continuing for about 2-2.5 months for both treatments, my hands periodically felt like the whole hand was tightening and perhaps contracting without any noticable sign of disease progression, but then went away pretty much went away. My hands feel fine now. It's been 6 months since the start of treatment.

04/10/2016 17:17
dpjcrfsh 
04/10/2016 17:17
dpjcrfsh 
Re: RT in Hamburg by Prof. Seegenschmiedt

spanishbuddha:
I've not been there in the last year, but in the last 2.5 years. The description in the article remains accurate. I have to say that the hand I had done 2.5 years ago suffered an injury last year, and lo - new sore nodules appeared in the radiated field.

Can you elaborate on how you injured your hand? And how quickly the disease started again afterwards? Has it calmed back down yet?

04/10/2016 17:59
Peacefulbird 
04/10/2016 17:59
Peacefulbird 
Re: RT in Hamburg by Prof. Seegenschmiedt

dpjcrfsh:
I was treated on both hands by Dr. S in Oct 2015 and Jan 2016. I would say I'm happy with the results. I had general slow but regular progression prior to the treatment, but it seemingly stopped after that with perhaps slight reduction in nodes. I have Ledderhose in both feet as well, but decided not to treat them. They haven't progressed noticably either, but perhaps slightly. No new nodes though. Curiously, I had an interesting effect. Starting at about 1 month after radiation and continuing for about 2-2.5 months for both treatments, my hands periodically felt like the whole hand was tightening and perhaps contracting without any noticable sign of disease progression, but then went away pretty much went away. My hands feel fine now. It's been 6 months since the start of treatment.

I have made arrangements to be treated by Prof. Dr. S on May 23, 2016. I was quoted a price by him as follows: "The costs for ONE extremity and ONE RT series (consisting of five RT sessions) are about 800 Euro. If more sites have to be treated one should take the factor two, three or four depending on the number of sites requiring treatment."

Currently I have obvious nodules and very little contraction in my dominant right hand. However, I also have slight indications of the disease in my left hand, and a suspicion of it in both feet. My questions today are: (1) When you had RT for both hands, was the cost double? (2) Why did you decide not to treat your feet? (3) Did you have full use of your hands during the RTs and during the week or two following RT?

Thanks so much for your reply and for the 6 month report of your treatment.

Wishing you all the best,
Peacefulbird
Washington state, USA
right hand DD, onset Oct. 2015

04/10/2016 18:25
dpjcrfsh 
04/10/2016 18:25
dpjcrfsh 
Re: RT in Hamburg by Prof. Seegenschmiedt

I don't remember the exact cost, but I think it was about 1200 Euros for both hands. I remember thinking his cost structure was odd. Adding the 2nd extremity is pretty cheap but adding 3rd and 4th are greater increments. I also remember him saying his price hasn't changed in 20 years.

Dr. S won't treat disease if it's not advanced enough. Sounds like your one hand would be treated, but the others are probably not advanced enough yet. But then again he can spot disease that's not obvious to patients.

My feet have had the disease for about 8 years and have never bothered me much despite having 3-4 nodules on each foot. They are all under the arch where they don't seem to matter too much. I specifically was worried about side effects such as slight cancer risk and that the radiation is pretty much a one time option. If I get it now, I can't do it again later, so I figured just wait to the point that I needed it. Still I gave much thought about whether to do it or not and eventually decided not to. Dr. S thought my disease was clearly advanced enough to treat, but he said it was perfectly fine to wait if the feet didn't bother me much.

I always had full use of the hands.

Do you have nodes on your feet? If not, what make you think the disease is there?

04/10/2016 19:09
Stefan_K. 
04/10/2016 19:09
Stefan_K. 

Re: RT in Hamburg by Prof. Seegenschmiedt

Peacefulbird:
(1) When you had RT for both hands, was the cost double?

I only had one hand treated but on the rate card I was given the cost for the second hand is 50% of the first. The cost of the second round is also lower as diagnosis has already been done and the time spent with the doctor is shorter.

I was prepared to have both hands treated because of the savings on time and money, but even at the second round the professor thought it was too early. This way I had a direct comparison and knew what were skin changes due to RT and what was in my imagination...

Quote:
(3) Did you have full use of your hands during the RTs and during the week or two following RT?

Yes (except for the 2 x 5 x 60 seconds they were stuck in the machine ), and I see no reason why anyone wouldn't. All you should see - only after about three weeks - is some skin dryness and peeling as the upper layer of the treated skin renews. You can moisten your skin with Urea cream. I found the one suggested by the clinic too oily but was very pleased with a little tube of Handsan 5% urea which penetrates much faster. It comes in a small, blue & white tube (30ml) and was more than sufficient for my one hand through both sessions (www.handsan.de). You find it in the local drugmarkets like Budnikowsky, in the bins with the other travel size cosmetics (which have the advantage of going into your hand luggage).


Stef

[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]

Edited 04/10/16 23:26

04/10/2016 20:12
Peacefulbird 
04/10/2016 20:12
Peacefulbird 
Re: RT in Hamburg by Prof. Seegenschmiedt

dpjcrfsh:
Do you have nodes on your feet? If not, what make you think the disease is there?

Thanks so much for your reply... helps a lot! I just want to be prepared, to make sure my credit card will cover the whole amount BEFORE I get there , in case he finds a treatable condition in my other hand and/or feet.

My feet? Well, since about the same time as the hand nodules appeared, I've noticed two things about my feet... a tendency for my toes to curl, both when I'm sitting and when I'm standing, and more recently, there is some tenderness/soreness in my arches, and the inability to wear the orthotic insoles that have previously been quite comfortable. I do not feel any nodules, however. It will be very interesting to find out what Dr. S finds when he palpitates.

Wishing you all the best,
Peacefulbird
Washington state, USA
right hand DD, onset Oct. 2015

04/10/2016 20:18
Peacefulbird 
04/10/2016 20:18
Peacefulbird 
Re: RT in Hamburg by Prof. Seegenschmiedt

Stefan_K.:
I only had one hand treated but on the rate card I was given the cost for the second hand is 50% of the first. The cost of the second round is also lower as diagnosis has already been done and the time spent with the doctor is shorter.

I was prepared to have both hands treated because of the savings on time and money, but even at the second session the professor thought it was too early. This way I had a direct comparison and knew what were skin changes due to RT and what was in my imagination...
I found the one suggested by the clinic too oily but was very pleased with a little tube of Handsan 5% urea which penetrates much faster. It comes in a small, blue & white tube (30ml) and was more than sufficient for my one hand through both sessions (www.handsan.de). You find it in the local drugmarkets like Budnikowsky, in the bins with the other travel size cosmetics (which have the advantage of going into your hand luggage).

VERY helpful, Stefan, thanks!

Wishing you all the best,
Peacefulbird
Washington state, USA
right hand DD, onset Oct. 2015

04/11/2016 06:14
spanishbuddha 

Administrator

04/11/2016 06:14
spanishbuddha 

Administrator

Re: RT in Hamburg by Prof. Seegenschmiedt

dpjcrfsh:
spanishbuddha:
I've not been there in the last year, but in the last 2.5 years. The description in the article remains accurate. I have to say that the hand I had done 2.5 years ago suffered an injury last year, and lo - new sore nodules appeared in the radiated field.

Can you elaborate on how you injured your hand? And how quickly the disease started again afterwards? Has it calmed back down yet?
I injured my hand by using the wrong tool, pump pliers, to try and undo a jammed nut on some machinery. The pliers slipped several times, and the handles closed suddenly in doing so. It was painful doing it and I should have stopped but pig headed I carried on. I failed to undo the nut then and there, and had to get the right tool.

The very next day I had two sore new nodules, quite large and angry ones too, very disappointing! This was October last year. There are now three nodules in that area lining up nicely in the palm to form a cord, which they have not done and I still have the flexion I had before. The soreness has gone, the two nodules not so large and angry, so it seems to be stabilising. I tell people to protect their hands, but regularly fail to do so myself - just been laying paving slabs, so much easier without gloves. Survived that one I think.

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progression   radiotherapists   Seegenschmiedt   treated   dupuytren-online   specialist   dupuytrensymposium   Alistair   contracture   hand-embroidering   treatment   Disease   radiotherapy   Hamburg   nodules   spanishbuddha   interesting   Peacefulbird   1007%2FPL00002371   hyperproliferative