Any activity that requires gripping something for hours is going to aggravate the Dupuytrens as with your canoeing and kayaking. I replaced our conventional kayaks with Hobie kayaks which are propelled by the feet and the paddle is only needed to leave the shore or dock. I can go twice as far and twice as fast and not use my hands. Think about bicycling if you had to use your hands and arms to move the pedals instead of your legs and feet.

I had the best results with a combination of Xiaflex injected on the first day and manipulation and NA performed on the following day. The hand surgeon could assess which areas would benefit the most from the Xiaflex and which would require and were safe to treat with NA.

The doctor who is a board certified hand surgeon and who has performed thousands of NA procedures and many hundreds of Xiaflex ones, Dr. Keith Denkler in Larkspur California, prefers to do the combination of NA and Xiaflex over either procedure individually and believes that both are preferable to performing a fasciectomy.

Joyce:

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Moondanc: NA was an option but stats given me of reoccurring were great.Have had DD nearly 10 years. (69 now). Very active yogi and able to flatten hand for "down dog" with pressure. Now impossible to flatten and painful. Also recently excessive itching.

OnetopMom
Forgot to mention. I discussed with Dr. Chen my concern on best next steps for right hand and she got me a referral to what she considered the best duypretrens surgeon to discuss right hand options. Noting we can also do RT in the event I want to go that route also. From what I am hearing it may be unusual for RT specialist to work with specialist in surgery. Appointment couple weeks out.
Joyce

My opinion if you have been diagnosed with DD have any nodules or contracture it is never too early for RT. RT primary use is to slow DD down and from what I know there is no.such thing as DD not progressing yet slower for some than others.
About surgeon not knowing about RT. Don't buy it. If they are treating DD they should know and know that it's promising. Maybe they don't want to cross lines of expertise but that's unfortunate and I would be leary.
Yes I had MRI and extensive "blocking" beforehand to pinpoint exactly where to radiate
In fact I had a new nodule when I went and she redid area so as to include new effected area.. That's why she didn't want to tatoo the area i.e. new inflammation.
I am learning as I go. Have seen several hand docs but was.hoping the Xiaflex would be answer. I lived awhile in Sarasota and believe my doc there (that did injection) was very knowledgeable DD. His staff helped me get grant for xiaflex from Healthwell Foundation. His name is Dr Michael Gordon @ Sarasota Orthopedic.Assoc. I would go back to him in a minute but moved back to NY and thus NY insurance plus it was before. RT. At the time Xiaflex.was.very new and he was.one of few doing it.
About supplements Vit E Magnesium, massage et al yes I've done.the gamet but truth is DD has progressed severely in right hand and beginning left and though these may help the symptoms of pain,.hardening, etc I don't think any of these is enough (for me).
Lastly go to oncologist or doc armed with questions. Check out 2015 International Duypretrens Foundation Symposium video sessions which include videos from experts on what's new what's working and what's on the horizon. Anyone treating you should be up on this. Remember it's in your hands not his or her's.

Yes we all have our own opinions and.hopefully when asked I qualified I was basing mine purely on my experiences these last 10 years dealing with the progression now in both hands. BUT if someone tells me they want to wait "for maximum effectiveness" based on research.I would ask why take the chance on waiting when research has also shown RT most effective early stage and can be retreated. Also age and lifestype are factors for me. DD became my nemesis late 50s when I was retired, felt I was in great physical shape and doing rather strenuous activities.
I thought homeopathy means, xiaflex injections. NA and all less evasive treatmenta were best for me and now I.can add RT. Why not try all that these learned researchers are researching..until there is a cure and until they know.the cause.