I am new to this site but have a need for real life input. I have multiple nodules in my palm and my little finger is about 45% degrees. My doctor recommended Xiaflex as my best option but my insurance denied as they stated that I did not have enough contractures yet. It is crazy. They said I could purchase it myself for $3540. I am still waiting to hear if they will approve NA or surgery. It may be the same answer.

The doctor said that if they don't cover it - I could have NA through his office for $1500.

My question is that does NA worth it? How many of you had the contracture return after NA and how many have had return after surgery?

The problem that you will learn is that Dupuytren's and procedure recovery are not linear. Everyone is different. My situation was 90 degrees contracture in little finger. I had surgery 12 years ago and the finger is still perfect (zero contracture) and no sign that I ever had Dupuytren's. As you might expect, this is not the same result as some other people. I had very little pain (Tylenol) with the whole procedure and recovery. I would have surgery on my other hand if I need to have a procedure.

I did have RT on the other hand 10 months ago and the technician showed me his little finger which looked normal and he said he had surgery on that finger more than 16 years ago.

I think your choice would be NA to see if that would work and then surgery if it doesn't. I am not sold on Xiaflex as a lasting option, especially with the costs and pain involved.

Edited 10/28/13 23:44

Callie is right. The only thing predictable about DC is it's unpredictability! Each person is different and how they respond and their outcome with the various procedures really differs. I think that is why it is important to find a hand surgeon that you trust and who is very knowledgeable about the disease. I wanted a doctor who did NA and surgery so he could access my situation and decide which treatment was best for my given situation.

I had Xiaflex 1.5 years ago and it did give me a good result. However, I am 99% sure I won't do it again. The cost is ridiculous. The results are not any better in the long term than NA.

Four weeks ago I had pretty extensive surgery on my right hand. It involved my palm, pinky and middle finger. Surgery was my only option because of the complexity of the disease in that hand. I'm still in recovery but am hoping for a positive outcome and that it will last for a good while.

My left hand is not as complicated right now. So NA is a good option for it. My hope is to have NA done by the end of this year. Even in the same person, different treatments are better options depending on the hand or the finger involved. Personally, if your doctor feels you are a good candidate for NA AND he has a lot of experience doing NA, I'd start with that.

It is tough because there just aren't any cut and dry answers. But learn as much as you can and be informed and then make a decision with your doctor. Ask questions here ... there's a wealth of collective knowledge and experience.

~ dawn

Deboragriffith,

There are reasons why you are being told " have not lost enough function or use yet". Many people go their whole lives without a procedure. I am very surprised that you have been told that with 45 degrees contracture however. 45 degrees is in the optimum spread of contracture to have surgery and certainly NA. It is realistic to realize that procedures can stimulate additional Dupuytren's activity so the advice you have been given isn't totally a problem.

I know what you mean about NA scaring you. I watched a YouTube video but couldn't watch it through the first needle. The things I have read that it is not too painful and after a couple of days the pain is gone. I hope that will be true for me.