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Just Diagnosed Looking For San Diego Doctor
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08/06/2017 16:02
gigisocal 
08/06/2017 16:02
gigisocal 
Just Diagnosed Looking For San Diego Doctor

Hi just diagnosed, looking for a doctor in san diego with experience in this. I have Anthem Blue Cross Silver Plan Insurance and am usually treated at UCSD. Any help would be appreciated! Thanks in advance!

08/06/2017 19:04
spanishbuddha 

Administrator

08/06/2017 19:04
spanishbuddha 

Administrator

Re: Just Diagnosed Looking For San Diego Doctor

Welcome to the forum. You don't say what stage your hands are at, your age, the rate of progression, and the treatment you are seeking? RT is appropriate for early stage and recent active symptoms, and performed by a radiologist. NA or Xiaflex for moderate contracture, surgery for severe or difficult to treat contracture, performed by hand surgeons. The majority of hand surgeons will not recommend RT. Even so so we list some Radiologists here http://www.dupuytren-online.info/radiotherapy_clinics.html and surgeons here http://www.dupuytren-online.info/NA_list_North_America.html

08/07/2017 15:09
gigisocal 
08/07/2017 15:09
gigisocal 
Re: Just Diagnosed Looking For San Diego Doctor

Thank you for your answer. I am 58, no family history, not of northern european descent, etc. It literally occurred overnight. I've been receiving PT for frozen shoulder and my ortho suggested I try acupuncture. The acupuncturist stuck some needles in my right hand and then sent some sort of electrical current through the needles. He said he'd be back in a few minutes but came back 30+ minutes later. At that point all 4 fingers (not my thumb) were contracted -bent over. By the time of my apt with my ortho two weeks later they were contracted almost into a fist. She as well as an orth hand surgeon did some tests and confirmed DC. I received 12 xrays, 2 MRIs, seen three ortho doctors twice and 3 internists and have had daily PT in the past few months and all noted there was nothing wrong with my right hand. The hand surgeon said "it's one for the books". Great. I'm seeing a DO on Wednesday to confirm the diagnosis. I've done a lot of research on what else it could be but it appears, particularly from the photos, that the diagnosis is correct. It's particularly troublesome because I am a right handed photographer and really can't use my right hand at the moment. Thanks for sharing the info!

08/07/2017 16:35
Stefan_K. 
08/07/2017 16:35
Stefan_K. 

Re: Just Diagnosed Looking For San Diego Doctor

If you had four fingers go from 0 to almost 180° in two weeks that would indeed be something for "the books". Do you have nodules and cords (you can see examples on this website) and if yes when did you first notice these? I am no doctor but something sounds very odd here.

Stef

[55, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017, night splint glove]

08/07/2017 17:06
gigisocal 
08/07/2017 17:06
gigisocal 
Re: Just Diagnosed Looking For San Diego Doctor

My fingers went from zero to about 90+ immediately after the acupuncture. Then another 90 in the following 2 weeks. The two ortho surgeons pointed out a nodule to me on the palm between the ring finger and middle finger & one that appears to be forming on the palm under my index finger & something else on my palm but can't remember what they called it. My palm and fingers do look like those I've seen on the web. They did a few tests, including table top, etc. - first my regular ortho surgeon then she called in the ortho hand surgeon & he examined and redid the tests. Both said they ruled out other things and confirmed DD. They said it was rare to have all fingers affected & to have it appear & act so aggressively. They checked my xrays and both MRIs which included my hands and everything showed normal. My ortho and my internists recently examined my right hand right before the acupuncture when they were checking my bicep tendinitis and there was nothing on my palms or wrong with my fingers. My masseur who I see every other day, and both my PTs examine and use my hands daily 6 days a week for the past two months and all note right hand normal on my charts. All of my fingers (except thumb) are really swollen as well. Seeing a DO on Wednesday.

08/07/2017 17:25
Stefan_K. 
08/07/2017 17:25
Stefan_K. 

Re: Just Diagnosed Looking For San Diego Doctor

Has any of these medical professionals commented on the apparent link between the accupuncture/electrical current and the onset of the contractures in four fingers? With DD contracture occurs through the formation of collagen along the tendons of the affected fingers. Do you or do your doctors feel such cords in the four bent fingers?

I was curious about electrical current and its effect on collagen, googled "collagen electrical current" and immediately found this result of an experiment with rabbit skin:

"The hydroxyproline content was found to be increased in wound tissue at the end of 72 hrs of applying current which indicated that collagen synthesis is promoted by electric current."

https://www.ncbi.nlm.nih.gov/pubmed/8828294

You can probably find more stuff yourself.

I'd try to find out find out what exactly was done to your hand during that acupuncture session: location of the needles and current delivered. Then make the person who performed the treatment aware of the apparent consequences and get his insurance involved at a minimum to get any expenses resulting from it for treatment and not covered by your own insurance, if not damages.

Stef

[55, Dupuytren diagnosis 2006, RH contracture and PNF/NA 2014, radiotherapy RH 2015, LH 2017, night splint glove]

08/07/2017 17:48
spanishbuddha 

Administrator

08/07/2017 17:48
spanishbuddha 

Administrator

Re: Just Diagnosed Looking For San Diego Doctor

I'm a bit sceptical. Maybe you do have DD, and nodules can appear overnight after trauma. But, as Stefan says, contracture is caused by the latter stages of the formation of a collagen cord, and does not happen overnight. Also cords can be felt by palpation and an experienced, experienced in treating DD, specialist will be able to diagnose and differentiate from other possibilities by palpation, and a functional examination. Electrical current overdone suggests muscle contracture, sometimes called spastic hand.

But, internet diagnosis or otherwise is not really viable, however I would suggest seek a second opinion from someone experiencedin treating lots of DD patients,you have the links, and avoid recommendations for DD surgery for now.

08/07/2017 21:20
gigisocal 
08/07/2017 21:20
gigisocal 
Re: Just Diagnosed Looking For San Diego Doctor

the acupuncturist is well aware of the situation, I made him take a photo and note it in my chart and immediatately called my ortho. I'm being treated at UCSD ortho which is rated #25 in the country & my ortho was familiar with it but brought in the ortho hand surgeon who is very experienced at diagnosing and treating it. He looked through my charts for the past three months (on a big screen tv on the wall) & noted there was zero indicating this was occurring & said it could definitely have been caused by the electric current in my hand for 30+ minutes & then mentioned something about "electrical" something or other in relation to DC itself in the medical literature but I was in such shock I didn't really hear exactly what he said.

If you are referring to the nodules or chords in the fingers (the stripey looking things) and also nodules at the bottom of the fingers right where the fingers meet the palm - those appeared about an hour ago - not kidding. Or, if they were there before they were imperceptible to the untrained eye but literally just became extremely prominent in the last hour. Almost looks like when you stay in the ocean too long and your fingers are water logged and shriveled. I just saw a pix on google images and it looks exactly like it.

Am seeing a DO this week, and turns out a doctor who supposedly specializes in this - his office is about 10 houses away from mine, literally a one minute walk! Dr. Greg M. Balourdas. He doesn't accept my insurance and am waiting back for a cost estimate on how much exam will cost without insurance. Haven't been working since January from the shoulder injuries so not sure I can make that work.

08/07/2017 21:52
Stefan_K. 
08/07/2017 21:52
Stefan_K. 

Re: Just Diagnosed Looking For San Diego Doctor

Most people developing DD have lots of time to observe the evolution of the disease and to look into treatment options (although many are advised to watch and wait too long). In your case things are evolving so fast it could lead to rushing things, or not having all of the options anymore (notably radio therapy). But luckily you found this forum and are getting good advice.

Three things I would do from here:

1. Make sure it is DD. What has been happening to you is so untypical for DD that doubts are permitted, even if your ortho seems to validate the theory that the electrical current may well have been the cause, and you now do identify nodules and cords.

2. Look at all alternative treatment options before letting someone do surgery. Surgery can make things worse because any injury and bleeding can trigger new DD nodules/cords in other places, and the recovery can be long. You probably saw that your neighbor Dr. B (thehanddoctor) on his website lists collagenase as a treatment he performs for DD.

3. As I suggested before, and especially since the ortho now confirms, backed up by the documentation of the state of your hand prior to the acupuncture/electrical current, that this is what caused your DD, look into the possibility of having your acupunturist's insurance pay for your treatment, so that you can get the best possible treatment. It's at least worth trying considering the money involved in the U.S.

Good luck,

Stef

08/07/2017 22:45
gigisocal 
08/07/2017 22:45
gigisocal 
Re: Just Diagnosed Looking For San Diego Doctor

Thanks Stef for the advice and for this forum. Very happy to have found it. I would never just go and get surgery for anything! I am much more a holistic type of person. What's freaking me out at the moment is on the 3rd both orthos were showing me the difference between my right palm/fingers and left palm and fingers to explain the right hand/palm; i.e. the left is what a normal palm/fingers look like. The hand surgeon took photos of both left and right from many different angles. Now, just today, literally in the last few hours the left is starting to look like the right - not with curled fingers, the fingers are straight - but what look more like calluses forming on the palms and those line things going up and down the fingers - definitely not there last Thursday; also bi-laterally on the bottom of the palms near the wrist it appears a rash or redness is forming - again, within the last hour or so. Just going to take a deep breath and see what the DO says and hopefully the Dr. up the street doesn't charge an arm and a leg and I can see him.

Thanks for all the advice, much appreciated.

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