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Just Had Xiaflex Injection
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01/06/12 00:17
mastersjosh 
01/06/12 00:17
mastersjosh 
Just Had Xiaflex Injection

Hi all,

I had a Xiaflex injection this morning, and the manipulation is tomorrow. I have four cords that run from the base of my right middle finger (thankfully, I'm a lefty) down the central tendon of my hand. My doctor injected the whole dose of Xiaflex into the biggest cord, which is just beneath the base of the middle finger. It's now quite swollen, but it's not too uncomfortable (the person who compared the injection to a bee sting is spot on).

The question that I forgot to ask my doctor is if the Xiaflex would spread to the other cords or if they would need to be treated separately. It sounds like some folks have had their dose injected into multiple cords, and I'm wondering if my doctor could/should have done the same. My insurance covered much of the Xiaflex, but I had to pay $325. I don't mind having to go through another injection, as long as it was necessary.

Also, how long is the healing process after the manipulation? Any golfers or tennis players out there? When are folks returning to normal (sporting) activities (bike riding, weights, golf, etc.)?

Thanks!!!

p.s. I'll post about how the manipulation goes. I think I accidentally popped the injected cord a couple of hours ago. Nearly knocked over a glass, went to grab it with my right hand, saw stars, and now I've got noticeably less contraction, despite all the swelling.

01/06/12 10:14
wach 

Administrator

01/06/12 10:14
wach 

Administrator

Re: Just Had Xiaflex Injection

I believe that for the time being Auxilium recommends to only inject one cord at a time. Trials have started to test multiple injections but your other cords will probably need additional injections. That's a cost issue and NA, and even surgery, is probably cheaper for multiple releases.

I myself had Xiaflex injected 5 weeks ago into my little finger and my hand about doubled its volume afterwards. I also had considerabl hematoma (I guess that the enzyme slows down closing of wounds and thus bleeding is more extensive). That wasn't very painful nor was the manipulation. For me it took about 3 weeks until the swelling was gone. My doctor was a little afraid that a tendon might accidentially be damaged and recommended to avoid heavy loads on the little finger. I am still trying to avoid that but have full use of the hand otherwise.

I am wearing a night splint. My correction was not complete (that was a difficult PIP joint with a big nodule next to it). The contracture is nearly gone when I take off the splint in the morning but seems to increase to about 20 deg over the day. It was 45 deg before the manipulation.

Wolfgang

01/06/12 19:33
mastersjosh 
01/06/12 19:33
mastersjosh 
Re: Just Had Xiaflex Injection

Thanks for the response, W. I really appreciate it.

The manipulation seemed to go smoothly this morning. I had it done without an anesthetic. The doctor put pressure on the injection site (ouch), while straightening out the finger. Three small crackles (what I thought was a pop yesterday was just a little crackle), then one big pop. One moment of pretty intense pain, and then nothing, just a little soreness.

Three hours later, the hand is still pretty swollen, but I have almost 100% extension. I'm 42, and I first noticed the contraction about 5 years ago. The contraction was 20-25%, so probably not as extensive as many people have experienced. There might be more pain in more advanced cases during manipulation--I'm not sure.

Anyhow, it's pretty amazing to see my hand fully opened again. Even with the swelling, I'm finding it much easier to type. I'm worried, of course, about all the stories of recurrence and "flare ups," and so I want to be cautious about over-praising the Xiaflex treatment. Right now, however, I'm pretty happy with the result.

Josh

02/06/12 19:30
pia2some 
02/06/12 19:30
pia2some 
Re: Just Had Xiaflex Injection

Josh, I was just wondering how your hand was doing now. It's been about a month since your Xiaflex injections. How was the recovery time and did you experience much swelling?

How about you, Wolfgang? How's your hand at this point?

02/06/12 19:39
wach 

Administrator

02/06/12 19:39
wach 

Administrator

Re: Just Had Xiaflex Injection

My hand is stable with an extension deficit of 20 deg (but my other, healthy finger has 15 deg anyway ...). Side effects are gone (swelling, hematoma). I have been wearing my night splint consistently. My feeling is that the finger is better in the morning and gets worse over the day. I suspect that the contracture might return if I don't wear the splint regularily.

Wolfgang

02/06/12 19:45
pia2some 
02/06/12 19:45
pia2some 
Re: Just Had Xiaflex Injection

wach:
My hand is stable with an extension deficit of 20 deg (but my other, healthy finger has 15 deg anyway ...). Side effects are gone (swelling, hematoma). I have been wearing my night splint consistently. My feeling is that the finger is better in the morning and gets worse over the day. I suspect that the contracture might return if I don't wear the splint regularily.

Wolfgang

How long did you have swelling and bruising? Do you only wear the splint at night?

Just curious because I gave my doctor's office the go ahead to get authorization from my insurance for the Xiaflex. I've been reading through the forum to see what others experienced after their injections.

02/06/12 20:08
wach 

Administrator

02/06/12 20:08
wach 

Administrator

Re: Just Had Xiaflex Injection

About 10 - 14 days and I am waering the splint at night only. Too much splinting is not good, the joints get stiff.

Wolfgang

pia2some:
How long did you have swelling and bruising? Do you only wear the splint at night?

Just curious because I gave my doctor's office the go ahead to get authorization from my insurance for the Xiaflex. I've been reading through the forum to see what others experienced after their injections.

02/07/12 17:00
mastersjosh 
02/07/12 17:00
mastersjosh 
Re: Just Had Xiaflex Injection

My hand has almost completely recovered. No swelling or bruising and probably 95% extension. I alternated heat and ice treatments once or twice a day for the first two weeks (I heated up a smooth rock in the microwave for the heat, which worked nicely). I also try to remember to do a little stretching now and then that the physical therapist showed me when I was fitted for the night splint.

So, a month after the Xiaflex treatment, all is well.

02/07/12 23:44
pia2some 
02/07/12 23:44
pia2some 
Re: Just Had Xiaflex Injection

mastersjosh:
My hand has almost completely recovered. No swelling or bruising and probably 95% extension. I alternated heat and ice treatments once or twice a day for the first two weeks (I heated up a smooth rock in the microwave for the heat, which worked nicely). I also try to remember to do a little stretching now and then that the physical therapist showed me when I was fitted for the night splint.

So, a month after the Xiaflex treatment, all is well.

That's good to hear. I'm glad that it's been successful thus far! How long did your hand stay swollen? Are you having any more injections or was it just that one?

04/05/12 19:47
cujok 
04/05/12 19:47
cujok 
Re: Just Had Xiaflex Injection

mastersjosh:
Thanks for the response, W. I really appreciate it.

The manipulation seemed to go smoothly this morning. I had it done without an anesthetic. The doctor put pressure on the injection site (ouch), while straightening out the finger. Three small crackles (what I thought was a pop yesterday was just a little crackle), then one big pop. One moment of pretty intense pain, and then nothing, just a little soreness.

Three hours later, the hand is still pretty swollen, but I have almost 100% extension. I'm 42, and I first noticed the contraction about 5 years ago. The contraction was 20-25%, so probably not as extensive as many people have experienced. There might be more pain in more advanced cases during manipulation--I'm not sure.

Anyhow, it's pretty amazing to see my hand fully opened again. Even with the swelling, I'm finding it much easier to type. I'm worried, of course, about all the stories of recurrence and "flare ups," and so I want to be cautious about over-praising the Xiaflex treatment. Right now, however, I'm pretty happy with the result.

Josh


Hi there,

My name is Jerry and I just had the manipulation this morning after the injection yesterday now I have a large open wound in my hand. Is this normal?

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