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Just Had Xiaflex Injection
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04/07/2012 05:34
wach 

Administrator

04/07/2012 05:34
wach 

Administrator

Re: Just Had Xiaflex Injection

I would go back to the doctor who did the Xiaflex, present it to him and ask for advice. I personally find it quite strange to just leave it open like this.

Wolfgang

cujok:
No comment but to exercise it which I won't be able to do without ripping it open again if it ever closes. I have it un-bandaged right now to give it a little air and have to keep dabbing it. He did wrap it up but by the time I got home it was bleeding through the bandage.

J

04/07/2012 05:59
wach 

Administrator

04/07/2012 05:59
wach 

Administrator

Re: Just Had Xiaflex Injection

The trauma by Xiaflex is much less than surgery. There is not much healing required after injection and manipulation, so I don't expect much of a trauma effect for Xiaflex. But it still is a fairly active medication that lets your hand swell and causes bleeding and bruising, so it might have some other side effects. Eventually we will get enough evidence to understand side effects and recurrence better and to determine where collagenase is best for treating Dupuytren's.

BTW, there probably will be studies down the road comparing Xiaplex, PNF (=NA), and surgery. Those will help to better understand all three options. The study by van Rijssen et al. is only a first step in that direction.

Wolfgang

callie:
The thing I wonder about the Xiaflex is the "trauma"? Many people use "trauma" as a reason not to have surgery for Dupuytren's because it might stimulate future growth. It seems like the "trauma" from the Xiaflex injections/release is every bit as much as that from surgery. Does this seem to be any concern?

05/05/2012 09:49
cujok 
05/05/2012 09:49
cujok 
Re: Just Had Xiaflex Injection

My finger is almost completely healed but it appears that the cord didn't fully pop and is still partially attached. It hurts to completely extend my finger in that it appears to tighten up after awhile. I am thinking of going back to the doctor and maybe having needle aponeurotomy on the rest of the cord instead of another injection. My insurance was billed $11,500 for this injection. It was rejected and will be re-submitted. I had no idea it was this expensive.

05/05/2012 17:46
pia2some 
05/05/2012 17:46
pia2some 
Re: Just Had Xiaflex Injection

cujok:
My finger is almost completely healed but it appears that the cord didn't fully pop and is still partially attached. It hurts to completely extend my finger in that it appears to tighten up after awhile. I am thinking of going back to the doctor and maybe having needle aponeurotomy on the rest of the cord instead of another injection. My insurance was billed $11,500 for this injection. It was rejected and will be re-submitted. I had no idea it was this expensive.

They charged $11,500 for the medication? That is crazy.

I'm sorry that you didn't have full success from the Xiaflex. Did your doctor have any thoughts as to why? I had one injection last month and it did do the job on the one cord. I hope you're able to get that cord to fully release.

~dawn

05/08/2012 01:37
mharrel 
05/08/2012 01:37
mharrel 
Re: Just Had Xiaflex Injection

I had RT nearly 2 years ago and the results have been excellent--except that, in the last several months, I have developed a nodule on the metacarpal of my ring finger, where I had nothing before. It's not causing much problem but is beginning to get in the way. I am considering Xiaflex since there is only the one spot. What is the cost range of this. If it will be $11,000 for one nodule, I will go back to Dr Seegenschmiedt. And, is Xiaflex used only for cords and contracture? Would it be used in my sitation?

05/29/2012 01:45
Borg 
05/29/2012 01:45
Borg 
Re: Just Had Xiaflex Injection

mharrel:
I had RT nearly 2 years ago and the results have been excellent--except that, in the last several months, I have developed a nodule on the metacarpal of my ring finger, where I had nothing before. It's not causing much problem but is beginning to get in the way. I am considering Xiaflex since there is only the one spot. What is the cost range of this. If it will be $11,000 for one nodule, I will go back to Dr Seegenschmiedt. And, is Xiaflex used only for cords and contracture? Would it be used in my sitation?


Does Xiaflex reduce the size of the nodules? I know it releases the cord but I can't find any info the nodule. Thank you...

05/29/2012 02:32
Christl 
05/29/2012 02:32
Christl 

Re: Just Had Xiaflex Injection

RT will take care of your nodules, but will do nothing for your cords, at least that is my experience. Xiaflex should work on cords, not sure if it also does something to the nodules, have not had the pleasure yet.

Christl

05/29/2012 05:48
wach 

Administrator

05/29/2012 05:48
wach 

Administrator

Re: Just Had Xiaflex Injection

Xiaflex is collagenase, i.e. an enzyme dissolving collagen. Collagen is the main constituent of cords but not of nodules. The purpose of Xiaflex is breaking Dupuytren's cords and it has only been tested and approved for injection into Dupuytren's cords.

BTW, RT does not work on collagen that's why it does not work well on cords. Cords still have a core of myofibroblasts and RT might still work a little on those. Yet it's much better on new, growing nodules which consist mainly of myofibroblast cells.

Wolfgang

Christl:
RT will take care of your nodules, but will do nothing for your cords, at least that is my experience. Xiaflex should work on cords, not sure if it also does something to the nodules, have not had the pleasure yet.

Christl

05/29/2012 06:18
mharrel 
05/29/2012 06:18
mharrel 
Re: Just Had Xiaflex Injection

Thanks Wolfgang--
That's the info I wanted. I haven't the patience, or desire, to go through what Eastwind has gone through. I'm not tolerant of physical problems. I am probably going to have RT one more time and if this continues to give me problems, I am considering amputation. I have ten fingers and can probably get along well with only nine. Do people ever do this? My wife is not too hot on idea but I'm the one with problem.
Mike

05/29/2012 09:27
wach 

Administrator

05/29/2012 09:27
wach 

Administrator

Re: Just Had Xiaflex Injection

Hi Mike,

amputation is occasionally performed when the contracture is causing severe problems and surgery is not feasible anymore. So far I have only heard that a little finger has been amputated. Though it's feasible, to me a hand with an amputated finger doesn't look very appealing. I don't think I would do that.

In case of severe contracture options still might be NA, Xiaflex, or surgical fasciotomy (the cord is cut by a surgeon without removing the Dupuytren's tissue. That's what Baron Dupuytren had done in 1831. This often is still feasible for pre-operated fingers where normal surgery is not an option anymore). Without contracture radiotherapy is an option if that area hasn't been irradiated before.

Wolfgang

mharrel:
Thanks Wolfgang--
That's the info I wanted. I haven't the patience, or desire, to go through what Eastwind has gone through. I'm not tolerant of physical problems. I am probably going to have RT one more time and if this continues to give me problems, I am considering amputation. I have ten fingers and can probably get along well with only nine. Do people ever do this? My wife is not too hot on idea but I'm the one with problem.
Mike

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