I believe that some people have what I would call "dormant" Dupuytren's sites and those sites might get activated. One activation mechanism might be the healing process after surgery. When you have a major wound, the whole body reacts and that might trigger dormant Dupuytren's wherever it is located. It's not necessarily something infectious that is travelling through the blood, I believe that it might also be normal, healthy reactions that trigger Dupuytren's into growth.

Unfortunately it is so far impossible to predict prior to surgery whether a patient has dormant sites because they might so small that they are not palpable. It's therefore not possible to predict whether Dupuytren's might flare up eösewhere after surgery. One of the risks of having surgery.

A flare up in several sites without surgery might have a similar background. Something in your body triggered growth of Dupuytren's and it starts growing where already mini-sites of the disease exist. BTW, I had the feeling that my Dupuytren's became also more active after I had a thyroid surgery.

Wolfgang

callie:

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I think there is more to the "the only difference being that the disease started in six new sites in both hands (3 each) within two months after the surgery".

When Dupuytren's has flared up for me it has been in multiple places (other hand or feet) almost simultaneously. It seems as though the disease has traveled through the bloodstream or some other signal. This has happened when no procedure had happened.

Edited 09/07/13 18:59

Seph:

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callie:

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Seph,

I wonder about the build up of cords when NA is repeated so many times? Is there an increase since the cord is left in? Does the cord grow back together? With my surgery the diseased material was completely removed and it is hard to tell that I ever had Dupuytren's.

With NA the area where the cord is broken seems to go soft. I have had cords reappear in the same spot but doesn't seem to be any worse than the previous time.

I have terrible keloid scarring. I have a problem with scar tissue in general. After abdominal surgeries (I've had numerous ones), I'd get terrible adhesions in my abdomen. Once they had to do more surgery to release the adhesions. I also had shoulder surgery for two large bone spurs. I developed a frozen surgery very rapidly because I ended up with excessive scar tissue around the shoulder joint.

I'm definitely fair skinned and of European heritage!

~ dawn

wach:

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I believe that some people have what I would call "dormant" Dupuytren's sites and those sites might get activated. One activation mechanism might be the healing process after surgery. When you have a major wound, the whole body reacts and that might trigger dormant Dupuytren's wherever it is located. It's not necessarily something infectious that is travelling through the blood, I believe that it might also be normal, healthy reactions that trigger Dupuytren's into growth.

Unfortunately it is so far impossible to predict prior to surgery whether a patient has dormant sites because they might so small that they are not palpable. It's therefore not possible to predict whether Dupuytren's might flare up eösewhere after surgery. One of the risks of having surgery.

A flare up in several sites without surgery might have a similar background. Something in your body triggered growth of Dupuytren's and it starts growing where already mini-sites of the disease exist. BTW, I had the feeling that my Dupuytren's became also more active after I had a thyroid surgery.

Wolfgang

callie:

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I think there is more to the "the only difference being that the disease started in six new sites in both hands (3 each) within two months after the surgery".

When Dupuytren's has flared up for me it has been in multiple places (other hand or feet) almost simultaneously. It seems as though the disease has traveled through the bloodstream or some other signal. This has happened when no procedure had happened.

I've been thinking about the comments each of you made ever since I read this but have been preoccupied by my NA and the comment I wanted to make just didn't come to me. One of the things w/Xiaflex is that it travels throughout the entire body through the lymph system-- anyone who has ever had Xiaflex and experienced the swollen arm and lymph nodes will know what I'm talking about. Immune markers also appear in the blood uip to 5 years after (I haven't read any data after 5 years and don't know if there is a study that tracks it).

Also, according to Keith Denkler, MD's website: "After the injection there is a lot of swelling and bruising. There can be redness, itching, pain, and bruising up the arm into the armpit days after the injection. All the Dupuytren's that is dissolved is metabolized out through the body via the lymphatic system. I'm not sure what that even means-- the cord dissolves, it's DD and metabolized throughout the body??? What exactly is metabolized? Does that mean it can land at any site where DD occurs and then start growing there-- or is it totally dissolved?

Interpretations-- or study documentation, anyone?

Diane

cschieber:

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Hi Diane. Most likely what he means is that the portions of the cord dissolved (metabolized) by the enzyme, which are now smaller biological molecules (metabolites), are removed from the body via the lymphatic system. This dissolved material is in no way related to the cells in the active fibroblasts and therefore, cannot cause the disease to proliferate elsewhere . In fact, the cellular makeup of the fibroblasts and cords are quite different, even before Xiaflex treatment. The enzyme also biodegrades and it's metabolites are removed from the body in the same way. This is why, when injected properly, it doesn't dissolve stuff it shouldn't. Hope this helps.

Are your hands getting any better?