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New diagnosis and lots of questions
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07/31/2017 16:58
KKubinski 
07/31/2017 16:58
KKubinski 
New diagnosis and lots of questions

Hello, all. I am new to this forum and new to this disease. I haven't been officially diagnosed with this but I saw an orthopedic surgeon about a frozen shoulder and he mentioned these nodules that I have on my right palm. Then, a hand-therapy physio also mentioned this disease after she looked at my hand. She isn't treating the disease but some weird symptoms I have in my hand. She doesn't think that the hand symptoms have anything to do with DD but now I am wondering about this.
My history-had 2 compressed nerve in neck causing neurological symptoms and I had a frozen shoulder at the same time. I had neck surgery-those symptoms much better-but of course frozen shoulder still there. I am thawing out now but still have pretty sore shoulder and stiffness. About 3 months ago, I started having very stiff fingers-all of them-and pain/tenderness in my palm and fingers. I then noticed these nodules in my palm-had no reason to look at my palm before-and hence the tentative diagnosis of DD.

My question: What symptoms does DD usually cause and could my hand symptoms be at least partially due to DD? At this time, the physio thinks that the hand symptoms may be due to bad posture, guarding my shoulder so that I have tight pectoral muscles causing compression of artery/nerve down to my hand. The stiffness is a bit better since starting stretches but still pretty prominent. And the tenderness is quite apparent in my palm and fingers, even my little finger. I am also noticing possible nodules coming up in the lower part of my fingers but not sure if they are real nodules. More in the palm.

Another question: What type of doctor is best to follow up with? I have little confidence in my GP but he can give referrals to appropriate specialists at least. I am following up with my neurosurgeon who did my neck surgery tomorrow in case the hand symptoms are neck-related--I don't think they are but...
3rd question--I understand there is treatment available but am wondering if there are ways of slowing down the process--i.e. physio, exercises, stretches for the hand. I dont really want radiology if I can avoid it. Luckily, I am left-handed, so not overly concerned about the contractures yet. More concerned about pain, stiffness, etc. if DD is causing these symptoms.

Sorry for the looong email but if anyone can fill me in about anything that would be great. Thank you. Tina.

07/31/2017 17:16
Stefan_K. 
07/31/2017 17:16
Stefan_K. 

Re: New diagnosis and lots of questions

Welcome to the forum, Tina. First off: Do you have any cords yet or only nodules, what is your age, and in what country/state do you live? This will help understand your situation give you good advice.

Stef

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

07/31/2017 19:40
KKubinski 
07/31/2017 19:40
KKubinski 
Re: New diagnosis and lots of questions

Stefan_K.:
Welcome to the forum, Tina. First off: Do you have any cords yet or only nodules, what is your age, and in what country/state do you live? This will help understand your situation give you good advice.

Stef

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

Thanks for the reply. I believe i have one long cord in the middle of my palm and a couple nodules too. I am 55-going on 85 it seems sometimes-and live in BC, Canada.

07/31/2017 20:07
spanishbuddha 

Administrator

07/31/2017 20:07
spanishbuddha 

Administrator

Re: New diagnosis and lots of questions

Hi Tina

Welcome to the forum. It's really a bit unwise to make a diagnosis via an Internet forum, but frozen shoulder, lumps or are they nodules in the hand, and something you describe as a cord, could well be DD.

You really need to see a hand specialist to get a diagnosis. Not an orthopaedic surgeon or other generalist. Likely a hand surgeon, who may say wait and see or offer surgery now or when you have a contracture, if it is DD.

Wait and see can be fine, but if it's early DD the only proven possibility of slowing it down is RT which you say you wish to avoid. Alternatives, are specialised massage, self application of various oils, avoiding trauma to the hand, a steroid injection and avoiding other established risk factors. You could ensure you have no other inflammatory conditions or systemic inbalances which sometimes seem to go hand in hand (!).

There's lots of information on our website, do some reading and decide what you want you do if you do get a diagnosis of DD. For many it progresses slowly and also for the majority it does not lead to a contracture, even with cords, but it cannot be predicted for individual cases.

Best wishes SB

07/31/2017 20:49
Stefan_K. 
07/31/2017 20:49
Stefan_K. 

Re: New diagnosis and lots of questions

Tina, spanishbuddha has already given you the advice I would have given, too. I'll just add that 55 is a typical age for the onset of Dupuytren's (http://www.dupuytren-online.info/dupuytr...stribution.html) and that if your diagnosis is confirmed, radiotherapy is indeed the early treatment most effective to slow or halt progression. There are no known serious side-effects for the kind of RT done on DD hands, but cost in many places may be an issue especially when you have to make the decision not knowing how bad it would get without it. One other thing you could try if one day the cords start pulling on your fingers, and before you have other treatment, is to start wearing a splint glove at night. This may sound unorthodox as it is usually done after a procedure such as NA, Collagenase or surgery to prevent fingers from bending again as the cord (if only severed and not removed) forms again, but it has clearly helped me prevent my pinky from bending again for two years now although that cord has been pulling and I wished I had started before my pinky ever started bending the first time, so I like to mention that as an option which patients often hear about rather late. There's no point in trying it before there is tension on a finger, though, and then in your case you'd have to see if there is any impact on the stiff fingers you mention.

Good luck especially finding a competent doctor first.

Stef

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