Please see my experience 5 Years ago - no recurrance !

Go to : http://www.angelfire.com/rings/dupuytrens/

5Dman

It's great that Hidlreth believe in the use of cortisone injections to slow Dups progression. It softens the nodules and reduces pain as well. I had Kline do this for me. Great results. Take his advice.

What I find so interesting is that CHS who only do Open Surgery are generally not interested in cortisone. It's the MD's who do NA that realize the benefit. When I see an obvious correlation like this I always wonder *why?*. My guess is that the Docs that are open enough to see the benefit of NA are also the same type of people who will be open to other proven options as well. The "Surgery Only" crowd is so deep in their rut that they can't see out. Fortunately our great American NA Hero docs are making an impact on their profession, and have I ever benefited from this. I'm more: "Tried Surgery, ready for NA and Cortisone" :-)

Brian open surgery does have a variety of uses over NA.

For example if the contracture is extreme OS may be the only effective option available.

Also OS in general has a slower re-occurance rate.

Now while your right that some doctors give bad advise regarding NA this does not mean you should condemn OS as a whole as both methods have there uses.

I just had OS at the end of January and am very happy with the results and thought it was the right thing to do at the time. I may opt for a different procedure when it comes back but when that happens if they where to entirely discount OS it would be just as much a error as discounting NA now

Brian,

I can see how personal greed could be attributed to CHS who only do OS. However, some years ago I demonstrated on this and the previous site that OS carries with it considerable costs and time, whereas NA has neither. At $700 for a simple in-office procedure, those doing NA are not particularly short changing themselves.

Will using XIAFLEX be more profitable than doing NA? I doubt it. The bulk of the cost will be for the product itself. Even so, most CHS are looking forward to using XIAFLEX. They know they need an option to OS and will jump at it. By your accounting they will be cutting their own financial throats. I think not.

I believe the fundamental reason for resistance to NA is lazy ignorance and fear. They still don't trust a "blind procedure" where they can't see what they are doing and must rely on the patient to avoid citing a nerve. They'd rather rely on *themselves* and cut you open than rely on the patient. Also, it is generally assumed (wrongly) that the recurrence levels from NA are unacceptable. That is how they were all trained in med school. NA has yet to be taught.

I've interviewed Eaton, Gary Press and Denkler about this and other NA issues. None even hint at greed amongst their fellows. NA docs are swimming against current medical opinion and have very little motivation to do so. That is not to say that at some level some "OS only" CHS aren't acting out of some kind of financial protectionism. However, at $700 a pop for NA (so to speak) they need not.

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"What I find so interesting is that CHS who only do Open Surgery are generally not interested in cortisone."

Hi Randy,

That was my experience completely. When I first noticed my nodule, I went to my dermatologist, who told me I needed to see a CHS, so I dutifully went to see Dr. "X." Dr. "X" gave me the usual "wait until you contract and then we'll slice..." He told me there was nothing I could do in the interim. I was concerned because my nodule was very tender and in the middle of my hand, making tasks like sweeping the floor uncomfortable (which I told Dr. "X".) Fortunately, I got on this website, saw Dr. Kline, etc. The ironic part of my story is that several weeks after receiving an injection from Dr. Kline (which helped A LOT), I had an annual exam with my General Practitioner and I told her that I'd gone to Boise to see a specialist. She said to me, "oh, we would have sent you over to Dr. "X" for cortisone injections...I refer a lot of patients to him." In other words, Dr. "X" obviously gives cortisone injections when patients are referred to him, but never mentioned them as a possiblity to me. I wrote a letter asking him why he hadn't informed me about cortisone and he sent a letter back saying that there is nothing in the medical literature that suggests that cortisone has a beneficial effect on Dupuytren's nodules. I then made copies of several medical papers and sent them off to him. Can you tell I still get steamed up thinking about this?
Megan L (Bellevue, WA, USA)

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Edited 03/26/09 05:52