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Women with Dupuytren's
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05/09/2015 06:41
spanishbuddha 

Administrator

05/09/2015 06:41
spanishbuddha 

Administrator

Re: Women with Dupuytren's

Sarah:
I would like to know more about radiation treatments. I noticed not every state even has a place that will do it. It is an accepted procedure by insurance companies (or like some things you have to fight an insurance company to cover)? Is it a one time treatment or does it require several treatments. I would like to know as much as I can.
Hi Sarah

The protocol used by Hamburg clinic, pioneers in the field is, 5 days of 3Gy, then a gap of 12-16 weeks, then another 5 days of 3Gy, making a total of 30Gy. That counts as one treatment.

A second treatment of the same area is not recommend. But in specific exceptional cases a half treatment of the same area may be done under the judgement of the physician/radiologist.

In the US more hospitals are now providing this, and some insurance companies will support it too, but not all. There is an active DC FB group mostly with US posters who can tell you more about insurance. They have created a second FB group advocating the use of RT in the US, the group is called DART. Let me know if you cannot find these two groups.

We list US clinics providing this treatment, who we have verified http://www.dupuytren-online.info/radiotherapy_clinics.html

RT is only effective during an active cycle, usually early symptoms when first noticed, but can be effective later on with recurrence or reawakening. So timing is critical as it is not a prophylactic treatment otherwise.

Best wishes
SB

05/09/2015 13:00
Lori-T 
05/09/2015 13:00
Lori-T 
Re: Women with Dupuytren's

I met with Dr. Kline, who typically works in Boise ID, however, he did meet with patients in a Portland OR office several times a year. I say that because it's been 3 years since my treatment- (summer 2012). At the time, I knew my Dups was active because the nodule was large and sore and a cord was starting to form rapidly. Dr. Kline gave me a steroid injection and referred me to Dr. Goubin Song, a radiologist who works at Virginia Mason Hospital in Seattle WA. My treatment was 5 days, then I believe it was about an 8 week break, and then another 5 days. It is important to have the procedure coded correctly, so that your insurance will cover it. I did get it approved prior to my treatment. My insurance company didn't give me any hassle.
Best of luck to you.
Lori

05/09/2015 23:06
Cherise 
05/09/2015 23:06
Cherise 

Re: Women with Dupuytren's

Lori-T:
I met with Dr. Kline, who typically works in Boise ID, however, he did meet with patients in a Portland OR office several times a year. I say that because it's been 3 years since my treatment- (summer 2012). At the time, I knew my Dups was active because the nodule was large and sore and a cord was starting to form rapidly. Dr. Kline gave me a steroid injection and referred me to Dr. Goubin Song, a radiologist who works at Virginia Mason Hospital in Seattle WA. My treatment was 5 days, then I believe it was about an 8 week break, and then another 5 days. It is important to have the procedure coded correctly, so that your insurance will cover it. I did get it approved prior to my treatment. My insurance company didn't give me any hassle.
Best of luck to you.
Lori


Hi Lori,

U live in my neck of the woods. I looked the doc up in Seattle and there is a page which listed all the codes for treatments for each proceedure the dr. specializes in and costs. (About 20 or more proceedures) . His bio listed he is a specialis in lung and breast cancer/ oncologist. DD was not listed. Just curious how many DD patients has had success ?

How much experience does he have with DD? Both my hand specialists did not recommend RT in my case.
When you had RT treatments were your hands contracting? Mine are and just straightened out my pinky from 180' to open using the bio drug Xiaflex. Every time a treatment on my hand is done including Xiaflex it always sets off a flare .
I had nodes in my hands for 20 yards and no docs knew why or what it was. The hand doc recommended surgery on the pinky and that set off another flare causing more damage. DD in my case is very tricky to treat. We are now just doing the wait and see!

Very glad to hear that you are doing well. That's great to hear! I wish you much more success treating DD !

05/15/2015 22:38
cindy850 
05/15/2015 22:38
cindy850 
Re: Women with Dupuytren's

Sarah where do you live? My radiologist is in Liberty Missouri. I love my doctor. Would never go to a different doctor unless i had to. He saved my hands. Thank you Dr. Cozad. I can put info for him if you are interested.

05/18/2015 20:27
robinrenee 
05/18/2015 20:27
robinrenee 
Re: Women with Dupuytren's

Laurie:
I'm very curious about the age of onset for women on this forum. Everything I've read says that men are affected way more often than women. I'm 55 and noticed my first nodule several years ago. The condition stayed the same for years until this year when it became very active. I don't know if it's coincidental that just as I hit menopause, it became active. I'm wondering if this could account for the disproportionate numbers of men that get it. Maybe there's a protective factor that estrogen levels provide younger women. What do you all think?

Looking back, I had my first nodule on my left hand, ring finger in my 50's. It was painless, so I didn't think anything about it.

When I turned 70, suddenly both hands had nodules and bands and contractures. I knew what it was because my grandmother had had DD. I say "suddenly" because it happened within a period of weeks. I live out in NC hill country, and I've always fed wildlife around my house. I would stand on my back porch and clap my hands to let them know I had put food out. I firmly clapped my hands until they would be red and warm and slightly tingling. I did it for years... then suddenly DD. (I figure my clapping is what brought DD on with a "vengeance.")

I'm also very into alternative, holistic medicine. I read somewhere that people who have Ledderhose Disease get the nodules but not the contractures because the weight of walking stretches the tendons. Sooo... I started pressing my hands together firmly.... not until it hurts, but firmly. It helped tremendously! Today, (2 years later) I can press my palms together FLAT. My finger dexterity is much improved. I still press my palms together every time I think about it... at least once an hour. It's a habit now... a good habit.

01/27/2016 14:01
DSWB 
01/27/2016 14:01
DSWB 
Re: Women with Dupuytren's

I firmly believe there is a connection between estrogen and Dupuytren's contracture.

I had a hysterectomy in my late 40's and took Premarin for about 10 years. At that time, there was a large study that said women were dying from taking estrogen and progesterone, and while I was taking estrogen only, I decided to stop. Shortly before I stopped, I had noticed a small nodule in my little finger. A few months after I stopped taking it, my Dupuytrens exploded. So much so that my doctor wanted to use my case in a lecture.

Some years later, I decided to experiment on myself. I again took estrogen (this time via patches) for 18 months without much change in my condition. And again, after I stopped, my Dupuytrens accelerated.

Based on my personal experience, I now wish I had never stopped taking estrogen, and I would suggest to any woman who has Dupuytrens to take estrogen after menopause.

Dot

01/27/2016 17:50
nanshands 
01/27/2016 17:50
nanshands 
Re: Women with Dupuytren's

Hello Dot and others,

Though I cannot speak to your individual experiences and how the patterns have related to your taking or not taking estrogen, I can say that the continued use of estrogen since my hysterectomy 22 years ago has not seemed to prevent or help my DD and LD.

That is not to say, however, perhaps I may have gotten the disease sooner, than later in life. In general women who are estrogen deficient are often slim. Since body fat and estrogen relate to one another. After menopause, most of the estrogen in your blood comes from a chemical process in your fat and muscle cells. The more fat you have, in general, the higher the estrogen levels in your blood stream.

Women that take the minimal amount of replacement estrogen after a complete hysterectomy (where both ovaries are taken) still receive less estrogen than those that go through menopause naturally, something to keep in mind.

I initially spent months after my surgery studying the pros and cons of estrogen replacement for women who have had a complete hysterectomy. My greatest concern was bone loss and preventing osteoporosis because I am very small boned.

I have noticed a correlation of those with DD, not sure about LD, that have thinner, non-fatty or thick hands, and small boned. They seem to experience more problems with DD. And, I have been told the disease likes fat. Though not everyone who is thin, body wise, has thin hands or vice a versa. Much of that depends on body frame.

I think your post has raised the possibility of a correlation for women that might better relate to estrogen, fat, and this disease.

Thank you for your post it gets us all to think!

Nan

Edited 01/31/16 20:48

01/31/2016 05:29
kenedy 
01/31/2016 05:29
kenedy 
Re: Women with Dupuytren's

I have the same question and I need a detailed answer please?

01/31/2016 19:00
nanshands 
01/31/2016 19:00
nanshands 
Re: Women with Dupuytren's

Hello Kenedy,

Not sure what your question is or to whose post you are referring to? Since your comment followed my post thought I should respond.

Please state your question.

Thanks, Nan

03/22/2016 20:31
sumay 
03/22/2016 20:31
sumay 
Re: Women with Dupuytren's

Hi, I am 64 and have had Dupuytrens for around 4 months although only just diagnosed, so for me no link to the menopause and I have never taken any hormone replacement nor is there any history of the condition in my immediate family.

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