I had the Xiaflex injections 12 days ago, with the manipulation the following day. Dr Verheyden in Bend Oregon who has done about 200 of these. I had a 90 degree contracted pinkie with heavy involvement in the PIP - so kind of worst case scenario as the doc said. The injections for me were excrutiatingly painful, but he used a local the next day for the manipulations so I didn't feel much with that. He said the degree of my pain was highly unusual....go figure.

12 Days later - most of the swelling and bruising is gone, still have a large hematoma and the gash in the bottom of the finger where the skin ripped is healing nicely - but still a week or so from being done. How's the fingah you ask?

Well - I am playing the violin and piano again and using my pinkie for the first time in years. It's not working 100% yet - but I'm confident that after everything calms down over the next couple of weeks and with hand therapy it will really be good. I actually booked a gig for early November on jazz violin....that's optimism. I'm actually playing the instruments for the therapy - it really loosens things up.

My finger is probably at about 15 degrees - so not perfectly straight - but the doc said I would be lucky to get 45...with a wink....hoping for more. So we got more. Wearing a custom splint at night to keep it fairly straight, going to PT twice a week. Doc said I'm the only person he has prescribed PT for - my hand was pretty messed up after the procedure.

I have a nodule and the beginnings of cords on the index finger on the same hand, with no contraction yet. What to do? Not sure I can stand another Xiaflex (really they should just knock me out) - and NA probably won't work if you don't have a cord and a contraction. So I'm thinking radiation to slow things down. I do like German wines....

BTW - I'm going to post this in the Xiaflex Advice Thread as well - I got carried away here - probably should have just done it there.

No - he does surgery and Xiaflex - with almost everything Xiaflex nowadays. He's doing like 3 a week and people are flying in from all over the country. In my case for the pinkie since I'd had previous nerve damage from surgery in that finger I felt that repeated NA procedures were likely to cause further issues. As far as the nodule on my palm near the index finger - I'm not sure that NA will really do anything since a cord does not exist yet. The doc recommended another Xiaflex - but I don't think I can handle it. So I may do radiation.

mikejake:

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brianprice:

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I had the Xiaflex injections 12 days ago, with the manipulation the following day. Dr Verheyden in Bend Oregon who has done about 200 of these. I had a 90 degree contracted pinkie with heavy involvement in the PIP - so kind of worst case scenario as the doc said. The injections for me were excrutiatingly painful, but he used a local the next day for the manipulations so I didn't feel much with that. He said the degree of my pain was highly unusual....go figure.

12 Days later - most of the swelling and bruising is gone, still have a large hematoma and the gash in the bottom of the finger where the skin ripped is healing nicely - but still a week or so from being done. How's the fingah you ask?

Well - I am playing the violin and piano again and using my pinkie for the first time in years. It's not working 100% yet - but I'm confident that after everything calms down over the next couple of weeks and with hand therapy it will really be good. I actually booked a gig for early November on jazz violin....that's optimism. I'm actually playing the instruments for the therapy - it really loosens things up.

My finger is probably at about 15 degrees - so not perfectly straight - but the doc said I would be lucky to get 45...with a wink....hoping for more. So we got more. Wearing a custom splint at night to keep it fairly straight, going to PT twice a week. Doc said I'm the only person he has prescribed PT for - my hand was pretty messed up after the procedure.

I have a nodule and the beginnings of cords on the index finger on the same hand, with no contraction yet. What to do? Not sure I can stand another Xiaflex (really they should just knock me out) - and NA probably won't work if you don't have a cord and a contraction. So I'm thinking radiation to slow things down. I do like German wines....

BTW - I'm going to post this in the Xiaflex Advice Thread as well - I got carried away here - probably should have just done it there.

I am curious, did your doctor did your doctor discuss the NA procedure and rule it out? It appears NA may not work for everybody and my hand is not "perfect" but it is good enough and fortunately, I did not suffer near the pain you described. Hope you get better soon.

callie:

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Has anyone done a profit analysis (for providers) between surgery, NA and Xiaflex? Xiaflex has sure been advertised a lot.

The typical insurance billing for Xiaflex is around $300-400. The doc makes 6% off the $3000 injection - so their total income off this procedure is around $500-600. For the same amount of time they can definitely make 4-10X more money off a surgery, can't speak to NA but I believe Dr Kline in Idaho was something like $1100 or something.

mikejake:

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callie:

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Has anyone done a profit analysis (for providers) between surgery, NA and Xiaflex? Xiaflex has sure been advertised a lot.

This is an excellent question. I sense surgery is more lucrative for the docs. I checked into Xiaflex and my insurance company would pay for the 3 injections the doctor said I needed but with me paying approximately $3,000 in out of pocket costs. The doctor also said that the Xiaflex manufacturer would help some with the out of pocket expenses but I never found out how much because I opted for the NA procedure.

My NA doctor told me he spends the same amount of time doing an NA procedure as he does surgery for treatment of the same problem but at much less cost to the patient. Again, he didn't volunteer how much and I didn't ask him.

Still, doctor profit has to be considered when a patient is evaluating which option to pursue. This is why a second opinion in these cases is so important or at least it was for me.