So, I saw a new doctor yesterday who specializes in Dupuytrens, has reputation for not rushing to surgery and practices NA. He told me my fingers weren't bad enough to do anything yet and that I wasn't a good candidate for NA or Xiaflex because I don't have big, obvious cords and that these treatments don't work on PIP contractures anyway. He gave me cortisone shots in the two fingers that developed triggers after the NA I had in January and told me to come back in 6 weeks if they don't improve.

I'm scheduled for the second round of RT in Hamburg in the middle of August. Dr. Denkler told me in January, when he performed NA, that I definitely have Xiaflex in my future. Haha. After the problems NA caused, he agreed it wasn't a good idea to try that again.

My understanding is that PIP joints are best worked on sooner than later because the more contracted they become, the less successful most procedures are at getting them really straight. So, if mine are at 30 degrees now, shouldn't we be trying to straighten them rather than wait till they are 50 or 60? At the same time, it just doesn't sound like a good idea to have a Xiaflex treatment a month or so before my next round of RT.

My current plan is to continue splinting till I finish RT in August. If this keeps my fingers from bending any further I will wait till September before looking into Xiaflex. I do have some concerns about Xiaflex because my fingers are stuffed with nodules and scarring (from NA) and I'm not convinced that surgery wouldn't be a better option. But I really don't want surgery! I also don't have a plan for if the fingers continue to worsen between now and August. I have a long history of indecision when presented with mutliple imperfect options so all of this is not playing to my strengths! I have no idea what to do.

Good advice, Diane. That's what I thought about PIP joints. I should have asked him about that but he was somewhat unapproachable. I did ask him if it was diffuse and he said no. I don't know who's right. Every doctor tells me something different. Four doctors, four opinions. How is a lay person supposed to know what to do????

I have some cords because Prof. S and Dr. Denkler could feel them but they aren't typical, I guess. When I saw Dr. Press, he insisted the limited range of motion in my thumb was because of my arthritis, yet Dr. Denkler felt the cord and released it. Go figure.

If the contracture worsens between now and July, I'll schedule a trip to San Fran. If things remain the same, I'll wait till I finish my RT.