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Dupuytren - When to have surgery!
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10/29/17 10:08
newman 
10/29/17 10:08
newman 

Re: Dupuytren - When to have surgery!

Hi ,for information the night splint will prevent the fingers from curling whilst sleeping.

Edited 10/29/17 10:21

10/29/17 16:24
Curt 
10/29/17 16:24
Curt 
Re: Dupuytren - When to have surgery!

Thanks Newman.

Good advice.

Even though they said only splint it at night. I grab a bag of frozen peas and put the splint on every couple of hours. As I tighten down the Velcro straps my hand gets really straight. The ice helps. Then I work on making a fist. At this point a can’t make a fist. Fingers still too swollen. I’ve come to realize why TOUCH is one of the 5 senses. I continually run my hand threw my hair. It feels so good on my hand.

10/29/17 17:46
Captain_Mike 
10/29/17 17:46
Captain_Mike 
Re: Dupuytren - When to have surgery!

Thank you to all previous subscribers for their helpful suggestions. Off to see a hand physio tomorrow.

10/29/17 18:03
Curt 
10/29/17 18:03
Curt 
Re: Dupuytren - When to have surgery!

Make sure you like him/her Capt Mike no need to rush. A good car machanic is good a bad one is bad. No differant with a doctor.

10/29/17 18:11
Curt 
10/29/17 18:11
Curt 
Re: Dupuytren - When to have surgery!

Oh good luck Captain Mike. No question to ask the doctor is a bad one.

01/23/20 08:40
Cas2019 
01/23/20 08:40
Cas2019 
Re: Dupuytren - When to have surgery!

I am new 61 yo Aussie male here, live in Adelaide, Australia, but been reading for few years. I am finding your posts riveting. I have seen doctors for past couple of years. Like many of you, I want to avoid surgery if possible but not sure that is wise. My left hand ring finger and palm are affected (in a straight line) since 2010, but i can live with it right now, it has progressed, can't flatten hand. My current Plastics Dr suggests surgery through the public health system (I'm not insured) using a Registrar performing surgery. YUK. Any advice? Sadly and unfortunately my previous DR hand specialist passed away in the recent bush-fires here, Dr Clayton Lang. He turned seemed to turn his nose up at surgery and suggested Xiaflex treatment for $4000. I was still considering it, too late now because it has been taken off the market here in Australia. My predicament is now what do I do. My dupuytren disease is advancing a little bit by bit. Any suggestions welcome - what are my sensible options for an uninsured man down-under? I am thinking of getting a x-ray and ultrasound just because I can, why the doctors ignore this imaging is a concern to me. Lost...when to have surgery???

Edited 01/23/20 08:57

01/23/20 19:00
spanishbuddha 

Administrator

01/23/20 19:00
spanishbuddha 

Administrator

Re: Dupuytren - When to have surgery!

Cas2019:
I am new 61 yo Aussie male here, live in Adelaide, Australia, but been reading for few years. I am finding your posts riveting. I have seen doctors for past couple of years. Like many of you, I want to avoid surgery if possible but not sure that is wise. My left hand ring finger and palm are affected (in a straight line) since 2010, but i can live with it right now, it has progressed, can't flatten hand. My current Plastics Dr suggests surgery through the public health system (I'm not insured) using a Registrar performing surgery. YUK. Any advice? Sadly and unfortunately my previous DR hand specialist passed away in the recent bush-fires here, Dr Clayton Lang. He turned seemed to turn his nose up at surgery and suggested Xiaflex treatment for $4000. I was still considering it, too late now because it has been taken off the market here in Australia. My predicament is now what do I do. My dupuytren disease is advancing a little bit by bit. Any suggestions welcome - what are my sensible options for an uninsured man down-under? I am thinking of getting a x-ray and ultrasound just because I can, why the doctors ignore this imaging is a concern to me. Lost...when to have surgery???
I’m not familiar with the Aussie health system, but prevailing wisdom is minimal intervention, such as NA or Xiaflex ahead of surgery whilst the contracture(s) are not too bad and the cords are prominent and isolated. I would, in your place investigate NA, since Xiaflex is not available, followed by RT if there are ongoing signs of progression. But how that works for your circumstances I don’t know.

Yes, NA has quite a high rate of recurrence, but there’s no guarantee of no recurrence even with surgery.

So that means finding a doctor/surgeon down under who is highly experienced with NA. We have some listed here https://www.dupuytren-online.info/NA_lis..._countries.html and maybe some fellow Aussies can provide recommendations.

One thing to add, some joints and tendons can become irreversibly bent or shortened if more severe contracture are left for too long.

Edited 01/23/20 19:02

01/24/20 00:55
Cas2019 
01/24/20 00:55
Cas2019 
Re: Dupuytren - When to have surgery!

"One thing to add, some joints and tendons can become irreversibly bent or shortened if more severe contracture are left for too long."

My plastics DR told me this fact recently and it was the first time I've heard of that fact, and now you have confirmed it. Dr said the ligaments shorten and remain short irrespective of any intervention. That scared me. Dr did say at the moment he can make my ring finger straight - but not to wait too long before intervention. He only does surgery and he uses Registrars for public patients. I can have him do surgery in his private practice for $4K to $6K estimate.

Will you make comment on my condition if I post pictures, spanishbuddha? This will be helpful to me.

Australia has good free medical system but it is far from perfect especially for dental and many elective procedures, far too many and too detailed to list for this post. It is fair to say if one has private insurance things are better, more choice of doctor, and less out of pocket expenses but still far from perfect.

I will be seeing Dr Phillip Griffin on 24 March 2020 for initial consultation - excited about that, and felling lucky and much better now. My recent QEH hospital appointment left me in a depressed state.

Has anyone had surgery or consultation at the QEH Adelaide hospital for dupuytrens?

01/24/20 08:09
spanishbuddha 

Administrator

01/24/20 08:09
spanishbuddha 

Administrator

Re: Dupuytren - When to have surgery!

Cas2019:
Will you make comment on my condition if I post pictures, spanishbuddha? This will be helpful to me.
Sure, but I’m not a Dr just another patient on the internet. I would want to see location of cords, and this is not always easy with photos, maybe one without and one with pen markings if needed?

Edit to add in this post https://www.dupuytren-online.info/Forum_...294_13.html#127 there is a recommendation for Dr Griffin in Adelaide. If you search the forum, near top left, you might find others.

Edited 01/24/20 13:19

01/26/20 02:58
Cas2019 
01/26/20 02:58
Cas2019 
Re: Dupuytren - When to have surgery!

Having difficulty downloading image (learning) but these three are from my "One Drive". Any comments on severity or otherwise, whether NA possible or is surgery only option. Xiaflex has been taken off the market in Australia which makes me think why/what was wrong with it. I did read somewhere that if cord has reached second joint on the finger, which mine has, then NA not doable -I hope not.


The recent image is after 10 years from the time I noticed something was wrong with my left hand ring finger and palm. Ten years ago I had never heard of dupuytrens.

https://g4hapq.dm.files.1drv.com/y4mSRld...p;cropmode=none


https://g4fbbg.dm.files.1drv.com/y4maBFw...p;cropmode=none


This image below shows the flat hand on the table test. Note - 2.5 years ago I could easily flatten left hand with some help from my other hand. Today I cannot and the measurement from the table to the top of my ring-finger knuckle is 36mm or 1.4 inches. Based on this test I'm thinking it is progressing rather quickly.


https://g4elhq.dm.files.1drv.com/y4m1Eoc...p;cropmode=none


Any comments, suggestions, advice before I see DR GRIFFIN late March 2020. Thanks.

Edited 01/26/20 03:06

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considering   intervention   Australia   Griffin   surgery   recommendation   one-handed-ness   unfortunately   straight   Dupuytren   cropmode=none   recommendations   Xiaflex   dupuytrens   contracture   surgeon   dupuytren-online   treatment   suggestions   spanishbuddha