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Injection or Surgery? (RATHER, I SHOULD SAY AFTER HAVING NA, FIND A DOC WHO DOES NA FIRST!!!)
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08/19/2012 22:08
BRIANB 
08/19/2012 22:08
BRIANB 
Re: Injection or Surgery?

Nothing is perfect...EVERYTHING comes with risks...

The crap I listened to from hand surgeons { the ones that do not do NA } is now laughable..

Ex. regarding NA .. { I have to sleep noghts }

Another told me { NA I have no idea what you are talking about...you need surgery }

Thank God for this site...and for the fact I can read and research.....

08/19/2012 22:19
mikejake 
08/19/2012 22:19
mikejake 
Re: Injection or Surgery?

Randy, I really appreciate the advice. I am certainly disappointed a supposed top hand surgeon did not provide me with all of the options even if they could not perfom an NA as based upon your suggestions this procedure is performed by a number of highly qualified surgeons. I checked and the closest is in Dayton. Do you live in Florida as it appears that is where the most experienced practitioner is located? I just wonder if I need to go see him as opposed to one of the doctors on the link you provided. What are your thoughts?

Thanks a lot

Edited 10/20/12 14:02

08/19/2012 22:36
Tusk 
08/19/2012 22:36
Tusk 
Re: Injection or Surgery?

mikejake,

Dr. Eaton offers a 20 minute video conference. Might be worthwhile.

https://2nd.md/profile/charleseaton

There are a number of hand surgeons who offer NA but I suspect most don't do a high volume like Eaton. Dr. Bourland in Memphis, TN has a nice NA practice. He might be closer to you. Bourland learned the procedure from Eaton.

08/19/2012 22:49
Randy_H 
08/19/2012 22:49
Randy_H 

Re: Injection or Surgery?

Mike,

Regrettably, it's not that your local experts "could not" perform NA. They know about it and choose to ignore it.

Eaton is the notable exception that actually *watched* the French NA video given to him by a gal for which he was recommending surgery. He knew the procedure was simple for a man of his training, so without further contact with the French who invented NA he just gave it a try on her. He was AMAZED. He immediately contracted the French and went to Paris for all the training he could get. Now he is leading expert and NA trainer in North America.

No, you don't need Eaton to do NA. But if you need a plane ride and a night in a hotel, then just as well. However, if your case is standard, anyone who has spent a day with Eaton can do this. If CHSs were compared to auto mechanics, NA is just a Major Tune up. It's not even a valve job. Eaton is overkill if you have someone closer. Can you book a flight to Dayton, have NA, and fly home that night? Looks like it. I went from LA to Florida for Eaton, but now I have local choices that I would use if I need more help.

08/19/2012 23:12
mikejake 
08/19/2012 23:12
mikejake 
Re: Injection or Surgery?

Randy_H:
Mike,

Regrettably, it's not that your local experts "could not" perform NA. They know about it and choose to ignore it.

Eaton is the notable exception that actually *watched* the French NA video given to him by a gal for which he was recommending surgery. He knew the procedure was simple for a man of his training, so without further contact with the French who invented NA he just gave it a try on her. He was AMAZED. He immediately contracted the French and went to Paris for all the training he could get. Now he is leading expert and NA trainer in North America.

No, you don't need Eaton to do NA. But if you need a plane ride and a night in a hotel, then just as well. However, if your case is standard, anyone who has spent a day with Eaton can do this. If CHSs were compared to auto mechanics, NA is just a Major Tune up. It's not even a valve job. Eaton is overkill if you have someone closer. Can you book a flight to Dayton, have NA, and fly home that night? Looks like it. I went from LA to Florida for Eaton, but now I have local choices that I would use if I need more help.


Randy,

Thanks a lot. The doctor in Dayton who is on the list (perfroms NA
procedures) you provided me is about a 2.5 hour from where I live. It is worth a drive to meet with him and inquire
about the number of NA procedures he has performed and then make a decision
about whether I would feel more comfortable going to Memphis or Florida.

I don't mind traveling to get competent treatment. I also have severe
glaucoma and for the last 8 years I have been going to Johns Hopkins in
Baltimore for treatment at the Wilmer Eye Institute. This was after my
opthamalogist in Lexington allowed my eyes to permanently detiorate. I
should have learned from that experience to excercise more independent due
diligence when choosing a physican rather than simply choosing someone who
lives close by. Like any other profession, there can be vast differences
in skill sets and as you have pointed out, it pays to do one's own research
before selecting a physician. This is particularly true when there are
less invasive and less costly operations than can accomplish the same
outcome.

Again, many thanks. Because of your admonition, I am much better informed.

Edited 10/20/12 14:04

08/22/2012 14:54
mikejake 
08/22/2012 14:54
mikejake 
Re: Injection or Surgery?

To all concerned, I called and made an appointment with a doctor 200 miles from me who has significant experience with NA. I couldn't get into see him until October 19th because he has such a busy practice in doing this kind of work. I was surprised to learn that I would be examined and have the NA performed all in the same day because I lived out of state. I was advised that this doctor has many patients who travel from out of state for NA treatment. I am still baffled why more hand surgeons are not familiar with this treatment. I will update this post after my visit.

08/22/2012 17:48
Randy_H 
08/22/2012 17:48
Randy_H 

Re: Injection or Surgery?

Mike,

Given the fact that NA only takes 20 minutes or so depending on the severity of contraction, this is what I would expect. Why drive twice?

It's not that CHS are unfamiliar with NA, most are. And it's not like they haven't been shown the facts on safety and effectiveness. About 5 years Eaton ago gave a lecture at the national convention of the American Society of Surgery of the hand. While this did expand the number of surgeons that visited him in Florida, your doc still has more work than he can handle. Why?

I think what we have here is a demonstration of professional conservatism and a profound resistance to change. After years of banging my head against the wall as a patient advocate for NA, I don't look at Western Medicine with the same Blind Faith I had previously. No, you don't want MD's chasing around after the L&G ideas out there either. But come on folks, what does Eaton have to do to be taken seriously? These guys almost need a religious conversion to "get this". Let us know what your NA guy has to say.

The answer will hopefully be the publishing of research I know Eaton has completed. After almost ten yeas and 10,000 procedures he's got impeccable clinical data that will fly in the face of conventional wisdom:

NA is actually *safer* than OS (far less nerve damage)
Recurrence rates are only somewhat > than with OS
It's easily repeated if necessary
Recovery is a few days, usually zero post-op therapy
It's dirt cheep in comparison

Therefore: NA is the fist line of defense before OS should be considered.

But.............will his colleagues even bother to read it?

08/23/2012 01:18
daleladue 
08/23/2012 01:18
daleladue 
Re: Injection or Surgery?

I just saw my hand surgeon regarding bilateral DD. The surgeon emphasized that she did only hand surgery and none of the other options I had read about. I have a 45 degree contraction in my dominant pinkie finger joint accompanied by a frozen joint as well. The ring and middle fingers on the same hand have the beginning of a contracture plus arthritis. The procedure would involve four incisions - flaps followed up by PT twice a week for God knows how long, probably several weeks. I have so many pre-existing issues that I might as well plan on recurrence. I can't even imagine going through all this pain and trauma with a negative result looming in front of me! The pinkie would be straightened during the surgery and in all probability resume its contracted position after surgery because it's been contracted for to long. I am in a quandry regarding what to do. The risks of surgery versus not doing anything are quite compelling! Bilateral Ledderhose adds another dimension to this picture as well as other bone related issues. What to do, what to do?? I made an appt with my primary MD to discuss my situation and hear her recommendations. I think the mot frustrating issue regarding this is that the nodules continue to grow with or without surgery, and it is so complex to find an appropriate avenue.

08/23/2012 01:47
hammer 
08/23/2012 01:47
hammer 
Re: Injection or Surgery?

Here is my pinky advice,My right one has had surgery and NA and multiple Xiaflex injections and is still at 10-50 degrees depending on how long since the last splinting,That as good as it gets for that one.My left one is fused straight.Always straight no hassle,even with a cord tryin to bend it,it wont bend.Its the only thing holding my hand open because of the cords goin to my ring and middle finger.The ring finger is 150 degrees I call it stage 5.LOL. You can live with it bent.fuse it straight or very last resort amputation.Dave

08/23/2012 03:17
flojo 
08/23/2012 03:17
flojo 
Re: Injection or Surgery?

Dale,

I think you are a candidate for NA. Read about it and ask questions on the Forum

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