I now realize that radation and NA may be better suited for my condition. I am in early stages and have no curling of my ring finger, even when relaxed, just a slight “V” in the skin with the big end at the base of my ring finger and the point of the “V” at the little bump. I have no trouble opening my finger up completely, or squeezing it tight, and only a little pain when the little bump is pressed.

I have not looked for a radiation doc but Dr. David Kline who does NA is about 7 hours away in Oregon. In reading on this forum about NA, it does seem to be a good choice for the early stages. My question is, is my condition too early? It seems that most who have had NA were more advanced and could not straighten their finger.

Also, does anyone know of a radation doc in the Pacific Northwest or should I rig up some waveguide, hook it up to the microwave, and nuke it myself? !!!

Joe

Joe, I am afraid, microwaving won't do the job. Afterwards your hand would probably be "well done" but of no use anymore .... don't event think of it ....

If you are looking for radiotherapy in the US you might contact research oriented hospitals, e. g. those related to a university. They need to have the right equipment and experience in using it. We can provide a guideline of the Dupuytren therapy if they haven' treated Dupuytren yet. Radiotherapy of Dupuytren is not very different different from other radiotherapies (except that it uses low energy x-rays). It is important that the disease is still "infant" because radiotherapy works best on initial, small nodules.

With the obnoxious charges in the US it is also important that your insurance covers your treatment. Otherwise you are much btter off travlling to Europe and spending 2 months of vacation there. Less cost and more fun.

Wolfgang

Joe,

I too pay my own medical as I have a large deductible and am self-employed. My concern along with treatment costs has been recovery time, which is why NA for correcting the contractures was important and I had the procedure performed by Dr. Denkler in Larkspur, CA (40 minutes from San Francisco airport).

From my experience I could have arrived in SF in the morning and seen Dr. Denkler in the afternoon for the procedure, stayed over one day in the area, and flown home the next day with no worries.

I am planning on radiotherapy treatment in Germany as soon as I can get more information which has been slow in coming and tends to be piecemeal.
My understanding, which I am trying to get verified, is that treatments are once a day for 5 days and then the patient's body takes a break to recover from the radiation. It is then repeated 2-3 months later. What I do not know is how large the gap can be between the two sets of treatments.
The larger the gap can be the more options I have for planning treatments.

It is relatively easy to get flights into Germany the weekend before a Monday treatment and fly back the following weekend, so each set would involve the cost of the air travel and the cost of lodging and food for 8-9 days in Germany. The cost for the treatment at the clinic I expect will be roughly $1,400 and my travel is less of a factor as I have a lot of frequent flyer miles, so the add-on is food and lodging of about $200 a day and 14 days in Germany adds $2600 so total tab will be about $4000 for the two sets of treatments - subject to revision as I get more information.

In addition to the cost considerations, I would expect that the experience of the personnel in Germany who have treated over a thousand hands has value over a very experienced radiotherapist in the USA that may not have ever radiated a section of a hand for Dupuytren's and may not properly radiate the sites involved and this might in turn effect the likelihood of later progression of the disease. I do not really want to take that risk to save some money.

I have no medical training with regard to radiotherapy but I know that the more a medical practitioner performs an operation the better job they do and their is much less risk of complications which occur with much greater frequency at locations that rarely perform a specific procedure, and this is clearly shown with published US government statistics.

Bruce

Joe, there are, us usual, various theories about the development of Dupuytren. One of those, and the one which I believe in, is that the original nodule develops into cords when getting pulled on. If the nodule happens to be in a place where the skin doesn't move much it will probably stay a (growing) nodule and not cause much problems, except when growing too big. This is for example the case on the arch of the foot where most Ledderhose takes place.

If the nodule fixes a part of the skin that is under normal conditions very movable, e.g. in the parts close to the MCP, the fixed part is then getting pulled on when the finger moves and the nodule reacts by developping cords. Those then eventually fix the bent finger and can be broken by NA.

A nodule itself cannot b treated by NA because there is nothing to break.

At least, that's my view.

Wolfgang

Lots of us have had kenalog injections. I had one a few months after NA from Dr. Denkler. He explained it shrinks and softens nodules and that proved to be true. He gives a numbing injection first as the stuff can sting. It took a while to see effects but it definitely helped. This was for a nodule that became more prominent some months after NA as well as a spot on the finger cord. .

FYI, my younger brother has had a nodule and cord in one hand for 15 years. He has had no contraction and no pain or interference with use of hand at all. So some people get this condition but don't ever have to do much. In my own case I got a pretty major contraction within a year of onset. Go figure. But my point is that you may never get bent fingers. Lets hope so.