03/16/2018 18:26
Luciferette
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Re: Surgery
Hi Andy, Where are the nodules and cords? As I understand it, if they're in the palms then there are other options worth trying, as Spanish Buddha says. If they're actually in your fingers, around the PIP joints as mine are, then surgery is usually what a British consultant would suggest. My disease first started in my late 20s/early 30s, with very painful aching joints and rapidly developing nodules on the knuckle side of both hands (most fingers). By my mid-30s, large nodules had started to form in my little finger. Contrary to some doctors' beliefs, they were (are!) quite painful, especially when knocked, and my joints are very sore. It was misdiagnosed as rheumatoid arthritis for quite a while, until it was finally confirmed as an aggressive case of Dupuytren's Diathesis in November 2016 (I was 40). In February last year, I had an extensive fasciectomy on my right hand. I, too, run a business that involves physical work, and the state of my hands was becoming intolerable. I had a 90 degree contracture at the PIP joint which was quickly worsening. I was told I'd have to have at least 6 weeks off work; I reckoned on 2! As it was, I was off a month. The operation was done under a nerve block -- very scary and quite uncomfortable, but on the upside I left hospital that night, and the anaesthesia lasted around 24 hours, after which I went onto codeine and ibuprofen. I was in a full cast like a boxing glove, almost to the elbow, with a sling for a week. To be honest, that was the most painful thing, because the stitches were quite tight, particularly around the side of my hand, so any pressure -- putting on clothes, OUCH -- was rather uncomfortable. After the plaster came off, I had another 10 days before they removed the stitches. Again, not pleasant, but bearable. Then another 10 days or so, starting physio (continuing for around 4 months) and slowly getting used to working with it again. The wounds took a while to heal: about 2 weeks after having the stitches out, one area was still quite open and weepy. I'm a writer "on the side", so holding a pen was top of my list! If you want to succeed, you will :) A year on, and the contracture is about 40 degrees (the dup tissues had grown around the joint and tendons so it was hard to get right). There's some scarring and scar tissue, and it's still rather stiff and can be sore but I keep up with the physio even now. On balance, I'm glad I had the surgery. My left hand - same nodules, same joint - has rapidly worsened in the last year (possibly as a result of the trauma of the previous surgery!), and I'm seeing the consultant soon about another fasciectomy. I've been warned that it's likely the disease will recur/become more aggressive as I get older, but now I know what to expect, I think it'll be easier. I'll try and post some photos of my hand post-surgery if it'll help. It's the not knowing that's scary. I hope my story is useful. This forum was a great support to me when I was first diagnosed!
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