Jack,

Without Palmer involvement the invasiveness of Open Surgery will be minimized and swelling not sever. Statistically the chance for recurrence is on your side. May you barcord again soon :-) Downside is that NA would have done as well with no recovery. Your CHS is typically misinformed. It's actually safer.

"I'm guessing no grafts are involved"

I don't guess anymore. I demand answers from *anyone* who is going to put me to sleep and come at me with a knife :-)

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Thanks - I appreciate the comments. I'm only going for the Plexus Block, tourniquet, and mild sed so I'll be awake.

Confirmed the "otomy" vs the "ectomy" so no graft, but still what frustrates me is that so few that even have an inkling about this. No one other than the CHS has any clue - both in the office and at the hospital.

The nodule is so hard/prominent right on the distal portion of the phalanx that it was hard to see how NA could resolve it by criss-crossing cutting needles, but after all the talk here I'm in doubt again. Part of it, I guess, was how a cosmetic surgeon mainly involved with tucks and lifts had a edge over a CHS. NA seems to have advanced in stature since last summer which was when I learned about NA.

Since I have early on-set, I'm sure I'll be back at some point and I hope both NA, collagen therapy, etc. are more mainstream. Especially for folks who only take their MD's reccos...

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Jack:

I hope things work out for you.

In the future, I'd go with N.A.

Dr. Denkler did my N.A. in August, and I think Denkler is terrific.

Good luck.

Mark

Well, all done. Excised a pretty involved nodule described as infiltrating the nerve at the root in the palm, and spiraling helix-like around the nerve past the PIP.

Dr. Birkebeck, CHS in Napa CA did the job and a pretty good one at that. Said the he had to rough up the nerve a bit to get the nodule undone. Drains came out yesterday and PT starts next week.

Turns out we used a Bier (sp?) block instead of a Plexus so that was cool. To tell the truth I was more concerned about the Plexus Block than the actual cutting.

Surgery was not that much worse than expected, but of course rehab will be longer term.

I guess when it comes back on other hands or other areas, we'll see about the NA. I'm lucky to have pretty good options right here in my back yard.

Proof of all this will be how well my finger can extend to the 7th positions on the fret-board. I think for any other area that doesn't involve finger technique, I might give NA a shot - can always go back to a CHS.

At some level though, I'm glad to have that thing outta my hand rather than "scissored-up" stuff still floating around in there. I know - it may all come back anyhow and maybe after the full PT routine I'll feel differently...

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Jack.

As vocal an NA proponent as I have been, there is no question that OS can be the right choice for some people. Now it's up to you to get all your mobility back. It's all up to you to max out the results. Hopefully it will turn out that having the OS will reduce your chance of recurrence. Those are the stats.

For the record, most NA practitioners are CHS. Dinkier was a CHS but made a professional and personal choice to focus on other types of surgery. He is not inferior in NA to anyone out there in my view.

As soon as you can, I'd start using your hand on the guitar. I started playing drums two weeks post op. My CHS said to "ignore" the pain. Easy for him to say :)

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Thanks for the encouragement. And it's great to hear all the positives about Dr. Denkler - I'm much more likely to look him up again next time. (in addition to all his swell "before and after" photos on the web site !)

I do appreciate the PT advice - my first appt is next week and I have no idea what they are going to recommend. I hope I can convince them to let me bring my guitar in and that will count!

Thanks again for all the thoughts and for this great site...

I can only echo what others have said except to stress that you should make sure that your therapist is a Certified Hand Therapist. If the person with whom you have the appointment with is not a CHT, find one who is. As fellow musician (double-bassist) and recent Dupuytren's OS patient, I know from experience that good therapy can get you back to playing sooner and stronger.

Thanks for the heads-up. I'm using "CA Hand and Rehabilitation" and I just called to ensure that my first appt. this week is with a CHT.

As an aside - man, what a nasty incision...Looks like I tried to take a Flounder away from a Great White...Farg, I still don't see how can my CHS prescribe PT to start his week. Unless it involves weakly wagging my pinky to and fro, I'm not sure what else it will do!

Again, thanks to all, and to this web site.