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VA Hand Surgeon Scared Me with the Possibility of Finger Amputation!!
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05/12/22 08:24
JohnPBailey 
05/12/22 08:24
JohnPBailey 

VA Hand Surgeon Scared Me with the Possibility of Finger Amputation!!

I just saw a VA hand surgeon named Dr. Bond at the Oklahoma City VAMC this morning. I heard nothing but horror stories from him. Possibility of fingers being amputated, how nerves and blood vessels wrap themselves around the chord/fascia tissue and how Xiaflex cause the contracture tissues, nerves and blood vessels to become all fused together. How the nerves and blood vessels become shortened in the pinky finger. My left finger (pinky)is now bound at a 90 degree angle. There is a big chord connecting from the palm of my hand to the lowest joint (or is it the middle joint??) of the pinky. I still have movement and full feeling in that pinky.

Three years ago I had a "steroids" injection to treat this contracture when it was not as severe. The doctor at the VAMC in Boise, Idaho successfully fully extended this pinky but there was still some lumps at the base of the pinky joining and in the palm below it. The left hand was fully functional and I could play my piano up until late last summer when the pinky started to close up again. Here is what I discovered last week. The VA medical center in Boise, Id. did not actually use "steroids injection" but rather Xiaflex. I did have pain in the left armpit for about a day, swollen limp node. I check my VA medical records and it was indeed Xiaflex used in March of 2019 to treat my contracture.

Should I just stick with repeated Xiaflex treatments as needed and say no to Doctor Butcher of the VA Ortho Surgery department? I was in the army and got out in 1995. Soldiers would often tell me how their surgeons just love to cut. Maybe some VA surgeons are just as carve-happy. I did have hand surgery in this same region in 1995. The army did the surgery under Bier block and the results were great. It was just small lumps they removed in the palm of my hand and there was little or no pinky bending back then, however.

This Dr. Bond claims that since I already had previous Xiaflex treatment, that hand surgery now would be very complicated and quite dicey according to him. He has even admitted to me that some of his patients have had finger amputations as an outcome to hand surgery. I am a male age 58 now and of northwestern European ancestry.

Edited 05/12/22 08:25

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05/12/22 09:08
spanishbuddha 

Administrator

05/12/22 09:08
spanishbuddha 

Administrator

Re: VA Hand Surgeon Scared Me with the Possibility of Finger Amputation!!

Hi John, the cord affecting your pinkie appears to be in the palm. Most cords in the palm can be successfully treated with NA or Xiaflex. That leaves the pinkie nodule which you say is soft; so the question there is whether that is causing any contracture or is the start of a cord? I would in the first case discuss options for NA or Xiaflex, but not with a Dr you have no apparent trust with. NA requires greater skill, training, experience than Xiaflex and has less side effects or down time so you need to find the right Dr., and for Xiaflex I would want a doc who has done lots of them too. At some stage you might look into RT if both hands continue to progress. Best wishes SB

05/12/22 11:51
JohnPBailey 
05/12/22 11:51
JohnPBailey 

Re: VA Hand Surgeon Scared Me with the Possibility of Finger Amputation!!

spanishbuddha:
JohnPBailey:
I just saw a VA hand surgeon named Dr. Bond at the Oklahoma City VAMC this morning. I heard nothing but horror stories from him. Possibility of fingers being amputated, how nerves and blood vessels wrap themselves around the chord/fascia tissue and how Xiaflex cause the contracture tissues, nerves and blood vessels to become all fused together. How the nerves and blood vessels become shortened in the pinky finger. My left finger (pinky)is now bound at a 90 degree angle. There is a big chord connecting from the palm of my hand to the lowest joint (or is it the middle joint??) of the pinky. I still have movement and full feeling in that pinky.

Three years ago I had a "steroids" injection to treat this contracture when it was not as severe. The doctor at the VAMC in Boise, Idaho successfully fully extended this pinky but there was still some lumps at the base of the pinky joining and in the palm below it. The left hand was fully functional and I could play my piano up until late last summer when the pinky started to close up again. Here is what I discovered last week. The VA medical center in Boise, Id. did not actually use "steroids injection" but rather Xiaflex. I did have pain in the left armpit for about a day, swollen limp node. I check my VA medical records and it was indeed Xiaflex used in March of 2019 to treat my contracture.

Should I just stick with repeated Xiaflex treatments as needed and say no to Doctor Butcher of the VA Ortho Surgery department? I was in the army and got out in 1995. Soldiers would often tell me how their surgeons just love to cut. Maybe some VA surgeons are just as carve-happy. I did have hand surgery in this same region in 1995. The army did the surgery under Bier block and the results were great. It was just small lumps they removed in the palm of my hand and there was little or no pinky bending back then, however.

This Dr. Bond claims that since I already had previous Xiaflex treatment, that hand surgery now would be very complicated and quite dicey according to him. He has even admitted to me that some of his patients have had finger amputations as an outcome to hand surgery. I am a male age 58 now and of northwestern European ancestry.
Hi John, the cord affecting your pinkie appears to be in the palm. Most cords in the palm can be successfully treated with NA or Xiaflex. That leaves the pinkie nodule which you say is soft; so the question there is whether that is causing any contracture or is the start of a cord? I would in the first case discuss options for NA or Xiaflex, but not with a Dr you have no apparent trust with. NA requires greater skill, training, experience than Xiaflex and has less side effects or down time so you need to find the right Dr., and for Xiaflex I would want a doc who has done lots of them too. At some stage you might look into RT if both hands continue to progress. Best wishes SB

I had great success with the VA ortho surgeon, Dr. Nicholas Yokan, who did my collagenase injection and manipulation in March 2019 at the Boise, ID VA medical center. I did get that nasty pain in my left armpit, the lymph node, for about a day. No numbing drug was used for the injections of Xiaflex but Carbocaine was used on the manipulation ay two days later because I told them I was allergic to lidocaine and epinephrine. The VA did have to special order the Carbocaine for me. I ask for Carbocaine at the dentist too. I moved to Oklahoma in May of that year and even the VA doctors in Oklahoma City seem like dumb hicks. I don't know if the VA will put me on a plane back to Boise, ID to see Dr. Yokan if he even still practices there. Yokan seems to have known what the devil he was doing. The injections require expert "marksmanship" on the part of the doctor administering he injections or good tissues like nerves and tendons could be harmed. Under the Mission Act, I might also get an independent contactor with the VA. Should I trust somebody like the Oklahoma University medical center for a Xiaflex procedure? I am a low-income Vet and have to either get medical care through the VA system of the state Medicaid program, SoonerCare. I don't know if I should trust a Medicaid provider on this one. I've heard some not so good things said about Medicaid.

Edited 05/12/22 16:13

05/12/22 13:03
spanishbuddha 

Administrator

05/12/22 13:03
spanishbuddha 

Administrator

Re: VA Hand Surgeon Scared Me with the Possibility of Finger Amputation!!

JohnPBailey:
Should I trust somebody like the Oklahoma University medical center for a Xiaflex procedure? I am a low-income Vet and have to either get medical care through the VA system of the state Medicaid program, SoonerCare. I don't know if I should trust a Medicaid provider on this one. I've heard some not so good things said about Medicaid.
I always check out, background, references, publications, online reviews, any new to me consultant Dr before I agree to see or be treated by them. You should do the same. You need an experienced hand surgeon, trained in Xiaflex who has done lots of them, with predominantly good results and patients who were happy with their doc-patient relationship. It sounds like maybe you cant pick and choose? Good luck.

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northwestern   spanishbuddha   contracture   Surgery   medical   Oklahoma   Possibility   successfully   Carbocaine   Surgeon   injection   Medicaid   manipulation   administering   marksmanship   injections   predominantly   publications   Amputation   Xiaflex