Hi everyone,

I'm 57 and I've had Dupuytren's for 2.5 years in the right hand, one nodule and a cord. Then this year another has come, and also with a cord, so it's on the move. Nothing has spread to any finger yet, but what's frustrating is the idea to "wait and monitor" for contracture. Yet, there is stated evidence that RadioTheraphy has worked very well on early stages, before cords develop. I'd hate to kick myself for waiting if it can be significantly dealt a blow now with RT.

This ties into my doc selection. I want a doc that knows treats the disease, and not specializing in one solution. One who knows ALL treatments well: RT, Xiaflex, needle aponeurotomy and of course surgery, and doesn't have a stake in any treatment, or prefer that treatment just because it's his "thing". That's the frustrating thing when I read the horror stories, especially with surgery.

So, how do you find such a Doc?

Or should I play Doc myself and get referred into an RT guy based on my own research, and follow up with Xiaflex?

Note: I work with computers and play instruments as well, so I want to be aggressive and not wait.

Dallas, TX

XRT is used to delay the progression of the disease. I had it done as soon as I realized I had Dupuytren's.

For Xiaflex and NA it is best to go to an experienced hand surgeon who has extensive experience with both treatments. The NA is good overall but it is risky in areas of the hand where there are nerve bundles. I got the best overall results with Xiaflex injections on Day 1 followed by NA and manipulation on Day 2.

A hand surgeon is not going to have a background in radiology. In the USA most radiologist are involved with treatment of cancers and have zero knowledge of Dupuytren's.

I don't believe there is any doctor who knows the full range of treatments for Dupuytren's. That's why this forum is so valuable. I would go to the best specialist in each of the disciplines and get their opinions, then make my own decision as to which one to pursue. I ended up going to a hand surgeon recommended by two friends who had had the Xiaflex injection from her with excellent results. My results weren't as good, but she was able to explore two of the options fully with me - Xiaflex injections and hand surgery.

I had hand surgery 18 years ago on my right hand and that hand is fully functional and looks good. I had a hand surgeon who was also a plastics surgeon. That's important if the look of your hand is important to you.

I had the Xiaflex injections on my left hand, but waited too long (due to lack of insurance coverage), so that was less successful, but still better than doing nothing. I had some improvement and hopefully, it stopped or slowed down the progression.

I didn't even know about the other treatment options until I came to this forum.