I submitted to a Xiaflex treatment two weeks (and 2 days) ago. My RH little finger was bent inward 90% with a massive cord below (and partially in to it) in my palm, which had also contracted the adjoining ring finger but only by 20-25%. Two days later my cords were "broken" and I was fitted with a splint that encouraged my little finger to stay vertical. Here's my 2 week update and comments:

1. The tip of my little finger is pretty much in line vertically with the adjoining fingers. However I still have a slight bend at the PIP joint (the doctor arranged 2 vials of Xiaflex for my treatment, however he opted to delay the little finger PIP injection for a few weeks). I have regained use of my little finger (I am a pianist) to about 90%.

2. The swelling and bruising in my palm has subsided for the most part. Also the area below my little finger where the skin had broken during manipulation is healed to the point of just a small scab remaining. I have developed a sort of "water blister" at the base of my ring finger, however, which was punctured and drained two days ago, but I see now has reappeared. I am guessing it's related to the splint I wear 10 hours a day, but haven't asked anyone.

3. The splint was so disruptive to my (already horrible) sleep patterns that I decided to wear it during the DAY, for 8-10 hours, then remove it at nighttime. That decision has helped immensely with my sleeping.

4. I received my statement yesterday from my insurer and was disappointed to learn I owe over $1600 as my share of the treatment costs. I had a devil of a time trying to find out what this procedure was going to cost me, personally (I have Medicare and an "Advantage" plan). All anyone could tell me was that Medicare covered 80% of the "approved cost". My issue was: 80% of WHAT!! A percentage of anything is irrelevant unless you are informed of the item's gross cost (and it is "gross", believe me!). My worst-case assumption--$600 (based on someone telling me Medicare's approved cost for a vial of Xiaflex was $3000 or so)--was horribly off. Would I have denied myself this treatment had I known the actual cost? Probably not, but it would have been nice to have known what to prepare for, financially.

My current intent is to have the little finger PIP area treated and manipulated sometime in July (after I have completed a few performances, to insure whatever side effects or issues that follow will not impede me), and will report back at that time. I engaged with the Xiaflex process after careful review of my options, deciding that if it improved my condition enough to be able to perform on the keyboard (and on a computer keyboard as well, which I use a LOT) for at least one year, I would be satisfied with the decision. Until something better comes along that is a more permanent or longer lasting fix, I believe this is my best option.

Edited 05/19/18 14:24

Gregory Sobol MD, (248) 644-3920
HAND SURGEON
BEVERLY HILLS ORTHOPAEDICS
17877 W 14 MILE RD
BEVERLY HILLS, MI 48025

I have a Medicare "advantage" plan that has no monthly premiums but unfortunately didn't contribute to offsetting my portion of the Xiaflex cost after Medicare covered its 80%. I have thought about switching into a "supplement" plan instead, however the approx. $150 monthly premium--other than possibly in a year in which Xiaflex is involved (and even at that I'd still be paying $1200 more a year)--didn't make financial sense.

Edited 05/27/18 15:53