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Forum for Dupuytren's and Ledderhose 
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  • Found NA in the USA
    • Found NA in the USA
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    09/26/2003 23:30
    jim h

    not registered
    09/26/2003 23:30
    jim h

    not registered

    		 DC

    I don't think it would be right for me to post the information she sent me privately. Maybe she doesn't want to set up her surgeon for a barrage of phone calls. There is really no barrier to emailing her - the spam-blocking service is easily negotiated. Before long, we may all be using such services, so we should just get used to them now :-)
    09/26/2003 23:37
    jim h

    not registered
    09/26/2003 23:37
    jim h

    not registered

    		 DC

    Mary Beth,

    Yes, NA is similar to a fasciotomy in that the cord is severed and the affected tissue remains. But I think there's an important difference. Many of us think that surgical incisions initiate a scarring process which then accellerates the progress of the disease. Conventional fasciotomy is via incision and the cord is cut with a scalpel. With NA, only a tiny needle penetrates the skin. This needle is used to weaken the cord until it can be snapped. So the amount of "cutting" is vastly less, and perhaps (we hope) there is correspondingly less stimulation of the underlying disease process. It is this distinction that I think surgeons are ignoring when they recommened surgery over NA.

    09/26/2003 23:57
    Your Answer

    not registered
    09/26/2003 23:57
    Your Answer

    not registered

    		 DC

    I know for a fact that the physician mentioned by Betsy DOES NOT perform NA.

    Europe is where NA is performed.

    Discussion ended.
    09/26/2003 23:10
    Sean 
    09/26/2003 23:10
    Sean      		DC

    Jim h,
    I'm not convinced that the surgery causes more DC to occur (even though it is repeated over and over on this forum). If that were the case, there would be a much higher recurrence from surgery and that is just not the situation from every extensive study that I have seen. Surgery might seem to promote DC in some cases just because the diathesis of a particular patient. But that happens with NA also, causing some people to have the procedure over and over.

    09/26/2003 23:33
    Eddie 
    09/26/2003 23:33
    Eddie      		Definitions

    Please have a look at : http://www.dupuytren.org/wwwboard/messages/1215.html
    09/27/2003 23:17
    jim h

    not registered
    09/27/2003 23:17
    jim h

    not registered

    		 DC

    Sean, I agree that the link is based on nothing but anecdotal evidence. My own experience with 2 surguries seems to follow that pattern - atfer each surgery, signs of DC soon appeared in other areas and progressed rapidly for a few months, then slowed drastically or stopped. But of course that really proves nothing. One could just as well argue that the disease was in a progressive phase immediately before, and for some time after, the surgery - and that's why I needed surgery at those times.


    Still, if one wants to merely sever the cords and take a chance with recurrence, it seems to make sense to do it in the least invasive way possible, consistent with reasonable safety.

    09/27/2003 23:42
    Sean 
    09/27/2003 23:42
    Sean      		DC

    Jim h,
    I agree with you. It comes back to the discussion of whether or not it is advantageous to remove the diseased tissue. I haven't seen the discussion of that topic in the scientific literature, although it must be there. I think that is what most surgeons and medical schools believe and teach, which may or may not be correct. I do know that present day microsurgery is very much better than previous surgery not using micro techniques. They have the ability to identify and remove the diseased tissue much better now. Whether or not this helps prevent recurrence, I'm not convinced either way. My surgeon was very convinced that this was the case, however. I would like to read the technical studies that either support or reject the removal of diseased tissue and its influence on recurrence.
    09/27/2003 23:59
    JERRY 
    09/27/2003 23:59
    JERRY      		Sean/Gary/diathesis

    Sean,

    I am not baiting you; however I am interested in learning to which extensive studies you are referring?

    It would be nice, and add to your credence if you were to answer my questions for a change.
    09/27/2003 23:57
    JohnW

    not registered
    09/27/2003 23:57
    JohnW

    not registered

    		 Sean/Gary/diathesis

    Sean is totally wrong about DC.
    Please ignore his requests for documentation.
    This is a discussion forum, not a courtroom.

    09/27/2003 23:18
    TOm

    not registered
    09/27/2003 23:18
    TOm

    not registered

    		 HELLO EVERYONE

    Sean, could you please provide us with the source documentation you have referred to in this thread?
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