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Suregry & Work? Advice Fast Please
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09/16/02 02:26
jim h

not registered

09/16/02 02:26
jim h

not registered

disagreements

I've seen the disagreements on this message board and, without taking sides, I do understand the frustration. Surgery often seems to be oversold, the results can be quite disappointing, and especially because of the cost, time, discomfort and inconvenience involved one could be left with some real bad feelings.

But, much as we might wish, I don't think we can just start telling everyone to have NA instead (not that anyone posting here has done so).

I've been following this discussion for several years now, and reading everything I could find on the web about DC. In my opinion it comes down to this: no one - neither the surgeons nor the NA practitioners - has solid recurrence data. And without that it's impossible to really make a good decision. All we get is anecdotal evidence a collection of stories from various patients, without statistical validity.

09/16/02 02:02
Eddie 
09/16/02 02:02
Eddie 
Removing deseased material

Martin, in your post you mentioned "A fasciectomy, on the other hand, removes the deseased material, nodules and all".
Now, I am a layman myself, but I read somewhere (don't remember where at the moment) that when one has DP, not only the visually detectable tissue damage is diseased, but biogically, the DP is present latently in the rest of the hand.
If and when I come across the source of that information, I will surely post it here.
On the aponevrotomy: clearly this doesn't have sense if no contracture is present.
A note to Kay : I also have pits and nodules in my left hand, and those bother me 'some' ( not sure if I can call it pain ). I will try to avoid surgery as long as possible, maybe even longer :).

09/17/02 02:23
Martin 
09/17/02 02:23
Martin 
info

Thanks Eddie, I would appreciate any info on this disease.
Martin

09/17/02 02:39
Martin 
09/17/02 02:39
Martin 
surgery

Hi Gary,
My surgeon describes himself as an 'aesthetic plastic surgeon', he is based in Johannesburg, South Africa, and has done a lot of hand reconstruction work. As mentioned previously, I am very pleased with the result, after 2 months my palm is completely flat and that scars are hardly noticable, just need to work on my fingures. I did have a fasciectomy with zig-zags starting at the base of the fingers.
Martin

09/17/02 02:32
John Browne

not registered

09/17/02 02:32
John Browne

not registered

Report on a Needle Aponevrotomy experience

Report on a Needle Aponevrotomy experience:
I had the little finger of my left hand contracted at 90 degrees. I had Dr. Badois in Paris do a needle aponevrotomy on it in July 2002. Took 20 minutes and 180 Euros (about 180 $US) The anaesthetic was very local - in the needle doing the cutting - almost completely painless. I was watching all the time. No scars, just a few tiny neede pricks. Took about two weeks for the internal trauma to heal. Now my finger is all but flat and I don't even notice I ever had a crooked finger. I expect I might have to have this operation again in 5 or 10 years time. But it's a great excuse to go to Paris again! In sum, I am extremely pleased with Dr Badois' needle procedure, and couldn't have expected it to be any better.

09/19/02 02:10
Jan

not registered

09/19/02 02:10
Jan

not registered

biological aspects of DP

If and when my DC gets to the AV stage, this is what i plan on doing, unless the needle becomes available in Montreal.

09/19/02 02:44
Eddie 
09/19/02 02:44
Eddie 
biological aspects of DP

Martin (and all others of course),
What I mentioned about DP being present in the rest of the hand was taken from http://www.ccmbel.org/Chap16.html
( thesis Dr Moermans on segmental aponeurectomy )

10/10/02 02:05
Tim Gilbert

not registered

10/10/02 02:05
Tim Gilbert

not registered

Complications - NA - nope

I have DC in my right pinky. It appeared approximately 7 years ago after a bike accident. The initial dx was a ganglion cyst and I watched it grow for 3 years. When it became large I decided for an operation that would remove the cyst. During the surgerty the surgeon remarked it was not a ganglion cyst. It was later diagnosed as DC. After the operation, which was no big deal and it healed after two weeks, the finger was flat. It came back within the first year and has grown so that the finger is now at about 45 degrees. In all honesty it does not bother me except sometimes to shake someones hand. I do nothing, and I mean nothing, special for the finger. I weightlift 4 to 5 times a week and take no special precautions. Given the degree of contracture my hand surgeon recommended that I have the surgery. He said I had a PIP contracture and there did not seem to be much cord, if at all, in the palm and perhaps not much cutting of the palm was necessary . [Note that in my first surgery the only cut was made just below the first joint on my right pinky so the recoup was minimal]. However he is telling me that the recoup period now may be 5 to 6 weeks. It is getting near ski season and quite frankly I do not want to take that amount of time out of my life and risk a surgical procedure. I could just sit it out but the contracture is only going to get worse and now is the best time to take care of it. I am strongly thinking about the needle in Paris. The fact that it is short term is not troublesome to me because I believe there is a great likelihood the DC will return. My surgeon is skilled but nonetheless this is surgery. My concern with the needle is whether it will work with my DC. Mine is really a PIP contacture. I have a big node in two places on my left pinky with nothing in the palm.

By the way, I was accepted into the Stony Brook trials but he delays are interminable and there has been very littel communication. I also believe that the procedure is really just a chemical needle. As it was explained to me the chemical just dissolved the cord in one location. I do not see the difference betweent the two procedures.

One other question, has anyone heard of any complications with the needle. Any horror stories that one should be aware of .

I would appreciate any info or insights. I need to schedule the surgery or go to Europe soon.


Thanks for any help.

Tim

10/11/02 02:21
Kristen Metzger

not registered

10/11/02 02:21
Kristen Metzger

not registered

Complications - NA - nope

Tim -I just had NA for the third time yesterday. If there are complications, they haven't occurred to me. (For crying out loud, I'm typing in a cybercafe in Paris a day later.) I recommend it highly. Good results, minor inconvenience - about as unpleasant as getting a tooth filled, but not more. Given the aggressiveness of my case, surgery is out of the question - if you have surgery three times, they send you home loaded with scar tissue and announce your hands as finished. Dr. Lellouche pretty much said I could continue to do this every year if necessary, though that is rare. I'm hoping for a remission. I had 13 years between a raging case of knuckle pads and a raging case of contracture, so I'm hoping for a decade or so of remission. If not, Paris here I come. Good luck.

10/11/02 02:39
Jan

not registered

10/11/02 02:39
Jan

not registered

NA

Wow! What a great success story, inspirational, too. So there is more than one doctor in Paris that does NA.

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procedure   Contracture   nodules   fingers   contraction   understanding   because   medical   establishment   heeeeeelllllllPPPPP   fasciectomy   practitioners   disagreements   surgery   surgeon   disease   Dupuytren~sq~s   contracting   Complications   Aponevrotomy