GWB,

I strongly recommend that you and other newbies spend time on Dr. Eaton web site to educate yourself. His site is *the* definitive information center for all things Dups. As an example:

<<<<What happens to the cord after it has been cut? The cord is softened and digested by the body's normal enzymes, and heals in a lengthened state. The cord is a normal structural layer which has become wider and shorter from the effects of Dupuytren's. It is not a tumor - it does not have to be removed, and when it is returned to it's proper length, it becomes hard to feel - just like it was before Dupuytren's affected it.

What happens to the nodules? Nodules soften up from two effects. They soften after the tension has been relieved from cutting cords attached to them. They also soften after being injected with a small dose of a long lasting cortisone. The softening and flattening takes place over month or two after the procedure.>>>

See: http://www.handcenter.org/newfile16.htm

Hi Randy,

we shouldn't mix nodules and cords, they consist of different material (to cite Eaton "The disease process includes two structures, the nodule and the cord, which are quite different microscopically and biochemically.") The nodule is the typical intial stage while the cords causes the contracture.

"What happens to the cord after it has been cut? The cord is softened and digested by the body's normal enzymes, and heals in a lengthened state." I am not sure that this is the whole answer. Why should enzymes start to eat up cords after NA and not before? I think the whole process of NA is not yet researched in detail, but it is a good empirical therapy (I dont question the healing in a lengthended state, that's evident).

"What happens to the nodules? Nodules soften up from two effects. ... They also soften after being injected with a small dose of a long lasting cortisone." That means that the softening is not due to NA but the additionally injected cortisone. You can achieve this effect also but only injecting cortisone.

By the way, I don't want to question Eaton, I think his web site is great!

Wolfgang

Is collagenase available yet?

Wolfgang

From my single NA experience, the breaking of the cord *definitely* had an effect on an adjacent nodule which was located just past the PIP joint of my right ring finger. Immediately after the release the nodule was a bit seemed smaller. The surprise was that over the next few months it continued to shrink. Now, nearly a year later, there is not much left of it and it is quite flat and soft. Just the way I like my nodules :)

I have no idea why this works like this. I think somehow the breaking of the tension (like breaking a link in a "chain") seems to relax the whole structure. And, whereas the nodule was continuing to grow, it is now dormant. (Naturally I keep a close eye on it because of what we know about recurrence after NA.) Whatever the mechanism is, it is a fortunate aspect to this disease. Beyond the release itself, the dissolving of cords and the softening of nodules are part of what makes NA so powerful. This should be the case with Collagenase as well.

*But*, in very aggressive cases this does not seem to happen. The cords and nodules just come right back almost immediately. Then the patient is facing what you and I hope to forever avoid.

Good chatting with you Wolfgang

Randy