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Dupuytren's NA Surgery Planned with Dr. Benhaim
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09/13/06 02:50
Randy H.

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09/13/06 02:50
Randy H.

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For The Record

No CM, you said that reports of nerve damage were inevitable in the *future*. I agreed fully. However, I maintained that we were at Zero reports that anyone on this site knew of. This you did *not* challenge.

For the record I needed to correct that. Denkler's report indicates US NA nerve damage. That needed to be said.

We still need instruction as to why you said the study I've mentioned is flawed and can't be trusted. Looks pretty solid to me. What 'ya got?

09/14/06 02:08
Mark D

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09/14/06 02:08
Mark D

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NA Nerve Damage - Don~sq~t Quibble

Hey Guys:

We're all on the same side.

Keith Denkler discussed the data with me last month, before he did my N.A.

Dr. Denkler clearly stated that the risk of nerve damage (& of other complications) related to N.A. is significantly less that that of alternatve procedures.

That statement is consistent with what Keith reported at the CHS conference last week.

That DIFFERENTAIL in the risk profiles of N.A. & the alternative treatments is the main point.

Put plainly, there can be no risk-free procedure. It just won't happen.

But,gosh, I could also have gotten in an accident driving over the bridge to get to Larkspur to have my N.A. done.

Mark

09/17/06 02:33
Carmen

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09/17/06 02:33
Carmen

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NA Surgery Planned

This is to everyone, but especially to Mark D and Randy H. You all have been extremely helpful in sorting out all the information about NA vs OS. I am still scheduled for NA on Wednesday with Dr. Benhaim at UCLA and am looking foward to getting good results. I figure we all need to be positive with any operation. Thanks for the pointers you gave. I will definitely let Dr. Benhaim know if I feel tingling or anything out of the ordinary during surgery. Despite what Dr. Benhaim said, I think the Dups is also having an effect on my elbow and forearm. It is hard working at a computer or piano with one finger out of alignment with the rest of the hand. Anyway, I will let you all know how this works for me.--Carmen

09/18/06 02:51
Mark D

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09/18/06 02:51
Mark D

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You~sq~re Welcome

Carmen:

That was nice of you to take the time to thank Randy H & me.

I must say that in no way do I put myself up there with Randy as an expert about N.A.

Like you, I'm indebteded to people like Randy H, Suzie Q, Wolfgang, & others who have shared their experiences.

Had it not been for those folks, I would have suffered through open surgery by now (instead of N.A. last month).

I've just tried to pay back part of that debt by sharing my own N.A. adventures these last few months.

Anyway, good luck with the N.A.

If you have a chance, please tell Dr. Benhaim that Mark D. sends his regards.

Dr. B. will know who I am - as I'm one of his patients.

All the best.

Mark

09/19/06 02:30
Randy H.

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09/19/06 02:30
Randy H.

not registered

God Speed Carmen

Carmen,

We look forward to your report on how things go on Wednesday. You will be able to type, though probably still numb from the injections until Thursday. God Speed

Mark,

*Please* take me off your "NA experts" list. I'm a patient advocate just as you are. I've just had the distinct pleasure of being beat up around here for the last few years, learning to defending the procedure against some who aren't *quite* as excited about it as you and I are :-) Welcome to the club. Glad to have you abroad.

09/19/06 02:09
Mark D.

not registered

09/19/06 02:09
Mark D.

not registered

Randy H - Thanks

Randy:

In my book you're tops!

I'm honored simply to be mentioned by Carmen in the same sentence as you.

Mark

09/24/06 02:08
Carmen

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09/24/06 02:08
Carmen

not registered

NA surgery planned follow up

I said I would let you know how the NA went with Dr. Benhaim on Wednesday. So far, so good. I was surprised that they put me in a twilight sleep--which in my case was the same as being completely out. The procedure itself took about 45 minutes and after cutting into the cords, Dr. Benhaim manipulated the fingers to snap the cords from their grip on the tendon. (Glad I was asleep for that.) He was kind enough to go ahead and work on early dups formations he found on my pinkie, middle, and index fingers. He is most kind and caring and when the post-op color in my fingers didn't look right, he kept me at the UCLA surgical center until things look better. He really wrapped up my hand so I definitely needed a driver to take me home--not to mention the after effects of sedation and pain killers. I started OT the next morning and she made me a splint and gave me lots of exercises. I will return to Dr. Benhaim on Wednesday of this week and let you all know what he says. But my finger is straight! and I can put my palm flat on the table. YEAH!! So far, I would have to recommend NA. Even if it does not last forever, I would be willing to do it again. I still have a couple of pads or bulges under/alongside my pip joint because he would not use NA there. We will see if they dissolve on their own. They are not all that annoying.

Carmen

09/24/06 02:18
Graeme

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09/24/06 02:18
Graeme

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~dq~twilight~dq~ NA

Hi Carmen

the hyperextension of fingers to assist the snapping of the cord is actually a pleasant experience and an experience that signals the succesful completion of the proceedure. The pain killers that are given prior to the NA deaden any sensation so it is pain free.Most of us have hyperextended our hands at some stage and that's all it is.
For myself I wouldn't relish having any "twilight" proceedure as patient feedback is very important in case a tendon is struck. "Twilight" removes this element of safety. I do realize that your Dr had his reasons for doing this but in my humble opinion one should insist on a Dr giving the patient very compelling reasons for adopting "twilight"

09/25/06 02:38
Randy H.

not registered

09/25/06 02:38
Randy H.

not registered

Clarification Needed

I'm glad things went well for you Carmen, but I am surprised that Dr. Benhaim removed the patient feedback loop that is the nerve "safety net" for this procedure. Without it the surgeon *is* blind as a bat as far as your nerves are concerned, a criticism of NA long held by CHS. It may have been that he was working in an area of the palm where he knew nerves were not located.

You mentioned that in Benhaim's view you were not a candidate for NA because you had "DC up to the knuckle". That doesn't make sense to me as the second knuckle from the palm (PIP) is released *routenely* using NA. It is *not* done so with the patient under any kind of sedation however. The nerves are tightly bundled in that aria and without patient feedback the rate of nerve damage would probably be just as prohibitive as CHS have previously complained.

Clarifications would be helpful here from Dr. Benhaim's patients. It would appear that Dr. Benhaim is currently taking a *very* conservative approach to needle release for Dups and not comfortable with relying on patient feedback. This would rule out a PIP release. Please verify/correct this assumption.

09/25/06 02:24
Carmen

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09/25/06 02:24
Carmen

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NA Surgery Planned follow-up

Randy et al:

Based on the comments at the UCLA surgical center from the other staff, I gathered this is just the way Dr.Benhaim does it--twilight sleep. He had previously informed me he would not do the pip joint via NA because of there being so many nerves involved at that point, and blind surgery was not advisible; he suggested a modified/mini OS there at a later date. So, we decided to follow a wait and see approach. He felt confident that since there are few nerves located near the tendons in the palm--a view tht was shared by the *hand fellow* who was also there--NA was safe as he practices it. I had previously read about Dr. Denkler doing the pip joint; but I did not feel like telling Dr. Benhaim what to do. I am very satisfied so far and still would recommend the procedure. One last thought--he is being extremely cautious with my hand because I have RSD.

I will see him again on Wednesday. Back to the OT in about an hour.

Carmen

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