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Finally a controlled study!
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08/28/06 02:23
Frances

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08/28/06 02:23
Frances

not registered

Data re NA vs OS

Personally I welcome critiquing of information; it often spurs lively debates and from that process we can then begin to make our own informed decisions.

Thanks for your thoughts Randy, noname and everyone else.

Frances

08/28/06 02:21
Mark D.

not registered

08/28/06 02:21
Mark D.

not registered

Data re NA vs OS

Randy, et al:

When I saw Dr. Denkler on 8/16, he showed me a preliminary version of the data he was compiling for his Sept. talk at the Hand Surgeons confrence.

The data I saw also supported the thesis that NA has a lower complication rate than OS.

Mark

08/28/06 02:44
Sean 
08/28/06 02:44
Sean 
NA

I think it is common sense to expect NA to produce fewer complications than a fasciectomy. There is considerably less being done in the procedure. Similarly, a fasciotomy has fewer complications than a fasciectomy. Correspondingly, the recurrance is greater with NA and a fasciotomy than with a fasciectomy.

08/28/06 02:17
No Name

not registered

08/28/06 02:17
No Name

not registered

Controlled Study

Sean,

That it is a very insightful observation. Since less is being done, it does make sense to expect fewer problems. So, I think it may really matter on how severe the condition is and the stats may be misleading. I don't know, but prudence requires a wait-and-see approach before claiming victory.

Thanks for the good input.

NN

08/29/06 02:52
Randy H.

not registered

08/29/06 02:52
Randy H.

not registered

Counter Point

Sean, No Name, et al.

The really good news for all of us who have made the emergence of NA of particular interest is the fact that the Dutch study in question has *two* parts. The second is to look specifically at five year recurrence rates for the same subjects who originally participated. It has already been conceded by the NA camp that recurrence will be higher.

The question will be how much, and is it statistically worth it. The first respected US recurrence data will come from Eaton who will not publish until he has a significant number of cases > five years. This of course will be clinical data, not scientific where the subjects don't choose the procedure for themselves. The second half of this current paper will be our first controlled look at such data. That's still five years away.

For me, Victory will come when both patient and doctor can look at the best data as it likely applies to them and choose from the available options. Hopefully this will include Collegenase as well. Cost, Recovery time, Risk and Recurrence should all be factors in the informed decision. However, as I have said repeatedly, in almost all of medicine, when in doubt the least invasive usually has the edge until it proves ineffective in any particular case. Then you simply move up the ladder. To me, even our preliminary data would lean in this direction for new cases now that the stats on risk are becoming decidedly one sided.

At present we don't even have a ladder to move up. It's been nearly 100% knee jerk Limited Fasciectomy, one size fits all, no questions asked.

Call me Pro Choice on this one.

08/29/06 02:36
Donald 
08/29/06 02:36
Donald 
NA vs surgery

This is my first post. I have read many of them and got a fantastic education. Many thanks to all of you.

I had DC on my right hand and, after several surgeries (the last one was 15 years ago) have been free of DC on that hand. I have had DC on my left hand for 5 years. The contracture now is about about 25 - 30 degrees, which is becoming a handicap for my piano playing. So I am now debating what to do.

The discussion about the pros and cons of surgery vs NA has been great. However the long term effects of NA have not, I believe, been discussed. I would be grateful for any thoughts on the subject.

The first question is: does NA encourage DC growth that would not have occurred without NA? As an illustration of this issue, my hand could stop contracting any time but, if I have NA, might it contract more than if I had left it alone? The second question is: does repeated NA make a potential surgery later on less likely to yield good results?

08/29/06 02:54
Randy H.

not registered

08/29/06 02:54
Randy H.

not registered

NA vs surgery

Donald,

These are two good questions, because if you decide to try NA, now is the time for the best outcome.

1) We have had *no* posts here that indicate NA seemed to speed up the progression of the disease. In fact the disruption of the cord(s) in numerous places tends to slow it down for most people, at least in the short term. NA is fairly low impact and non-traumatic, not likely to trigger a flare.

That's my 2 cents. However, the most qualified opinion would come from Eaton. He has dealt with nearly 3,000 patients and should know by now.

2) Since NA doesn't remove anything from the hand, existing diseased tissue is free to continue to spread. So if at the End Of The Day you will eventually to resort to OS anyway, why not just start there? Problem is, there is no way to closely predict the future course. So I asked Eaton: "What percent of *all* patients will be able to use NA to avoid OS for the rest of their lives" ANSWER: "Something well over 50%."

My take would be that age and aggressiveness of the disease are the main factors for taking a stab (so to speak) at where you will wind up. Eaton's sight only states that if NA fails, OS is always still there. No comment from him on NA possibly worsening a future OS scenario.

Hopefully as a potential patient you can get Eaton on the phone or at least email. We'd all benefit from his opinion on both of these questions.

08/29/06 02:16
Donald 
08/29/06 02:16
Donald 
NA vs surgery

Randy,
Many thanks for your thoughts on the subject. I will be in Florida early January and am going to see Eaton for a consult. I will ask him those questions and will let all of you know what he says.

08/29/06 02:07
No Name

not registered

08/29/06 02:07
No Name

not registered

Another Fake Posting

Randy / Donald,

You should be ashamed of yourselves. This (Donald) is clearly a fake posting designed only to bring the topic back to the benefits of NA. Donald is a fake postings and everyone should ignore them.

Maybe it is impossible to have an honest forum.

08/29/06 02:49
Frances

not registered

08/29/06 02:49
Frances

not registered

NA long term effects

Ahhhhh....that comment reminds me of the good old days when this forum was like the wild west...kinda fun it was...(big grin).

Frances

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