It is commonly believed that there must be contracture before performing NA. Dr. Denkler claims this isn't true - that enough tension to snap the cords can be generating by hyperextending (bending back) the fingers. He says he has successfully performed NA on non-contracted people.

If my current attempts to get radiotherapy fall through, that's the route I'll take.

- MML

I can verify what Michael L said about Dr. Denkler performing NA on nodules before contracture has started. During my 2 sessions last August with him where he released 3 contracted fingers and a thumb, he also broke down two newly forming nodules on different non-contracting fingers. Since I've had this dreaded disease for many years and this was my 2nd round with NA I've become pretty familiar with how the nodules progress into chords and then contracture. Since Dr. Denkler did NA on those 2 nodules, both flattened out and sort of disseminated, but mostly I've noticed it nearly stopped the normal progression that I've experienced with previous nodules. Granted this is short term so far (7 months) but it is definate. Hope this helps someone. Best to all, Jey...

Frustrated:

There are many among us who would not say "as if", but *definately* did trigger new growth. Trauma triggers Dups in many people. That's why the surgeon tries to get *all* the diseased tissue out of the hand so that like cancer, it doesn't spread. The problem is that the biology of the whole hand is whacky, and the trauma of the OS can trigger growth in other arias.

Now, for some, that might be a controversial statement. Your experience (and mine) would lead you to believe otherwise. That is why an entry level noninvasive treatment is so needed. The Indictable Collagenase of our host is one, NA is another. NA is available now, however. Given what we have learned over the last few years around here, I can't see the logic of bypassing NA and going straight to OS. I've had them *both* and I can't think of a single reason not to try the less invasive option before opting for fully invasive hand surgery.

Denkler: http://www.nvo.com/plasticsurgerys/home/

Hi - I'm a 36 year old mother of 2 that has just been diagnosed with dupuyrtrens. I fell off my horse, broke both arm bones at the wrist, and subsequently had surgery (1 plate and 8 screws) 7 weeks ago. Last Tuesday, at a surgical followup, I noticed a small nodule on my palm under my ring finger. I showed it to the Doc and he said Dupuytrens. He was suprised at my young age. In the last *week* however, I have developed another nodule in my pinkie with a large cord *and* 2 (yes 2) larger nodules at the base of my thumb and a cord! My rehab hand therapist (only been 3 times) is fascinated and has begun mapping/recording my hand at each visit because this is progressing so fast......has anyone had this rapid growth experience? It is hard to tell about the contracture because my entire hand and wrist are both sooooo stiff from the casting/splinting after surgery. I still wear the splint 85% of the day and all night. I have been reading all of your posts for the last few days and look forward to any helpful advice and support.

also, how long is Dr. Eaton's wait list? Do I need to get on it now since my disease is moving so fast?

thanks (sorry so long)

cat

Hi:

I developed a cord in the palm of my left hand in my early 40s.

I found out formally in 1993 (age 42) that I had Dups.

Now, at age 55, the PIP joint on my right ring finger has contracted to 26 degrees, and my MCP joint on the same finger has started to contract.

I also have other signs of Dups (cords & nodules) in both hands.

I'll be working with Dr. Benahim (at UCLA) & Dr. Denkler (at UCSF) to address these issues.

Getting older stinks! But, I guess it beats the alternative!

Mark