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How soon to start NA?
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08/22/2013 22:37
BRIANB 
08/22/2013 22:37
BRIANB 
Re: How soon to start NA?

FYI MY DUPS STARTED SOON AFTER I CUT MY FINGER WITH SCISSORS ....NO FAMILY HISTORY ...SO I AGREE ..WAITING AT TIMES MAY BE A SMART MOVE ...

08/23/2013 19:39
moondanc 
08/23/2013 19:39
moondanc 
Re: How soon to start NA?

wach:
Diane,

the problem is that after the needle procedure you need to pull heavily on the cord to break it. The usual advice is to wait until you have 20 deg contracture and then intervene. A few docs will use NA earlier and try breaking the cord by hyperextending the finger. If you have no contracture at all pulling on the cord will be difficult. Even if you are able to break the cord, without prior contracture the open ends of the cord will stay so close together that they will likely grow together again.


Wolfgang
moondanc:
...

Hi Wolfgang,
You're right, that certainly makes sense. I don't know why I have blocked out the "pulling" on the cord to break it (maybe because I don't watch and it doesn't hurt because of being numb?). However, I couldn't avoid hearing the *sound* when they broke my cord after Xiaflex. Too bad there isn't some substance that can be painted on the ends of the cord so "seal" them off!

Thanks,
Diane

08/23/2013 19:41
moondanc 
08/23/2013 19:41
moondanc 
Re: How soon to start NA?

callie:
While many people take offense/scoff to the "wait until contracture" that is often mentioned, there is valid reasoning. A primary reason is that often contraction does not reach a point of having any procedure done. Another good reason is that any procedure can trigger the advance of Dupuytren's. In my case surgery was the optimal procedure in which all of the diseased tissue was removed and there hasn't been any new development in the area.

Callie, you make good sense, also. I HOPE you're right in my husband's case although it seems to be progressing faster and faster. My case--there's barely anywhere left for cords to go.

Diane

08/27/2013 11:16
wach 

Administrator

08/27/2013 11:16
wach 

Administrator

Re: How soon to start NA?

Diane, some efforts have actually been made in that direction. Cellulose implants were tested as firebreaks after segmental fasciectomy
http://link.springer.com/content/pdf/10....7_25.pdf#page-1

and sometimes radiotherapy after NA is considered to postpone or avoid recurrence, though I haven't seen anything published on that.

Wolfgang

moondanc:
... Too bad there isn't some substance that can be painted on the ends of the cord so "seal" them off!

Thanks,
Diane

08/27/2013 19:28
moondanc 
08/27/2013 19:28
moondanc 
Re: How soon to start NA?

wach:
Diane, some efforts have actually been made in that direction. Cellulose implants were tested as firebreaks after segmental fasciectomy
http://link.springer.com/content/pdf/10....7_25.pdf#page-1

** Wow! Thanks for the information

and sometimes radiotherapy after NA is considered to postpone or avoid recurrence, though I haven't seen anything published on that.

Wolfgang

This certainly didn't work for me I had one hand treated with RT before NA and the other hand treated almost immediately after NA. The only thing that happened to me was a radiation burn on the hand treated immediately after RT. Otherwise no difference in the two hands although my case was probably too advanced to really benefit from RT.

Diane ...not using her HTML skills

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