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Large Nodule best treatment
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01/21/2013 13:57
Penny 
01/21/2013 13:57
Penny 
Large Nodule best treatment

Hi everyone,
I haven't posted since my return from Germany, Dec 2011. Had radiation on my Ledderhose twice and once on my hands as they felt like they were active again, but didn't opt to go back to Germany a third time for the second treatment on my hands as Prof. Seegenschmidt said there was only a 50/50 chance for stopping the progression, due to the degree of disease. The nodules on my feet have not changed for which I am grateful, however my feet are very sore and I can only walk short distances before sitting. My newest problem has just recently developed, the main nodule on my right hand has gotten so large tha it is interfering with daily tasks, and now seems to be infected since I keep bumping it all the time. There is a white spot in the middle of it and it is tender like an an infection. So, please advise that do you think is the best route to go? I really am at a loss.
Penny

01/21/2013 14:25
Penny 
01/21/2013 14:25
Penny 
Re: Large Nodule best treatment

l'm answering myself and feeling rather dumb, I just took a needle to it and it was infected...so much so that it was quite a mess. I guess because of the nodule it just didn't hurt like a regular sliver or something. Sorry for the crazy post, but maybe this can be a lesson for someone else.
Penny

01/21/2013 15:19
flojo 
01/21/2013 15:19
flojo 
Re: Large Nodule best treatment

Thanks for sharing. We all need to know the crazy things this disease does so we can be on the look out!

01/26/2013 13:00
Penny 
01/26/2013 13:00
Penny 
Re: Large Nodule best treatment

Ok this is continuing as I think what happened is about 2-3 months ago I got a sliver in my nodule. The nodule grew over that time, and I thought it was just my dupuytrens, as I couldn't feel any sliver or irritation as you normally would. Then it finally got a head on it and I opened it up and got out as much of the infection as I could, along with some flat white "stuff" that I can't really describe. So now the infection is continuing and whatever is in there is not coming out. I have tried to open it up myself and am probably headed to a doctor next week--however I don't really want alot of digging as I don't want to risk this being like and injury and causing my dup's to become more active. Any ideas???
Thanks,
Penny

01/27/2013 07:31
wach 

Administrator

01/27/2013 07:31
wach 

Administrator

Re: Large Nodule best treatment

Stop digging and see your doctor.

Wolfgang

01/28/2013 14:08
Larry 
01/28/2013 14:08
Larry 
Re: Large Nodule best treatment

Digg dagg digg dagg

... the clock to make a good decision is running up ...

Digg dagg digg dagg

So like Wolfgang mentioned: Stopp Digging

... and see a doctor !

01/29/2013 22:51
Penny 
01/29/2013 22:51
Penny 
Re: Large Nodule best treatment

Saw a doctor--whatever in in there is not coming out easy--looks like surgery is in my future. Anyone know of a good duputryen hand surgeon in the Dallas TX area.
Thanks,
Penny

01/29/2013 23:29
callie 
01/29/2013 23:29
callie 
Re: Large Nodule best treatment

Surgery for what? If it is to remove a nodule that doesn't sound right. If it is to remove a splinter (or something) you don't need surgery for Dupuytren's. What did he say was the problem? Some nodules or "dermal pits" have a core of tissue. Is that what you have?

01/30/2013 09:53
Penny 
01/30/2013 09:53
Penny 
Re: Large Nodule best treatment

He said that whatever is in there (possibly splinter) did not come out--and he could see something like a cyst or something that shouldn't be in there possibly a dermal pit from your post, which I didn't know about. He also said the fluid coming out is not the fluid from a regular infection--and he used a medical term which I didn't know. He thought the splinter is lodged deeper and probably in the duputryens (he again used medical terms I didn't know) and I should have asked more questions, but I was struggling not to pass out and was nauseated and not thinking so well. Anyway the surgery will be to get the foreign body out as the infection is ongoing and I guess depending on where it is lodged, will determine the amount of surgery.
Thank you so much for your feed back, I need to find a doctor quickly and need to know the questions to ask and the treatments to request

Thanks,
Penny

01/30/2013 10:23
Penny 
01/30/2013 10:23
Penny 
Re: Large Nodule best treatment

If I have to have surgery to remove the infected nodule I would like to improve my chances for normal useage after.

Cellulose Implants-Does anyone know of a doctor in the states using cellulose implants as it seems to produce better outcomes from surgery.

"We intended to improve the surgical outcome in Dupuytren’s disease by augmenting the “firebreak” effect of segmental fasciectomy with a cellulose implant, which is a known absorbable adhesion barrier." http://link.springer.com/chapter/10.1007...-642-22697-7_25

OR One who uses tamoxifen.


As quoted below by Dr. Eaton on usage of such.

"The most groundbreaking presentation was on the use of preoperative adjuvant tamoxifen to treat patients who had high risk for recurrence after a surgery. This randomized study showed that high-risk patients who had the preoperative treatment before limited fasciectomy for Dupuytren maintained their surgical correction to within about 10 degrees. Patients who were randomized to just the surgical treatment lost an average of 40 degrees of their initial correction.

The study used oral tamoxifen, but I’m considering a trial with topical tamoxifen. The big issues with patients who have aggressive Dupuytren are the extent of skin involvement and the dense relationship between the skin and the fascia as part of the biology. A minimal approach to straighten the fingers, followed by some sort of biologic intervention to maintain those results, would be great. "
Penny

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