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Ledderhose nodule and dupytrens contracture treated w Verapamil failing me
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04/16/2017 18:57
Tkal711 
04/16/2017 18:57
Tkal711 
Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

Overview : onset nodule to palm of hand for dupytrens following a fall into hand at 37 yrs of age or 36. Then later developed at 38 ledderhose nodule to my opposite foot. European descent. Went to hand doc locally not said to leave it alone cause how small it was and not yet affecting my range of motion. I like to bike/spin as able. Went to doc rwgrding the foot and was given Verapamil end of last year. I have to say. I improvement although not consistent w it either. Was very disappointed in the cream I was given.... I put it on and is very greasy and doesn't really seem to even absorb. Anyone really had luck w this? Foot nodule is larger and feel w about every step now. Makes me wonder too if anyone has done studies on oral Verapamil (CCB) rather than topical in efficacy. I read all these other forums and see. It much helps many. Wasting my money to have anything further attempted. Avoiding anything surgical as often w more complications w chronic pain or nerve involvement. I need guidance here. God bless.

04/16/2017 20:35
spanishbuddha 

Administrator

04/16/2017 20:35
spanishbuddha 

Administrator

Re: Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

Quick summary, the only published evidence based treatments are the ones described on the website, basically RT, NA, Xiapex, and Surgery of various forms. People try and are prescribed topical verapamil, or buy a compound commercially, but the results are inconsistent and for the majority prove not helpful. Same with other compounds such as DMSO/SSKI. More positive stories are posted anecdotally with the topical application of vitamin E or magnesium oil, but again the the results are mixed and it's hard to see how that is likely to reverse or stop progression. Similar for Tenex or hyaluronidase with some reporting LD nodules shrink and others reporting no long term gain. For early LD if orthotics, or footwear does not help then RT is the likely best option. In the US cryosurgery has positive reports for larger painful fibroma as. RT is a good early option for DD too, and you could check out the massage thread for early stage DD with just nodules.

It's not clear how fast your DD or LD is progressing? For RT to be effective the disease needs to be active with ongoing progression. There are lifestyle and health risk factors that may or or may not affect you? Have you seen an experienced hand doc and podiatrist. Experienced enough to know all the treatment choices before surgery is even mentioned?

04/17/2017 12:37
wach 

Administrator

04/17/2017 12:37
wach 

Administrator

Re: Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

In 2015 we surveyed 1,000 LD patients asking, besides others, about their experience with treatments of LD. Results for Verapamil were not very impressive http://www.dupuytren-online.info/patient_survey.html.

Wolfgang

04/22/2017 00:00
Tkal711 
04/22/2017 00:00
Tkal711 
Re: Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

Thank you for responding. I can tell the nodule is getting bigger, however I do not know about the progression rate as I haven't returned to my podiatrist that I saw. He's the one that prescribed the verapamil for me locally in Fort Myers Florida. But It was smaller at the time. Now I feel it with stepping and walking and try to wear cushy shoes. Sometimes tender. Thank you for letting me know about which therapies are best so far, as I think I'm going to have to pick one. I've seen Dr. Sagini for my hand however it was very mild and still doesn't need anything done for it. Any recommendations on physicians around Florida for radiation therapy? I was reading the reports thank you for attaching but I don't see you local podiatrist that specializes in this. I'll keep up the searching

04/22/2017 00:02
Tkal711 
04/22/2017 00:02
Tkal711 
Re: Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

Oh and also regards to risk factors I have none really. Pretty healthy other than this junk. Sad thing is I'm a family nurse practitioner and can't even fix this for myself. Frustrating.

04/22/2017 06:36
spanishbuddha 

Administrator

04/22/2017 06:36
spanishbuddha 

Administrator

Re: Ledderhose nodule and dupytrens contracture treated w Verapamil failing me

For RT in Florida, Drs Hochman and Wolfson listed here http://www.dupuytren-online.info/radiotherapy_clinics.html have also had recommendations from users on the forum.

06/02/2021 02:27
wheels 
06/02/2021 02:27
wheels 
Verapamil - Topical vs. Transdermal

Verapamil. One must be careful in the words you use. Verapamil - Topical vs. Transdermal.

A topical ointment cream or lotion is just that – Topical. It does not necessarily penetrate the skin much. Often times this will contain such items as Emulsifying Wax, Mineral oil and Petrolatum (petroleum jelly). These are not water soluble, and will not penetrate the skin much at all. Yup, probably greasy.

Transdermal means "denoting the application of a medicine or drug through the skin". These Transdermal lotions are engineered to help the medication to pass the skin. The molar mass of Verapamil molecule is quite large at about 400-454 g.mol*1 in size, approaching the limit of skin transmissibility, so a great Transdermal lotion is essential. Some recipes work better for different medications than others. There are many different popular versions on the market. They are not all the same. Which one works best for Verapamil HCL? I have no idea.

But if your lotion does not seem to work – then possibly you got a Topical Version - not a Transdermal Version. There is really no way it can work. Instead of poo-pooing the opportunity for success for others on any specific treatment, please note the active and inactive ingredients in your cream preparation – so we can all slowly learn what may or may not work.

Furthermore, one must ask for Verapamil HCL, not just Verapamil. The world is a technical place. We must be technical too - to inform the uninformed when we need a specific medication that a doctor is probably not aware of.

Just sayin'
Wheels

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dupuytren-online   recommendations   hyaluronidase   radiotherapy   podiatrist   topical   transmissibility   treated   experienced   dupytrens   practitioner   contracture   progression   Verapamil   complications   Ledderhose   inconsistent   Transdermal   application   commercially