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NA or surgery
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08/17/2008 12:21
patandpaula 
08/17/2008 12:21
patandpaula 
NA or surgery

Could anyone tell me if my understanding is correct? I only have the nodules on both palms, no cords yet, but nodules are very agressive. Is it correct that you cant have the NA until you get cords, but you can have radiation? Thanks Paula

08/19/2008 05:07
Wolfgang

not registered

08/19/2008 05:07
Wolfgang

not registered

Re: NA or surgery

Basically correct. With nodules you might also consider injection of cortizone. e.g. Kenalog (link: http://www.dupuytren-online.info/dupuytren_steroids.html ).

Wolfgang

08/20/2008 20:52
SteveB

not registered

08/20/2008 20:52
SteveB

not registered

Re: NA or surgery

Here are some youtube videos of a lady who had enzyme injections and manipulations (I suppose as an alternative to NA or surgery). Quite interesting.

http://www.youtube.com/watch?v=29RLwrkSWEc&;feature=related

http://www.youtube.com/watch?v=Seo9NWdZLsw&;feature=related

http://www.youtube.com/watch?v=yJ_vYLVDVMk&;feature=related

http://www.youtube.com/watch?v=6B1y25haPBM&;feature=related

http://www.youtube.com/watch?v=8m84XhoHi4A&;feature=related

http://www.youtube.com/watch?v=DYh3DR0WwPs&;feature=related

08/21/2008 04:37
Luba M.

not registered

08/21/2008 04:37
Luba M.

not registered

Re: NA or surgery

I watched all the videos on Youtube of the lady who had the enzyme injections and manipulation...very interesting, but the pain she describes sounds excruciating to the point that she is not sure that she'll go for the third injection.

Question: Is this the Auxillium Trial Phase III Injection that we are all anxiously awaiting to come out in 2009-2010?

I had NA two years ago (which was successfull, but it came back to pre-NA contracture within the year....and I will probably have to re-do it)...but at least...it wasn't painful like she describes it.

Are there others who have had the injections without suffering such pain? I would rather re-do the NA than go through what she is describing.

08/21/2008 06:15
Wolfgang

not registered

08/21/2008 06:15
Wolfgang

not registered

Collagenase videos

These videos are from a patient who participated in phase 3 trial of Auxilum's Xiaflex. But there might be a difference to later applications: my understanding is that during phase 3 trial no pain killer must be injected. I am sure this will be added once Xiaflex is approved and then the pain ought to be much less. What will still remain is the potential swelling of the hand and the time between injection and breaking of the cord requiring at least 2 visits.

Though those videos don't show the actual procedure they show the various stages of the treatment and the related emotions of the patients. I liked that and we included according links on our web page http://www.dupuytren-online.info/dupuytren_collagenase.html. Thank you, Steve!

Wolfgang

08/21/2008 06:47
Randy_H 
08/21/2008 06:47
Randy_H 

NA or surgery?

"It's so much better than it was that I would say.... 'fine'".

Not a ringing endorsement, but this was only one person's experience with an MCP. Release of the PIP is the gold standard in my view. We have few people who have had both NA and Collegenase so far.

Unfortunately we will never see is a trial of Collegenase Vs NA. The expense would prohibit that because who would put up the money? Who would have anything to gain? Certainly not the holders of the Collegenase patent. It's *so* much more expensive than NA it would have to blow NA away to be of benefit. Most of us know by now that is not going to happen.

It's still too soon to know the exact advantages of Collegenase, but so far I'm not impressed. Either way, I'd still exhaust these two alternatives before resorting to full Open Surgery. That is the entire reason millions are being spent to bring Collegenase to market. In other words, millions are being invested on the premise that both patient and surgeons desperately want an alternative to OS. The thing is, we already have one. NA is so *amazingly* under estimated.

Edited at 08/22/08 08:12

08/21/2008 15:10
SteveB

not registered

08/21/2008 15:10
SteveB

not registered

Re: NA or surgery

Here is a link to some good research that has been done of DC. Types of procedures etc. Hey, the more knowledge we have...the better!

http://answers.google.com/answers/threadview/id/219040.html

08/27/2008 03:06
Steve

not registered

08/27/2008 03:06
Steve

not registered

Re: NA or surgery

As I learned more about what kinds of treatments would be available, it became clear that I was too young to get NA every two-three years when surgery would remove (most) of the diseased tissue and is less likely to return to the same spot.

Yet with NA, I would have to have the same procedure repeated for the next 30+ years on the same finger to say nothing of the new cord growing under my other palm. Argh, I hate repeating the same task over and over and over for such an extended period.

It took 10 years to have it progress to the point I had to have something done. No way was I going to start down the path of such regular treatments that only treats the symptom without removing the diseased tissue so the cord reconnects and contracts again.

NA was not for me.

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