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New to the website - 22 year old musician student with DD! help very welcomed
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01/03/2013 21:04
nevermind 
01/03/2013 21:04
nevermind 
New to the website - 22 year old musician student with DD! help very welcomed

Hey guys nice to find this website have really learned a lot about the disease and the options that i have.

Im a 22 year old musician and have recently begun developing chords from a nodule on my left hand that i noticed about 2 years ago.

I went to the doctor and she confirmed that i had DD but told me to come back when it starts effecting my daily life..

After reading about the other less invasive (and potentially more effective) treatments i feel slightly more positive about the situation.

Im under the impression that the earlier you develop DD, the more aggressive it can be so i'm keen to do anything to reduce the progression rate especially as it will potentially effect my career as a musician.

So after some research it seems that radiation therapy is my best option at the moment, with the nodules formed and the chords beginning to develop i'm looking to start this asap however i'm not too sure how to go about getting it. If i go to my GP and ask to see a hand specialist is their a chance that he/she might recommend RT or is it common for doctors in the UK to wait till the hand contracts and then perform open surgery?

The RT statistics look very promising and really keen to have it done asap! any advice about specific doctors in the UK/prices etc would be much appreciated.

Thanks, leo

01/03/2013 22:43
Vikingorigins 
01/03/2013 22:43
Vikingorigins 

Re: New to the website - 22 year old musician student with DD! help very welcomed

Hi Leo,
DD can be very frightening for musicians. I play classical guitar, not professionally though, but i hope to play it for a long time. I agree that RT is the best option and didn't want to miss that window too so i traveled to Hamburg for treatment. So far, it has not progressed after RT and even feel more flexibility. Don't miss this window because your other options will involve waiting for some contracture and consequently some limitation in your dexterity. Depending on your preferred instrument, i guess the outcome can vary. If you google dupuytren and musicians you will find some testimonies of concerts pianists who had successful surgeries, but still, they had to stop playing for a few years. So don't miss the RT window. And in Canada, if i had waited for a referral for RT from a GP or a surgeon, i would still be waiting... So i contacted prof S and traveled the next month.
Practically, i still have all flexibility but playing triggers a great fatigue in the left hand, so i can't play for long and take long breaks. Actually, in retrospect, i remember starting to feel this fatigue a few months before even noticing the nodules. I thought afterwards that challenging my hand accelerated DD. It could be, but the fatigue now started in my right hand, which is put through less stress in my playing. It might be that the presence of the nodules, even in a size not visually noticeable, stresses the hand while playing and triggers this fatigue. So another reason to treat early.
I can't accept to stop playing. Wouldn't it be heartbreaking to stop, just to develop DD anyways ? I wish you a life long of music.
All the best

Edited 01/04/13 00:46

01/04/2013 00:26
callie 
01/04/2013 00:26
callie 
Re: New to the website - 22 year old musician student with DD! help very welcomed

I wondered about your statement? You said, "If you google dupuytren and musicians you will find some testimonies of concerts pianists who had successful surgeries, but still, they had to stop playing for a few years".

Can you remember why they had "to stop playing for a few years"? That surprises me because I was putting a lot of stress on my hands playing golf after three months following surgery.

01/04/2013 01:32
Vikingorigins 
01/04/2013 01:32
Vikingorigins 

Re: New to the website - 22 year old musician student with DD! help very welcomed

Maybe i was too general, i meant stop playing before they had surgery. Andre Gagnon, a composer, stopped playing for a few years due to contracture, until he got surgery. Misha Dichter did not stop but adapted his fingering and compensated with his other hand until he had to get surgery. (http://www.sfgate.com/entertainment/arti...ord-3199604.php). They seem to postpone treatment until they can't play anymore, and then get surgery. But this is not a systematic review

01/04/2013 08:35
spanishbuddha 

Administrator

01/04/2013 08:35
spanishbuddha 

Administrator

Re: New to the website - 22 year old musician student with DD! help very welcomed

nevermind:

So after some research it seems that radiation therapy is my best option at the moment, with the nodules formed and the chords beginning to develop i'm looking to start this asap however i'm not too sure how to go about getting it. If i go to my GP and ask to see a hand specialist is their a chance that he/she might recommend RT or is it common for doctors in the UK to wait till the hand contracts and then perform open surgery?

The RT statistics look very promising and really keen to have it done asap! any advice about specific doctors in the UK/prices etc would be much appreciated.

Thanks, leo
Most UK GP's will indeed suggest you go away and wait, only to return when you fail the table-top test with a contracture. Even if you ask for and get a referrral to a hand consultant it will be to a surgeon who will likely advise against RT.

Do your homework and take the NICE guidelines for RT along with you to the GP appointment, and ask for a referral for this treatment in your local PCT/CG. If the GP says no, you can write yourself to the PCT/CG.

However, experience shows that this is a long protracted process and even then most PCT/CG will not provide treatment using RT on the NHS.

That leaves choice of private treatment. There are two clinics in the UK, refer to the BDS website, http://dupuytrens-society.org.ukor of course you can go to Germany. Expect to pay £2000+ per hand or foot whether treated in the UK or abroad. £2000 in the UK covers just the treatment. £2000 in Germany would include budget level travel and accommodation for a week.

The BDS also provide a leaflet you can show your GP which covers the stages and range of treatment options. It's a useful starting point for discussion since many GP's are not up to speed with treatments available.

01/04/2013 08:41
wach 

Administrator

01/04/2013 08:41
wach 

Administrator

Re: New to the website - 22 year old musician student with DD! help very welcomed

Leo, I am afraid that some clinics might be reluctant to treat your Dupuytren's with RT because you are still quite young. This would increase the risk of developing cancer in the treated area. Thi risk might still be small but it will definitely be higher than for a patient of 60 years.

Wolfgang

01/05/2013 10:06
Seph 
01/05/2013 10:06
Seph 

Re: New to the website - 22 year old musician student with DD! help very welcomed

Leo; I am not understanding why you are running to RT and rejecting NA. NA is simple and relatively painless and you get full movement back immediately if you don't leave it too long. The downside is that it doesn't stop the progression of the disease and there is the possibility that it stimulates the the DD. Since you are young though the RT, drugs and surgery can always come later if required.

01/05/2013 11:31
nevermind 
01/05/2013 11:31
nevermind 
Re: New to the website - 22 year old musician student with DD! help very welcomed

Hey guys thanks for all the replies this website has been really useful and everyone seems to be helpful and polite.

I have considered NA but as you say it does not stop the progression of the disease and recurrence rates seem to be high. And as far as i know, RT does work on chords but as long as their is no contracture and the disease is active (ie: beginning to contract) which is the stage i'm at so time is running out.

I am considering going to Humberg to see Prof Seegenschmiedt to get RT as he seems to have high rates of success. Although it will be expensive especially as im a student, i cant see much hope in getting RT on the NHS and the cost for getting privately treated with RT in the UK is even more expensive that Germany.

Leo

01/05/2013 11:52
wach 

Administrator

01/05/2013 11:52
wach 

Administrator

Re: New to the website - 22 year old musician student with DD! help very welcomed

Hi Leo,

I believe most of the UK clinics listed on http://www.dupuytren-online.info/radiotherapy_clinics.html will also treat NHS patients. I don't know whether referal is an issue but they might be able to help, at least worth checking. As you need to go to the radiotherapy every day for at least a week, it's convenient to chose a clinic not far away or to stay in a close by hotel.

Wolfgang

nevermind:
Hey guys thanks for all the replies this website has been really useful and everyone seems to be helpful and polite.

I have considered NA but as you say it does not stop the progression of the disease and recurrence rates seem to be high. And as far as i know, RT does work on chords but as long as their is no contracture and the disease is active (ie: beginning to contract) which is the stage i'm at so time is running out.

I am considering going to Humberg to see Prof Seegenschmiedt to get RT as he seems to have high rates of success. Although it will be expensive especially as im a student, i cant see much hope in getting RT on the NHS and the cost for getting privately treated with RT in the UK is even more expensive that Germany.

Leo

01/05/2013 19:11
Vikingorigins 
01/05/2013 19:11
Vikingorigins 

Re: New to the website - 22 year old musician student with DD! help very welcomed

I fully understand the preference of a musician for RT. Playing music requires a full range of motion, speed, strengh, and precision. It is dexterity. A little contracture may not pose a significant problem for the grip in playing tennis or golf, but it can certainly mean that playing some particular musical pieces will become inaccessible. Shouldn't treatment take in consideration the activity of a person?

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