Hi dwilson!

I'm really glad to hear your report about the radiation treatment and I'm glad it's going so well. I'm especially glad to hear that you haven't had any side effects. I was asking Dr. Kline about side effects and he said there might be some dryness and occasionally some temporary tingling or numbness but it sounds like you haven't had any of these sensations.

I'd like to know how patients come to find Dr. Reymond...it's not as if hand surgeons refer people for radiation (at least, not in my experience!) and I believe you mentioned he is very experienced in treating this.

Thanks again for letting us know what this is like....I'll be getting mine in the fall. In the meantime, I'v had two steroid injections into the nodule, and it is noticeably smaller and flatter.

- Megan -

Steroid use in areas with tendons should be viewed with extreme caution. At one point it was a popular treatment for tennis athletes until there were some famous cases of tendons "exploding" and ending tennis playing forever.

PD Fadale and ME Wiggins - Department of Orthopaedic Surgery, Rhode Island Hospital, Providence.

Local injections of corticosteroids are commonly used in orthopaedic practice on the assumption that they will diminish the pain of inflammation and accelerate healing. Less often considered is the possibility that their use may delay the normal repair response. Among the multitude of conditions treated with corticosteroids are acute athletic injuries, overuse syndromes, nerve compression, bone cysts, and osteoarthritis. Unfortunately, there is a paucity of well-controlled studies that provide definitive recommendations for nonrheumatologic use of corticosteroids. Also troubling are the significant potential complications that can occur with their use. The authors believe that use of corticosteroids should be limited to the few conditions that have been proved to be positively influenced by them. Their use must be accompanied by a well-orchestrated treatment plan including close follow-up, physical therapy, and limitation of activities.

I would not consider the use of steroids to treat my hands on an experimental basis for Dupuytren's prudent nor would I take the advice of a general practitioner or someone not familiar with Dupuytren's. Steroids from my experience can lead one to conclude the injured area has healed and can be stressed again long before this is actually true.

With regard to Dupuytren's, Dr. Denkler, a NA certified hand surgeon, believes it is very helpful to stretch their hands and tendons after the NA procedure to minimize the likelihood or severity of a renewal of the contracture. Dr. Denkler points to people, who while they may find Ledderhose makes walking painful, do not suffer from contracture of the foot to the extent that people do with their hands who are suffering from Dupuytren's. He believes that the continued stretching is a positive therapy. I would be cautious in getting steroid injections into the tendons and then doing any strenuous activity with your hands much less stretching them to reverse the amount of contracture.

Hi Lisa,

I'm sorry to hear about your diagnosis...and also about your surgery. I wish you a speedy recovery. Boy, when it rains it pours.

Regarding your question about radiation and the implications it might have for surgery, just wondering whether you might try calling the office of Dr. Denkler, Dr. Kline, or the doctor in Topeka some of the people on the forum are being treated by (Dr. Reymond). They might be willing/able to answer that question for you.

I hope you are able to get radiation treatment in Michigan...fortunately, I can drive to Boise...and there are hotel costs and all that, but I can't complain. My husband has always wanted to go to Germany, but we weren't prepared to go abroad this year!

Megan

Atlanta, GA. 37 yrs old. Male. Diagnosed with DD 3-weeks ago. Early stages with strands in left hand. No contracture.

My orthopedist simply stated, by way of his assistant, that radiation was not an option for treatment. I have been trying to reach doctors in Virginia (Weiss & Cuttino), Idaho (Kline & Kuhn), Kansas (Reymond), California (Torrigoe), and Florida (Eaton) to get anyone to give me insight into doctors in Georgia who might be open to RT as a viable treatment or might even be familiar with RT. No response yet.

I have contacted Radiation/Oncology departments of local hospitals and the best I could find out is I need to know the type of machine being used for treatment - then I may be able to convince someone to make a referral or do some research.

Does anyone have information on the details of RT? I am not even sure what the right questions are to ask should one of the above doctors get back to me. Does anyone have a lead on physicians in the southeast who have used RT?

hi Bruce,

Thanks so much for the information. It sounds like the steroids could, potentially, damage the tendons?

quote: "As a patient I find it irresponsible to the point of malpractice on the part of these surgeons."

I agree with you 100% about this. By the time I saw the second hand surgeon, I had read about radiation treatment, and he wouldn't even discuss it with me...he said my case was "too mild" and that I shouldn't assume it would progress! He told me to "watch and wait" but he didn't tell me what to watch and wait for! If I followed his advice, I'd be guaranteed to pass the point at which radiation was most effective.

I find it very frustrating that so many of us find ourselves in the position of wanting to get radiation therapy, but having to go extraordinary lengths to find a place to get it! I hope to turn my frustration into something positive; I am thinking about writing a letter to the head of radiation oncology at one of our big cancer institutes here in Seattle to ask them to look into offering this therapy so that other people don't have to go through this. Don't know if it will do anything, though. I guess another thing to do is bring it up to my general practitioner....so that they learn about it. However, it's doesn't seem to be a good situation right now. Megan