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Looking for Good Doctor for NA in or near DC or Virginia
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03/16/21 01:26
Maddie 
03/16/21 01:26
Maddie 
Looking for Good Doctor for NA in or near DC or Virginia

Hello everyone! I am a long time member of this forum who moved to central VA (Charlottesville) several years ago. I haven't had any treatment for my DD since 2013, when I had an extensive (four finger!) NA procedure by Dr. Pess in NJ. Before that I had RT in Hamburg, Germany.

I've made it for 7 1/2 years with no treatment, but it is that time again... So I am looking for a hand surgeon with a lot of experience with NA, to get another NA procedure plus an rx for splinting (I've found night splints to be effective for halting and even reversing contracture).

I'm hoping to find someone in VA or in the DC area. Dr. Pess was great but is now a 7 hour drive from me.

And yes, I've checked the listings on this forum, but would love to hear personal experiences as well.

Thanks in advance for any help you can provide!

Edited 03/16/21 01:28

03/16/21 08:13
spanishbuddha 

Administrator

03/16/21 08:13
spanishbuddha 

Administrator

Re: Looking for Good Doctor for NA in or near DC or Virginia

Maddie:
Hello everyone! I am a long time member of this forum who moved to central VA (Charlottesville) several years ago. I haven't had any treatment for my DD since 2013, when I had an extensive (four finger!) NA procedure by Dr. Pess in NJ. Before that I had RT in Hamburg, Germany.

I've made it for 7 1/2 years with no treatment, but it is that time again... So I am looking for a hand surgeon with a lot of experience with NA, to get another NA procedure plus an rx for splinting (I've found night splints to be effective for halting and even reversing contracture).

I'm hoping to find someone in VA or in the DC area. Dr. Pess was great but is now a 7 hour drive from me.

And yes, I've checked the listings on this forum, but would love to hear personal experiences as well.

Thanks in advance for any help you can provide!
I can't give a personal experience recommendation, and I expect you found this too via Google, the Virginia Hand Centre https://www.virginiahandcenter.com/handandarmproblems/

03/16/21 10:28
wach 

Administrator

03/16/21 10:28
wach 

Administrator

Re: Looking for Good Doctor for NA in or near DC or Virginia

A few more Virginia addresses:

https://www.orthovirginia.com/stuart/dup...le-aponeurotomy

https://www.handsurgeonfairoaks.com/dupu...fairfax-va.html

https://nvpwomen.com/womens-health/healt...DOCHWID=abp3208

I have no idea how good they are but maybe worth a try?

All the best

Wolfgang

03/16/21 18:25
BobL 
03/16/21 18:25
BobL 
Re: Looking for Good Doctor for NA in or near DC or Virginia

Links to ortho practices are not all that useful. We can all find them with a quick web search. And lists, such as the ones on the International Dupuytren Society web pages are of only very-limited help too, because they are inevitably out of date. I just tried to call one surgeon and learned that he is now retired:
Dr. Richard D. Goldner (CHS)
Professor, Orthopedic Surgery
Box 3480 Duke Medical Center
Durham, NC (North Carolina) 27710

What we really need is good data about doctors and various specialties. Which doctors did the most N.A. procedures last year? What ae their success rates or complication rates? In my limited experience - such data is impossible to get. Which leaves us just sort of guessing and hoping that we can find a doctor that we like and that, hopefully, does a competent job. That is, unless we know someone who has personal experience that they will share. It is certainly frustrating.

03/16/21 19:39
wach 

Administrator

03/16/21 19:39
wach 

Administrator

Re: Looking for Good Doctor for NA in or near DC or Virginia

Thanks for the input. Our listing is corrected now. We have to rely on what docotors tell us, If they don't tell us, we need input from patientes.

Wolfgang

03/16/21 22:55
Maddie 
03/16/21 22:55
Maddie 
Re: Looking for Good Doctor for NA in or near DC or Virginia

Thanks, everyone! Yes, I was hoping to find someone who had actual experience with a Virginia NA doc, but I have checked several venues (including here and FB groups) and so far have not turned up anything.

It seems like most people in the mid-Atlantic region are traveling to NJ to see Dr. Pess for NA- at least, those who post in DD groups.

It is interesting - though somewhat discouraging - that it appears that the practice of RT for DD is disseminating throughout the US much more rapidly than NA. When I was first diagnosed with DD in 2010, I searched for docs for both RT and NA. At that time, there were only a handful of docs (ROs and hand surgeons) knowledgeable about these procedures in the US.

Fast forward to 2021, and it appears, from the searching I've done at least, that there are tons of ROs now doing RT for DD. I found three highly recommended ones within a two hour drive, and I wasn't even trying to search for ROs - I just came across them while looking for hand surgeons doing NA in the region. This is great news regarding RT, of course. But I have not been able to find a single personal recommendation for an NA practitioner within a 5 hour drive of where I live, even though this technique has been used in the US for more than 10 years.

I wonder what accounts for the difference? Is NA harder to learn? Are surgeons already busy enough and just not interested? Are radiological oncologists more open-minded about new techniques? I don't think it is a lack of demand for NA, because a lot of posters seem to want it. But they are just all traveling to see Dr. Pess.

Would love to hear your thoughts on this topic!

Edited 03/16/21 22:59

03/17/21 11:36
wach 

Administrator

03/17/21 11:36
wach 

Administrator

Re: Looking for Good Doctor for NA in or near DC or Virginia

Hi Maddie,

to your question: yes, RT of Dupuytren's is rather trivial (provided you have the equipment and know what you are doing). NA needs learning and on top of that, many hand surgeons don't feel comfortable with it because it is a "blind" procedure, meaning that the surgeon does not see what he is doing because he is working through a tiny hole in the skin.

Travelling a few hours to see a doctor who is good at NA doesn't seem like much to me because usually it is just a one time visit. In the past patients from all over the USA used to travel to Florida to get treated by Dr. Eaton. - RT is different in that respect: you usually have to go there 10x, so travelling 5 hours for a 2 min treatment and then travelling home another 5 hours and that 10 times would be quite inconvenient.

Wolfgang

03/17/21 17:36
Maddie 
03/17/21 17:36
Maddie 
Re: Looking for Good Doctor for NA in or near DC or Virginia

wach:
Hi Maddie,

to your question: yes, RT of Dupuytren's is rather trivial (provided you have the equipment and know what you are doing). NA needs learning and on top of that, many hand surgeons don't feel comfortable with it because it is a "blind" procedure, meaning that the surgeon does not see what he is doing because he is working through a tiny hole in the skin.

Travelling a few hours to see a doctor who is good at NA doesn't seem like much to me because usually it is just a one time visit. In the past patients from all over the USA used to travel to Florida to get treated by Dr. Eaton. - RT is different in that respect: you usually have to go there 10x, so travelling 5 hours for a 2 min treatment and then travelling home another 5 hours and that 10 times would be quite inconvenient.

Wolfgang

I agree with your point about the difference in difficulty of learning the procedures. Still, I am concerned that it is not best for the patient community to have such a limited number of NA experts. Dr. Pess will retire someday, as Dr. Eaton did. Apparently he has trained another surgeon in his practice, which is good. But it is still bad for the field, in my opinion, that the intervention that is the best opinion for correcting contracture for many of us is not disseminating more in the surgical community.

Regarding travel time - yes, NA is one day as opposed to the week needed (twice) for RT. But, travel for NA is not necessarily as easy as you describe. Many people are traveling more than "a few hours" to get to Dr. Pess - for me, it is a full day's travel each way. That means a hotel stay of at least two nights. Many NA procedures are also being done with light sedation now, so that means either bringing a travel companion to help (who needs to take 3+ days off from work) or hiring a caregiver near Dr. Pess (the office will not release you after light sedation unless you have someone to accompany you home).

My last NA with Dr. Pess was very extensive - 4 fingers on one hand, with large cords. It was done in a surgical center and took close to an hour. I did it under local anesthesia but would never do that again as it was very painful - or, more actually, there was significant pain that went on and on for a long time. He eventually had to give me a nerve block to finish the procedure. Also, I had thought I would be able to drive home the next day, but recovery was harder than I expected, so I ended up staying at the hotel for several days. My hand was black and blue and painful for weeks. It was very different than just treating one cord, which I have also had done.

So all in all, if I travel to Dr. Pess to have this procedure re-done, I am looking at 2 full days of travel and 3-4 nights in a hotel, plus hiring a local caregiver to accompany me after the anesthesia. That is comparable to my experience in 2010 of getting RT, which involved a full day of travel there and back and 5 nights in a hotel (then repeated for the follow up). But today if I needed RT I could get it in a 15 minute drive.

Another example - my 85 year old mother had open surgery to correct a contraction in a pinkie last year. It could have been done by NA by a skilled doctor. But, she would have had to travel for that, and that was too much for her. And she does not live in a rural area - she lives near Washington, DC, a metropolitan area with medical resources that rival those anywhere in the world. But, no NA experts.

I know there are limited resources to move the DD agenda forward. But I think at some point a focus on increasing NA expertise in hand surgeons could improve the field significantly.

Ok, off my soapbox now!

Edited 03/17/21 17:39

03/17/21 18:39
Maddie 
03/17/21 18:39
Maddie 
Re: Looking for Good Doctor for NA in or near DC or Virginia

A correction to the post above: apparently Dr. Atik received his NA training in France.

06/08/21 05:17
Like2bake 
06/08/21 05:17
Like2bake 
Re: Looking for Good Doctor for NA in or near DC or Virginia

Hi Maddie,

Although I have no personal experience with him and don't know of anyone who has used him for NA, Dr. Richard Barth in DC does this procedure. My understanding is that he does not take insurance. But perhaps you have found someone by now. I'm not sure yet where I am on the Dupuytren's spectrum, but I'm also looking for doctors in the DC area who specialize in Dupuytren's treatment.

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