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Request from Patients who have had Dupuytren Surgery
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11/09/15 23:05
gferrante 
11/09/15 23:05
gferrante 
Re: Request from Patients who have had Dupuytren Surgery

Vicmc

Thanks for feedback- keep stretching, massaging fingers and the especially the scar even though there may be substantial pain

My daughter who works with post surgery patients emphasized you have about 6 months and the first few months are important- you are still within the window and most importantly you want those fingers to return as close to normal as they were prior to the disease.

Good Fortune and hopefully you will return to work!

Gferrante

11/14/15 09:01
newman 
11/14/15 09:01
newman 

Re: Request from Patients who have had Dupuytren Surgery

Hi this might be of interest. I've had plenty of surgery and each time I had the tingling sensation you mention. Always the risk of slight nerve damage after any intervention. In the first instant my surgeon sent me off to see a neurologist. He performed a simple test called Electrodiagnostic test (NCS) which was simply sending an electric current down the arm and measuring the time it took to reach the tip of the fingers. There is also another test Electromyography EMG test. In my case it was decided to take the wait and see protocol for 6 months . The sensation disappeared after time. Back in March of the year I experienced the same sensation after PNF and I find that now it has just about disappeared. So you can do the test if it worries you too much .
Finally I concur with Wolfgang with his comments. Don't overdo it. Leave the push ups to the young bulls.

Edited 11/14/15 09:07

11/17/15 23:54
emelem 
11/17/15 23:54
emelem 
Re: Request from Patients who have had Dupuytren Surgery

Your Doctor is right. Everyone heals differently. Each hand is different. I had surgery on my left pinkie in September 2014. It took the better part of a six months, and a second surgery for carpal tunnel, before I could make a fist. Very painful recovery. Same surgery on my right hand in September 2015. I was able to make a full fist in about 5 weeks. Same doctor, same severity of contraction, same issue (pinkie PIP and cords). Very different outcome.

The advice I received from folks in this forum is sound: it takes time to heal, be patient, and don't overdue your exercises or physical therapy.

Edited 11/17/15 23:55

06/16/18 05:43
GailSusan 
06/16/18 05:43
GailSusan 
Re: Request from Patients who have had Dupuytren Surgery

I had surgery on my right hand for the ring and little fingers. My surgeon was a hand surgeon with a plastic surgery background. That was 20 years ago. No recurrence. I have full use of my hand and fingers. Only the little finger has a slight bend. Scar is barely noticeable. I had two months of physical therapy. I remember it was intense, but I regained full use. Never used a splint.

I just had Xiaflex done on my left hand this week. Again I will go to physical therapy. This time for about a month.

11/07/18 05:47
Melly 
11/07/18 05:47
Melly 
Re: Request from Patients who have had Dupuytren Surgery

I had surgery to same fingers 8 weeks ago. I just went to see my surgeon and he wasnt happy with the progression, says i should be able to do a fist by now and proceeded to bend them in that position till i was crying from the pain. while i have been diligent in my daily exercises, pushing myself to a fair degree of pain but not till I am crying, he reckons i have been too slack and need to do ten minutes of his incredibly grueling heart palpating exercises every hour...and without pain killers.
Today my fingers are bruised and my hand tingling more than ever.
Pushing myself into such pain can't be good and to be honest, i really can't stomach it. I am massaging every day and doing the exercises the physio is giving me. But i am very concerned that it hasnt gone as well as my brothers and my dad, who both healed easily and could make a fist within a few weeks.
For those who have had surgery, what do you think?
Thanks
Mel

11/07/18 08:37
spanishbuddha 

Administrator

11/07/18 08:37
spanishbuddha 

Administrator

Re: Request from Patients who have had Dupuytren Surgery

I would ask your physio/OT, they, and nurses, are trained in recovery more than surgeons. It’s true that they will often push patients gently into a pain zone but they also know how much and when to stop so things are not worse. It would be helpful to understand what the restriction is, scar tissue, swelling, blood supply, joints, tendons and flexibility? Tackle these if they exist.

Did you see the helpful exercises posted by the BDS http://dupuytrens-society.org.uk/treatme...-fasciectomy-2/ ?

11/07/18 17:13
GailSusan 
11/07/18 17:13
GailSusan 
Re: Request from Patients who have had Dupuytren Surgery

Melly:
I had surgery to same fingers 8 weeks ago. I just went to see my surgeon and he wasnt happy with the progression, says i should be able to do a fist by now and proceeded to bend them in that position till i was crying from the pain. while i have been diligent in my daily exercises, pushing myself to a fair degree of pain but not till I am crying, he reckons i have been too slack and need to do ten minutes of his incredibly grueling heart palpating exercises every hour...and without pain killers.
Today my fingers are bruised and my hand tingling more than ever.
Pushing myself into such pain can't be good and to be honest, i really can't stomach it. I am massaging every day and doing the exercises the physio is giving me. But i am very concerned that it hasnt gone as well as my brothers and my dad, who both healed easily and could make a fist within a few weeks.
For those who have had surgery, what do you think?
Thanks
Mel

Hi Mel,

I know the scar tissue begins to form by 6 weeks, so both hand surgeons I had were very aggressive about doing PT. I remember the first surgeon taking my hand a week or so after surgery and slamming it down on the table so hard the blood spurt out. He said he did it so I wouldn't be afraid to see blood when I did PT. I never did see blood when I did PT, but I got the point and pushed myself in PT. I can't remember when I could make a fist with that surgery as it was 20 years ago. I never worked my hand to the point of tremendous pain, just discomfort and mild pain.

As you know, I just had the left hand operated on October 22, two and a half weeks ago. I can almost make a fist with my left hand and I haven't even had the stitches removed yet (that happens tomorrow). My pinkie finger is swollen and bruised, but the rest of my hand is fine. I do feel tingling in my pinkie finger, but I expect this to go away over time. I can tell that the surgeon did a fine job just by looking at my incisions and the way my hand functions and feels at this early stage.

Hand surgery requires a high degree of skill. I live near a major medical center and was able to get top notch surgeons each time. Surgeons like to feel a sense of accomplishment with their surgeries and rather than blame themselves, it's easier to blame the patient for not being aggressive enough in PT.

Did your surgeon recommend the physical therapist? Is your PT a hand specialist? How often do you have PT? Does your PT push you to the point of discomfort and mild pain? Are you still going to PT?

I'm sorry you were manhandled by your own surgeon. I think he was out of place forcing your hand. That's the physical therapist's area of expertise. He has no right to manipulate your hand unless he has training in PT and no PT I know would force someone's hand like that. The manipulations are gradual, over time. If he wanted to see how far your hand could make a fist, he should have asked your permission first and explained that it would be painful but he was doing to see how far your hand could physically go, then you could have consented or not, just as you consented to surgery or physical therapy.

It's no coincidence that I chose a female hand surgeon this time. She would never slam my hand on a table to watch the blood spurt up or force your hand into a fist. She's factual and straightforward. No bedside manner, but that's not what I want from a surgeon. I expect a certain amount of respect and consideration from my doctors, which is why I didn't go back to the first one.


Gail

Edited 11/07/18 17:16

11/07/18 22:24
Scarlettnova 
11/07/18 22:24
Scarlettnova 
Re: Request from Patients who have had Dupuytren Surgery

I had my surgery the end of June, 2018. It involved the palm and middle, ring and pinky fingers with scaring going up the fingers and across the palm. I had no bent fingers, but a beginning cord and nodules. Dr. said it was better to get it earlier which apparently isn’t the norm. Anyway, hand has healed nicely with flat scars. I wear a splint at night. My husband was great about massaging my scars to make sure they didn’t attach to tendons. I have been going to a physio for several months. I still cannot make a fist after 4 months, but getting close. Physio said I’m still retaining fluid in my hand which is blocking the fist closing. It’s in the pads on the palm at the bottom of the fingers. Still puffy. I guess I’m more for the 6th month “deadline.” I soak my hand to loosen it up and constantly bend and rub it. Physio is down to once a week. No grip strength, but supposedly it will return when fist can be made. I am doing weights to strengthen my fingers and wrist. Just keep using it and give it time. No doctor should be abusing your hand! The dr. Put me on low dose Celebrex to help with swelling and inflammation.

11/10/18 01:57
Melly 
11/10/18 01:57
Melly 
Re: Request from Patients who have had Dupuytren Surgery

GailSusan:

Hi Mel,
ry requires a high degree of skill. I live near a major medical center and was able to get top notch surgeons each time. Surgeons like to feel a sense of accomplishment with their surgeries and rather than blame themselves, it's easier to blame the patient for not being aggressive enough in PT.

I'm sorry you were manhandled by your own surgeon. I think he was out of place forcing your hand. That's the physical therapist's area of expertise. He has no right to manipulate your hand unless he has training in PT and no PT I know would force someone's hand like that. The manipulations are gradual, over time. If he wanted to see how far your hand could make a fist, he should have asked your permission first and explained that it would be painful but he was doing to see how far your hand could physically go, then you could have consented or not, just as you consented to surgery or physical therapy.

Gail

Hi Gail

Thanks so much for your confirmation on what I suspected. No, the surgeon not only didnt ask to push into a fist, he told me that I need to be pushing as hard at home for ten minutes every hour. i mean, how is that even possible? It goes against the grain to push yourself to excruciating pain. Anyway, my PT had warned me to take pain killers when I saw him because she knows what he's like. I am going once a fortnight or so for PT, sometimes more if she can fit me in. She does push me to pain but not nearly as eye watering hard. So I do feel I am doing everything pretty well correctly and diligently. Soaking my hand in warm water for five minutes, pushing into all exercises for about ten. And this is EVERY HOUR. By late afternoon I just cant bear to do anymore but I do them at least 8 times a day. That's around two hours a day I'm devoting to my hand. Plus all those moments during the day when Im massaging my hand.
What no-one talks about here is how vulnerable you feel. A hand is such an important piece of the body. The first few weeks I was ok, I knew it was going to take time and patience. In week three, i could make a better first that I can in week 8. I didnt expect the middle finger to go out in sympathy. Best i can do without pushing is a 'C' shape 'fist'. I didn't expect this amount of scar tissue or swelling. By night time, i can visibly jiggle the fluid in my fingers. I am still taking anti-inflammatories. I didn't expect the tingling shifting to my good fingers as well. I didnt expect I couldnt work for such a long time. My surgeon told me it'd take about a month to six weeks and I'd be back working making jewellery. I can't even hold a knife to cut my bread. Most of all, I didn't expect to feel like it's my fault that I can't make a fist when Im working so hard on my hand every day.
So, there ya go. I'm baring all. And while I'm at it i will tell you that I'm still frightened I'll never be able to work my hand properly again. And the thought of having to endure these exercises for many more months ahead...oh gawd. How do full time working people cope when you have to dedicate a 1/4 hour every hour to warm hand baths and exercises?
Thanks for letting me let off steam and thanks for reaching out Gail. Also thanks to Scarletnova.
Would appreciate hearing from others who at week 8, couldn't make a fist.
Cheers
Mel

Edited 11/10/18 02:02

11/10/18 08:29
wach 

Administrator

11/10/18 08:29
wach 

Administrator

Re: Request from Patients who have had Dupuytren Surgery

Hi Mel,
personally I would not do such painful exercises every hour. Moderate exercises several times a day might make sense and helped me to recover my hand function after surgery. I am just a patient myself but what you are describing sounds to me excessive and wrong. Would it be possible to consult another experienced hand surgeon, maybe from another Hospital or clinic, what he would recommend for PT?

Wolfgang

Melly:

..., he told me that I need to be pushing as hard at home for ten minutes every hour. i mean, how is that even possible? It goes against the grain to push yourself to excruciating pain. Anyway, my PT had warned me to take pain killers when I saw him because she knows what he's like. I am going once a fortnight or so for PT, sometimes more if she can fit me in. She does push me to pain but not nearly as eye watering hard. So I do feel I am doing everything pretty well correctly and diligently. Soaking my hand in warm water for five minutes, pushing into all exercises for about ten. And this is EVERY HOUR. By late afternoon I just cant bear to do anymore but I do them at least 8 times a day. That's around two hours a day I'm devoting to my hand. Plus all those moments during the day when Im massaging my hand.
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