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looking for treatment in Prague, Czech Republic
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07/17/2017 07:58
Beth 
07/17/2017 07:58
Beth 
looking for treatment in Prague, Czech Republic

Hi, I am new to this forum and would like to find a doctor who specializes in Dupuytren in Prague. I have it in one hand and not sure if it is early enough for radiation therapy or not.
Germany is not so far away but hoping to find someone in Prague.
Thanks so muc

07/17/2017 11:17
wach 

Administrator

07/17/2017 11:17
wach 

Administrator

Re: looking for treatment in Prague, Czech Republic

Welcome to the forum, Beth!

Unfortunately we are not aware of any specialists for Dupuytren's in Prague or the Czech Republic, which of course does not mean there aren't any. If you are interested in hand surgeons experienced with DD, we can contact Joe Dias who has published on treatment in Europe, including the Czech Republic. You could also have a look at https://www.estheticon.com/surgeons/hand.../czech-republic .

In the medical literature one of the more recent publications, though on Ledderhose, was from
Klinika ortopedie a traumatologie pohybového ústrojí FN a LF UK Plzeň

As for radiotherapy in Germany, Bayreuth or Erlangen might be possibilities http://www.dupuytren-online.de/strahlent...e_adressen.html but keep in mind that treatment is usually on 5 consecutive days, i.e. you would have to stay there.

I am very sorry that for the time being we have no better answer!

Wolfgang

07/17/2017 11:25
wach 

Administrator

07/17/2017 11:25
wach 

Administrator

Re: looking for treatment in Prague, Czech Republic

Hi Beth,

two more comments:

- to find a clinic with experience in treating Dupuytren's by radiotherapy you could ask one of the radiotherapists in Bayreuth or Erlangen. They might know of a colleague in Prague. Or you might inquire with local University clinics and there specifically with the radiotherapy department or oncology department.

- generally radiotherapy works the earlier the better. I don't think you can be too early but there are two other considerations, one is age (the younger you get treated the more likely it is to develop fibrosis or cancer because of the radiotherapy but it would still be not very likely if the treatment is conducted properly). The other consideration is that many, or rather most, patients never need any treatment at all http://www.dupuytren-online.info/radiation_therapy.html .

Wolfgang

07/17/2017 12:18
Beth 
07/17/2017 12:18
Beth 
Re: looking for treatment in Prague, Czech Republic

Hi Wolfgang!
Thank you for a quick response! Yes, I looked at the site and saw the Bayreuth location. The site Esteticon seems to list only plastic surgeons. Is it considered a job for a plastic surgeon?
The doctors here want to send me to Orthopaedic surgeons but I have yet to find someone who specializes in specific treatments for this. I have even asked a friend of a friend who is a doctor and on the board at Charles University teaching hospital here, but he has yet to give me a useful contact.
I am 56 years old. I saw the strange coloring on my right palm about 4 years ago and thought it was due to necrosis in one bone of my hand that was found about 13 years ago after carpal tunnel went untreated. I have not had any surgery because the hand specialist in the U.S. who found it said he would only recommend it if I was in pain. I don't have pain still, just limited flexibility in my wrist flexing back. So, my friend here, who has Dupuytren's called it and I am 100% sure that is what it is since my Mom has both small and ring fingers completely bent in now and can barely use her hands. Just recently, I have noticed my pinky finger is stiff and has a nodule below the first joint. I can make it straight still even with just my flexing in the air, but at rest, it is slightly curving inwards. I had many things of more importance happen with my family in the last 2 years, so I neglected this search for a treatment until now.
But I really don't want to let this go further because I am a painter, an artist and I do not want to be disabled.
Is it possible that maybe it won't become worse? Maybe. But I would like a specialist to give their expert opinion.
thanks for your help.
Beth

07/17/2017 12:48
wach 

Administrator

07/17/2017 12:48
wach 

Administrator

Re: looking for treatment in Prague, Czech Republic

Hi Beth,

it is very well possible that your condition stabilizes or progresses only very slowly but, unfortunately, it is not possible to predict progression individually. Even for the same patient one nodule can be stable for 10 years and another affected finger contract within a year. Therefore the general rule is that not everyone should undergo radiotherapy but only those showing progressive disease. This is not a very precise rule because everyone with a nodule obviously had progression at some point of time because otherwise there would be no nodule. So, at the end having radiotherapy or not is a decision that the patient and the doctor need to make jointly.

As long as you have not contracted fingers you should avoid surgery because surgery can Trigger Dupuytren's into more agression. And yes, if you need surgery, you should select a doctor who does often operate on Dupuytren's. Hand surgeons might have more experience in operating Dupuytren's than plastic surgeons, but some plastic surgeons are also very good in operating Dupuytren's. You need to look at the individual surgeon and find out how experienced he/she is with treating Dupuytren's.

Wolfgang

07/26/2017 21:40
bstenman 
07/26/2017 21:40
bstenman 
Re: looking for treatment in Prague, Czech Republic

The pioneering work on the NA procedure for Dupuytren's was in France so you are likely to have more success looking for practitioner in that country. For X-ray treatment I would go to Essen, Germany to the clinic there. I traveled to Germany for my XRT and I live in California.

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