Until yesterday I never heard of NA, now my eyes are crossed reading everything I can on it.

If some of you more experienced people could offer some advice;

- I was told by my hand doctor in Portland Oregon (15 years ago, 10 years ago and again 3 years ago) that surgery was the only option and that I should wait until the finger (pinkie finger, left hand) was virtually atrophied before having surgery. I am now a Stage 4 with no pain and slight movement in the finger.

- I live in Northern Italy but still maintain medical insurance in the U.S. with access to the medical systems (and free places to stay) in Washington D.C., Boston and Portland, OR. It is a convenient train ride to Paris.

- I have decided too proceed with NA.

- Based on the amazing base of experience in this forum, what would you advise I do - Go to Paris, try to find a doctor in one of the cities I mentioned, or try to find a doctor here in Italy?

Thank you in advance and thank you to the group who maintains this site.

Saluti
Donna

Wolfgang,

Thank you! I have sent an inquiry to Dr Lermusiaux's office in Paris and Denkler in Larkspur. At this point my gut tells me Dr. Denkler may be the best option since he has done a number of these procedures on Stage IV patients. I am intimidated about the language issue with the Paris/German Doctors, also since I do have insurance in America, it seems a better way to go if there are complications, etc.

You said, "I was told by my hand doctor in Portland Oregon (15 years ago, 10 years ago and again 3 years ago) that surgery was the only option and that I should wait until the finger (pinkie finger, left hand) was virtually atrophied before having surgery."

That is a remarkable statement. Did this "hand doctor" have a medical degree? I have never heard that kind of advice anywhere. You overpaid for his services if you paid anything.

Donna, You said, "I was given the standard advice that nothing could be done until the disease progressed and my contractures were more severe." That is not uncommon advice whether talking about NA, or surgery.

That is completely different than the advice you said your hand doctor told you.

So what degree of contracture do you have at this time? The standard advice for surgery is between 30 and 45 degrees contracture. I had surgery 7 1/2 years ago for 90 degree contracture on my little finger. The finger is still as good as it was prior to Dupuytren's (0 degrees contraction).

Donna, my advice is to do what Keith Denkler tells. He has alot of experience. The only thing where I would take exception is having NA radiated to avoid recurrence. I don't think there is a a real good target for RT in this situation. Another thingthat is ceretialy helpful is wearing a night splint for 3-6 months untilthe finger has stabilized. The splint should be comfortable and easy to put on and take off, e.g. like the fixxglove on http://www.dupuytren-online.info/dupuytr...techniques.html.

Wolfgang