| Lost password
128 users onlineYou are not loggend in.  Login
Feedback on NA performed at Lariboisière hospital, Paris
 1
 1
09/07/14 11:41
Stefan_K. 
09/07/14 11:41
Stefan_K. 

Feedback on NA performed at Lariboisière hospital, Paris

Hello everyone. I am a 52 year old male of German origin living in Paris, diagnosed with Dupuytren on my right pinky about eight years ago.

Until this year the contracture had been very slight, I had normally no pain or significant discomfort unless I put pressure on the single nodule. My general practitioner had told me that at this stage there was nothing to be done. Earlier this year I noticed that the contracture had reached about 20 to 25 degrees and that the nodule had grown. It started to disturb me. A rheumatologist suggested I make an appointment at Lariboisière.

After reading this forum for a couple of months I had NA performed by Dr. Philippe PIZZUTI 3 days ago. Within no more than 2 minutes he had my finger straightened. I had the impression he himself was surprised how easy it was. I felt nothing but the one injection, and the cracking actually felt good. I have had no pain following the procedure, even after the anesthesia wore off and the hand stayed quite usable with the small bandage although I have been careful. So far I am very pleased and relieved and can recommend NA and Dr. Pizzuti for similar cases. I am fortunate to live less than half an hour by metro from such skilled experts.

I just removed the bandage. I feel a slight soreness and tension. While the pinky is almost straight, I cannot put my right hand fully flat on the table as I can with the left hand. Is this likely to remain?

Dr. Pizzuti didn’t suggest any other treatment, including of the small nodule in the left pinky (second knuckle from the tip), and after the procedure I was so relieved that I forgot to ask about RT. I haven’t seen any progression (but will keep an eye on it), and have no contracture on the left hand. Any views on this?

I am adding a before/after comparison. Thanks so much to everyone who has contributed to this website and forum. It has been a big help for me.

Stefan

Attachment
before-after NA.jpg before-after NA.jpg (46x)

Mime-Type: image/jpeg, 465 kB

09/07/14 13:28
wach 

Administrator

09/07/14 13:28
wach 

Administrator

Re: Feedback on NA performed at Lariboisière hospital, Paris

Hi Stefan,

congratulations for your easy and so successful NA! I f you haven't any growing nodules, I wouldn't see much sense in getting additonal radiotherapy. I would wait and see how the situation develops.

Wolfgang

09/26/14 11:55
Stefan_K. 
09/26/14 11:55
Stefan_K. 

Re: Feedback on NA performed at Lariboisière hospital, Paris

Hello everyone. It has been three weeks since the NA on my pinky and while the healing has been progressing, especially this past week, and I can now put my hand almost completely flat on flat surface, I still have slight discomfort/a tearing/sore feeling when extending the finger completely. The main nodule is still there, but seems a bit flatter and softer.

So I ask myself if the sore feeling is normal at this stage post-NA or if I should consult the specialist or the referring rheumatologist. What is the experience of those of you who have had NA performed?

My doctor didn't suggest any particular exercise, but I noticed that moderate swimming feels good for helping in straightening the pinky. Does anyone have experience with this, or an opinion?

Thanks,

Stefan

09/26/14 19:02
newman 
09/26/14 19:02
newman 

Re: Feedback on NA performed at Lariboisière hospital, Paris

Hi Stefan,
I would have thought that after 3 weeks there should be no pain .You do not mention if you had only needle punctures on the skin or was there any tearing of the tissue.
Are you wearing a night splint? This holds the finger in the passive position over night . Just a pointer I was told by Dr Meinel in Wuerzburg not to exert pressure to straighten the fingers after PNF (NA)

Edited 09/26/14 19:06

09/26/14 19:43
Stefan_K. 
09/26/14 19:43
Stefan_K. 

Re: Feedback on NA performed at Lariboisière hospital, Paris

Thanks for the question. No post-NA treatment was recommended and no splint, just not to put strain on the finger for two weeks which have now passed. As for the slow swimming, or just passing the hand through the water after two weeks, it just felt good and seemed to allow to dose moderate strain and stretching, in the hope I could eventually completely flatten my hand again. Any swimmers out there?

04/04/15 14:24
Stefan_K. 
04/04/15 14:24
Stefan_K. 

Re: Feedback on NA performed at Lariboisière hospital, Paris

Update

Unfortunately 6 months after my first NA I feel at least two new nodules on the same pinky, the beginning of a very slight contraction and slight pain when flattening the hand. It may be a result of too much repetitive strain during gardening work a month ago, or coincidence. In any case I believe this is now the time to consider RT and I plan to consult quickly, in Hamburg since the French medical community is still way behind (no RT for DD here).

Any advice anyone on how to proceed, e.g. on whether it makes sense to consult again my NA specialist who had done an excellent job releasing the contracted pinky but has gotten all knowledge he has on RT from links I gave him?

Also, anyone in the French Social Security system who has had RT done abroad and got cost covered?

Attaching a photo with nodules marked up, although hard to see. The new nodules are those on the pinky itself.

Edited 04/04/15 14:28

Attachment
IMAG1668_nodules 3-2015 marked.jpg IMAG1668_nodules 3-2015 marked.jpg (35x)

Mime-Type: image/jpeg, 452 kB

04/04/15 17:30
wach 

Administrator

04/04/15 17:30
wach 

Administrator

Re: Feedback on NA performed at Lariboisière hospital, Paris

I am afraid the NA specialist would probably not be able to help much in that stage. Heavy gardening might have triggered some of your new growth but it might as well be just coincidence. personally I would try RT.

Wolfgang

04/04/15 17:45
Stefan_K. 
04/04/15 17:45
Stefan_K. 

Re: Feedback on NA performed at Lariboisière hospital, Paris

wach:
I am afraid the NA specialist would probably not be able to help much in that stage. Heavy gardening might have triggered some of your new growth but it might as well be just coincidence. personally I would try RT.

Thank you Wolfgang. Is there a risk that RT could get in the way of future NA on this finger?

Still thinking about getting an apointment with my NA doctor anyway, if nothing else to have him witness his first before/after RT case and what happens to the nodules (since he showed interest in discussing RT with his French olleagues)...

04/04/15 18:27
wach 

Administrator

04/04/15 18:27
wach 

Administrator

Re: Feedback on NA performed at Lariboisière hospital, Paris

Radiotherapy shouldn't create any problems with a later NA.

If your doctor is interested in radiotherapy he might consider attending the upcoming International Conference on Dupuytren Disease in Groningen, Netherlands http://www.dupuytrensymposium.com/. Heinrich Seegenschmiedt will give a lecture on radiotherapy at this conference. And, of course, it includes many other interesting papers and discussions.

Wolfgang

Stefan_K.:
.... Is there a risk that RT could get in the way of future NA on this finger?

06/25/15 22:50
Stefan_K. 
06/25/15 22:50
Stefan_K. 

Re: Feedback on NA performed at Lariboisière hospital, Paris

Another update on my DC: For various reasons I didn't get around to making an RT appointment for my pinky retracting again 6 months after NA, but in hindsight that was probably a good thing because my nodules have gotten slightly smaller again, the tension has eased up wearing a self-made night splint which I describe at http://www.dupuytren-online.info/Forum_E...int-0_2023.html and I would most likely have falsely attributed this positive evolution to RT had I had it performed in the meantime. So for now I continue to buy time with my night spint and will look into RT again when contraction resumes.

Question: Have nodules decreasing in size and decreasing cord tension without any particular intervention or treatment been observed and explained?

 1
 1
coincidence   radiotherapy   International   Lariboisière   nodules   contracture   contraction   Feedback   rheumatologist   Unfortunately   Seegenschmiedt   straightening   dupuytren-online   hospital   practitioner   straightened   dupuytrensymposium   congratulations   specialist   performed