Dupuytren's contracture

Psamathe
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Re: Dupuytren's contracture

Post by Psamathe »

Think I'm getting one now (though not yet pulling any fingers in). Got appointment with GP in a few weeks to double check that is what it is as it does not completely fit the pattern as per Dr Google.

Ian
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Mick F
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Re: Dupuytren's contracture

Post by Mick F »

This is my left one.
Obvious really, as its evidently the left hand! :D
IMG_1183.jpg
Mick F. Cornwall
Jules59
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Re: Dupuytren's contracture

Post by Jules59 »

Jdsk wrote: 11 Mar 2022, 8:23am
Mick F wrote: 10 Mar 2022, 8:23pm Thanks, but that is what they were going to do to me as an interim measure.
They still wouldn't do it with high BP so that was the end of that as far as they are concerned.
My BP isn't high unless I'm in a hospital.

Waiting for a contact again from them, but I'm coming to the idea that 531colin suggested up-thread.

Amputation.
That's only going to work if you follow the Ranulph Fiennes approach of DIY with domestic power tools. And he still needed a surgeon to tidy it all up later.

You've posted many blood pressure readings taken at home that are elevated. So it isn't only high when you're in a hospital.

But I don't understand why your blood pressure is getting in the way of either surgery or the injection of collagenase. Many people undergo much longer and more complex procedures with bigger problems of blood pressure that you've described in the forums.

I suggest communicating with the surgeon well before your appointment, including what you think is happening with your blood pressure and the two other relevant factors that you have shared with us. If it were me I'd want to have a single plan in advance for what procedure is to be carried out, the workup before the procedure, and the type of anaesthesia.

And, as always, I recommend writing down the questions that you'd like answered so that they aren't forgotten during the consultation.

I hope that it goes well.

Jonathan
You probably should have a review by the anaesthetist, even if a regional anaesthetic is proposed, as its usually the "gasman" that has to deal with the hypertension rather than the surgeon. Otherwise alarm bells will ring every time you turn up for the op.
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531colin
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Re: Dupuytren's contracture

Post by 531colin »

75 next month, and the progression of my Dupuytren's has just about stopped. Its been slowing for a couple of years, I think.
Not quite as much a relief as when I "grew out of" migraines in about my fifties, but nevertheless welcome; improvements at my age are to be celebrated, i feel!
Psamathe
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Re: Dupuytren's contracture

Post by Psamathe »

I hope I'm not duplicating a treatment previously posted by others (I had a scan back but might have missed it) so anyway:
https://www.theguardian.com/science/2022/may/05/dupuytrens-disease-hand-finger-bending-treatment-clinical-trial-oxford-university wrote:Treatment for finger-bending disease may be ‘gamechanger’
Researchers have hailed a breakthrough in the treatment of a common, incurable disease that causes hand deformities by bending the fingers firmly into the palm.

A clinical trial at Oxford University found that a drug used for rheumatoid arthritis appeared to drive Dupuytren’s disease into reverse when used early on, a result described as a potential “gamechanger” for patients.

“We are very keen to pursue this,” said Prof Jagdeep Nanchahal, a surgeon scientist who led the trial at Oxford’s Kennedy Institute of Rheumatology. “This is a very safe drug and it’s important patients can access a treatment if it’s likely to be effective.”
...
Ian
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simonineaston
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Re: Dupuytren's contracture

Post by simonineaston »

Obvious really, as its evidently the left hand!
You say that, Mick (and welcome back, btw!) but there's a growing trend towards the inclusion of images shown online in reverse, whether on purpose for some weird reason, or just by mistake, I've no idea. Giveaways are text, obs - or as in the case of your piccie of left hand, a fairly obvious wedding band, etc. etc..
Good Luck with your treatment, when you get around to it. :D
left hand...
left hand...
right hand ?
right hand ?
S
(on the look out for Armageddon, on board a Brompton nano & ever-changing Moultons)
Jdsk
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Re: Dupuytren's contracture

Post by Jdsk »

Psamathe wrote: 5 May 2022, 12:12pm I hope I'm not duplicating a treatment previously posted by others (I had a scan back but might have missed it) so anyway:
https://www.theguardian.com/science/2022/may/05/dupuytrens-disease-hand-finger-bending-treatment-clinical-trial-oxford-university wrote:Treatment for finger-bending disease may be ‘gamechanger’
Researchers have hailed a breakthrough in the treatment of a common, incurable disease that causes hand deformities by bending the fingers firmly into the palm.

A clinical trial at Oxford University found that a drug used for rheumatoid arthritis appeared to drive Dupuytren’s disease into reverse when used early on, a result described as a potential “gamechanger” for patients.

“We are very keen to pursue this,” said Prof Jagdeep Nanchahal, a surgeon scientist who led the trial at Oxford’s Kennedy Institute of Rheumatology. “This is a very safe drug and it’s important patients can access a treatment if it’s likely to be effective.”
...
Thanks for posting. Very interesting.

The original paper:
"Anti-tumour necrosis factor therapy for early-stage Dupuytren's disease (RIDD): a phase 2b, randomised, double-blind, placebo-controlled trial":
https://www.thelancet.com/journals/lanr ... 5/fulltext

Jonathan
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Mick F
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Re: Dupuytren's contracture

Post by Mick F »

I heard today, from a reliable source, that "Viking Fingers", and that high cholesterol is a Viking thing as well.

I'm a Viking! :D

Queue: "What's Opera Doc?"
https://vimeo.com/444002896
Mick F. Cornwall
Jdsk
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Re: Dupuytren's contracture

Post by Jdsk »

Mick F wrote: 6 May 2022, 4:23pm I heard today, from a reliable source, that "Viking Fingers"...
That was a widely used term. But as you'll see from the link in the Guardian article cited upthread it's now disproven and obsolete.

And the putative association is discussed on the first page of this thread:
Tangled Metal wrote: 9 Nov 2020, 1:49pmViking in Cornwall!!! Raiding party found a good land to take or just got lost Mick? It's a sign of viking genetics.
Jonathan
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Mick F
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Re: Dupuytren's contracture

Post by Mick F »

Went to Derriford Hospital, Plymouth yesterday for an 11am appointment.
Chatted about blood pressure and how mine was 132/81 after breakfast and 118/61 later.
The doc had been contacted by my doc here, and she (the doc at Derriford) was happy.

That went out of the way, and nurse was in attendance as well as a student nurse. I was asked if I was happy to have the student there. Of course I was!

Hand injected with anaesthetic and went numb. I didn't look, and chatted to the nurses and looked out of the window.

The doc cut and pricked and cut into my sinews(?) and tendons(?) and by all accounts, there was blood! :shock:

She couldn't straighten my pinkie and she said I had tough hands. All that cycling eh?
Job done, and now over 24hrs later, I'm happy. I drove to go shopping today with bandages, but to my amazement, I could grip the steering-wheel with my left hand with all four fingers and thumb, that I've not been able to do for a couple of years.

My left pinkie was very contracted and was an issue, but after the tinkering by the doc, it's better than my right pinkie! :D

Photos to follow, but not if you're squeamish. I had a couple or three pints earlier, and exposed it all to renew the dressings.

Don't look, if you don't want to.
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Mick F
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Re: Dupuytren's contracture

Post by Mick F »

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Mick F. Cornwall
Jdsk
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Re: Dupuytren's contracture

Post by Jdsk »

Mick F wrote: 10 May 2022, 3:10pmThe doc cut and pricked and cut into my sinews(?) and tendons(?)...
Sinew means tendon, but isn't commonly used in medical parlance.

The aim of treatment is to increase the mobility of tendons and tendon sheaths in the surrounding connective tissue.

There are several different procedures: do you know which one was done? Was it needle fasciotomy?

Thanks

Jonathan

Edited: Crossed with photos.
Last edited by Jdsk on 10 May 2022, 3:32pm, edited 1 time in total.
Psamathe
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Re: Dupuytren's contracture

Post by Psamathe »

Mick F wrote: 10 May 2022, 3:10pm ... I was asked if I was happy to have the student there. Of course I was!
...
That is an interesting aspect as always in the past I have said "fine" and been happy with medical students present. But last year at a neurology appointment there were two med. students present and I had the distinct impression the Consultant has made a diagnosis from the GP referral letter and explained his diagnosis to the med students before I even got in the room. As my symptoms had developed and major new ones appeared he completely ignored the new (rather major) symptoms and said "probably <x> or maybe <y>". Afterwards I had the distinct impression he could not change his view given to the med. students before my arrival (he was a bit of a arrogant fool with two young female med. students ...).

Other consultants have since been somewhat flabbergast at his "<x> or <y>" and commented "no way is it <x>" (given the specialist consultant concerned happened to suffer from <x> and also, "if he thought it was <y> then you test for <y> (easy and cheap tests) because <y> is very treatable!"

Since then when asked if I mind med. students I say I don't mind but explain my concerns and admin immediately says they will not be present. I feel very guilty but one (likely) bad experience that caused wasted months (over a year later and subsequent referrals and I'm still in an endless waiting list for same specialty)

Ian
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Mick F
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Re: Dupuytren's contracture

Post by Mick F »

Jdsk wrote: 10 May 2022, 3:23pm Was it needle fasciotomy?
Yes, I think that was it.

I'm happy now. Would like the same procedure done to my right.
Not sure if I want a "proper job" doing.
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Jdsk
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Re: Dupuytren's contracture

Post by Jdsk »

Thanks

Sounds good. I hope it recovers quickly. Have you got all the advice that you need on that?

Jonathan
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