Dupuytren'S Contracture

[jrtmedic]

MY sincere Apologies !

Here are links that do work !

http://www.assh.org/...ensDisease.aspx

http://www.mayoclini...ments-and-drugs

http://www.aaos.org/...0/clinical2.asp

http://www.aaos.org/news/aaosnow/dec11/clinical6.asp

Edited February 3, 2013 by jrtmedic

[Ratsima]

I had the NA procedure by Dr. Kanit in Chiangmai less than 24 hours ago. Now I'm home in Korat and able to touch type easily; something I haven't been able to do in some years.

The procedure was fast; about 45 minutes. The improvement, while not 100%, is significant. I can actually almost totally straighten my ring and little fingers. Dr Sumroeng had told me that he probably couldn't do anything with the little finger and would only do one finger per surgery because of blood circulation issues.

The NA procedure was almost painless. I did take a mild pain pill before sleeping, but it probably wasn't necessary. I have needed none today.

I am extremely happy with the improvement and with how easy it was to accomplish. Recovery has been fantastic.

The total cost, including meds (an antibiotic and three kinds of pain medication) was 4000 baht.

[meatboy]

I had the NA procedure by Dr. Kanit in Chiangmai less than 24 hours ago. Now I'm home in Korat and able to touch type easily; something I haven't been able to do in some years.

The procedure was fast; about 45 minutes. The improvement, while not 100%, is significant. I can actually almost totally straighten my ring and little fingers. Dr Sumroeng had told me that he probably couldn't do anything with the little finger and would only do one finger per surgery because of blood circulation issues.

The NA procedure was almost painless. I did take a mild pain pill before sleeping, but it probably wasn't necessary. I have needed none today.

I am extremely happy with the improvement and with how easy it was to accomplish. Recovery has been fantastic.

The total cost, including meds (an antibiotic and three kinds of pain medication) was 4000 baht.

was that your tickling finger

[TravelerEastWest]

Ratsima,

Wonderful news - I am very happy that all went well.

JRTmedic,

Thanks for the links - slowly America is adding NA to the old style choices.

Dr Eaton is the doctor in Florida that I was thinking about. Sadly it seems he is no longer practicing Dupuytren NA but the good news is that he is researching cures now.

Insurance still seems to be slow in accepting it which is perhaps the biggest reason why we are behind Europe.

Reading the articles carefully I see that opinions are also changing with traditional hand surgery no longer the standard.

I think that if you look again at the literature you will find down the road that NA becomes the gold standard and traditional surgery is only used as a last case option.

As you can see from this quote NA has only been offered in America for about 10 years and for the first 5 years there was a very, very few doctors doing the procedure.

I think there are still only a small number offering NA in America.

"This technique was developed in Paris by Dr. Lermusiaux at the Hopital Laribosière. Dr. Eaton was personally instructed on this method by Dr. Lermusiaux and his colleagues in 2003. Dr. Eaton was the first physician to offer this procedure in the United States."

Edited February 10, 2013 by TravelerEastWest

[dcliddle]

TravelerEastWest

I am not sure where you obtained your information from !

However in the UK the technique of NA is well known to specialist hand surgeons as it is in most (if not all ) of the Western/Eastern world !

The technique in its present form has been utilised for well over 20 years!

Some hand surgeons prefer not to offer NA because they percieve the (often) early recurrence of contracture to be unacceptable.

There are in addition to NA and open surgery other treatment options.

Look here,,,,,,,,,,,,,,,,http://www.nhs.uk/Co...es/Surgery.aspx

The choice of treatment is a matter for discussion between a patient and the surgeon. Having a fixed thoughts as to what is the "best" treatment, based on internet searches is , perhaps , not the best of ideas

I understand and respect your point of view but strongly disagree.

I have never been to the UK and I do not understand the options of the UK medical system but I can comment on real life experience (not internet) in America, France and Thailand.

After talking to others with this condition the general consensus (not a statistical survey - smiling) is that in most cases NA is the best treatment in terms of speed, cost and pain.

The injections that have been under development in America are a promising new treatment but are very expensive and not widely available.

Thank you for your link - are the injections free in the UK?

When they become available in Thailand I would be interested in trying them.

I remember before moving to Thailand talking to very experienced expert hand surgeons and most of them had not heard of NA and were not interested until after it became widely accepted in the medical journals.

The medical system in America has many challenges so perhaps the UK is ahead of America with treatment? How many UK doctors are trained in NA I wonder?

Also perhaps in the last 5 years there have been changes in the West?

But I can assure you that when I first had this condition almost no one in America was using NA - actually perhaps zero doctors were using it. There is a good doctor in Florida currently who is a hand surgeon who is using it and a few here and there in America but not many as far as I know.

I would be very pleased to find out that I am behind the times (I have not been to America in over 5 years) but I think mainstream medicine does not favor NA yet and they are wrong based on my personal experience.

I can verify that there are few doctors in the US that perform Needle Release. (NA). But more seem to be coming online. My insurance which ranged from $250 - 550/mo never covered it which is just typical of the state of the US health system.

I have had great success with Dr Eaton in Florida ( now retired) and after 4 procedures on both hands with him, and one less than effective procedure by the guy Denkler in Marin County CA. It pays to thoroughly check out who is doing it. While I was living in NYC, from 94 -2008 there was no one who could or would do it there. Later Dr Pess in NJ began to.

I am now living in Perth Australia and have just had NA performed by the only handsurgeon who performs NA there Dr Dilley. I am less than satisfied with the result after spending for a trip to Sydney, and $1300 (about $100/cord is covered by Medicare) for 3 cords to be be treated on my left hand. I still have pain a month later and its not straight as my past NAs have resulted. I hope he will correct it as I know it was a complex band formation but if not there are other docs in Melbourn and Adelaide but it might just be worth it to spend much less for a vacation to Thailand and have it done there with Dr Danit. I believe you can go through 1 Dr here in Perth via Medicare but that nightmare has little appeal and I dont get a sense that he performs NA very often which to me screams 'inexperience'.. no thanks, I think I tried that already.

A list of doctors can also be found here....http://www.dupuytren-online.info/needle_aponeurotomy.html

[SimoSays]

I thought I'd try to resurrect his aging thread. I'm looking for an experienced hand practitioner in Thailand, specifically for treatment of dupuytrens using xiaflex enzymes.

Any ideas?

[Sheryl]

3 hours ago, SimoSays said:

I thought I'd try to resurrect his aging thread. I'm looking for an experienced hand practitioner in Thailand, specifically for treatment of dupuytrens using xiaflex enzymes.

Any ideas?

 

Where in Thailand are you located?

[SimoSays]

3 minutes ago, Sheryl said:

 

Where in Thailand are you located?

Not in Thailand, may get procedure done on a holiday visit - when I can leave Australia, when OK to enter Thailand. ????‍♂️

[Sheryl]

8 minutes ago, SimoSays said:

Not in Thailand, may get procedure done on a holiday visit - when I can leave Australia, when OK to enter Thailand. ????‍♂️

 

That may be quite a while from now, unless you come in as a medical tourist subject to 14 day quarantine and all the other hoops and attendant costs.

 

The doctor to see would be

 

Professor Panupan Songcharoen, MD

 

or

 

Assistant Professor Saichol Wongtrakul, MD

 

Both can be seen at Siriraj Hospital, the private wing is  https://www.siphhospital.com/en/home

 

Prof. Panupan can also be seen at Phyathai 2 Hospital and honburi Hospital, each 1 day a week

 

https://phyathai2international.com/doctor.php?pid=148&lang=en

 

http://www.thonburihospitalkh.com/index.php/profile/prof-dr-panupan-songcharoen/

 

Fior most visitors Phyathai 2 would be the most convenient, it is close to Victory Monument

 

[SimoSays]

9 minutes ago, Sheryl said:

 

That may be quite a while from now, unless you come in as a medical tourist subject to 14 day quarantine and all the other hoops and attendant costs.

 

The doctor to see would be

 

Professor Panupan Songcharoen, MD

 

or

 

Assistant Professor Saichol Wongtrakul, MD

 

Both can be seen at Siriraj Hospital, the private wing is  https://www.siphhospital.com/en/home

 

Prof. Panupan can also be seen at Phyathai 2 Hospital and honburi Hospital, each 1 day a week

 

https://phyathai2international.com/doctor.php?pid=148&lang=en

 

http://www.thonburihospitalkh.com/index.php/profile/prof-dr-panupan-songcharoen/

 

Fior most visitors Phyathai 2 would be the most convenient, it is close to Victory Monument

 

Thanks Sheryl for your recommendations. I'll look into this further with a plan towards getting done at end of covid lockdowns.

[oldcpu]

On 5/29/2012 at 7:12 PM, TravelerEastWest said:

I finally found a hand doctor who treats Dupuytrens with the French Na procedure in Chiang Mai - Dr Kanit Sananpanich who has his own clinic and teaches at Chiang Mai University.

 

A follow up to this old thread.  I had the Dupuytren's condition in my left hand conducted by Dr.Kanit late last week using "Percutaneous Needle Fasciotomy" (PNF)  procedure.  Prior to the procedure there was about a 60-degree bend in my left ring finger (when I was trying to keep the finger straight).  Currently, 4 days after the procedure, the bend is only about 10-degrees.  While not perfectly straight, this is the closest to being straight my hand has been in over 10 years.

 

I searched, and I could not find another clinic in Thailand that would conduct "Percutaneous Needle Fasciotomy" (PNF) . This procedure is very common in North America and in Europe.   All the other Thai Hospitals/clinics that I called to treat the Dupuytrens in my hand wanted to conduct full scale surgery, which is very intrusive and takes 1/2 year or more to recover from.  In contrast, one recovers from PNF in less than a week.

 

The "Collagnenase injection" ("Xiaflex injection") procedure is NOT available outside of USA, as the company that makes Xiaflex no longer will ship the drug outside of the USA (and also Xiaflex, even if allowed to be shipped outside of USA, is not approved for use in Thailand).

[steveco]

On 11/15/2022 at 3:51 PM, oldcpu said:

A follow up to this old thread.  I had the Dupuytren's condition in my left hand conducted by Dr.Kanit late last week using "Percutaneous Needle Fasciotomy" (PNF)  procedure.  Prior to the procedure there was about a 60-degree bend in my left ring finger (when I was trying to keep the finger straight).  Currently, 4 days after the procedure, the bend is only about 10-degrees.  While not perfectly straight, this is the closest to being straight my hand has been in over 10 years.

 

I searched, and I could not find another clinic in Thailand that would conduct "Percutaneous Needle Fasciotomy" (PNF) . This procedure is very common in North America and in Europe.   All the other Thai Hospitals/clinics that I called to treat the Dupuytrens in my hand wanted to conduct full scale surgery, which is very intrusive and takes 1/2 year or more to recover from.  In contrast, one recovers from PNF in less than a week.

 

The "Collagnenase injection" ("Xiaflex injection") procedure is NOT available outside of USA, as the company that makes Xiaflex no longer will ship the drug outside of the USA (and also Xiaflex, even if allowed to be shipped outside of USA, is not approved for use in Thailand).

Hi, thanks for the follow up on this, is it possible you can give me some contact details, and what the cost was for this treatment. The clinic name would be of use as well. Thanks for your help in advance.

Edited May 21, 2023 by steveco

[oldcpu]

On 5/21/2023 at 3:35 PM, steveco said:

Hi, thanks for the follow up on this, is it possible you can give me some contact details, and what the cost was for this treatment. The clinic name would be of use as well. Thanks for your help in advance.

The procedure was done by Dr.Kanit Sananpanich of the Department of Orthopedics, in the Faculty of Medicine, Chiang Mai University.  He also has an evening clinic that he runs in Chiang Mai, which is where I went to.  Phone # f the clinic is 053-329-432 (Hand Ortho Clinic). Hours of operation Tuesday to Thursday 17:30-19:30 ... and Saturday 09:30-11:30.  Email is ksananpa at gmail.com.  Lat/Long of the clinic location: 18.77114 N,  98.95052 E in Chiang Mai..

 

Prior to going I sent him both images and videos of my hand, so he could make a remote assessment (and hence be reasonably confident it was something he could treat).

 

I confess I can no longer remember the cost ... I think it was around 7,000 or 8,000 Thai baht ??  It was cheaper than the airfare (for my wife and myself) to fly from Phuket to Chiang Mai.  My (European) Health Insurance paid for it !   We went in November when the air quality is reasonable ok in Chiang Mai.

[steveco]

Thanks so much for the detailed reply and useful information, I'll go book an appointment.