Wednesday, 28 March 2012

Xiapex in the UK, up North this time.

My Day:

So  I shall do the usual trick and talk about my day for a little bit and then go into some news. So my days are not getting any easier, I am still having to make the choice between severe pain from an early point in the day or not getting that much work done (I mainly opt for the getting the work done side and only struggle on the days where it is bad from the time I wake up) and to be honest sometimes I can not even get as much work done as I would like and still be in quite a considerable amount of pain.

Left foot:

Today I again experienced the numbness in the bottom of my left foot, this is something that I think Becky has mentioned having but something that I only experienced for the first time last week. Whether this is further progression of the disease or just some oddity I do not know but I have certainly had it twice in the last week and never before that and my foot has been the most painful it has even been in the last 3 weeks.

Right Foot:

I was also having pain in my right foot again today and this reached its most painful level to date. I am still unsure as to whether this is Ledderhose or perhaps just something like plantar fasciitis caused by the increased strain it is under due to the problems with the other foot. I do now think that I can feel some lumps in my right arch but I am not certain and what I think it the main one or at least seems to be associated with pain is in a slightly different location to the left foot lump and is closer to my heel.

Rough location and guestimation of size of the lumps. 

Xiapex in the North East of England:

It was announced on Monday that there was a reversal on the initial decision on Xiapex (to reject it) and they are now going to put it forward as an option for Dupuytren's in the North East. This sounds good right?

I am not sure it is a simple as all that to be honest as it is only allowed to be used on one joint and it has to be contracted to at least 40 degrees. I am happy that this choice has been reversed and this is a good step towards getting come good clinical data on its effectiveness and how well it is going to work and then maybe it can be considered for Ledderhose patients. 

I mean one of the reasons that they have agreed to do this is because it is cheaper than doing surgery and so it makes sense. I think that when it comes to money Ledderhose must be more expensive than Dupuytren's (though this is a guess) and I am basing this on the fact that I am assuming that because the surgery is on your foot there is more likely to be a long(er) time spent in hospital and recovering that it is going to cost lots of money. 

Plus the fact that (again not really a fact I guess but I am guessing) that scar tissue in the foot is more problematic in the foot than in the hand so surely it makes sense that this should be an earlier option in the foot than surgery. 

Anyway this is the second kind of thing like this for Xiapex for Dupuytren's in the last few weeks and so hopefully progress like this can continue and we can start to see better treatments and better care for patients with Ledderhose disease and Dupuytren's disease.