Tuesday, 2 July 2013

Interview with DD and LD patient

This is an interview that I have had for a while and I am waiting for an update from the patient, however they have become silently harder to get hold of so I thought I would post the interview and then I can always add an update. This patient has Dupuytren’s, Garrod’s pads and suspected Ledderhose with some family history. They were early post-surgery which is why we were going to wait.

Read on for the interview:

1) Do you have Ledderhose Disease, Dupuytren’s disease or both? 

I have Dupuytrens Disease on both hands with Garrods Pads to all my PIP joints. Effectively my palm and ring finger to the PIP on my left hand and my right hand is contracted on the palm and to the little finger PIP. Whilst I haven't yet sought medical advice I have a pea sized lump on each of my feet in the arch area which I suspect will be diagnosed as Ledderhose Disease (hopefully I'm wrong)

2) Do you have a family history of the disease? If yes how prevalent is it? If no are you at risk from anywhere else such as diabetes, excessive alcohol, smoking etc?

My Grandfather had Dupuytrens to one hand. The disease has not passed over to (his son) my father or my siblings.

I do not smoke, drink excessively or have Diabetes.

3) What is your age and how long have you been symptomatic? (Can talk about disease progression etc such as how long it took to reach a certain point etc)

I am fifty years old. I think I first noticed the creases in the palms of my hands and the lumps on my knuckles approximately fifteen years ago. I was told by my GP regarding my palms I had Dupuytrens Disease and to stretch my affected fingers. I was x-rayed for my knuckle condition and told everything was fine.

Over time and very slowly the creases in my palm became deeper and imperceptibly the fingers contracted towards my palms. There was no pain or real inconvenience until recently I noticed clapping (the Olympians parade in London) and putting on gloves was becoming awkward.

4) What treatments have you received? 

Apart from my GP's advise to stretch the fingers I received no treatment. Recently I was referred to an Orthopeadic Surgeon who advised partial fasciectomy to my left hand, once that has healed he recommends the same surgery to my right hand.

5) How successful were these treatments? 

I can not really say as I am still wearing the dressing, however I can see that the contracture to the PIP joint has not be resolved, hopefully once the bandages are removed I'll see that the overall angle is less, it feels as if that will be the case (stretching my fingers out within the dressing). I'm also hoping that post operative physiotherapy will improve the situation.

6) You said you had surgery, what was this experience like? 

The surgery thus far has been fine, very little discomfort although I wouldn't recommend knocking the hand! Obviously I'm not sure as to the position after the dressings are removed but at this point I'm feeling optimistic even though I'm prepared for a time of scar healing which I expecting to be sore for some time.

7) Are you currently satisfied with the treatment that you have received?

I am very satisfied in as much that the route I've taken seems to be the most common scenario. I would say the development and use of Xiapex seems to be very promising and given a choice I would of opted for that course of action before surgery.

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