My top moments to get to 100,000 page views

Ok so the crazy moment has arrived where my blog had now had 100,000 page-views!!!!

When I started the blog I never imagined I would get 10,000 page-views let alone to 100,000 and sometimes 5000+ in 1 month. Although I have been the one asking a lot of the questions and doing the research I have to thank everyone that has done an interview as they are really popular and helpful posts that really make the blog as successful as it is. 

When I got to 1000 and 10,000 page views I did a recap on some of my favourite posts and things since I started and I thought it would be nice to do that all again, especially as so much has changed. Not surprisingly none of the science posts or treatment posts will make my list as although they are useful they were not as enjoyable as many other posts. 

1) The original post that I have been updating. This is by far and away the most viewed post on the blog and probably is one the most useful posts. I started this post when I was very low and my foot was really starting to progress and get to me more and more. It began to show to others how I was feeling and how bad the foot was, it ultimately it was started the blog and got the ball rolling. 

Everyone who ran / walked to help raise money for me to get radiotherapy.

2) The run to raise money - Whilst the post was not that significant and may not be that useful to visitors the run itself showed me how much various people cared for me, how much of their time efforts and money they were willing to donate to help me and to get my foot better. Thank you again to everyone who ran and donated as this was the start of road to radiotherapy.

3) I got married - It seems like a long time ago but back in February 2012 I got married to my wonderful wife. She was my rock when this condition was awful and I owe a lot to her. There is no specific post for the wedding but instead I'll link to the interview she did for the blog.

Me and the machine about to zapp me.

4) Starting Radiotherapy with Dr Shaffer - Back in May 2012 I started radiotherapy with Dr Shaffer. This treatment has so far led me to be able to live a normal life, no walking stick and I can run and play badminton. I remember the day my wife and I went for this first day, it filled me with hope and was the first time I had had anyone draw on my feet.

5) My interview with Dr Shaffer - I am not referring to the consultation (which was very good) but to the interview I did for this blog. It was the start of getting specialists to post on here, a great addition and it brings a genuine medical perspective to the treatments. I am biased because Dr Shaffer treated me but he did give a very detailed review of things and I am still in contact with him now.

6) Helping other and their e-mails - By far the best thing to have come out of the blog is that I have managed to help others. It is a fantastic feeling when someone tells me that my blog has helped them, whether it just be that they no longer feel alone or whether it is like the linked e-mail where the lady found Radiotherapy and Dr Shaffer. I have continued to stay in touch with the very nice patient who contacted me and she, like me, has seen a great improvement after radiotherapy.

7) Ditching the stick - Pretty much all of 2012 was spent hobbling around with a walking stick and in a great amount of pain. Towards the end of 2012, after my radiotherapy, I gradually started to walk without the stick and come the end of the year I decided to walk with the stick. It got put away and I no longer carried it with, since then I have not need it and have progressed on to...

8) Playing badminton and running again - When I originally started the blog I did a post along the lines of the things that I miss, when I came back to it later the only thing I really missed was badminton and my freedom to be able to get off the bus a stop early or walk from a car park to a restaurant etc. I am now back fully playing badminton and running (up to) 10km. Anyone who has this condition will know what it feels like to live with it day in day out and to get away from that and being able to run was the ultimate way to celebrate radiotherapy working.

9) Amelia -Just as I was starting to get over this condition my wife became pregnant, this was fantastic news and I remember how delighted I was to see the positive test. However from there the pregnancy was awful, constant sickness and trips to the hospital for dehydration. Still at the end of it our beautiful daughter arrived. Amelia is fantastic and her smile never fails to light up a room. I can wait to see her develop and I am loving seeing all the changes that take place as her personality takes shape.

Some things still annoy like when doctors say they will do an interview and never send back their answers or they just ignore the first e-mail, I am not asking a lot of them and not only could the interview help patients but it also helps patients find them.

I guess the next goal is to get to 1,000,000 page views and more importantly hopefully help at least 9 times as many people in the next 900,000 page views as we have helped in the first 100,000 page views. 

Thank you.

Interview with Dr Hochman, an RT specialist in Florida

Today I have an interview with Dr Hochman. He treats patients with radiotherapy in Florida, I am in contact with a patient of his and he agreed to do an interview. This interview is basically a transcript of a phone conversation we had as this is how he wished to communicate. I did learn from him that persistent patients can be a good thing as that is what got Dr Hochman started with treating Dupuytren’s and plantar fibroma’s. So if you are looking for a local guy or girl to do radiotherapy it is sometimes worth asking questions and giving them the information.

Dr Hochman is based in New Port Richey, Florida

1) How long having you been treating Dupuytren's and Ledderhose disease (plantar fibromatosis) and where are you based?

I started treating Dupuytren’s disease in the hands just over 3 years ago in 2010. It was actually a patient’s husband that came to me, his wife being a harp player she needed her fingers. The patient and her husband asked me about radiotherapy for Dupuytren’s and at the time I did not think there was enough information. They pointed me in the direction of the work of Professor Seegenschmiedt in Germany who had recently published a new article. I read the article and contacted Professor Seegenschmiedt to discuss his work and decided that I would like to offer radiotherapy for Dupuytren’s patients. The patient mentioned above had a hand treated and then came back later to get the second hand treated. It was from this that I started treating both Dupuytren’s and Ledderhose. 

2) Roughly how many Dupuytren's patients have you treated and how many Ledderhose patients have you treated? 

In total I have treated around 20 patients. About 3 of these patients have been feet patients and I have treated about 5 feet in total. Several patients have been treated for a combination of hands and feet.

3) How common do you think Dupuytren's and Ledderhose are in the USA? They are supposedly more common in males then females and have been linked to a family history (of these conditions), smoking, alcohol consumption and diabetes are these risk factors you see in your patients?

I would say that certainly the foot condition is not that common and appears less frequently than Dupuytren’s. Looking at past patients about 20-30% have been female, so in my experience males to seem have an increased incidence.

A familial history of the condition is fairly common however many patients do not notice this until they are told that there is a possible genetic link for these conditions. Once they are aware of this they start to remember how their Dads hands were curled up.

I have not noticed the other risk factors in the group of patients that I have treated.  

4) You treat with radiotherapy, what protocol do you use (dose, no of doses and gap between the 2 weeks of treatment etc.) and what is the success rate on these diseases with radiotherapy? 

I treat with 3gy of radiation of 5 consecutive days followed by a 6-8 week gap, ideally 8 weeks, followed by another 5 consecutive days of 3gy.

Dupuytren’s patients are very happy with the outcome, many experience improved flexibility in their fingers after radiotherapy.

Ledderhose patients are again very happy; they normally experience a significant improvement through a decrease in pain.

5) Why is radiotherapy a better course of action than other treatments such as surgery?

Radiotherapy is a better course of action because it is a non-invasive option. Invasive options such as surgery typically do not have as good an outcome as non-invasive treatments.

6) What are your thoughts on other treatments that are becoming available such as Xiapex and cryosurgery?

I do not know any patients that have had Xiapex and I have not heard of the use of Cryosurgery to treat Ledderhose. I have come across patients who have used verapamil, it seems to work but often not as well as the patient would like.

7) Finally do you have any advice or other information that you would like to share with Dupuytren's / Ledderhose patients?

I would recommend that patients seek as many options and as much advice as they can and try to learn all of the options and make an informed choice. Too many patients will see a surgeon and have surgery or a see a radiotherapist and so have radiotherapy, patients should see a range of specialists and make an informed decision. 

Interview with Ron McColloch, Podiatrist at London Podiatry Center

Today I have an interview with Ron McCulloch. See below for the interview and details. I actually got in touch with Ron because his centre treats Ledderhose but it also uses Cryotherapy. He has not yet used cryo to treat plantar fibroma's but has not ruled out used it for this purpose in the future.

 Bio: 

Ron McCulloch is the principal Podiatric Surgeon and Director of the London Podiatry Centre. During his many years as a specialist Podiatric Surgeon, he has performed thousands of successful foot operations.

Ron McCulloch is Consultant Podiatric Surgeon at London's Homerton University Hospital.He lectures extensively both on the national and international circuit and helped to develop podiatry in the Middle East.

Ron McCulloch built a state of the art gait laboratory at The London Podiatry Centre. This is one of the most advanced dedicated podiatric gait facilities in the world. He is a published author on surgical techniques and is one of only two practitioners in Great Britain to offer invasive cryosurgery of the foot. 

This information was taken, with Permission from http://www.londonpodiatry.com/podiatry/staff/

1)    How long having you been treating Dupuytren's and Ledderhose disease?  

About 20 years

2)    Roughly how many Dupuytren's patients have you treated and how many Ledderhose patients have you treated?

 Plantar fibroma formation varies from discreet nodules to multiple lesions. (Of course you know this).  I have probably treated several hundred of these over my career. They are not uncommon.  I cannot recall exactly how many I have operated on probably around 20 or 30

 3)    What treatments have you used for these conditions? Would you recommend the treatment and roughly how successful is the treatment for each condition?

 Conservative care/redistributive orthoses. Injection therapy, mainly steroid. Surgery to excise the lesions. As you know I'm now looking at providing cryosurgery as cases now come along.

 4)    What would your recommendations be to Dupuytren's and Ledderhose patients and do you have any advice you would like to give?

 Always start with conservative care. If this fails injection therapy which involves breaking the fibroma down with a needle and then infiltrating the steroid. After this I would be inclined to try cryosurgery and full wide excision if this fails.

 5)    What do you think of other treatments such as steroid injections, Xiapex, Radiotherapy and cryosurgery (which I see you do for other conditions)? 

 I only have experience with injections and excision.  The key thing with excision is to do a large marginal one to minimise the chance of recurrence.

 6)    What success have you had with cryosurgery for other conditions? 

 I have done almost 100 operations with cryosurgery but these have mainly been for the management of neuroma formation. As of now I have not had to treat   fibroma using cryosurgery as this is a fairly new treatment in our facility. However when the right case comes along I'm sure we will be using this as part of our armoury to treat plantar fibroma formation.