February 1, 2015 PDI Newsletter
Greetings to all PDI and DCI Warriors,
Welcome to this February 2015 PD Institute newsletter. I trust all my friends are making good treatment progress and keeping warm as winter continues to nip at us in the Midwest.
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Once again this month’s newsletter will use the familiar and popular format of presenting a simple exchange and blending of emails between someone who has written me an interesting and topical email that will be informative for our reading audience. This month we will use an email that is mainly about Dupuytren’s contracture, but discusses ideas that apply directly to the subject of Peyronie’s disease. For this reason all of our reading audience will be able to learn while reading over my shoulder as we review this recent email.
Everyone should read the information about Dupuytren’s contracture treatment results that I explain in the long paragraph of the first email, because the answer is also the same for Peyronie’s disease.
Please read these two combined emails like the back-and-forth exchange of two people talking to each other, while one person occasionally interrupts the other to make an important point or answer a question. To understand the flow of the conversation, keep in mind that the text in black is from MWXXXXX and the text in red is from me. Here we go:
Please see below for my comments placed into your recent email…
Theodore R. Herazy, DC, LAc
Peyronie’s Disease Institute
Dupuytren’s Contracture Institute
Sent: Sunday, January 18, 2015 8:30 AM
Subject: Please help me
Dear Dr Herazy
I would greatly appreciate your input into helping me with my Dupuytren’s Contracture.
In August 2013 I was diagnosed with a boutonniere’s deformity of my finger a result of a dislocated pinkie. I have been in intensive physiotherapy lasting about 4.5 hours per day since then. In April 2014 I had surgery on the pinkie. In October 2014 I discovered one lump in the palm of my left hand and was diagnosed with early Dupuytren’s Contracture (I am 47 years old and female). Additionally I suffer from chronic fatigue and have various food intolerances (wheat, peanut butter, beetroot, celery and a sensitivity to anything chemical). I also have early onset menopause as a result of the chronic fatigue and osteo arthritis in my back. I had a recent acute gout attack after the usual December overindulgences and have a few lumps in my left foot where the uric acid appears to have deposited. I am taking Dr. Auer’s Base Powder to stabilize the PH balance in my body. Apart from that I have normal glucose levels, blood pressure, cholesterol levels, am a non-smoker, drinks moderately and weighs 68 kg. No other members of my family that I am aware of has Dupuytren’s Contracture.
I currently still have full function in the hand and am able to flatten it. I have done a moderate amount of manual work with the hand since my dominant hand is my right hand. (house work and gardening). I have never played any musical instruments and have not received any treatment for the lump in my hand other than the surgery I mentioned in April of 2014 for the little finger dislocation.
I have a few questions:
- With the intensive physiotherapy I am doing is there a risk of accelerating the development of the Dupuytren’s Contracture and would you advise me to reduce the time spent on exercising (currently 1/2 hr with therapy clay 5 x per day and 2 hours of clamping the pinkie to stretch the shortened tendon). Just as important as WHAT kind of therapy activities you are doing, is HOW you are doing these exercises. For example, someone who is running for exercise can be moving at just a little more than a walk, or furiously pounding the ground to the point of exhaustion. With a little imagination I can easily picture someone injuring themselves when they write they are doing “2 hours of clamping the pinkie to stretch the shortened tendon.” What I am saying is that you might be too forceful when you are doing this clamping you mention. Any time someone forces contracted tissue to straighten some part of the body with a mechanical device the possibility is presented for doing more harm than good. Just how forcefully are you clamping your finger and hand? If these prolonged stretching sessions you mention are done too aggressively they can damage the hand tissue and exacerbate your Dupuytren’s contracture. Currently, my hand specialist and therapist are both of the opinion that the exercise will not contribute negatively to the development of the Dupuytren’s Contracture. Over-stretching can be traumatic, as I have mentioned. Only you and your doctor know exactly how you are conducting these exercises, so I am at a disadvantage on this particular point, but I think it is wise to use great caution and prudence when stretching your finger, if you have not already been told to do so. Many doctors are so fearful of worsening Dupuytren’s contracture if a patient would over-stretch that they advise no stretching of any kind, lest someone do more than is safe and appropriate.
- Are you aware of a link between gluten intolerance and Dupuytren’s Contracture? If so, what is your advice, if any, in this regard and on diet in general? I would like to change my diet to completely removing gluten from it and cut out all sugar except for a treat or two over the weekends. I do believe that the solution must lie in the food that we eat and currently am on about a 80% organic diet. In my opinion, your DC started secondarily to the trauma of the pinkie dislocation, and perhaps it is also related to the surgery you had done to correct the dislocation problem; I see this kind of relationship frequently when people have crush injuries or hand surgery to one hand and a few months later develop DC in the other hand. And I also have heard of a severe case of Dupuytren’s contracture that will actually cause a boutonniere deformity to occur, so it is interesting that you got into this problem in the way that you did by starting with the boutonniere deformity. Faulty dietary habits in the form of excessive gluten might contribute slightly in sensitive people who already have DC as you appear to be, but would not likely be the sole cause of your DC. Improve your diet certainly as you wish, but you will not see results until you actually spend more time directly treating your DC in an aggressive way as outlined on the DCI website. A good place to start on the DCI website is at http://dupuytrens-contracture.com/new-customer-how-to-select-your-best-treatment-plan-2/ To further underscore this point, I have to mention that I receive emails and phone contacts from people who are world-class athletes (who for years have followed diets that avoid wheat, soy, gluten and most other known sources of allergy) and still can develop Dupuytren’s contracture or Peyronie’s disease (a similar problem that affects the male reproductive tissue). Being in great physical shape or eating a marvelous diet does not seem to preclude a person from developing either of these two problems. Major factors in developing DC or PD are genetic predisposition, trauma, and chemical (drugs of a few different types) insult. From my experience after doing this work with DC and PD for almost 14 years now, I repeatedly have seen evidence that a great diet does not prevent DC or PD from happening and is insufficient by itself for treating these two problems. And I see that the diet must be heavily supplemented with specific nutrients and enzymes in an attempt to enable the immune system to heal and correct the tissue damage of these two problems. Of course, there are many other methods and ideas DCI and PDI have developed over the years to assist this repair process that are described on the websites. I see that you are located in New Zealand. People who now live in New Zealand and Australia are descended from ancestors who originated in northern Europe and the Scandinavian countries, and for this reason are predisposed to both DC and PD where thee problems are comparatively common. We have sent products to New Zealand at least a few times a week for the past 14 years without any problem.
- What kind of treatment results do people get with the DCI methods? What chance for success can I expect if I follow your ideas of treatment using the vitamins and other kind of care I see on your website? As you have probably read in a few places on the DCI website, at this time we cannot conduct controlled studies as would a multibillion dollar drug manufacturer or university that could provide a controlled environment that lends itself to the creation of hard statistics about treatment results you are looking for.
We are working privately with ordinary laypeople in a very casual and uncontrolled environment to learn more about how each person responds to individualized treatment using Alternative Medicine. To do this, we ask that our people self-monitor the changes that might occur in the size, shape, density and surface features of the hand nodules and cords, reduced finger range of motion, and changes in interfascial mobility displayed during concentric displacement of the nodular mass. Each person monitors him- or herself to the best of their ability.
Some people do a better job of this than others. For the most part, this work of helping men and women increase their tissue resistance and increase the function of their immune system by means of various Alternative Medicine methods (vitamins, minerals, enzymes, ultrasound, DMSO and other topical applications, non-needle acupuncture stimulation and gentle stretching) is done on a one-on-one basis with volunteer subjects who self-monitor and self-treat; when asked for help, I offer information and suggestions as their self-treatment progresses. But, not all people ask for help. Many never ask for help. As you can imagine, I have found that not all people who say they are using the DCI method do the same level of work or are equally dedicated or committed to success. I find that a few people say they want to get rid of the hand contracture, but are too lazy to help themselves. Some people want to get well, but only if it is a fast and easy process – otherwise they are not interested or able to get involved. Some people have financial trouble, and are truly unable to do what they would like to do to help themselves. Many different levels of volunteer involvement, compliance and tenacity are encountered as I work with these people from all over the world. Some people with DC are in the early stages of their condition, just as some are in a chronic stage; some are pre-surgical, while some are post-surgical; some people with DC have nodule formation only while others have both cord formation and finger contracture; some people are dedicated, precise and rigorous in their approach to self-treatment while others are less so. Each person modifies his/her treatment plan not only at the start of care but also as care progresses, so that no one follows a consistent or universal regimen of care. It’s like playing the piano – everyone does it a little differently.
With as much variation of subject population and treatment I encounter, our current DCI format for working with all these different kinds of people is not appropriate for the creation of meaningful statistics. On top of all this, I am unable to personally verify the accuracy of what they report about their basic treatment results and outcomes of care I receive from each person.
For all these reasons it is difficult to tell you in a clear and meaningful answer how well people do when they correctly used the DCI method of Dupuytren’s contracture care using Alternative Medicine. But I can definitely tell you this: On average, I receive 8-10 reports of favorable response and success for each one report of non-response or failure that I receive from the people I work with. However, when I communicate with that one person who is failing to get good DCI results, (compared to the 8-10 who are happy with their results) I find that those people who report lack of favorable change do not faithfully or aggressively follow the DCI methods. When I dig into what they are actually doing to treat themselves I learn that they follow a smaller size or imbalanced treatment plan, or that they admit to changing the DCI method of treatment in small and large ways to make treatment easier for themselves. These folks admit they can be forgetful about following their schedule of taking their supplements or doing their DMSO treatment. Probably the most shocking discovery is that they make their conclusions about lack of success after only a few weeks – or a few days! – of DCI treatment. When you are dealing with the public you have to do your best with all kinds of unbelievable situations. TRH
Thank you very much.
Greetings again MWXXXXXXXX,
Please see below for comments…
Theodore R. Herazy, DC, LAc
Peyronie’s Disease Institute
Dupuytren’s Contracture Institute
Sent: Monday, January 19, 2015 3:00 AM
To: ‘Theodore Herazy’
Subject: RE: Please help me
Dear Dr Herazy
Thank you for the quick response and the time and effort to assist me. I appreciate the advice. I do not think there is much experience in my country relating to Dupuytren’s Contracture. Unfortunately your experience with poor information and low enthusiasm for treating Dupuytren’s contracture (or Peyronie’s disease) is the same all over the world. There is very little treatment available for this kind of problem that makes sense to patients, and the surgery that can be performed for either one of these problems is risky because of complications and poor results that can arise, and the fact that the problem recurs in a worse form usually in a few years (sometimes in as little as 12-18 months later) after the surgery. I believe most MDs are not excited about engaging a DC patient for treatment because they know the results are often disappointing to both parties. On top of that, there is also the occasional surgical disaster that occurs that prompt many MDs to discourage patients from surgical intervention except in extreme situations. My specialist is of the opinion that the accident and subsequent operation to my finger is completely unrelated to the development of the DC but it is clear from the limited research I have done that this is a problem that few understands. Yes, I am sure that any surgeon would tell you that the surgery he/she did would not cause any problem that you might later develop. However, it is well known and well reported that DC can develop after many kinds of trauma to an extremity, even the trauma of surgery. My medical aid only seem to pay for a faciotomy and I am certainly not keen to have this operation in future. If you would question your surgeon about the post-surgical outcome of a fasciotomy you would find that an honest answer is for the DC to return to the same hand in anywhere from approximately 3-5 years – sometimes as soon as 12-18 months and sometimes as long as 10 years– later, and that the resultant DC would be worse than your current DC. Not very encouraging, indeed. Surgery does not correct a DC problem; it offers short periods of time in which the patient does not exhibit the original problem, but this respite has the price of exacerbating the underlying problem.
I would just like to clarify that I live in South Africa Sorry. The notation of “za” in your email address confused me a bit and I mistook that as the abbreviation for New Zealand. Yes, ZA is the standard postal abbreviation for South Africa, sorry for error. Nonetheless, as far as your question is concerned, because many people of European ancestry now live in South Africa we ship to your country often, also. and am a white female from European descent hence the genetic predisposition to Dupuytren’s Contracture.
I have difficulty in choosing the correct treatment plan as I have an overlap in symptoms between the description on your website of the small and medium plans. I seem to fit into the small plan, except for having the nodule (which is painless) and the operation I had on my pinkie. The nodule is in line with my ring finger; if this is important. I was hoping you could advise me on the history I gave below on which of the small or medium plans to choose. No direct advice can be offered, sorry, other than the general guidelines I provide here. What I can tell you for sure are two things: First, is that the broader and more aggressive the treatment plan that is used, the better the results tend to be for each individual. Second, is that the more faithfully and carefully each plan is followed using the DCI ideas of slow gradual increase of the therapies, while monitoring the hand lumps and cords for small changes to determine when to stop increasing the plan, the more successful the results of self-care seem to be. As with most things in life, the treatment results are commensurate with the effort you put into assisting the immune response. I generally comment that anyone who is serious about getting rid of this problem uses the largest plan that they can afford to sustain while they faithfully and aggressively follow their plan for at least 3-4 months, while they see if they are going to favorably respond to this conservative form of self-care.
Are you currently, or have you in the past, delivered your products to South Africa? If so, were there any issues as we have a large theft problem in this country? We have delivered parcels to your country at least a few times per month since we started this work many years ago. During this time we have never been involved with a problem of theft. Based on what I know to be true, there is no problem of theft of parcels going to ZA because it has never happened with any orders we have sent out. TRH
Have a wonderful day.
That is how this little Dupuytrens discussion proceeded with this lady from South Africa. She is obviously working hard to make the right decisions about her hand problem, and I tried to give her the best information I could.
Bear in mind that while she was only asking questions about her Dupuytren’s contracture, the same ideas and information also applies to Peyronie’s disease.
Look again for another PD Institute Newsletter next month.
Stay focused to your plan and be successful. Please send any questions you have for me to answer at firstname.lastname@example.org