What should I change in my Dupuytren treatment plan?

Hi Dr. Herazy,

I am about to place my third order with you. I wanted to let you know about my 5 weeks of treatment so far. I started with your medium Dupuytren’s contracture treatment plan. For 2 weeks I have been taking 5 Neprinol capsules with 2 fundamental sulfur 3 times per day. I find it difficult to find times in the day where I haven’t eaten or plan to eat within 2 hours. I try to take one dose when I wake up in the middle of the night to visit the bathroom. Additionally I am taking your vitamin E and PABA (2 caps ea) once per day. I also try to take Scar X twice per day. Lastly I use topical vitamin E, copper serum with DMSO. This topical Dupuytrens treatment has really softend the surface of my palm. Callouses nearly gone.

I must say, it may be early in treatment but I have not noticed any difference in the dupuytren cords or nodules as far as reduction in size or hardness. I must tell you the unexpected good news about my foot. Plantar Fibroma (aka soft lumps) on the sole of my right foot. they are notably smaller. I have had them for 10 years at least. This to me is proof that your treatment is doing something. These foot lumps are not as hard as the hand dupuytrens lumps.

Additionally I have had 2 dupuytrens surgeries. First one in 2009 needle aponeurotomy. It was quick, some sharp pain during surgery. Results lasted about 3.5 years and grew back. My second surgery was just in Sept 2012. I tried Xiaflex. Dr. injected into the main cord only. It softened the cord enough where he could release it. I could hear and feel it snap like a rubber band. This is when I started your treatment. I am hoping your methods will at least prevent the cord from growing back. I still have cords running up my ring finger and in the web between my ring and pinky.

My questions to you are: what should I change? More Neprinol? or something else? I know you say its trial and error. I was just wondering if you had any comments or recommendations. I am sure these hard firm bands will take more time. But question the treatment plans effectiveness.

Also. When I wake I take my morning Neprinol dose with coffee. I know you say water but I can’t find three times per day where I can commit to 3 doses for 2 hour periods without some kind non-water intake. does caffeine negate the enzymes?

What about wine in the evening? Is that a no-no too?

Thanks for you help.

Jim VH

 

Greetings Jim,

Congratulations on the early progress you are making with the several problems you are dealing with. Five weeks is not a lot of treatment time and your therapy levels apparently have made some good tissue changes for you to be able to notice them so soon.  

What you have going on that puts you in a slightly different (and more difficult) category than a lot of people is that you have had multiple surgeries and you have more than just a Dupuytren’s contracture problem to correct. People who have had Dupuytrens hand surgery tend to take longer to recover while using Alternative Medicine, bu then again people who have had Dupuytrens surgery need this work a lot more since they have seen that recurrence of the lumps on the palm and cords is a real problem.  You cannot continue to have hand surgery when the problem will always come back, because a surgery or two more you will run out of tissue for the surgeon to work with.  At that point you will be worse off than before the surgery.  

I have worked with many people in the past who had plantar fibromas just as you do and I find that this tissue drains a lot of the Dupuytren treatment products away since it competes for them at the same time you are attempting to reduce the nodules and cords on your hand.  The more of these soft tissue problems that are present, the more therapy products that the body will need to address them all.  There is no way, other than the topical or external therapies that you use, to direct or select where the internal therapies will be used by the tissue; the rule apparently is an equal distribution since they travel in bloodstream.  I am confident that if you only had Dupuytren’s contracture and not the plantar fibromas to deal with, your current plan would be giving you greater improvement with the hand contracture problem. 

I suggest that you reduce the vitamin E to two capsules daily, total.  Also, I suggest that you consider taking perhaps three Neprinol more than your current dosage, and that you add these additional three to the end of the day when they will stay in your stomach and bloodstream longest while you go the longest time without eating.  You might also consider adding in acetyl-L-carnitine to your plan, starting at 3-4 capsules daily. 

Taking your Neprinol with coffee is not a great problem since caffeine does not influence the enzymatic activity or availability in any way.  Limited wine intake is also OK.    TRH   

How should I change my Dupuytren’s contracture treatment plan for best results?

I have been applying the recommended Dupuytrens therapy for about four months with increases to try to get to the maximum.  Currently I am taking both E vitamins internally and vitamin E, copper and DMSO externally.  I started with Neprinol a few weeks ago and currently take 2 querecitin/bromelain, 4 Neprinol, fundamental sulfur and PABA twice a day. After the DMSO treatment I stretch and massage my fingers and the palm of my hand that has some blister-like areas over the palm where I think I should be massaging but it concerns me that I may be increasing the blisters by so doing.  I hope I am proceeding correctly with the massage. I have not seen any appreciable improvement except that before the DMSO and massage I get a reading of 122 and then it has gone to 126 – 128 after the stretch and massage however it reverts to 122 by the next treatment time. I have been getting good reduction of an external scar from a previous surgery on my other hand by an aggressive stretching and massage as well as scraping (as though it was a callous) after the DMSO treatment. I am not sure if the internal and external therapies are working as they should although I think I am using a pretty aggressive plan. Hopefully I am on track.
DLB

 

Greetings DLB,

Yes, you are on the right track for your Dupuytren’s contracture treatment but I think you need to be more proactive with your plan. 

You are using your assumption for what an aggressive plan might look like, and you are counting pills to tell yourself that you are following an aggressive plan, to tell yourself that your plan is active and aggressive when in fact it is not.   Based on my experience with plans that have been developed over time that are getting results, I see that they are larger and more aggressive than what you are taking currently. 

If you have followed this plan for four months with increases as you say, then you have either started at an extremely low dosage, or you have increased your therapy intake very slowly with many weeks or even months between increases, or you have increased at a very low level of intake per increase.  Perhaps all of these are true, since you did not give information how you came to be taking this current dosage level.  This lack of information of how you have been working these increases puts me at a disadvantage to guide you to make increases going forward. 

I do not know what you mean by a blister on your palm.  When you mention blister in your email I would have to assume you know what a blister looks like and what to do about that.  If you mean a nodule or lump of denser than normal tissue that is consistent with Dupuytren’s contracture, then I can comment about that type of finding.

There is early indication of progress in that the increased temporary movement from 122 to 126/128 is not small.  A lot of people would like to have that change happen in the early part of their treatment course.   Over time, and with appropriate increase of your intake you should see these numbers increase as well as notice reduction of size, shape, density and adhesion of the nodules and cords.

Overall, your plan is rather modest in spite of it being applied for the last four months.  It seems you are being very conservative and slow in your response to the results that you are earning. I suggest that you consider increasing the Neprinol intake to 9/day, following the directions that are given to you with each order.  I cannot describe that long detailed procedure to work up to 9/day in this email response.  All you need to do is to read and follow the directions you already have that explain how to increase therapy levels safely and effectively.  I also suggest that you contact me about a phone discussion so I can get down to some of the details of how you should be stretching your contacted palm tissue.  I suspect you might be going about this incorrectly, and if so this might be an additional factor in your slow response.    TRH