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Question for Sonorex, Orbasone, and Dornier Representatives

Posted by Duane E on 4/23/00 at 00:00 (019267)

Regardless of which machine is used, and even with the best patient selection criteria, ESWT fails between 10% and 25% of the time.

1. What are the reasons for the failures?

2. What are the possible solutions your researchers are exploring to help these patients that ESWT has failed?




Re: Question for Sonorex, Orbasone, and Dornier Representatives

Rob on 4/23/00 at 00:00 (019273)

Hello Duane. There can be many reasons for treatment failure. Misdiagnosos and severe thichening on the PF that becomes resistant to shock waves are some possibilities. Some solutions are to see if using higher energy beyond what ESWT is currently using may work or more treatments may be in order. Also there is a debate that some of the PF cases are not PF cases and that bacteria or some other problem may give PF like symptoms. It is important to remember that there is no medical procedure that offers 100% success and ESWT is no exception to the rule. We must also remember that the patients who have been treated with ESWT have failed conventional therapys so we are getting a problematic group to start with. It would be interesting to see what percentage of patients can be treated successfully if the general population of PF sufferers were to be treated with ESWT first. Something to think about.
Posted to the eswt board

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/23/00 at 00:00 (019291)

When you talk with the researchers (Dr. Buch and others) in Germany, would you gather information (reports, papers, verbal information) about their latest successes and failures in these areas, and share the information with the board when you return? This board is packed with recalcitrant plantar fasciitis cases.

Posted to the eswt board

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr. Zuckerman on 4/24/00 at 00:00 (019329)

For the tough cases that have pf, and there is involvement of the insertion of the pf at the medial tubercle there is another procedure that I am aware if orbasone has failed. One of the failure reasons could be that the patient has s stress fracture of the heel. There are four stages to this stress fracture. If you miss the first or second psstage then the sucess rate goes, down. There was an article written by a Dr. Smith the title is called Fatigue Perturbation of the OS Calis (heel bone), this was a new theory that he had it was written in 1994 What this Dr. Smith does is drill holes into the heel and a screw for stabilzation he then has the patient use a bone stimulator to try and get the heel bone to heal. I have never examined any of the Ossatron patient but it seems that they have very little of the criteria that I use to screen patients for either heel spur surgery and or orbasone treatment. A stress fracture must be ruled out either by an mri and or bone scan and a good examination and history.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/25/00 at 00:00 (019341)

Does MIP (Orbasone) have medical research staff that investigates why properly selected and diagnosed plantar fasciitis patients are not all cured after Orbasone treatment?

For the numerous and extensive discussions about OssaTron patient selection criteria on this web site, please do a search on 'OssaTron.'


posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Lynda S. on 4/25/00 at 00:00 (019367)

I have had PF in both feet for over nine years now (started after having done high-impact aerobics for a few years}. Have had many pods., rheumy, orthos, & assorted other docs who tried to treat this. Went through all conventional treatment, including an EPF and the more open procedure. All have failed. The only things that have helped are wearing Birkenstocks all day and taking Nortriptyline, 150 mg. My doc thinks that because it has lingered for so long, what I experience now is chronic nerve pain. Without examining me in person, would ESWT or Sonorex be even useless to consider? I would like to get off the meds, as they make my mouth very dry among other reasons. Thanks.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr, Zuckerman on 4/25/00 at 00:00 (019370)

My opinion is that there is a stress fracture. John Warlick's opinion is that there is an avasular necrosis of the heel. So I guess that all heels would need to have a bone scan and an mri before the treatment is done. Did you read my note about treatment of stress fracture with drilling,screw fixation and bone stimulation. I will send this to anyone who wishes to read this. Just e-mail me Duane E
with a fax and I will send you the article.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019394)

If I were in your position, I would make an appointment at a medical school with a Professor of Foot and Ankle Surgery for a consultation/evaluation. At this time, many medical schools are very familiar with ESWT.

posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019395)

Thank you for your efforts. The specific question was:


'Does MIP (Orbasone) have medical research staff that investigates why properly selected and diagnosed plantar fasciitis patients are not all cured after Orbasone treatment?'

If MIP does have a research staff, the board would be interested in hearing about their efforts to help those patients that ESWT has failed.




posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr. Zuckerman on 4/26/00 at 00:00 (019398)

No. but you still are missing the point. There are so many factors when treating PF that your questions doesn't exist in the real world
Doctors are always trying to find the answer to the question why doen't everyone get better with treatment. The answer is that they don't know. Medicine is an art and practice not an exact science.

Now back to a simple question that I asked and you never answer. Do know the amount of MPa and joules/mm2 that the ossatron performs at it focal point. With this answer I may be able to give some insight into why ossatron patients are having so much pain after tx.

Thanks
posted to the eswt board . . . keyword:


Re: Question for Sonorex, Orbasone, and Dornier Representatives

john h on 4/26/00 at 00:00 (019415)

duane: since i am a long suffering pf guy and plan on doing the orbasone within the next couple of months you can get it from the horses mouth. some of my reasons for selecting the orbasone and they are by no means scientifc just instinct: (1)less pain and down time for a shorter length of time (2) this is probably a result of less power being used to shock the area (3) if the area that is to receive shock waves (fascia) is just below the skin is all the high power really necessary (4) from the post i am reading about the ewst from those who have been to canada i am not real comfortable with what i am reading. no one has really stepped up and said i am really a lot better. (5) drs zuckerman and weil have probably done 100-150 pf procedures between them. neither promise a cure. both seem positive in the results they are seeing and i sense they are not just trying to sell us treatments since most of us do not live anywhere near their facilities and no one has posted on our board that they have received a orbasone treatment. perhaps i will be the first as that is my plan for june or july (6) if an orbasone treatment can make me better then there will be hope for all of you as i have had this for a very long time and have tried all known devices,pills,massage,tens,accupuncture,etc. i am not looking for any guarantees just hope.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019460)

The sole intent of my question was to find out what research was being performed by the various ESWT manufacturers to improve their success (cure) rate for plantar fasciitis. There is no magic to ESWT: it works for valid reasons. If it fails, there are also reasons for that outcome.

The intent of the question was not to upset, or anger anyone. Rob had no problem giving a clear answer to the question -- and that was all I was seeking. I definitely agree with Rob that it is important to compare the treatment success rates for the various ESWT devices. This includes the way the equipment is used -- the treatment protocol.

TO DATE ON THIS BOARD:

1) We do not have any studies or reports about the efficacy of the Orbasone for the treatment of plantar fasciitis. You say this information exists in Europe; but you will not share it with the board.

2) We do not know your complete treatment protocol for plantar fasciitis. Again you will not share it with the board.

3) No patients have posted about their Orbasone treatment.

4) You have asked for the OssaTron's operational data. Scott and I have given this information to you several times. Once again, for operational parameters about all the ESWT devices discussed on this board, except the Orbasone, go to: http://heelspurs.com/eswt/specs.html

The above information is readily available for all ESWT devices discussed on this board -- except the Orbasone.

posted to the eswt board . . . keyword:


Re: Question for Sonorex, Orbasone, and Dornier Representatives

Rob on 4/23/00 at 00:00 (019273)

Hello Duane. There can be many reasons for treatment failure. Misdiagnosos and severe thichening on the PF that becomes resistant to shock waves are some possibilities. Some solutions are to see if using higher energy beyond what ESWT is currently using may work or more treatments may be in order. Also there is a debate that some of the PF cases are not PF cases and that bacteria or some other problem may give PF like symptoms. It is important to remember that there is no medical procedure that offers 100% success and ESWT is no exception to the rule. We must also remember that the patients who have been treated with ESWT have failed conventional therapys so we are getting a problematic group to start with. It would be interesting to see what percentage of patients can be treated successfully if the general population of PF sufferers were to be treated with ESWT first. Something to think about.
Posted to the eswt board

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/23/00 at 00:00 (019291)

When you talk with the researchers (Dr. Buch and others) in Germany, would you gather information (reports, papers, verbal information) about their latest successes and failures in these areas, and share the information with the board when you return? This board is packed with recalcitrant plantar fasciitis cases.

Posted to the eswt board

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr. Zuckerman on 4/24/00 at 00:00 (019329)

For the tough cases that have pf, and there is involvement of the insertion of the pf at the medial tubercle there is another procedure that I am aware if orbasone has failed. One of the failure reasons could be that the patient has s stress fracture of the heel. There are four stages to this stress fracture. If you miss the first or second psstage then the sucess rate goes, down. There was an article written by a Dr. Smith the title is called Fatigue Perturbation of the OS Calis (heel bone), this was a new theory that he had it was written in 1994 What this Dr. Smith does is drill holes into the heel and a screw for stabilzation he then has the patient use a bone stimulator to try and get the heel bone to heal. I have never examined any of the Ossatron patient but it seems that they have very little of the criteria that I use to screen patients for either heel spur surgery and or orbasone treatment. A stress fracture must be ruled out either by an mri and or bone scan and a good examination and history.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/25/00 at 00:00 (019341)

Does MIP (Orbasone) have medical research staff that investigates why properly selected and diagnosed plantar fasciitis patients are not all cured after Orbasone treatment?

For the numerous and extensive discussions about OssaTron patient selection criteria on this web site, please do a search on 'OssaTron.'


posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Lynda S. on 4/25/00 at 00:00 (019367)

I have had PF in both feet for over nine years now (started after having done high-impact aerobics for a few years}. Have had many pods., rheumy, orthos, & assorted other docs who tried to treat this. Went through all conventional treatment, including an EPF and the more open procedure. All have failed. The only things that have helped are wearing Birkenstocks all day and taking Nortriptyline, 150 mg. My doc thinks that because it has lingered for so long, what I experience now is chronic nerve pain. Without examining me in person, would ESWT or Sonorex be even useless to consider? I would like to get off the meds, as they make my mouth very dry among other reasons. Thanks.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr, Zuckerman on 4/25/00 at 00:00 (019370)

My opinion is that there is a stress fracture. John Warlick's opinion is that there is an avasular necrosis of the heel. So I guess that all heels would need to have a bone scan and an mri before the treatment is done. Did you read my note about treatment of stress fracture with drilling,screw fixation and bone stimulation. I will send this to anyone who wishes to read this. Just e-mail me Duane E
with a fax and I will send you the article.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019394)

If I were in your position, I would make an appointment at a medical school with a Professor of Foot and Ankle Surgery for a consultation/evaluation. At this time, many medical schools are very familiar with ESWT.

posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019395)

Thank you for your efforts. The specific question was:


'Does MIP (Orbasone) have medical research staff that investigates why properly selected and diagnosed plantar fasciitis patients are not all cured after Orbasone treatment?'

If MIP does have a research staff, the board would be interested in hearing about their efforts to help those patients that ESWT has failed.




posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Dr. Zuckerman on 4/26/00 at 00:00 (019398)

No. but you still are missing the point. There are so many factors when treating PF that your questions doesn't exist in the real world
Doctors are always trying to find the answer to the question why doen't everyone get better with treatment. The answer is that they don't know. Medicine is an art and practice not an exact science.

Now back to a simple question that I asked and you never answer. Do know the amount of MPa and joules/mm2 that the ossatron performs at it focal point. With this answer I may be able to give some insight into why ossatron patients are having so much pain after tx.

Thanks
posted to the eswt board . . . keyword:


Re: Question for Sonorex, Orbasone, and Dornier Representatives

john h on 4/26/00 at 00:00 (019415)

duane: since i am a long suffering pf guy and plan on doing the orbasone within the next couple of months you can get it from the horses mouth. some of my reasons for selecting the orbasone and they are by no means scientifc just instinct: (1)less pain and down time for a shorter length of time (2) this is probably a result of less power being used to shock the area (3) if the area that is to receive shock waves (fascia) is just below the skin is all the high power really necessary (4) from the post i am reading about the ewst from those who have been to canada i am not real comfortable with what i am reading. no one has really stepped up and said i am really a lot better. (5) drs zuckerman and weil have probably done 100-150 pf procedures between them. neither promise a cure. both seem positive in the results they are seeing and i sense they are not just trying to sell us treatments since most of us do not live anywhere near their facilities and no one has posted on our board that they have received a orbasone treatment. perhaps i will be the first as that is my plan for june or july (6) if an orbasone treatment can make me better then there will be hope for all of you as i have had this for a very long time and have tried all known devices,pills,massage,tens,accupuncture,etc. i am not looking for any guarantees just hope.
posted to the eswt board . . . keyword:

Re: Question for Sonorex, Orbasone, and Dornier Representatives

Duane E on 4/26/00 at 00:00 (019460)

The sole intent of my question was to find out what research was being performed by the various ESWT manufacturers to improve their success (cure) rate for plantar fasciitis. There is no magic to ESWT: it works for valid reasons. If it fails, there are also reasons for that outcome.

The intent of the question was not to upset, or anger anyone. Rob had no problem giving a clear answer to the question -- and that was all I was seeking. I definitely agree with Rob that it is important to compare the treatment success rates for the various ESWT devices. This includes the way the equipment is used -- the treatment protocol.

TO DATE ON THIS BOARD:

1) We do not have any studies or reports about the efficacy of the Orbasone for the treatment of plantar fasciitis. You say this information exists in Europe; but you will not share it with the board.

2) We do not know your complete treatment protocol for plantar fasciitis. Again you will not share it with the board.

3) No patients have posted about their Orbasone treatment.

4) You have asked for the OssaTron's operational data. Scott and I have given this information to you several times. Once again, for operational parameters about all the ESWT devices discussed on this board, except the Orbasone, go to: http://heelspurs.com/eswt/specs.html

The above information is readily available for all ESWT devices discussed on this board -- except the Orbasone.

posted to the eswt board . . . keyword: