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eswt appropriate for me, stuck in rural country?

Posted by brent williams on 5/29/00 at 13:21 (021032)

i am considering having eswt for plantar fasciitis (the pf onset was in june 1998). i am hesitating because of three factors. #1. i have atypical plantar fasciitis- the pain is throughout both my feet, from the balls to the heels. the pain is not localized to one spot, nor are my feet sore to the touch anymore. the pain occurs after 30-60 seconds of weight-bearing by my feet. #2. my feet and legs are quite weak. i have lost 10-15 lbs of muscle from my lower limbs since i became forced to spend the majority of my time in bed since november 1999. (i am almost underweight for my height now). i cannot even sit and exercise as i did pre-november 1999 because the extended sitting led to the development of pressure sores on my buttocks. (i can't beleive i'm putting this on the internet, but that is how desperate i am). i can sit for a maximum of 20 minutes at present. which leads to reason #3. the nearest eswt treatment centre is over a 1000 kilometres away. i can't sit or stand or combination thereof for the time it takes to travel to ontario, canada on even the fastest plane. DO I RISK THE TRIP AND THE ALMOST CERTAIN SEVERE REAGGRAVATION OF THE PRESSURE SORES FOR A TREATMENT FOR PLANTAR FASCIITIS THAT MAY OR MAY NOT WORK?
posted to the eswt board . . . keyword:

Re: eswt appropriate for me, stuck in rural country?

BJC on 5/29/00 at 13:56 (021033)

Brent, I am not a doctor, but based on the info you have given, this doesn't even sound like atypical pf. Before I had any additional treatment, I would seek another opinion, and include evaluation for more than just your feet. It truly sounds like there is a lot more to your condition, especially with the resulting pressure sores. My very best to you...keep us posted.
posted to the eswt board . . . keyword:

Re: eswt appropriate for me, stuck in rural country?

brent williams on 5/29/00 at 15:08 (021037)

thanks for the reply. i would like to believe that my problems are something else which has a miracle cure, but i tend to believe that the diagnosis of plantar fasciitis is correct. that is the opinion of my gp, physiotherapist, 2 podiatrists, 2 orthopaedic surgeons, and a physical medicine specialist. i've also seen a pedorthist, accupuncturist, reflexoligist, and a rolfer. (rolfers, or at least the one i saw, are dangerous quacks. her tx and advice led to a serious reinjury of my pf, forcing me to spend much more time sitting, which led to the pressure sores. my feet had been improving before rolfing. i was able to walk 5 minutes without unbearable pain-and improving-before the rolfing fiasco. please excuse the rant. but remember that rolfers can be dangerous.)

back to my point. i am confident that the pressure sores(ps)
and problems with my feet are 2 seprate problems. the ps simply resulted from my extended periods off my feet. HOWEVER, i need all the help i can get. thanks for your input. any suggestions of what other specialist(s) i should have check me out? the doctors here do not know who else to refer me to.
posted to the eswt board . . . keyword:


Re: eswt appropriate for me, stuck in rural country?

Pauline on 5/29/00 at 19:23 (021049)

Sounds like you need immediate medical attention. Have you thought
about contacting a large medical center for a complete physical? The fact that you are loosing so much muscle in inself needs to be treated. It sounds like some depression as well. I don't know how
your medical system works but I think you should begin seeking new
help as soon as possible. If you go to orthopedic Dr. perhaps he
could address the muscle loss and the bed sores. Why not ask
the help of a friend or family member to aid you in getting medical help. PF is long term but when other illnesses factor into it additional help is very necessary. Good Luck and let us know what
kind of help you can find. Please don't give up. Keep writing.

posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Pauline on 5/29/00 at 19:27 (021050)

Dr. Zuckerman,
Expert help needed here.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Dr. Zuckerman on 5/29/00 at 20:13 (021054)

Pain that involves the entire pf isn't going to be helped very much with ESWT. ESWT is used for insertional pf. Where the fascia and or tendon inserts into the bone. Now back to this specific case. Going to a large university medical center would be my recommendation. I am not sure of what work-up has been done. But pf can result from many systemic conditions instead of it being just a biomechanical and or weightr related condition. I hope that this is helpful.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

brent williams on 5/31/00 at 11:24 (021109)

thanks for your input dr z and pauline. the local health professional that i trust the most (physio) also suggested that eswt would not be appropriate for widespread pf. unfortunately time, rest, and manageable(sp?) exercise seems to be the only possible solutions to my problems. i am leery to travel a long distance to a large university medical centre b/c of the potential aggravation of the pressure sores. i fear the professionals there won't offer me anything i haven't heard or tried. however it seems to be my only option left. probably toronto or montreal will be my destination. maybe i'll cross the border and try boston. halifax is closect but i don't think they are in the same league as the university medical centres in the 3 other cities. thanks again for your replies.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

David L on 5/31/00 at 11:50 (021110)

My opinion Brent, for what it's worth....I'd go to a US medical center for treatment if you can afford it. While there are great doctors in Canada, access to the latest technology and access to the system in general is severely limited, as I'm sure that you've found out. This notion of waitlists to see a specialist is absurd. You get exactly what you pay for.
Regards,
David
(Vancouver BC)
posted to the eswt board . . . keyword: Sonocur Sonorex

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Pauline on 5/31/00 at 16:54 (021122)

Hi Brent,
While time, rest, exercise, and a whole lot of patience are necessary
when one has PF it is still important that we not allow our bodies
to deteriorate. The loss of the amount of muscle mass you describe
and the fact that you can no longer sit sends red signals that a complete physical is necessary so that you can begin not only healing the PF but other parts of your body. It is difficult for those of
us who have access to many different doctors to understand what you are truely up against, however, with our encouragement and with
a strong will on your part it's time to find real medical assistance. Start today, make a committment to yourself and to your new friends on line to begin medical treatment. Use your head, your phone, your family, your friends anything it takes to get you to the proper medical facility for treatment.

When your muscle is back, when you can sit again, when your sores are
gone, you may still have PF but so do the rest of us and we can and
will get rid of it someday. Remember the most difficult step is always the first (kind of goes along with PF).

Keep in touch, write often because we can help when your discouraged.
posted to the eswt board . . . keyword:


Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Dr. Zuckerman on 5/31/00 at 19:09 (021132)

I would like to have you see a doctor who is a Rheumatogist.
posted to the eswt board . . . keyword:

Re: Dawn of a new day----road to health

Pauline on 6/01/00 at 08:53 (021157)

Hi Brent,
Well it's the dawn of a new day and your new opportunity to take that first step down a NEW road to health. We're all going and we leave no one behind and that includes you.

First things first ---we hope you are eating right. To build your
muscle back your going to need a good balanced diet, rich in protein. You'll need some carbohydrates along with those fruits and vegetables. You probable know the routine. If your a little lax in this department you can add some 'Ensure' products. They make
puddings and liquid and I tell you the Chocolate is pretty good. I lived on it for a while,but remember this is not a substitute for fresh food.

Next begin today with some simple exercise. Somethings can actually be done in bed, like leg lifts, ankle rolls. You can do arm lifts and bends using only a closed fist first, then graduate to soup cans or small weights. Got to start moving those body parts.

Try getting out of your bed more often. I know its hard for you to sit. Have you tried lambs wool pillows or any soft padding like that
egg crate matress padding to sit on. Even if you can extend by only 5 minutes a day thats five minutes less in bed. I read somewhere that everyday spent in bed requires 7 days to recoup the strength you loose not to mention respiratory problems it causes. Slowly increase
your time out of bed.

Last but certainly not least make some phone calls today to find that medical center you want to treat you.

P.S. Keep positive (easy to say hard to do) If necessary when you get a negative thought stop immediately and write down the opposite positive one. The act of writing it down really helps.

Let us know your progress and your accomplishments.


posted to the eswt board . . . keyword:


Re: Dawn of a new day----road to health

brent williams on 6/22/00 at 14:56 (022232)

hi folks and thanks to all who've shared their ideas. i'll answer some questions:
1. i haven't seen a rheumatologist but i've had bloodwork done twice. there were no problems whatsoever.
2. i think i eat pretty well. what is your definition of a diet 'rich in protein'? i was surprised about the importance of carbohydrates-i thought that i may be eating too many carbs.
3. i have an egg-crate mattress. what are the benefits of a lambs wool pillow? where do i get one?
4. i do try to spend as much time as possible out of bed. i am just frustrated with how little time i actually am able to be on my feet or seated. i do physio exercises and various treatments every day. altogether they take me hours to do, partly because i need to lie down to rest my feet or buttocks periodically while doing them. yes i will continue to slowly increase the amount of time i do actually walk and exercise.
i think that's all for the questions.

presently i am continuing as per normal, with the addition of the drug amitriptyline to my regimen. this drug is a muscle relaxant. we are trying it for 5 weeks. the idea is that the drug will help me sleep better, especially during a stage of sleep that is crucial for healing. i didn't think i had any trouble sleeping, but i'm giving it a try. it was the only suggestion the physical medicine specialist had when i saw him 2 weeks ago. so far i've seen no noticeable improvement. i'm also taking a 'double the normal daily' dosage of the anti-inflammatory celebrex. i am not a big fan of popping pills, but i do see some benefits from that drug.

i see the physical ed. specialist in mid july. i hope to have some significant news to share then. thanks again to all who've helped.
brent
posted to the eswt board . . . keyword:


Re: eswt appropriate for me, stuck in rural country?

BJC on 5/29/00 at 13:56 (021033)

Brent, I am not a doctor, but based on the info you have given, this doesn't even sound like atypical pf. Before I had any additional treatment, I would seek another opinion, and include evaluation for more than just your feet. It truly sounds like there is a lot more to your condition, especially with the resulting pressure sores. My very best to you...keep us posted.
posted to the eswt board . . . keyword:

Re: eswt appropriate for me, stuck in rural country?

brent williams on 5/29/00 at 15:08 (021037)

thanks for the reply. i would like to believe that my problems are something else which has a miracle cure, but i tend to believe that the diagnosis of plantar fasciitis is correct. that is the opinion of my gp, physiotherapist, 2 podiatrists, 2 orthopaedic surgeons, and a physical medicine specialist. i've also seen a pedorthist, accupuncturist, reflexoligist, and a rolfer. (rolfers, or at least the one i saw, are dangerous quacks. her tx and advice led to a serious reinjury of my pf, forcing me to spend much more time sitting, which led to the pressure sores. my feet had been improving before rolfing. i was able to walk 5 minutes without unbearable pain-and improving-before the rolfing fiasco. please excuse the rant. but remember that rolfers can be dangerous.)

back to my point. i am confident that the pressure sores(ps)
and problems with my feet are 2 seprate problems. the ps simply resulted from my extended periods off my feet. HOWEVER, i need all the help i can get. thanks for your input. any suggestions of what other specialist(s) i should have check me out? the doctors here do not know who else to refer me to.
posted to the eswt board . . . keyword:


Re: eswt appropriate for me, stuck in rural country?

Pauline on 5/29/00 at 19:23 (021049)

Sounds like you need immediate medical attention. Have you thought
about contacting a large medical center for a complete physical? The fact that you are loosing so much muscle in inself needs to be treated. It sounds like some depression as well. I don't know how
your medical system works but I think you should begin seeking new
help as soon as possible. If you go to orthopedic Dr. perhaps he
could address the muscle loss and the bed sores. Why not ask
the help of a friend or family member to aid you in getting medical help. PF is long term but when other illnesses factor into it additional help is very necessary. Good Luck and let us know what
kind of help you can find. Please don't give up. Keep writing.

posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Pauline on 5/29/00 at 19:27 (021050)

Dr. Zuckerman,
Expert help needed here.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Dr. Zuckerman on 5/29/00 at 20:13 (021054)

Pain that involves the entire pf isn't going to be helped very much with ESWT. ESWT is used for insertional pf. Where the fascia and or tendon inserts into the bone. Now back to this specific case. Going to a large university medical center would be my recommendation. I am not sure of what work-up has been done. But pf can result from many systemic conditions instead of it being just a biomechanical and or weightr related condition. I hope that this is helpful.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

brent williams on 5/31/00 at 11:24 (021109)

thanks for your input dr z and pauline. the local health professional that i trust the most (physio) also suggested that eswt would not be appropriate for widespread pf. unfortunately time, rest, and manageable(sp?) exercise seems to be the only possible solutions to my problems. i am leery to travel a long distance to a large university medical centre b/c of the potential aggravation of the pressure sores. i fear the professionals there won't offer me anything i haven't heard or tried. however it seems to be my only option left. probably toronto or montreal will be my destination. maybe i'll cross the border and try boston. halifax is closect but i don't think they are in the same league as the university medical centres in the 3 other cities. thanks again for your replies.
posted to the eswt board . . . keyword:

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

David L on 5/31/00 at 11:50 (021110)

My opinion Brent, for what it's worth....I'd go to a US medical center for treatment if you can afford it. While there are great doctors in Canada, access to the latest technology and access to the system in general is severely limited, as I'm sure that you've found out. This notion of waitlists to see a specialist is absurd. You get exactly what you pay for.
Regards,
David
(Vancouver BC)
posted to the eswt board . . . keyword: Sonocur Sonorex

Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Pauline on 5/31/00 at 16:54 (021122)

Hi Brent,
While time, rest, exercise, and a whole lot of patience are necessary
when one has PF it is still important that we not allow our bodies
to deteriorate. The loss of the amount of muscle mass you describe
and the fact that you can no longer sit sends red signals that a complete physical is necessary so that you can begin not only healing the PF but other parts of your body. It is difficult for those of
us who have access to many different doctors to understand what you are truely up against, however, with our encouragement and with
a strong will on your part it's time to find real medical assistance. Start today, make a committment to yourself and to your new friends on line to begin medical treatment. Use your head, your phone, your family, your friends anything it takes to get you to the proper medical facility for treatment.

When your muscle is back, when you can sit again, when your sores are
gone, you may still have PF but so do the rest of us and we can and
will get rid of it someday. Remember the most difficult step is always the first (kind of goes along with PF).

Keep in touch, write often because we can help when your discouraged.
posted to the eswt board . . . keyword:


Re: Dr. Zuckerman can you address this? eswt appropriate for me, stuck in rural country?

Dr. Zuckerman on 5/31/00 at 19:09 (021132)

I would like to have you see a doctor who is a Rheumatogist.
posted to the eswt board . . . keyword:

Re: Dawn of a new day----road to health

Pauline on 6/01/00 at 08:53 (021157)

Hi Brent,
Well it's the dawn of a new day and your new opportunity to take that first step down a NEW road to health. We're all going and we leave no one behind and that includes you.

First things first ---we hope you are eating right. To build your
muscle back your going to need a good balanced diet, rich in protein. You'll need some carbohydrates along with those fruits and vegetables. You probable know the routine. If your a little lax in this department you can add some 'Ensure' products. They make
puddings and liquid and I tell you the Chocolate is pretty good. I lived on it for a while,but remember this is not a substitute for fresh food.

Next begin today with some simple exercise. Somethings can actually be done in bed, like leg lifts, ankle rolls. You can do arm lifts and bends using only a closed fist first, then graduate to soup cans or small weights. Got to start moving those body parts.

Try getting out of your bed more often. I know its hard for you to sit. Have you tried lambs wool pillows or any soft padding like that
egg crate matress padding to sit on. Even if you can extend by only 5 minutes a day thats five minutes less in bed. I read somewhere that everyday spent in bed requires 7 days to recoup the strength you loose not to mention respiratory problems it causes. Slowly increase
your time out of bed.

Last but certainly not least make some phone calls today to find that medical center you want to treat you.

P.S. Keep positive (easy to say hard to do) If necessary when you get a negative thought stop immediately and write down the opposite positive one. The act of writing it down really helps.

Let us know your progress and your accomplishments.


posted to the eswt board . . . keyword:


Re: Dawn of a new day----road to health

brent williams on 6/22/00 at 14:56 (022232)

hi folks and thanks to all who've shared their ideas. i'll answer some questions:
1. i haven't seen a rheumatologist but i've had bloodwork done twice. there were no problems whatsoever.
2. i think i eat pretty well. what is your definition of a diet 'rich in protein'? i was surprised about the importance of carbohydrates-i thought that i may be eating too many carbs.
3. i have an egg-crate mattress. what are the benefits of a lambs wool pillow? where do i get one?
4. i do try to spend as much time as possible out of bed. i am just frustrated with how little time i actually am able to be on my feet or seated. i do physio exercises and various treatments every day. altogether they take me hours to do, partly because i need to lie down to rest my feet or buttocks periodically while doing them. yes i will continue to slowly increase the amount of time i do actually walk and exercise.
i think that's all for the questions.

presently i am continuing as per normal, with the addition of the drug amitriptyline to my regimen. this drug is a muscle relaxant. we are trying it for 5 weeks. the idea is that the drug will help me sleep better, especially during a stage of sleep that is crucial for healing. i didn't think i had any trouble sleeping, but i'm giving it a try. it was the only suggestion the physical medicine specialist had when i saw him 2 weeks ago. so far i've seen no noticeable improvement. i'm also taking a 'double the normal daily' dosage of the anti-inflammatory celebrex. i am not a big fan of popping pills, but i do see some benefits from that drug.

i see the physical ed. specialist in mid july. i hope to have some significant news to share then. thanks again to all who've helped.
brent
posted to the eswt board . . . keyword: