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Pre-surgical Questions

Posted by Donna Y. on 1/12/01 at 20:25 (036511)

I have been experiencing foot pain for some time now (a little over 3 1/2 years) with varying degrees of intensity. Lately (in the past year) the heel pain in my left heel has become nearly debilitating, causing me to stay home when friends or family ask me to accompany them to places I know will have me on my feet for more than half an hour at a time.

I have been trying various conservative treatments (stretching, night splints, Vioxx, side-kick walker) to relieve the pain to a point where I can at least go grocery shopping without experiencing intense pain, but none of the treatments worked for me. I finally agreed to cortisone injections since my father is an orthopaedic PA and works very closely with the surgeon. I feel confident in his abilities as a doctor and I trust his judgement for the most part. But I have only today had an x-ray (good question if you're asking why we're just now doing this... I have no answer for it, however) which revealed a substancial heel spur.

The pain has always been what most describe as classic Plantar fasciitis pain, but the treatments never worked for very long and now I'm feeling pretty convinced that this is due to the presence of the heel spur. My doctor has recommended surgery to remove the heel spur and do a fascia release, but I'm not quite convinced that I should go through with it given my father's longstanding advice which is this:

'The last parts of your body you'd ever want to have surgery on, barring an accident of some type, are your feet, your hands and your back.'

But after seeing his daughter in such pain, I believe he just wants to see me out of misery and given the success rate of the surgeon, whom we have known personally for over 10 years, he's willing to go along with it.

So I would like to ask some personal opinions from anyone reading who is either a physician who works closely with this type of disorder or opinions of those who have had the surgery performed or know people who have had it performed. Is there anything I should reconsider if I trust my doctor to do a good job with the surgery? Or should I attempt to avoid it at all costs? I have just really had it with the pain.

A few things to consider about me as a patient: I am a preschool teacher, but am only on my feet for 3 hours in the morning and not all of that is constant. I take breaks to make sure that the pain does not become unbearable. Also, I am of average weight, not at all overweight for my height (5'6', 125 pounds) I wear very good shoes with a good support, my feet actually feel much better in these shoes (New Balance and occasionally I wear Mephisto clogs) than they've felt in years. I have very good flexibility in the hamstring, calf and foot. I feel fairly confident that the pain started when I worked in the cosmetic department of a large department store, on my feet on marble floors six hours a day in high heels for over a year.

I apologize for the length of the message, but I wanted to make it as informative as possible on the treatments I've been through since I know that the surgery should not be considered lightly. Thank you in advance for any help or advice.

Re: Pre-surgical Questions

P. Ann on 1/12/01 at 22:17 (036517)

I am sorry that I am not a physician answering your question. I also have not had the surgery. But, I am having the same type of problems(plus some)and I have the same reservations you do. I work in a high school library and am on my feet all day on the concrete, I was told, bad shoes and hard floors will do this.
You did not mention whether you have tried orthodics. If you have not, since the good shoes helped, maybe custom inserts will too. In the interim, I would suggest as much research as possible before the surgery.
Good luck. I hope you find an answer.

Re: Pre-surgical Questions

Dr. Zuckerman on 1/12/01 at 23:04 (036520)

I would be happy to give you advice on any type of heel spur surgery. I perform miminial incision surgery which is the least traumatic procedure for heel spur syndrome. The reason why you have heel spur surgery is due to the pain that you get when you first arise in the morning after getting out of bed or after being on your feet for any length of time. and then you sit down and then try to get up such as driving in a car or sitting at at a desk or table .

The only other option beside heel spur surgery is ESWT. This is an option that I offer all of my patient who are at the stage of heel spur pain that hasn't responded to any non-surgical treatment. and are considering foot surgery.

So if you have any specific questions please feel free to ask. I could go on and on about the pro's and con's but would rather have your feelings concerns and fears discussed. I have been treating heel pain for ove twenty two years and will do my best to point you in the right direction.

There are alof of heel pain patients on this board that will be willing ot advice and discuss with you their personal experiences.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 00:03 (036528)

Thanks so much for your response to my post. Although I don't wish this kind of pain on anyone else, it is heartening to know that I'm not alone. I have tried custom orthotics, which do minimalize the pain while in those shoes. But the pain is always there. I can't wear them in my clogs, obviously, and only wear the clogs on rare occasions where I would like to dress up a little more than my tennis shoes. I am certain that most people reading this board will understand the frustration of being forced to practically live in your tennis shoes. I hope to at least, if I do go through with the surgery, be able to offer up my experiences on this board. Both good and bad. But before I do actually have the surgery I wanted to gather as many opinions as possible and continue to do my own independant research.

Thank you for your well wishes and you have mine in return. Let us all know how things progress for you.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 00:18 (036530)

I deeply appreciate your quick response to my post. I was told by my doctor today that the heel spur surgery would be done with about an inch (and maybe a half) incision. I don' t know that this is considered minimal incision, but he told me that he would do his best to keep the incision as small as possible and that it would require perhaps 8-10 stitches. I have had all of the classic symptoms you described, but up until this point thought that these were all Plantar fasciitis related. My biggest concern at this point is the fascia release surgery along with the heel spur removal. Part of me thinks that perhaps I should have the heel spur removed only, let that heal and see from there if the other pain subsides following surgery rather than have it done at the same time. Is this a plausible scenario? I will likely call my doctor over the weekend and discuss this possibility with him.

We did talk today about the newer ultrasonic procedures available for treating Plantar fasciitis. I don't know that this is in any way similar to the ESWT procedure you do, but I would like to find out more about yours. My doctor told me that while the ultrasonic procedure has been effective in treating Plantar fasciitis with roughly a 75 to perhaps 90 percent success rate, it very likely wouldn't help at this stage in my case. And it's only being done by 2 physicians that he knows of in my area. Not to mention the fact that it is still widely considered experimental surgery and wouldn't be covered by insurance. Don't we all love our insurance companies?

As I stated above, I suppose my biggest fear lies in the fascia release surgery which seems to be the most likely to possibly cause permanent damage. Like I said before, I have trust in this doctor. He's a very good Orthopaedic surgeon who only performs foot surgeries. And my father has acted as first surgical assistant to him for over 7 years. But the fears are still there, no matter how I personally feel about the doctor. Or my dad, for that matter. I know he will do his best, but sometimes permanent damage still results from the sound of the posts on this board.

Thanks again for all of your help and support. Looking forward to hearing more from you and sharing my experience so that I might possibly help someone else in the same situation.

Re: Additional Information

Donna Y. on 1/13/01 at 01:05 (036532)

After reading all of the patient surgery reports here on this site, I thought of some other information I would like to discuss if anyone has any input. My doctor has informed me that post op I will have stitches for 7-14 days, on crutches this entire time and no showers until the stitches are removed. At which time the crutches become optional. How long would you all say I will likely be on crutches following open fascia release and heel spur removal? Is it unrealistically optimistic of me to think that I might possibly be getting around without crutches after a couple of weeks?

Also, the doctor told me that recovery will be a 6-8 week process with a complete recovery from surgery taking anywhere from 6 months to a year. But after 6-8 weeks I should be able to start some light exercise such as cycling on a stationary bicycle. How accurate would some of you say these estimates are?

Also, being a preschool teacher and this being the middle of the school year, I would like to be able to get back to work with a very light load as soon as possible after surgery. I have very supportive coworkers who would gladly drive me to and from work and I would be off of my feet while there, helping children do center work while assisting a teacher. As well as my normal duties as computer specialist which don't require much walking around. Any estimates at all on how soon I might be able to return to this type of limited work activity? I almost hate to even have the surgery during the school year, but I've had 4 cortisone shots since August and the pain just doesn't seem to want to wait for a June surgery date.

Thanks in advance for your advice and input.

Re: Additional Information

Kay S on 1/13/01 at 08:16 (036536)

Donna--I have not had the pf surgery (about the only one I didn't have!) but I did have the eswt once and am going back again in a month for the second treatment. I didn't miss any work with the eswt, although I don't know if you are considering this or not.
The main reason I wanted to write back is to mention something that really helped me a lot after my tarsal tunnel surgery in September. I rented a 'rollabout' which is a little scooter type thing with four wheels and a platform to put your knee and it has a handle to grab onto and also a brake. This was an absolute LIFESAVER for me. I scooted around my house, did the laundry, cooking, etc. after the surgery.....all the time had my foot up with no weight bearing. After I mastered it and had a lot of confidence, I even went down my very long driveway to get the mail!! I tried using crutches, but my arm strength was not up to the task, and even if it were, they are awkward at best.
I don't know how your school feels about having assists like that in the workplace (I work in a hospital so no one can have any type boot, crutches, casts, etc. and still work. Isn't that ridiculous? A hospital!) However, if they are cooperative about this, you could get around quite nicely with the rollabout and still keep the weight off your surgical foot.
I can give you an email address if you are interested.
Kay

Re: Pre-surgical Questions

Karin L. on 1/13/01 at 10:18 (036552)

Donna,
Just a quick response to your question. I had the PF release surgery a year ago & for the first two months, I felt great. At about two months post-op, the PF pain came back. I couldn't believe it, but it was there. I thought there was nothing more to be done except go through another surgery. Then I heard about ESWT...I mentioned it to my pod and to make a long story short, I just had the procedure here in St. Louis. The machine was the OssaTron & I can't tell you how happy I am with the results so far. I am two weeks post-op & from the moment after the procedure, when my feet hit the floor, I have been pain free. I can't say enough good things about this procedure. Think long & hard about surgery...it takes longer to recover after surgery. I only had 3 or 4 stitches from mine, but was non weight bearing for 3 weeks. Read all you can about ESWT...it really is a miracle machine. Good luck & keep us posted.
Karin

Re: Additional Information

Donna Y. on 1/13/01 at 11:18 (036553)

Karin-

Any information you have on the rollabout would be greatly appreciated. My school has been wonderful about my boot (the side-kick walker, looks like a big black stormtrooper boot) and I think they'll be pretty good about crutches, but I'd like to have the information in the case that I find myself too worn out from using the crutches to get back to work.

I woke up this morning with the same familiar sharp, burning pain in my heel and I'm just so ready to be out of this. I would like to know if anyone out there knows of a podiatrist in or around the Atlanta area that performs the ESWT procedure? I haven't been able to locate one even if I wanted to consider this option.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 11:25 (036554)

I am definitely going to research the ESWT option. Though my father did reassure me this morning about the doctor, letting me know that though there are possible complications with any surgery, this doctor is a wonderful surgeon with a very good track record with these types of surgeries. So I'm starting to feel more comfortable with the open surgery, but I'm still going to continue to do research on other options. My doctor has been more than willing to discuss all other options before now and I am certain he will help me no matter what decision I make.

Re: Additional Information

Karin L. on 1/13/01 at 15:06 (036560)

Donna,
I think it was Kay that had the info. on the scooter. I have never heard of it. As for crutches, I know that after my surgery, I had the release & tarsal tunnel decompression, I was on crutches for 3 weeks, no showers either!! I was allowed at 3 weeks to begin gradual weight bearing with the crutches. It probably took about 2-3 weeks before I was full weight bearing. After surgery I had a cast for 4 days, it came off early because we were compressing a nerve on the top of my foot. I stayed in that lovely black cam-walker for 5 weeks post-op. Again gradually I worked my way into tennis shoes. Each case is different, & since I had 3-4 stitches from the release, they came out at 2 weeks, I had about 7-10 stitches from the tarsal tunnel which came out at one week. I can't believe that your Dr. has given 4 cortizone shots since Aug. I was under the impression that 3 shots in a year were the maximum. Is your Dr. a pod or an ortho pod? Your poor feet must be screaming. Look on the ESWT site, there is a list of Dr.'s that are doing the ESWT. I would do that procedure long before surgery. Like I said, each case is different, surgery did not work for me, but so far it appears that ESWT did the trick. Keep us posted & good luck.
Karin

Re: Additional Information

Kay S on 1/13/01 at 19:15 (036570)

It's me, Kay, not Karin! But here's the email address where I got the rollabout. ricardotech@earthlink.net
Even if he can't get it for you, he will know where you can get it in your area. He is such a nice guy, and very helpful.
Good luck!
Kay

Re: Pre-surgical Questions

james on 1/13/01 at 20:59 (036578)

well i hade the same problem with my feet and i had epfr surgery done on the 19th of december 00, and my feet feel great after the surgery i did not have a single day of pain, i am in the military and am on my feet constently and need the surgery badly i had been sufering for over 3 years and couldnt take the pain , it was the best thing i did i will be getting my other foot done i about a month and looking forward to it, so from m point it was well worth it, but i still know it is still early things could still go wrong but for now i am pain free, just make sure u have complet confedence in your dr. thanks for listing

Re: Additional Information

Donna Y. on 1/13/01 at 21:58 (036580)

Sorry about the name confusion there and thanks so much for the information! My almost 5 year old son told me the other day when he saw a commercial for one of the ultra mobile wheelchairs that I needed one of those. That's how awful I am most of the time. So I can't even imagine being worse after surgery.

Thanks again for your help and well wishes!

Re: Additional Information

Donna Y. on 1/13/01 at 22:06 (036581)

This doctor is an orthopaedic surgeon. It's not really advisable to have more than 2 cortisone injections in a year. Definitely unsafe to have 2 within 3 weeks of eachother, which I have never done. Both of those pieces of information are my doctor's words. But I was in so much pain I screamed for relief. And the first cortisone shot actually did help the pain mildly for a few days, but never very much. I just kept hoping that I'd get one and the pain would miraculously go away. It just never did. So we're done with shots. The most relief I've had was after using the cam walker for approximately 6 weeks. But as soon as I went back to tennis shoes I was immediately back to experiencing extreme pain. And let me just mention here that I did not find the cortisone shots painful at all. Not relative to what I'd been (and am still) feeling, if that gives you any idea of how bad the pain was.

I have combed through the ESWT stuff and the closest place I've found that offers it is in Florida. I can't really make that trip for treatment with my kids to consider and that kind of thing.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 22:12 (036582)

Congratulations on what sounds like a so far successful surgery! I will definitely let you all know how mine turns out. Because of the spur, my doctor says endoscopic surgery isn't an option for me. I trust that he would do the least invasive surgery possible, but I realize that there are several schools of thought on this. My father again today assured me that the doctor is an incredible surgeon and that he has never, in 7 years of working directly with this doctor in surgery, seen a sugery result in something horrible. Which is good to hear. Let's all hope that things turn out well. And if they do, you'll hear me singing the praises of the doctor. I plan on keeping up the post surgical database here with my information once the surgery is complete.

Re: Pre-surgical Questions

Dr. Marlene Reid on 1/14/01 at 23:36 (036625)

Donna,

It is not uncommon to experience typical plantar fasciitis pain for over 3 years. It sounds like you have run the gammit on the traditional conservative treatments.

I am assuming that the surgeon your father works with is an orthopedic surgeon. You should be aware that not all orthopedic surgeons are specifically trained in the foot and ankle.

Most podiatric surgeons now do not remove the bone spur. The decision between EPF and more traditional surgery is more surgeon preference. I myself perform open traditional heel surgery but with a small incision.

I wouldn't worry too much that you did not have an X-ray up until now. If your symptoms were consistent with fasciitis, he (or she) did not need the x-ray to begin treatment. (Standard of care; however, is to initally take an X-ray to rule out other bone pathology).

If I were you, I would consider one final option as surgery is not always 100% sucessful when it comes to heel pain. ESWT is a real non-surgical option now that the Ossa tron has FDA approval. It is the only machine that currently has FDA approval in the US, and it is available in several states. You will be able to get much more information on ESWT from other areas in this site.

Good luck to you.

Dr. Marlene Reid

Re: Pre-surgical Questions

john h on 1/16/01 at 10:44 (036676)

dr Z: i have read numerous articles that the spur is not the source of heelspur pain and that removing the spur is unnecessary. why do i read so many post where people are having the spur removed?

Re: Pre-surgical Questions

Donna Y. on 1/16/01 at 19:43 (036716)

Dr. Reid,

Thank you for your response to my posts. The surgeon is in fact an orthopaedic surgeon who specializes in the foot and ankle. It's a pretty large practice with several doctors, but this is his area of expertise.

ESWT doesn't appear to be an option in my case since I cannot find a doctor who uses the treatment in Georgia. The surgery is scheduled now for the 22nd (Monday) and I'm just hoping for the very best. I will let you all know how things go after the surgery, but all of the accounts I've heard from this doctor's patients have been positive. Leave it to me to be the one that has to question everything. :)

Re: Pre-surgical Questions

Dr. Marlene Reid on 1/16/01 at 23:09 (036728)

Donna, not to confuse you anymore, but there is a center in Atlanta that performs ESWT with the Ossa Tron, if you are interested. In response to John's comment/question, most podiatric surgeons feel the spur does NOT cause pain and is usually left intact during surgery. You will also find discrepancy between the post operative course, some surgeons say to stay off your feet for several weeks (old school) and some recommend only decreasing stressful/athletic activities and/or walk with crutches with partial weight bearing for a few weekd (newer thinking). Good luck!!

Re: Pre-surgical Questions

Donna Y. on 1/17/01 at 19:10 (036775)

I had no idea there was a center closer than Florida that performed ESWT. While it might not be something I do for the left heel at this point, I would seriously consider it for the right heel if the pain I have in that heel intensifies. I've actually had Plantar fasciitis in both heels for over 3 years, but the right heel seems to be doing much better. The pain in that heel is kept to a minimum using only conservative measures.

Would you mind letting me know any contact information you have for centers performing ESWT in the Atlanta area? Thanks so much for your feedback.

Re: Pre-surgical Questions

LisaCO on 1/17/01 at 20:43 (036782)

The ESWT page here on this site contains a listing of doctors and treatment centers, both for the Orbasone and OssaTron machines. I don't think that this listing is exhaustive , but does list the locations that many of the 'regulars' on this message board were treated at.

You can find a complete listing of OssaTron treatment locations at http://www.healthtronics.com , select the Orthotripsy page and then the link to the treatment site list. There is a clinic in Atlanta listed there.

Re: Pre-surgical Questions

P. Ann on 1/12/01 at 22:17 (036517)

I am sorry that I am not a physician answering your question. I also have not had the surgery. But, I am having the same type of problems(plus some)and I have the same reservations you do. I work in a high school library and am on my feet all day on the concrete, I was told, bad shoes and hard floors will do this.
You did not mention whether you have tried orthodics. If you have not, since the good shoes helped, maybe custom inserts will too. In the interim, I would suggest as much research as possible before the surgery.
Good luck. I hope you find an answer.

Re: Pre-surgical Questions

Dr. Zuckerman on 1/12/01 at 23:04 (036520)

I would be happy to give you advice on any type of heel spur surgery. I perform miminial incision surgery which is the least traumatic procedure for heel spur syndrome. The reason why you have heel spur surgery is due to the pain that you get when you first arise in the morning after getting out of bed or after being on your feet for any length of time. and then you sit down and then try to get up such as driving in a car or sitting at at a desk or table .

The only other option beside heel spur surgery is ESWT. This is an option that I offer all of my patient who are at the stage of heel spur pain that hasn't responded to any non-surgical treatment. and are considering foot surgery.

So if you have any specific questions please feel free to ask. I could go on and on about the pro's and con's but would rather have your feelings concerns and fears discussed. I have been treating heel pain for ove twenty two years and will do my best to point you in the right direction.

There are alof of heel pain patients on this board that will be willing ot advice and discuss with you their personal experiences.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 00:03 (036528)

Thanks so much for your response to my post. Although I don't wish this kind of pain on anyone else, it is heartening to know that I'm not alone. I have tried custom orthotics, which do minimalize the pain while in those shoes. But the pain is always there. I can't wear them in my clogs, obviously, and only wear the clogs on rare occasions where I would like to dress up a little more than my tennis shoes. I am certain that most people reading this board will understand the frustration of being forced to practically live in your tennis shoes. I hope to at least, if I do go through with the surgery, be able to offer up my experiences on this board. Both good and bad. But before I do actually have the surgery I wanted to gather as many opinions as possible and continue to do my own independant research.

Thank you for your well wishes and you have mine in return. Let us all know how things progress for you.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 00:18 (036530)

I deeply appreciate your quick response to my post. I was told by my doctor today that the heel spur surgery would be done with about an inch (and maybe a half) incision. I don' t know that this is considered minimal incision, but he told me that he would do his best to keep the incision as small as possible and that it would require perhaps 8-10 stitches. I have had all of the classic symptoms you described, but up until this point thought that these were all Plantar fasciitis related. My biggest concern at this point is the fascia release surgery along with the heel spur removal. Part of me thinks that perhaps I should have the heel spur removed only, let that heal and see from there if the other pain subsides following surgery rather than have it done at the same time. Is this a plausible scenario? I will likely call my doctor over the weekend and discuss this possibility with him.

We did talk today about the newer ultrasonic procedures available for treating Plantar fasciitis. I don't know that this is in any way similar to the ESWT procedure you do, but I would like to find out more about yours. My doctor told me that while the ultrasonic procedure has been effective in treating Plantar fasciitis with roughly a 75 to perhaps 90 percent success rate, it very likely wouldn't help at this stage in my case. And it's only being done by 2 physicians that he knows of in my area. Not to mention the fact that it is still widely considered experimental surgery and wouldn't be covered by insurance. Don't we all love our insurance companies?

As I stated above, I suppose my biggest fear lies in the fascia release surgery which seems to be the most likely to possibly cause permanent damage. Like I said before, I have trust in this doctor. He's a very good Orthopaedic surgeon who only performs foot surgeries. And my father has acted as first surgical assistant to him for over 7 years. But the fears are still there, no matter how I personally feel about the doctor. Or my dad, for that matter. I know he will do his best, but sometimes permanent damage still results from the sound of the posts on this board.

Thanks again for all of your help and support. Looking forward to hearing more from you and sharing my experience so that I might possibly help someone else in the same situation.

Re: Additional Information

Donna Y. on 1/13/01 at 01:05 (036532)

After reading all of the patient surgery reports here on this site, I thought of some other information I would like to discuss if anyone has any input. My doctor has informed me that post op I will have stitches for 7-14 days, on crutches this entire time and no showers until the stitches are removed. At which time the crutches become optional. How long would you all say I will likely be on crutches following open fascia release and heel spur removal? Is it unrealistically optimistic of me to think that I might possibly be getting around without crutches after a couple of weeks?

Also, the doctor told me that recovery will be a 6-8 week process with a complete recovery from surgery taking anywhere from 6 months to a year. But after 6-8 weeks I should be able to start some light exercise such as cycling on a stationary bicycle. How accurate would some of you say these estimates are?

Also, being a preschool teacher and this being the middle of the school year, I would like to be able to get back to work with a very light load as soon as possible after surgery. I have very supportive coworkers who would gladly drive me to and from work and I would be off of my feet while there, helping children do center work while assisting a teacher. As well as my normal duties as computer specialist which don't require much walking around. Any estimates at all on how soon I might be able to return to this type of limited work activity? I almost hate to even have the surgery during the school year, but I've had 4 cortisone shots since August and the pain just doesn't seem to want to wait for a June surgery date.

Thanks in advance for your advice and input.

Re: Additional Information

Kay S on 1/13/01 at 08:16 (036536)

Donna--I have not had the pf surgery (about the only one I didn't have!) but I did have the eswt once and am going back again in a month for the second treatment. I didn't miss any work with the eswt, although I don't know if you are considering this or not.
The main reason I wanted to write back is to mention something that really helped me a lot after my tarsal tunnel surgery in September. I rented a 'rollabout' which is a little scooter type thing with four wheels and a platform to put your knee and it has a handle to grab onto and also a brake. This was an absolute LIFESAVER for me. I scooted around my house, did the laundry, cooking, etc. after the surgery.....all the time had my foot up with no weight bearing. After I mastered it and had a lot of confidence, I even went down my very long driveway to get the mail!! I tried using crutches, but my arm strength was not up to the task, and even if it were, they are awkward at best.
I don't know how your school feels about having assists like that in the workplace (I work in a hospital so no one can have any type boot, crutches, casts, etc. and still work. Isn't that ridiculous? A hospital!) However, if they are cooperative about this, you could get around quite nicely with the rollabout and still keep the weight off your surgical foot.
I can give you an email address if you are interested.
Kay

Re: Pre-surgical Questions

Karin L. on 1/13/01 at 10:18 (036552)

Donna,
Just a quick response to your question. I had the PF release surgery a year ago & for the first two months, I felt great. At about two months post-op, the PF pain came back. I couldn't believe it, but it was there. I thought there was nothing more to be done except go through another surgery. Then I heard about ESWT...I mentioned it to my pod and to make a long story short, I just had the procedure here in St. Louis. The machine was the OssaTron & I can't tell you how happy I am with the results so far. I am two weeks post-op & from the moment after the procedure, when my feet hit the floor, I have been pain free. I can't say enough good things about this procedure. Think long & hard about surgery...it takes longer to recover after surgery. I only had 3 or 4 stitches from mine, but was non weight bearing for 3 weeks. Read all you can about ESWT...it really is a miracle machine. Good luck & keep us posted.
Karin

Re: Additional Information

Donna Y. on 1/13/01 at 11:18 (036553)

Karin-

Any information you have on the rollabout would be greatly appreciated. My school has been wonderful about my boot (the side-kick walker, looks like a big black stormtrooper boot) and I think they'll be pretty good about crutches, but I'd like to have the information in the case that I find myself too worn out from using the crutches to get back to work.

I woke up this morning with the same familiar sharp, burning pain in my heel and I'm just so ready to be out of this. I would like to know if anyone out there knows of a podiatrist in or around the Atlanta area that performs the ESWT procedure? I haven't been able to locate one even if I wanted to consider this option.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 11:25 (036554)

I am definitely going to research the ESWT option. Though my father did reassure me this morning about the doctor, letting me know that though there are possible complications with any surgery, this doctor is a wonderful surgeon with a very good track record with these types of surgeries. So I'm starting to feel more comfortable with the open surgery, but I'm still going to continue to do research on other options. My doctor has been more than willing to discuss all other options before now and I am certain he will help me no matter what decision I make.

Re: Additional Information

Karin L. on 1/13/01 at 15:06 (036560)

Donna,
I think it was Kay that had the info. on the scooter. I have never heard of it. As for crutches, I know that after my surgery, I had the release & tarsal tunnel decompression, I was on crutches for 3 weeks, no showers either!! I was allowed at 3 weeks to begin gradual weight bearing with the crutches. It probably took about 2-3 weeks before I was full weight bearing. After surgery I had a cast for 4 days, it came off early because we were compressing a nerve on the top of my foot. I stayed in that lovely black cam-walker for 5 weeks post-op. Again gradually I worked my way into tennis shoes. Each case is different, & since I had 3-4 stitches from the release, they came out at 2 weeks, I had about 7-10 stitches from the tarsal tunnel which came out at one week. I can't believe that your Dr. has given 4 cortizone shots since Aug. I was under the impression that 3 shots in a year were the maximum. Is your Dr. a pod or an ortho pod? Your poor feet must be screaming. Look on the ESWT site, there is a list of Dr.'s that are doing the ESWT. I would do that procedure long before surgery. Like I said, each case is different, surgery did not work for me, but so far it appears that ESWT did the trick. Keep us posted & good luck.
Karin

Re: Additional Information

Kay S on 1/13/01 at 19:15 (036570)

It's me, Kay, not Karin! But here's the email address where I got the rollabout. ricardotech@earthlink.net
Even if he can't get it for you, he will know where you can get it in your area. He is such a nice guy, and very helpful.
Good luck!
Kay

Re: Pre-surgical Questions

james on 1/13/01 at 20:59 (036578)

well i hade the same problem with my feet and i had epfr surgery done on the 19th of december 00, and my feet feel great after the surgery i did not have a single day of pain, i am in the military and am on my feet constently and need the surgery badly i had been sufering for over 3 years and couldnt take the pain , it was the best thing i did i will be getting my other foot done i about a month and looking forward to it, so from m point it was well worth it, but i still know it is still early things could still go wrong but for now i am pain free, just make sure u have complet confedence in your dr. thanks for listing

Re: Additional Information

Donna Y. on 1/13/01 at 21:58 (036580)

Sorry about the name confusion there and thanks so much for the information! My almost 5 year old son told me the other day when he saw a commercial for one of the ultra mobile wheelchairs that I needed one of those. That's how awful I am most of the time. So I can't even imagine being worse after surgery.

Thanks again for your help and well wishes!

Re: Additional Information

Donna Y. on 1/13/01 at 22:06 (036581)

This doctor is an orthopaedic surgeon. It's not really advisable to have more than 2 cortisone injections in a year. Definitely unsafe to have 2 within 3 weeks of eachother, which I have never done. Both of those pieces of information are my doctor's words. But I was in so much pain I screamed for relief. And the first cortisone shot actually did help the pain mildly for a few days, but never very much. I just kept hoping that I'd get one and the pain would miraculously go away. It just never did. So we're done with shots. The most relief I've had was after using the cam walker for approximately 6 weeks. But as soon as I went back to tennis shoes I was immediately back to experiencing extreme pain. And let me just mention here that I did not find the cortisone shots painful at all. Not relative to what I'd been (and am still) feeling, if that gives you any idea of how bad the pain was.

I have combed through the ESWT stuff and the closest place I've found that offers it is in Florida. I can't really make that trip for treatment with my kids to consider and that kind of thing.

Re: Pre-surgical Questions

Donna Y. on 1/13/01 at 22:12 (036582)

Congratulations on what sounds like a so far successful surgery! I will definitely let you all know how mine turns out. Because of the spur, my doctor says endoscopic surgery isn't an option for me. I trust that he would do the least invasive surgery possible, but I realize that there are several schools of thought on this. My father again today assured me that the doctor is an incredible surgeon and that he has never, in 7 years of working directly with this doctor in surgery, seen a sugery result in something horrible. Which is good to hear. Let's all hope that things turn out well. And if they do, you'll hear me singing the praises of the doctor. I plan on keeping up the post surgical database here with my information once the surgery is complete.

Re: Pre-surgical Questions

Dr. Marlene Reid on 1/14/01 at 23:36 (036625)

Donna,

It is not uncommon to experience typical plantar fasciitis pain for over 3 years. It sounds like you have run the gammit on the traditional conservative treatments.

I am assuming that the surgeon your father works with is an orthopedic surgeon. You should be aware that not all orthopedic surgeons are specifically trained in the foot and ankle.

Most podiatric surgeons now do not remove the bone spur. The decision between EPF and more traditional surgery is more surgeon preference. I myself perform open traditional heel surgery but with a small incision.

I wouldn't worry too much that you did not have an X-ray up until now. If your symptoms were consistent with fasciitis, he (or she) did not need the x-ray to begin treatment. (Standard of care; however, is to initally take an X-ray to rule out other bone pathology).

If I were you, I would consider one final option as surgery is not always 100% sucessful when it comes to heel pain. ESWT is a real non-surgical option now that the Ossa tron has FDA approval. It is the only machine that currently has FDA approval in the US, and it is available in several states. You will be able to get much more information on ESWT from other areas in this site.

Good luck to you.

Dr. Marlene Reid

Re: Pre-surgical Questions

john h on 1/16/01 at 10:44 (036676)

dr Z: i have read numerous articles that the spur is not the source of heelspur pain and that removing the spur is unnecessary. why do i read so many post where people are having the spur removed?

Re: Pre-surgical Questions

Donna Y. on 1/16/01 at 19:43 (036716)

Dr. Reid,

Thank you for your response to my posts. The surgeon is in fact an orthopaedic surgeon who specializes in the foot and ankle. It's a pretty large practice with several doctors, but this is his area of expertise.

ESWT doesn't appear to be an option in my case since I cannot find a doctor who uses the treatment in Georgia. The surgery is scheduled now for the 22nd (Monday) and I'm just hoping for the very best. I will let you all know how things go after the surgery, but all of the accounts I've heard from this doctor's patients have been positive. Leave it to me to be the one that has to question everything. :)

Re: Pre-surgical Questions

Dr. Marlene Reid on 1/16/01 at 23:09 (036728)

Donna, not to confuse you anymore, but there is a center in Atlanta that performs ESWT with the Ossa Tron, if you are interested. In response to John's comment/question, most podiatric surgeons feel the spur does NOT cause pain and is usually left intact during surgery. You will also find discrepancy between the post operative course, some surgeons say to stay off your feet for several weeks (old school) and some recommend only decreasing stressful/athletic activities and/or walk with crutches with partial weight bearing for a few weekd (newer thinking). Good luck!!

Re: Pre-surgical Questions

Donna Y. on 1/17/01 at 19:10 (036775)

I had no idea there was a center closer than Florida that performed ESWT. While it might not be something I do for the left heel at this point, I would seriously consider it for the right heel if the pain I have in that heel intensifies. I've actually had Plantar fasciitis in both heels for over 3 years, but the right heel seems to be doing much better. The pain in that heel is kept to a minimum using only conservative measures.

Would you mind letting me know any contact information you have for centers performing ESWT in the Atlanta area? Thanks so much for your feedback.

Re: Pre-surgical Questions

LisaCO on 1/17/01 at 20:43 (036782)

The ESWT page here on this site contains a listing of doctors and treatment centers, both for the Orbasone and OssaTron machines. I don't think that this listing is exhaustive , but does list the locations that many of the 'regulars' on this message board were treated at.

You can find a complete listing of OssaTron treatment locations at http://www.healthtronics.com , select the Orthotripsy page and then the link to the treatment site list. There is a clinic in Atlanta listed there.