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ESWT in Dallas Metroplex

Posted by Barbara TX on 1/23/01 at 00:37 (037131)

I went to my podiatrist today (Dr. Jay Lifshen @ Baylor-Irving) and he is now trained to do the Ossatron treatments. I believe that the surgical center is in Plano, for all those interested. It's about time this became available in Big D. I looked on the HRT site the other day and he doesn't show up yet, but he's doing them. I think that he's done two, and his schedule is gradually filling out.

He said that the FDA protocols REQUIRE the doctor to use general anesthesia (you go completely under)if they are using the Ossatron, but I can't find any FDA documentation to support this (could anyone help me here)? Frankly, I wouldn't subject myself to all the risks of general anesthesia, but I really feel that people should have the choice to have whatever pain meds they want (and NOT to have them if they DON'T want). Lifshen said that a simple local ankle block would work just fine, sure, but those are the protocols for the Ossatron, and he has to follow them. So get those little F2's ready, fellow Texans. B.

Re: ESWT in Dallas Metroplex

Dr. Zuckerman on 1/23/01 at 06:59 (037139)

This may be true . DR. K also told me that it is a FDA requirment at this time. I believe it is IV sedation and not general anesthesia, I could be wrong.

Re: To Dr. Z - ESWT in Dallas Metroplex

Barbara TX on 1/23/01 at 11:01 (037148)

I checked the Healthtronics web site and it says nothing about requiring general or and IV. This from the site:

'The ESW treatment may cause some pain or discomfort, so an anesthetic is commonly given before the procedure. Usually, this will be a local anesthetic or a regional anesthetic called a heel block. You will be asked to rest comfortably on your back while your doctor holds your foot up to the OssaTron shock head.... '

Isn't 'a local anesthetic or a regional anesthetic called a heel block' very different from IV sedation? I'm under the impression that with ID sedation you have the chemical pumped throughout your whole bloodstream and you go to sleep (or half asleep, and unaware or goofy). This is what they give you when you get a wisdom tooth pulled, and you sign consent forms a mile long. Correct me if I'm wrong. The brochure that Lifshen said the same thing - nothing at all about IV sedation, and this brochure is published by Healthtronics.

I suppose the FDA will tell me ;-).

What do you use when you do MIS for heel spurs... I saw the video and the guy is awake and talking to you. It seems to me that if you can have your have your spur plucked out with a local, then you can have ESWT with it safely. All the best, B.

Re: To Dr. Z - ESWT in Dallas Metroplex

Dr. Kurt Kaufman on 1/23/01 at 12:45 (037153)

There is no requirement for general anesthesia with the Ossatron.Most people do well under sedation.However we have done treatment under an ankle block. If I myself were going to have ESWT I would prefer the sedation over an ankle block. The Ossatron is a procedure that requires some type of anesthesia whether an ankle block or sedation.

Re: ESWT in Dallas Metroplex

john h on 1/23/01 at 18:46 (037163)

barb: i think i talked to a doctor in nashville that did not put you under for the treatment. that woud seem more risky and of course more expensive since you could not do that in the doctors office.

Re: To Dr. Z - ESWT in Dallas Metroplex

john h on 1/23/01 at 18:50 (037166)

i thought i read that the ossatron treatments in canada are with a local. since a number of people on the board have had orbasone treatments of 3000 shocks at somewhere in the range of 18KV without any sedation at all why other than fda protocol would want any sedation if they can handle the pain (which from all post is minimal)?i think i talked to a doctor in nashville who performs the ossatron using a local.

Re: ESWT in Dallas Metroplex

Barbara TX on 1/23/01 at 19:04 (037169)

John - you are just who we need! You want more treatment, and Ossatron needs a guinea pig. Since you are the stoic, military type, you could volunteer to have the Ossatron 'au naturale.' The Nancies and I will record your progress, Dr. K can administer the shocks, Kim and Uncle Steve can tend the bar, Kay and Cindy can fan you if you overheat, and Julie can be at your side, whispering healing mantras in your ear. Dr. Z can write a paper about it all and Scott can web-cam the whole party. Agreed? Now that would be some fun science. B.

Re: ESWT in Dallas Metroplex

Dr. Marlene Reid on 1/23/01 at 20:32 (037172)

Hey, what ablut me!!

Re: ESWT in Dallas Metroplex

Dr.Kosova on 1/23/01 at 22:46 (037177)

Barb, We use local sedation not general in our eswt. No one I taked to wants an ankle block without some sedation when we offer it. I dont want to do a local infiltration
block into the site like a pf injection do to puncturing the pf with a needle then doing eswt. On Friday we have three or four cases THEN I will be having some eswt without anesthesia to do out of focus vs f2 to hopefully get a numbing effect which might not be possible with this machine. It will be filmed, we are doing a training and lecture video and if Scott will show it after it is edited you will see the results but I will post friday.

Re: ESWT in Dallas Metroplex

Kay S on 1/24/01 at 08:49 (037200)

John---Cindy and I will be ready with our fans. They will be the best fans you have ever seen. We will be the best fanners you've ever known.
I'll have a Margarita, U. Steve, and Kim. We'll read of your experience in every newspaper/tabloid in the world. Dr. Z will be famous, along with his staunch followers.
What fun!
Kay

Re: ESWT in Dallas Metroplex

Julie on 1/24/01 at 09:00 (037202)

John, I don't know about the mantras, but I'll gladly talk you through a guided relaxation before you get zapped. And I'll have a G&T, thanks.

Let us know the plan.

Julie

Re: ESWT in Dallas Metroplex

Barbara TX on 1/24/01 at 16:39 (037249)

Dr. K - am I to understand that you are having it done on YOURSELF??? Now that is the sort of mad scientist that we need. but, couldn't you give yourself pf, or do you have it already? Tell us if it hurts, but I guarantee you that it will not be as painful as dealing with ESWT politics. Good luck, B.

Re: ESWT in Dallas Metroplex

Barbara TX on 1/24/01 at 18:45 (037259)

Dr. Reid - you could wait on the sidelines until an arguement about ESWT breaks out, and administer Valium to all parties involved! B.

Re: ESWT in Dallas Metroplex

Dr. Marlene Reid on 1/24/01 at 22:34 (037285)

I think I'll need the valium before that!

Re: ESWT in Dallas Metroplex

john h on 1/24/01 at 23:18 (037294)

dr weil in chicago advised me he gave himself a few blast with the ossatron to exerience what his patience felt.

Re: ESWT in Dallas Metroplex

Dr. Kosova on 1/24/01 at 23:47 (037299)

Barb. Yes I have been controlling pf for about 15 years with strectching, orthotics, an ocassional injection etc. I want to know if this machine can be used by defocusing and gradully bring the foot into the f2 area by first just shocking the skin etc as described by DR. Z We talked about how to do this and I called Dr. Kim Eichmyer and we want to figure this out with this machine. Im only doing it until I reach a numbing stage and how long that takes. Again how about a machine that can do low energy for numbing and high for tx. Anybody with 5 billion dollars for research???

As far as the FDA statement about fda cleared and illegal useage, this came directly from the physician liason of the legal dept of the fda. I gave this info again to Dr. Z directly because I think he is the best person to address these questions. I also asked the fda, healthronics and dr. Kim Eichmeier to review the previous posts for factual errors and corrections. The division of the fda was the 'clearance department' if you want to call.

I'll let you all know Fri how it goes. Wish me luck!

Re: Barbie, What are F2s? (eom)

Barbara TX on 1/25/01 at 11:16 (037326)

This is the 'focal point' of the area to be treated. When the electrical charge is fired, some water at the tip of the electrode is vaporized and produces a shock wave that is positioned to converge on a focal point in your heel. The F2 for ESWT is right at the special spot where the plantar fascia inserts into the heel bone. B.

Re: Barbara, question on this Big D doc.

Beverly on 1/25/01 at 17:40 (037353)

Hi Barbara,

I'm still playing catch up. Your doc whose just started doing EWST is someone I'd like to follow in terms of his success with it. A drive to Plano would be much easier than one to New Jersey. On the otherhand, I don't want to be anyone's first few patients. Do you know where he was trained? Did he get the same kind of training that Dr. Z. did on the thing? I still get these two machines mixed up. Which one does your Dallas doc use?
Thanks,
Beverly

Re: Barbara, question on this Big D doc.

Barbara TX on 1/25/01 at 23:08 (037388)

Hello, Bev TX! Doctor Jay Lifshen uses an Healthtronics OssaTron machine and was trained by that company. He practices in Irving, but travels to Plano to use it. So far he has done two or three, but you surely can call his office and ask what he's up to. I think that he does IV sedation. This you can ask too.

If you travel to Irving to consult with him, I will never forgive you if you don't stop for tea or lunch. I would love to meet you! We are only 5 minutes from Irving Hospital, where Dr. Lifshen is. So, think about it! Save my e-mail address above if ever you come our way. B.

Re: Barbara, question on this Big D doc.

Beverly on 1/26/01 at 19:14 (037466)

Barbara,

Thanks for the invitation. I will call his office. I like Dr. Z's suggestion posted some time back about a doc needing to do a certain number of EWST's before being really comfortable with it. I'll have to do a search for the number he gave. It was somewhere between 20 and 50, I think.
This is very encouraging to know a local doc is doing this.
I'd love to meet you anyway. It's going to be awhile before I can drive even halfway to Irving, but when I can, I'd love to go.

See ya,
Beverly

Re: ESWT in Dallas Metroplex

Dr. Zuckerman on 1/23/01 at 06:59 (037139)

This may be true . DR. K also told me that it is a FDA requirment at this time. I believe it is IV sedation and not general anesthesia, I could be wrong.

Re: To Dr. Z - ESWT in Dallas Metroplex

Barbara TX on 1/23/01 at 11:01 (037148)

I checked the Healthtronics web site and it says nothing about requiring general or and IV. This from the site:

'The ESW treatment may cause some pain or discomfort, so an anesthetic is commonly given before the procedure. Usually, this will be a local anesthetic or a regional anesthetic called a heel block. You will be asked to rest comfortably on your back while your doctor holds your foot up to the OssaTron shock head.... '

Isn't 'a local anesthetic or a regional anesthetic called a heel block' very different from IV sedation? I'm under the impression that with ID sedation you have the chemical pumped throughout your whole bloodstream and you go to sleep (or half asleep, and unaware or goofy). This is what they give you when you get a wisdom tooth pulled, and you sign consent forms a mile long. Correct me if I'm wrong. The brochure that Lifshen said the same thing - nothing at all about IV sedation, and this brochure is published by Healthtronics.

I suppose the FDA will tell me ;-).

What do you use when you do MIS for heel spurs... I saw the video and the guy is awake and talking to you. It seems to me that if you can have your have your spur plucked out with a local, then you can have ESWT with it safely. All the best, B.

Re: To Dr. Z - ESWT in Dallas Metroplex

Dr. Kurt Kaufman on 1/23/01 at 12:45 (037153)

There is no requirement for general anesthesia with the Ossatron.Most people do well under sedation.However we have done treatment under an ankle block. If I myself were going to have ESWT I would prefer the sedation over an ankle block. The Ossatron is a procedure that requires some type of anesthesia whether an ankle block or sedation.

Re: ESWT in Dallas Metroplex

john h on 1/23/01 at 18:46 (037163)

barb: i think i talked to a doctor in nashville that did not put you under for the treatment. that woud seem more risky and of course more expensive since you could not do that in the doctors office.

Re: To Dr. Z - ESWT in Dallas Metroplex

john h on 1/23/01 at 18:50 (037166)

i thought i read that the ossatron treatments in canada are with a local. since a number of people on the board have had orbasone treatments of 3000 shocks at somewhere in the range of 18KV without any sedation at all why other than fda protocol would want any sedation if they can handle the pain (which from all post is minimal)?i think i talked to a doctor in nashville who performs the ossatron using a local.

Re: ESWT in Dallas Metroplex

Barbara TX on 1/23/01 at 19:04 (037169)

John - you are just who we need! You want more treatment, and Ossatron needs a guinea pig. Since you are the stoic, military type, you could volunteer to have the Ossatron 'au naturale.' The Nancies and I will record your progress, Dr. K can administer the shocks, Kim and Uncle Steve can tend the bar, Kay and Cindy can fan you if you overheat, and Julie can be at your side, whispering healing mantras in your ear. Dr. Z can write a paper about it all and Scott can web-cam the whole party. Agreed? Now that would be some fun science. B.

Re: ESWT in Dallas Metroplex

Dr. Marlene Reid on 1/23/01 at 20:32 (037172)

Hey, what ablut me!!

Re: ESWT in Dallas Metroplex

Dr.Kosova on 1/23/01 at 22:46 (037177)

Barb, We use local sedation not general in our eswt. No one I taked to wants an ankle block without some sedation when we offer it. I dont want to do a local infiltration
block into the site like a pf injection do to puncturing the pf with a needle then doing eswt. On Friday we have three or four cases THEN I will be having some eswt without anesthesia to do out of focus vs f2 to hopefully get a numbing effect which might not be possible with this machine. It will be filmed, we are doing a training and lecture video and if Scott will show it after it is edited you will see the results but I will post friday.

Re: ESWT in Dallas Metroplex

Kay S on 1/24/01 at 08:49 (037200)

John---Cindy and I will be ready with our fans. They will be the best fans you have ever seen. We will be the best fanners you've ever known.
I'll have a Margarita, U. Steve, and Kim. We'll read of your experience in every newspaper/tabloid in the world. Dr. Z will be famous, along with his staunch followers.
What fun!
Kay

Re: ESWT in Dallas Metroplex

Julie on 1/24/01 at 09:00 (037202)

John, I don't know about the mantras, but I'll gladly talk you through a guided relaxation before you get zapped. And I'll have a G&T, thanks.

Let us know the plan.

Julie

Re: ESWT in Dallas Metroplex

Barbara TX on 1/24/01 at 16:39 (037249)

Dr. K - am I to understand that you are having it done on YOURSELF??? Now that is the sort of mad scientist that we need. but, couldn't you give yourself pf, or do you have it already? Tell us if it hurts, but I guarantee you that it will not be as painful as dealing with ESWT politics. Good luck, B.

Re: ESWT in Dallas Metroplex

Barbara TX on 1/24/01 at 18:45 (037259)

Dr. Reid - you could wait on the sidelines until an arguement about ESWT breaks out, and administer Valium to all parties involved! B.

Re: ESWT in Dallas Metroplex

Dr. Marlene Reid on 1/24/01 at 22:34 (037285)

I think I'll need the valium before that!

Re: ESWT in Dallas Metroplex

john h on 1/24/01 at 23:18 (037294)

dr weil in chicago advised me he gave himself a few blast with the ossatron to exerience what his patience felt.

Re: ESWT in Dallas Metroplex

Dr. Kosova on 1/24/01 at 23:47 (037299)

Barb. Yes I have been controlling pf for about 15 years with strectching, orthotics, an ocassional injection etc. I want to know if this machine can be used by defocusing and gradully bring the foot into the f2 area by first just shocking the skin etc as described by DR. Z We talked about how to do this and I called Dr. Kim Eichmyer and we want to figure this out with this machine. Im only doing it until I reach a numbing stage and how long that takes. Again how about a machine that can do low energy for numbing and high for tx. Anybody with 5 billion dollars for research???

As far as the FDA statement about fda cleared and illegal useage, this came directly from the physician liason of the legal dept of the fda. I gave this info again to Dr. Z directly because I think he is the best person to address these questions. I also asked the fda, healthronics and dr. Kim Eichmeier to review the previous posts for factual errors and corrections. The division of the fda was the 'clearance department' if you want to call.

I'll let you all know Fri how it goes. Wish me luck!

Re: Barbie, What are F2s? (eom)

Barbara TX on 1/25/01 at 11:16 (037326)

This is the 'focal point' of the area to be treated. When the electrical charge is fired, some water at the tip of the electrode is vaporized and produces a shock wave that is positioned to converge on a focal point in your heel. The F2 for ESWT is right at the special spot where the plantar fascia inserts into the heel bone. B.

Re: Barbara, question on this Big D doc.

Beverly on 1/25/01 at 17:40 (037353)

Hi Barbara,

I'm still playing catch up. Your doc whose just started doing EWST is someone I'd like to follow in terms of his success with it. A drive to Plano would be much easier than one to New Jersey. On the otherhand, I don't want to be anyone's first few patients. Do you know where he was trained? Did he get the same kind of training that Dr. Z. did on the thing? I still get these two machines mixed up. Which one does your Dallas doc use?
Thanks,
Beverly

Re: Barbara, question on this Big D doc.

Barbara TX on 1/25/01 at 23:08 (037388)

Hello, Bev TX! Doctor Jay Lifshen uses an Healthtronics OssaTron machine and was trained by that company. He practices in Irving, but travels to Plano to use it. So far he has done two or three, but you surely can call his office and ask what he's up to. I think that he does IV sedation. This you can ask too.

If you travel to Irving to consult with him, I will never forgive you if you don't stop for tea or lunch. I would love to meet you! We are only 5 minutes from Irving Hospital, where Dr. Lifshen is. So, think about it! Save my e-mail address above if ever you come our way. B.

Re: Barbara, question on this Big D doc.

Beverly on 1/26/01 at 19:14 (037466)

Barbara,

Thanks for the invitation. I will call his office. I like Dr. Z's suggestion posted some time back about a doc needing to do a certain number of EWST's before being really comfortable with it. I'll have to do a search for the number he gave. It was somewhere between 20 and 50, I think.
This is very encouraging to know a local doc is doing this.
I'd love to meet you anyway. It's going to be awhile before I can drive even halfway to Irving, but when I can, I'd love to go.

See ya,
Beverly