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If PF surgery is the answer then:

Posted by Pauline on 3/06/01 at 10:17 (040553)

If PF surgery is the answer when will we see folks posting that they had the surgery and are out of pain. I get concerned when posting after posting on the ' Ask the Doctor' board tells another tale of someone who didn't find (www.heelspurs.com) first, were talked into having surgery by their Pod and seemingly end up worse for having the surgery. Afterward they are either in the same pain, more pain, or substitue pain in another location on the foot or a combination of all of them. The folks posting most always tell us they were treated by a Pod. We don't see many surgery postings from patients having PF release by Orthos. Why?

I wonder if data would support a finding that PF release surgery has become a common place practice of most Pods even though the statistics on outcomes might not warrant the surgery? How many were performed nationwide in 2000 by Pods and how many performed by Orthos during the same time period? Who's out there pusing this type of surgery? If these Doctors are the 'bad apples' the Professional Associations should be cautioning the public. Think about it PF surgery is an easy sell. (1) It can be laprascopic. (2) It can be done in the office. (3) It is covered by insurance. (4) It's promoted as having a fast recovery time with few if any complications. Sounds good ---- If your in pain why wouldn't you have it done. The surgery is a piece of cake----but it's what they don't tell you that causes most people to post on our 'Ask the Doctor' board.

Re: If PF surgery is the answer then:

Dr. Zuckerman on 3/06/01 at 11:24 (040564)

We do have patients that post that they are out of pain, or are improving

EPF surgery isn't usually done in an office setting. This isn't a pod vs ortho issue .

We are always going to have patients with problems come to this board. If there was some way to educate patient about pf before it becomes chronic that is the real issue.

Educaton is the issue. I just did an educational tape for the public just on all the causes and treatments.

So is it the bad apples or is it the bad cases that we see. This is very difficult to determine.

Re: If PF surgery is the answer then:

GinaC on 3/06/01 at 14:54 (040619)

I'm scheduled for surgery next week (after 4 years of pf, heel spurs, and now, tarsal tunnel and countless treatments, including ESWT). After having PF for one year, the podiatrists I saw (with one exception) would casually offer surgery and be surprised when I wasn't interested. I had one general orthopod tell me to never have the surgery under any conditions. The foot/ankle ortho who will operate had an interesting take on all this. He knew that the conventional wisdom is to search for someone who has done the procedure numerous times. But his view was that if you find a doctor who has done a huge number of pf releases, you've just found someone who has done the procedure indiscriminately, without adequate screening of surgery candidates. He felt that some pf release failures were due to surgery being performed prematurely or unnecessarily. This ortho surgeon has done the procedure 10 times in the last 6 years, with this track record: 9 improved, 1 the same, none made worse. He has, however, done lots of other types of foot/ankle surgery. I'm desperately hoping he can keep his record intact with my surgery and am terrified enough of being worse that I would even settle for staying the same after surgery. It's amazing what pain and desperation lead one to try.

Re: Education

Julie on 3/06/01 at 16:24 (040624)

Dr Z, you're right about education being the issue. Before I had PF, I had never heard of it, and it was thanks to this site that I found out what I needed to know about it. Since then I have told every one of my regular yoga classes about PF, and every one of the outside groups I give workshops, seminars and training days too. I show my taped, Futuro-supported foot and my Birkenstocks, explain what the plantar fascia is, and talk for about five minutes on how to recognize and deal with PF.

Out of the hundreds of people to whom I've spoken, I've come across only five who have heard of PF (and four of them have had it). But now hundreds of people who had never heard of it know about it, and know what to look for in themselves and (if they are teachers) in their students. So I am doing my bit to educate.

All the best, Julie

Re: If PF surgery is the answer then:

ellen W on 3/06/01 at 16:52 (040632)

Good luck, and let us know how you are doing afterwards. I think Donna's updates on how she was doing post-surgery were helpful to anyone confronting foot surgery.

Re: If PF surgery is the answer then:

Dr. Zuckerman on 3/06/01 at 11:24 (040564)

We do have patients that post that they are out of pain, or are improving

EPF surgery isn't usually done in an office setting. This isn't a pod vs ortho issue .

We are always going to have patients with problems come to this board. If there was some way to educate patient about pf before it becomes chronic that is the real issue.

Educaton is the issue. I just did an educational tape for the public just on all the causes and treatments.

So is it the bad apples or is it the bad cases that we see. This is very difficult to determine.

Re: If PF surgery is the answer then:

GinaC on 3/06/01 at 14:54 (040619)

I'm scheduled for surgery next week (after 4 years of pf, heel spurs, and now, tarsal tunnel and countless treatments, including ESWT). After having PF for one year, the podiatrists I saw (with one exception) would casually offer surgery and be surprised when I wasn't interested. I had one general orthopod tell me to never have the surgery under any conditions. The foot/ankle ortho who will operate had an interesting take on all this. He knew that the conventional wisdom is to search for someone who has done the procedure numerous times. But his view was that if you find a doctor who has done a huge number of pf releases, you've just found someone who has done the procedure indiscriminately, without adequate screening of surgery candidates. He felt that some pf release failures were due to surgery being performed prematurely or unnecessarily. This ortho surgeon has done the procedure 10 times in the last 6 years, with this track record: 9 improved, 1 the same, none made worse. He has, however, done lots of other types of foot/ankle surgery. I'm desperately hoping he can keep his record intact with my surgery and am terrified enough of being worse that I would even settle for staying the same after surgery. It's amazing what pain and desperation lead one to try.

Re: Education

Julie on 3/06/01 at 16:24 (040624)

Dr Z, you're right about education being the issue. Before I had PF, I had never heard of it, and it was thanks to this site that I found out what I needed to know about it. Since then I have told every one of my regular yoga classes about PF, and every one of the outside groups I give workshops, seminars and training days too. I show my taped, Futuro-supported foot and my Birkenstocks, explain what the plantar fascia is, and talk for about five minutes on how to recognize and deal with PF.

Out of the hundreds of people to whom I've spoken, I've come across only five who have heard of PF (and four of them have had it). But now hundreds of people who had never heard of it know about it, and know what to look for in themselves and (if they are teachers) in their students. So I am doing my bit to educate.

All the best, Julie

Re: If PF surgery is the answer then:

ellen W on 3/06/01 at 16:52 (040632)

Good luck, and let us know how you are doing afterwards. I think Donna's updates on how she was doing post-surgery were helpful to anyone confronting foot surgery.