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One Year Later

Posted by Kathie Rost on 3/10/01 at 00:41 (040928)

Just thought I'd update with my progress a year after getting ESWT in Germany last year-3 treatmants with the Dornier. I continue to be MUCH improved.As long as I wear Birki-type shoes, I can do virtually anything without pain, and I work out 3 times a week both cardio and with weights.Nothing else has changed (I wish I could say I'm considerably lighter). I feel strongly that this treatment should be FDA approved and that HMO's should cover it! How much wasted time, pain, and stuff that doesn't work (even surgery) instead of a non-invasive procedure like this!!!!

Re: One Year Later

Camilla on 3/10/01 at 18:03 (040970)

Kathie,

I couldn't agree more about the HOM/insurance approach to coverage. Often the surgical release doesn't work and the recovery time is long and painful.

I've had PF for almost 5 years...been through all the conventional treatment. The only real help came from a combination of NSAIDS, custom orthotics and Rolfing. I have a bundle invested in expensive shoes to fit with the orthotics. When you mention Birkenstock style shoes are you referring to the foot bed? or something else?

Why was your treatment done in Germany? I travel to Europe often and have heard of this equipment/treatment for a long time. (FDA seems slow to approve...and then when they do; the insurance companies aren't covering...sad!) I plan to return to Germany April 10. I'm staying with a friend and won't be doing much sightseeing. I had considered treatment on April 3, prior to my trip. I can postpone the treatment...the trip is paid for and not refundable. Go or no go; the treatment or trip?

What was your treatment sequence? Both feet? How long since first treatment?

Thanks,
Camilla

Re: One Year Later

Dr. Zuckerman on 3/11/01 at 00:17 (040991)

I am in 100% agreement. I now have many patinets post-ESWT one year that are either pain free or have alot of improvement without having to risk or go thru foot surgery. Time will take care of the insurance issue. I just wish that I can offer ESWT to the entire pf circle but without insurance many people can't afford this procedure.

Re: One Year Later

Carol D on 3/12/01 at 07:22 (041131)

I disagree about the insurance. Mine was covered by my insurance except for $1000 (additional procedure would not cost anything). Doctors use different codes when applying for insurance coverage. I believe my doctor used the one for lithotropy until a new code for ESWT has been issued and it went through withno problem.

Re: One Year Later

Brian G on 3/12/01 at 11:51 (041151)

Hi Carol,

I looked up the description of Lithotropy. Here it is: 'Recently developed noninvasive technique that eliminates kidney and urethal calculi (stones) by ultrasound.'

My question is don't you think an insurance company will take notice if this procedure is done by a Podiatrist? I'm thinking you were really lucky to have yours approved. The rest of us may not be so lucky. Dr Z, any comments?

BG

Re: One Year Later

Dr. Zuckerman on 3/12/01 at 14:25 (041173)

Hi,

I will repeat that this isn't renal lithotripsy and if the doctor wants to commit fraud then there is nothing that I can do.

I have spoke to many insurance medical director's about the use of renal lithotripsy codes for orthopedic shockwave treatment and what I stated above is their exactly the view point that they have taken.

Re: For Kathie & Dr. Zuckerman

Cynthia D on 3/12/01 at 16:21 (041179)

Kathie: First of all, thank you, thank you for posting this positive message!! Congratulations on being cured. I have a few questions for you, and Dr. Z as well. How strong does the Dornier go compared to the Orbasone? Did you think all three treatments were necessary to have this great outcome? You are back into exercising - I'm jealous! What kind of cardio do you do?

And for Dr. Z., of your patients at one year that have a good outcome, are any runners, aerobics addicts or any other type sport or tennis players who need to be on their feet a lot for their sport? Are any back into their sport full-time yet?

Re: For Kathie & Dr. Zuckerman

DR. Zuckerman on 3/12/01 at 18:36 (041196)

I do have a tennis player back to playing tennis without pain . She isn't full one year. I have some golfer's back full time. I have some runners back but they never stopped.

Re: One Year Later

Beth D. on 3/13/01 at 13:19 (041314)

Hi Kathie,

What shoes do you have to wear now after the treatment? Do you have inserts? What do you wear for you cardio? Can you take a walk without pain?

Thanks,

Beth

Re: One Year Later

Kathie Rost on 3/15/01 at 01:08 (041520)

I was treated at the Orthopaedishe Klinik in Kassel- in Northern Germany (I was living in Hannover.) This is not exactly a tourist area. Nobody seems to speak English....there ARE, however, lots of other Kliniks where you could be treated. The key is to somehow get in touch with them ahead of time and make an appointment...the Germans are very big sticklers about planning ahead. If you know anyone who can read a bit of German it might behoove you to get online and research German websites about it.(I think the website for my Klinik is KasselKlinik.de . ) I e-mailed them in English and got an appointment within a couple of weeks! They found someone who spoke English to reply to me. It's worth just about any amount of effort. GOOD LUCK to you !!!

Re: For Kathie & Dr. Zuckerman

Kathie on 3/15/01 at 01:13 (041521)

Hi-- Thanks, I'm able to do walking in the Hawaiian hills where I live, as well as weight training and riding the bike, elliptical, etc. It's great!!I must make it clear that I was living in Germany at the time so it was covered by their excellent heath care system. Unfortunately one of the few things we liked about Germany!!! :)

Re: Inserts and shoes

Kathie Rost on 3/15/01 at 01:17 (041522)

I can only wear Birkenstocks or similar footbed shoes or my feet start to hurt. I found a pair of Adidas sneakers that has a heelcup like Birkis, or I would be wearing orthotics in my shoes of some sort.Dr. Sholls has a weird shaped horseshoe looking insert that seemed to be pretty helpful if I didn't do much mileage. Called something like 'Active inserts.' Hope that helps-keep trying till you find what works for YOU.

Re: One Year Later

Camilla on 3/10/01 at 18:03 (040970)

Kathie,

I couldn't agree more about the HOM/insurance approach to coverage. Often the surgical release doesn't work and the recovery time is long and painful.

I've had PF for almost 5 years...been through all the conventional treatment. The only real help came from a combination of NSAIDS, custom orthotics and Rolfing. I have a bundle invested in expensive shoes to fit with the orthotics. When you mention Birkenstock style shoes are you referring to the foot bed? or something else?

Why was your treatment done in Germany? I travel to Europe often and have heard of this equipment/treatment for a long time. (FDA seems slow to approve...and then when they do; the insurance companies aren't covering...sad!) I plan to return to Germany April 10. I'm staying with a friend and won't be doing much sightseeing. I had considered treatment on April 3, prior to my trip. I can postpone the treatment...the trip is paid for and not refundable. Go or no go; the treatment or trip?

What was your treatment sequence? Both feet? How long since first treatment?

Thanks,
Camilla

Re: One Year Later

Dr. Zuckerman on 3/11/01 at 00:17 (040991)

I am in 100% agreement. I now have many patinets post-ESWT one year that are either pain free or have alot of improvement without having to risk or go thru foot surgery. Time will take care of the insurance issue. I just wish that I can offer ESWT to the entire pf circle but without insurance many people can't afford this procedure.

Re: One Year Later

Carol D on 3/12/01 at 07:22 (041131)

I disagree about the insurance. Mine was covered by my insurance except for $1000 (additional procedure would not cost anything). Doctors use different codes when applying for insurance coverage. I believe my doctor used the one for lithotropy until a new code for ESWT has been issued and it went through withno problem.

Re: One Year Later

Brian G on 3/12/01 at 11:51 (041151)

Hi Carol,

I looked up the description of Lithotropy. Here it is: 'Recently developed noninvasive technique that eliminates kidney and urethal calculi (stones) by ultrasound.'

My question is don't you think an insurance company will take notice if this procedure is done by a Podiatrist? I'm thinking you were really lucky to have yours approved. The rest of us may not be so lucky. Dr Z, any comments?

BG

Re: One Year Later

Dr. Zuckerman on 3/12/01 at 14:25 (041173)

Hi,

I will repeat that this isn't renal lithotripsy and if the doctor wants to commit fraud then there is nothing that I can do.

I have spoke to many insurance medical director's about the use of renal lithotripsy codes for orthopedic shockwave treatment and what I stated above is their exactly the view point that they have taken.

Re: For Kathie & Dr. Zuckerman

Cynthia D on 3/12/01 at 16:21 (041179)

Kathie: First of all, thank you, thank you for posting this positive message!! Congratulations on being cured. I have a few questions for you, and Dr. Z as well. How strong does the Dornier go compared to the Orbasone? Did you think all three treatments were necessary to have this great outcome? You are back into exercising - I'm jealous! What kind of cardio do you do?

And for Dr. Z., of your patients at one year that have a good outcome, are any runners, aerobics addicts or any other type sport or tennis players who need to be on their feet a lot for their sport? Are any back into their sport full-time yet?

Re: For Kathie & Dr. Zuckerman

DR. Zuckerman on 3/12/01 at 18:36 (041196)

I do have a tennis player back to playing tennis without pain . She isn't full one year. I have some golfer's back full time. I have some runners back but they never stopped.

Re: One Year Later

Beth D. on 3/13/01 at 13:19 (041314)

Hi Kathie,

What shoes do you have to wear now after the treatment? Do you have inserts? What do you wear for you cardio? Can you take a walk without pain?

Thanks,

Beth

Re: One Year Later

Kathie Rost on 3/15/01 at 01:08 (041520)

I was treated at the Orthopaedishe Klinik in Kassel- in Northern Germany (I was living in Hannover.) This is not exactly a tourist area. Nobody seems to speak English....there ARE, however, lots of other Kliniks where you could be treated. The key is to somehow get in touch with them ahead of time and make an appointment...the Germans are very big sticklers about planning ahead. If you know anyone who can read a bit of German it might behoove you to get online and research German websites about it.(I think the website for my Klinik is KasselKlinik.de . ) I e-mailed them in English and got an appointment within a couple of weeks! They found someone who spoke English to reply to me. It's worth just about any amount of effort. GOOD LUCK to you !!!

Re: For Kathie & Dr. Zuckerman

Kathie on 3/15/01 at 01:13 (041521)

Hi-- Thanks, I'm able to do walking in the Hawaiian hills where I live, as well as weight training and riding the bike, elliptical, etc. It's great!!I must make it clear that I was living in Germany at the time so it was covered by their excellent heath care system. Unfortunately one of the few things we liked about Germany!!! :)

Re: Inserts and shoes

Kathie Rost on 3/15/01 at 01:17 (041522)

I can only wear Birkenstocks or similar footbed shoes or my feet start to hurt. I found a pair of Adidas sneakers that has a heelcup like Birkis, or I would be wearing orthotics in my shoes of some sort.Dr. Sholls has a weird shaped horseshoe looking insert that seemed to be pretty helpful if I didn't do much mileage. Called something like 'Active inserts.' Hope that helps-keep trying till you find what works for YOU.