Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

orbasone

Posted by john h on 4/16/01 at 11:00 (044706)

dr z: are you still using a power setting of around 16-18 on the orbasone? what % of your patients are now electing to use no shots prior to treatment? if you do not use shots are you still taking it up to around 18?

Re: orbasone

Dr. Zuckerman on 4/16/01 at 13:18 (044727)

Hi,

Still using settings up to 18kv. Very few patients are needing local anesthetic. I will take it up to 18 kv. or even higher, the important aspect is do I feel good shock or pressure vibration into the area of treatment. I do start at about 12 kv for about 100-150 shocks then slowing move up to 16-18.

Re: To Dr Reid OssaTron

Pauline on 4/17/01 at 09:30 (044805)

Dr. Reid,
What are you using with the OssaTron. I remember reading that Dr Alzarez during the testing was giving 1000 shocks at 16kv and this was with
anaesthesia. Is this still the case. When it was approved for the treatment of soft tissue diseases did the FDA attach any criteria for its use that have to remain constant?

Re: To Dr Reid OssaTron

Dr. Marlene Reid on 4/18/01 at hrmin (045040)

Wow, I've been off for a few days and it seems as if weeks have gone by here at heelspurs.com.

Healthtronics has informed us that the FDA gave specific approval for the OssaTron at a setting of 18kv for 1500 shocks. We actually do 500 more in a circular motion beyond the central point. This does require some type of anesthesia, whether local only, local with sedation or sedation only.

Other requirements are:

*PF must be chronic, at least 6 months of duration
*At least 4 other forms of treatment must have failed
*Tarsal Tunnel Syndrome must be ruled out (although if a patient has secondary TTS due to the swelling of PF, I will still do ESW).

We have a whole questionaire we must submit to Healthtronics in order to get the okay to due the procedure. They have the right to deny treatment on individuals who do not truely qualify.

My biggest fear is that this procedure will become abused, i.e. used as an early form of treatment. Due to the high expense, in it is abused, we're all going to be in trouble. I have heard that was happening in Europe (Germany, I think). I am glad that docs are required to get clearance from Healthtronics first. I think that is very responsible of them. It does help prevent the machine being used on everyone and their brother who otherwise should not have the treatment. (It is similar to a hospital monitoring surgeons performance, skill and ethics which is what goes on when a surgeon does surgery in a hospital or ASC. So for those of you that have surgery in an ASC or hospital, you have some assurances to the quality of your surgeon).

Testing is under way for the treatment with the OssaTron for achilles tendonitis, I for one will not offer it for achilles tendonitis.

Everyone wants to know if they are a candidate. As long as you have PF and have had a THROUGH exam to rule out misdiagnoses (very common to be misdiagnosed- I would have never thought so, but so many people come in after being treated elsewhere for PF and that is NOT what they have. No wonder their treatments weren't working)! There are some conditions that would disqualify for from receiving the OssaTron, especially those that involve bleeding disorders. See the Healthtronics web site for a complete listing. Its safety has not been determined on several conditions such as rheumatic arthritis, osteoporosis, etc. We had one insurance company deny the service because the patient had RSD. (The insurance co's - some of them- are really considering and investigating the treatment. We have had probably 70% of the insurance co's give the okay. We and Healthtronics are working on others. I don't have a list, I think it is different state to state).

Hope this helps!!

Dr. Reid

Re: To Dr Reid OssaTron

Dr. Zuckerman on 4/19/01 at 19:56 (045147)

I had a patient that had RSD. I was concerned that doing the ESWT which is additional trauma would be more harm. Do you more information or an opinion on ESWT for RSD.
Thanks,

Re: orbasone

Dr. Zuckerman on 4/16/01 at 13:18 (044727)

Hi,

Still using settings up to 18kv. Very few patients are needing local anesthetic. I will take it up to 18 kv. or even higher, the important aspect is do I feel good shock or pressure vibration into the area of treatment. I do start at about 12 kv for about 100-150 shocks then slowing move up to 16-18.

Re: To Dr Reid OssaTron

Pauline on 4/17/01 at 09:30 (044805)

Dr. Reid,
What are you using with the OssaTron. I remember reading that Dr Alzarez during the testing was giving 1000 shocks at 16kv and this was with
anaesthesia. Is this still the case. When it was approved for the treatment of soft tissue diseases did the FDA attach any criteria for its use that have to remain constant?

Re: To Dr Reid OssaTron

Dr. Marlene Reid on 4/18/01 at hrmin (045040)

Wow, I've been off for a few days and it seems as if weeks have gone by here at heelspurs.com.

Healthtronics has informed us that the FDA gave specific approval for the OssaTron at a setting of 18kv for 1500 shocks. We actually do 500 more in a circular motion beyond the central point. This does require some type of anesthesia, whether local only, local with sedation or sedation only.

Other requirements are:

*PF must be chronic, at least 6 months of duration
*At least 4 other forms of treatment must have failed
*Tarsal Tunnel Syndrome must be ruled out (although if a patient has secondary TTS due to the swelling of PF, I will still do ESW).

We have a whole questionaire we must submit to Healthtronics in order to get the okay to due the procedure. They have the right to deny treatment on individuals who do not truely qualify.

My biggest fear is that this procedure will become abused, i.e. used as an early form of treatment. Due to the high expense, in it is abused, we're all going to be in trouble. I have heard that was happening in Europe (Germany, I think). I am glad that docs are required to get clearance from Healthtronics first. I think that is very responsible of them. It does help prevent the machine being used on everyone and their brother who otherwise should not have the treatment. (It is similar to a hospital monitoring surgeons performance, skill and ethics which is what goes on when a surgeon does surgery in a hospital or ASC. So for those of you that have surgery in an ASC or hospital, you have some assurances to the quality of your surgeon).

Testing is under way for the treatment with the OssaTron for achilles tendonitis, I for one will not offer it for achilles tendonitis.

Everyone wants to know if they are a candidate. As long as you have PF and have had a THROUGH exam to rule out misdiagnoses (very common to be misdiagnosed- I would have never thought so, but so many people come in after being treated elsewhere for PF and that is NOT what they have. No wonder their treatments weren't working)! There are some conditions that would disqualify for from receiving the OssaTron, especially those that involve bleeding disorders. See the Healthtronics web site for a complete listing. Its safety has not been determined on several conditions such as rheumatic arthritis, osteoporosis, etc. We had one insurance company deny the service because the patient had RSD. (The insurance co's - some of them- are really considering and investigating the treatment. We have had probably 70% of the insurance co's give the okay. We and Healthtronics are working on others. I don't have a list, I think it is different state to state).

Hope this helps!!

Dr. Reid

Re: To Dr Reid OssaTron

Dr. Zuckerman on 4/19/01 at 19:56 (045147)

I had a patient that had RSD. I was concerned that doing the ESWT which is additional trauma would be more harm. Do you more information or an opinion on ESWT for RSD.
Thanks,