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ossatron esw treatment update

Posted by Dr.Kosova on 5/05/01 at hrmin (046697)

Hi everyone,
I would like to share some observations of the post esw treatments that we have given our patients .The patient's fill out a pain level scale sheet prior to having the treatment. This is the same pain scale that are outpatient hospital uses to evaluate the pain of their patients. I run a foot and ankle clinic for this hospital.. Our patients fill out this pain sheet also at the two-week mark, one month Mark, 2 month Mark, three month Mark and the six-month and one year. Not all patients are coming in exactly at these intervals but you get the idea.

I have had only one patient take her extra strength Tylenol for more then two days. The majority of the patients either took it that night of the procedure or nothing at all. At the two-week mark it seems that the majority of patients have a 50 to 65% improvement of their pain. Many patients had actually reported higher than 80% improvement. At the one month Mark most patients are about 65 to 80% improved. At the two month Mark the patient that work on their feet standing report at the 80% improvement while working but claim closer to 100% improvement when they are not working. At the three month Mark it seems that most patients claimed to be close to pain free if they are wearing their orthotics and doing their daily stretches. My post ESW treatment patients have become my best and most compliant patients for doing their daily plantar fascia isolated stretches and the Achilles tendon stretches. So far only one patient has had local anesthesia with aankle block all the other patients had local anesthesia with sedation. This was the choice of the patients.

Myself and Dr. Reid have also been attempting a study utilizing diagnostic ultrasound for diagnosis and visualization of the inflammation and microtears that occur with plantar fasciitis. I also uses this modality for diagnosis of ligament and tendon tears around the ankle and foot. We can also measure the amount of inflammation that occurs. And also the thickness of the plantar fascia. A normal plantar fascia thickness is around 3.5 cm. When there is inflammation in from plantar fasciitis we're seeing anywhere from five to twelve cm. After ESWT treatment we're noticing a decrease of the inflammation in thickness of the plantar fascia. We're trying to do this on a regular basis at the one month Mark and three month Mark six-month in one year interval. To my knowledge there is a doctor in California that is doing a similar type study utilizing MRI.

It is interesting to see that the patients that perceive that they are not getting any better have all rated their pain lower on subsequent visits. These same patients also are reporting a higher activity rate than the ever had in the last two to three years. Even when I do direct palpation to their plantar fascia we're previously they would scream or lift themselves off the treatment chair they report no pain or slight tenderness and do not move at all. These same patients all have had subsequent Achilles tendinitis or posterior tibial tenderness along with the plantar fasciitis prior to treatment. When I asked them to point to the source of pain it is usually in the back of the heel we're the Achilles tendon attaches to the heel bone or that the insertion of the poster tibial tendon to the foot. My worst patient overall who had to take steroids as the only source for pain relief and had requested Demerol, (which I did not give her ), so she could go on a business trip at the one month Mark reported about a 50% improvement and when they went to palpate her plantar fascia she had no pain. This was the same patient that I would gingerly touch her plantar fascia and she would jump off the chair.

To say the least we are very encouraged with the results so far. We're also very happy that Healtronics has decided to lower the price for the ESW treatments. It is almost half of where it started three months ago.

In the latter part of May or early June several articles will be published on the results of the Ossatron thus far. I believe that Dr. Weil is doing several studies on the Orbasone including its effect on animal tissue.

I am still seeing about 50% of the patients coming to my office for ESWT treatment, were misdiagnosed and have posterior tibial dysfunction or tendinitis or some other ailment. The same patients were treated for plantar fasciitis including injections orthotics etc and probably never had plantar fasciitis in the first place.

My patients that do isolated plantar fascia stretching with no other treatment except wearing shoes around the house that they did not do before and decreasing activity and utilizing a heel cup are reporting about a 50% improvement in one to two weeks. These patients usually have had plantar fasciitis for less than three months.

The only major negative with ESWT treatments is that Blue Cross is still not willing to pay for this technology. I have several patients that are having their own lawyers discuss this matter with Blue Cross. We have close to a 30 patient waiting list just of Blue Cross patients. Several of those same patients have decided to pay out-of-pocket for the procedure.Healthtronics is having all the patients now fill out forms describing all their previous treatments they have failed prior to shockwave therapy so that they can accumulate enough data to present back to the insurance companies that have neglected to pay for this procedure. I strongly encourage patients especially of HMOs to contact their carriers pushed them to pay for the procedure.

Sorry to be so long-winded but it has been awhile. Again these are only observations that will be formed into studys when enough data is collected.

I hope this helps.

Dr. Lawrence Mark Kosova
.

PS: To do a placebo esw wouldnt you have to created a esw absorber to take up the shock. This is what Healtronics did to some effect in their studies. My own feelings is that some of these shocks probably were not absorbed that well and thats why the fda results compared to the control group were so little,48 compared to 65%.Just a theory.

Re: ossatron esw treatment update

Scott R on 5/05/01 at 16:18 (046701)

I'll make a link to Dr. Kosovo's update on the ESWT page.

Re: ossatron esw treatment update

Pauline on 5/05/01 at 16:26 (046702)

Dr.Kosova.
I greatly appreciate the fact that you and Dr. Reid are collecting data
that will eventually be turned into studies. I'm sure you wouldn't do
it if you didn't see the need. Now we all need to push for insurance coverage. I don't think it's too far off.

Re: What about the patients who had both PF and PTT or AT?

Beverly on 5/05/01 at 16:45 (046705)

Dr. Kosoova,

Thank you for that detailed report... very encouraging.

Did some of your EWST patients have both PTT and AT? I ask that because I have all three. I've been trying to clear up or at least improve the tendonitis before I do EWST for the PF. I'm afraid that if I do that before I get the tendonitis under control, I'll 'waste' the EWST.
At present, I'm in a very supportive ankle brace (Rocket Soc). I have all three of these things bilaterally (although the AT is a new development that came last month after having two months of semi-recovery.)
Thanks,
Beverly

Re: What about the patients who had both PF and PTT or AT?

Dr. Kosova on 5/05/01 at hrmin (046708)

Hi Beverly,
Many pts have what you have or combinations. I see this as more normal then not. Few pts have just isolated pf in my practice or maybe Im just looking for the other problems where their previous drs did not.

I agree with you to treat the other problems first. The pts that I am talking about have mild cases of those problems. And had tx to decrease those problems. Its funny though many pts tell me that after esw tx that those problems are alot better. I did Ossatron esw to myself without anesthesia and even though I could not get up to fda levels( do to pain)I could feel the shocks go up my achilles tendon and post.tibial somewhat 4-5cm above the ankle joint.

Good Luck.

Dr. Kosova

Re: Really glad that the results are going weel

Dr. Zuckerman on 5/05/01 at 17:50 (046709)

Glad that the results are coming along. Sure wish you would convert this to
the present progress report or ask patients to fill the heelspur.com .

Re: To Dr. Kosova re. Insurance coverage

Pauline on 5/05/01 at 19:07 (046718)

Dr.Kosova,
If I wanted to check out my own insurance company to see if they would
cover ESWT do I have to give them a special code for it or just ask under the treatment name?

Re: Really glad that the results are going well

Scott R on 5/05/01 at 19:14 (046719)

Dr Kosova probably doesn't need to post patient progress reports at heelspurs.com if they are planning to publish in a journal. Usually, one of the requirements for publishing is that they do not publish the results elsewhere. heelspurs.com may have an image problem (hopefully because it's patient rather than professionally focused).

Re: ossatron esw treatment update

john h on 5/05/01 at 19:39 (046722)

dr kosova: a very informative and positive post. i was unaware the healthrtonics had lowered their price significantly.

Re: Really glad that the results are going well

john h on 5/05/01 at 19:41 (046723)

scott: 'we have an image problem'? my image of heelspurs .com is that it is the best most informative and uplifting board i participate in or access.

Re: What about the patients who had both PF and PTT or AT?

john h on 5/05/01 at 19:44 (046724)

dr kosovo: have you ever noticed any correlation between PF and hallux limitus/rigidus. i developed hallux limitus in both feet before i developed PF which of course prevented the normal stretching of the fascia.

Re: Really glad that the results are going well

Dr. Zuckerman on 5/05/01 at 20:58 (046736)

Writing in journals I could do this . But my satisfaction will come from patients being cured at a fair price with ESWT.

Re: To Scott

Pauline on 5/06/01 at 07:42 (046753)

Are you making light of Dr. Kosova desire to publish in a journal. I feel you might have been encouraging negative responses to the idea that studies were being conducted. Hopefully I am wrong about your intent.

Re: To Dr. Z Really glad that the results are going well

Pauline on 5/06/01 at 07:51 (046754)

Everyone satisfaction comes is various ways I guess, but you know I never heard a researcher refer to their published studies as a form of personal satisfaction, but rather a contribution to science.

Re: Really glad that the results are going weel

Dr. Kosova on 5/06/01 at hrmin (046765)

David,

I tell all my pts about posting their results. We have them fill out our survey in the office. We were thinking about copying scotts survey and have them fill it out but how did you get all them to post or did your office do it for them. I dont have the time to do it myself. Even other drs. that are doing this alot dont have their pts results reported. Whats your secret. The last couple of months I have NOT told my pts to come to this site for obvoius reasons. Hopefully now I can.

Re: To Dr. Kosova re. Insurance coverage

Dr. Kosova on 5/06/01 at hrmin (046766)

Pauline,
If you do it yourself it will probably get denied. The approval process can take 2-3months. If you are a police officer or fireman it takes 1-2 weeks!! You can call my office 630-852-8650 and ask Rose for help. If you have a hmo forget it. Aetna is making their own code for the procedure. I dont treat insurance companies. I treat patients all the same no matter what Insurance or if they dont have insurance.

Dr. Kosova

Re: Really glad that the results are going well

Dr. Kosova on 5/06/01 at hrmin (046768)

Scott,

I am willing to have pts post and I do tell them to do so but it is up to them not me. We were concidering copying your information to do this. Do I need your approval first? Our web site is being tweaked could I copy it to there? My pts are using this site for various info about ankle and foot problems but it is not done and will change alot in the next several weeks.I do have the video of my personal esw experience but need to edit it from 13 minutes to 2-3 minutes,any suggestins. It is on cd-rom format using windows media to open it. I dont thick people want to see Marlene trying to put my foot on the Ossatron and me pulling away and our marital agruing about this.

Thanks,
Dr. Kosova

Re: To Pauline

Scott R on 5/06/01 at 09:56 (046769)

Pauline, what's the purpose of your post? Is it about ESWT or foot pain? Is it useful to anyone? Was it nice?

Re: Really glad that the results are going weel

Dr. Zuckerman on 5/06/01 at 10:02 (046770)

Good Question.

We have patients either fill out the survey with the help of one of my assistants( we copy the heelspurs.com
form). The survey is filled out either by mail, in the office (best place it is on the patients mind). We call pateints to follow up at least for one year. We ask them to fill this out during the follow up calls. They take place about once every two weeks.

I find that the Doctor must ask the patient to fill out the form. when in the office. I tell the patient why we are doiing this and I tell them about heelspurs.com This way the pateint will take the time then. I don't personally ask the questions i then finish with asking them if they don't mind if one of my assistants come in with this survey . The key is the doctor telling them why the form and that they don't have to use their name on the form

Yes it does take time but I really think this is important.

In my own opinion this form is equal if not better then alot of survies that I have seen used with article published in either the APMA journal or the ACFAFS journal and these are excellent journels.

Re: What about the patients who had both PF and PTT or AT?

Dr. Kosova on 5/06/01 at hrmin (046771)

John H,

I am amazed at your understanding of the issuses. There was a surgoen from Italy or France at the World congress ankle and foot meeting in Chicago In 1996 I believe,that would cut the pf at the high arch level for his pts that had limatation of motion at the first mpj.(Great toe joint). Yes I think their is a direct correlation do to the non stetch ablity of the pf. This would be a good study when we are examing are pts. I was actually thinking about doing this but never put it on paper per se. Since I have a young pt population I can tell you that I have not seen this with our ESWT pts. But I had a pt the other day with hallus limitus and I was amazed at how tight her pf was but she did not have heel pain.

It is my understanding that the total Ossatron tx is about $3500 including drs fee,room fee, anesthesia fee and machine fees. Lab fee not included or other test if needed. This came from Roy Brown President of Heathtronics. We have lowered are pricing to make this happen. I hope I am not misstating anything. They are trying to make it more accesible.

Dr. Kosova

Re: Really glad that the results are going well

Scott R on 5/06/01 at 10:24 (046774)

Dr Kosova, you probably should just make a link to the following page:
http://heelspurs.com/eswt/patients.cgi?go=add&id=78

And add any introductory information above the link (such as disclaimer or background informatino of some sort if you feel it's necessary).

If you simply save the above page and transfer it onto your website, it will work when they fill it out online, but I don't think there is any reason to do this instead of just making the link.

I think the best option is to print it out, make copies, and have them fill it out at the time of the first visit. On subsequent visits, they would fill out the other form. I'll work on getting the forms fixed specifically for this since the current form has some confusing aspects and it comes out on two pages instead of one.

Re: To Dr. Z Really glad that the results are going well

john h on 5/06/01 at 11:11 (046777)

I think 'personal satisfaction' to important in any endeavor! if you do not derrive some personal satisfaction out of any endeavor it is unlikely you will do it very well. this post appears to me to be a bullet aimed directly at dr zuckerman and serves no purpose other than to inflame emotions. i hope all my doctors receiver personal satisfaction in thier work and in particular treating me.

Re: To Scott

john h on 5/06/01 at 11:16 (046778)

pauline you seem to always be in the attack mode sometime subtile and sometimes not. do you derrive 'personal satisfaction' out of this. to offer up counter opinions can be productive but to do it in the manner you sometimes do borders on being just plain 'rude'. in the 3 years i have followed this board i have never made such a statement. of course, as i have said everyone has the right to post what they want and each of us has tthe right not to read the post.

Re: ossatron esw treatment update

JudyS on 5/06/01 at 11:48 (046781)

Thank you, Dr. Kosova, for your detailed report here. It will become one more tool in my collection for 'educating' my Pod(s) about ESW.

Re: What about the patients who had both PF and PTT or AT?

Pauline on 5/06/01 at 14:29 (046796)

Certainly better pricing than quotes that were out there. It's nice to
see this happening.

Re: Thanks for the new pricing information

Dr. Zuckerman on 5/06/01 at 15:19 (046803)

This is going to be very helpful for patients that want the hospitization.

Do you have a copy of this letter. I am still using the old pricing manuel and haven't received anything in writing. Would appreciate faxint any thing you mayb have at 1-856-848-5122 I was wondering if if is possible to use the short procedure unit instead of the OR . The short procedure unit is less expensive and is used for short procedures sucha s laser foot surgery and biopsy studies. Most ASC have this available. Many of my GI friends use this same room and use Demeral/versed instead of the anesthologist use of more sedation. This could be another way to bring the room charge down.

Re: To Dr. Kosova re. Insurance coverage

Kim B. on 5/07/01 at 02:31 (046847)

One Doctor I spoke with told me that in many cases, they will be adjusting the price downward for persons who are without any insurance coverage at all. I hope other generous doctors will follow this lead.

Regards, Kim B.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at hrmin (046850)

Unfortunately, some information in the ESWT patient progress report database is intentionally incorrect. I got this information directly from the patient for whom the information is about. Knowing about this has disturbed me for some time now, especially considering that some here choose to site the database as a source of factual information on a regular basis.

This intentional breech of truthfulness tarnishes the intire database in my opinion. Where there is smoke there is fire. What else is incorrect or skued? I'm sorry to have to say this, and if it was't true, there would be no need for me to post this. The fact is, that the database is unscientific, and the information is too easily manipulated to serve one or more persons hidden agenda(s).

I will not post the specifics here, as I am not informing the board members of this to inflame anyone, just to inform other PF suffereres about this, and to let Dr. Kosova know that he will be adding clean data to an already tairnished database if he has his patients particpate in this database in the future.

Scott, I suspect that you are unaware of this, and if you are interested in knowing specifically what I am refering to, I will revail them to you upon your request.

Sincerely, Kim B.

Re: To Dr. Kosova re. Insurance coverage

Pauline on 5/07/01 at 06:56 (046857)

Wow Kim, this is good news.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 07:39 (046859)

Kim, Yes, I would like to know if any portion of the database is incorrect. I need to know the name of your 'informant' to see if I have a signed copy of their information on file.

Re: To Dr. Kosova re. Insurance coverage

Scott R on 5/07/01 at 07:42 (046861)

Pauline, why would an innaccurate database of patient information be good news to you? Assuming a patient was not helped as much as reported, why would it be good news to you that a patient may have been hurt?

Re: To Dr. Kosova re. Insurance coverage

wendyn on 5/07/01 at 07:52 (046862)

Scott - I am guessing that she is referring to Kim's comment about the price being adjusted downward. Same thread. Different post.

Re: To Dr. Kosova re. Insurance coverage

Scott R on 5/07/01 at 07:55 (046863)

Thanks, oops.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 07:57 (046864)

Since all Dr. Z's patients have signed a form testifying to the accuracy of the information, we have to assume it's not one of his if you don't provide a name. Also, the patient can post a correction to the database anytime they want, with an explanation of whatever they've told you. I don't see any reason why they would want to hide unless they are lying.

Re: To Scott Kosova re. Insurance coverage

Pauline on 5/07/01 at 09:07 (046871)

Scott,
I was refering to the news about the rates being adjusted. Would you please correct your statement. You sure like to jump on me for nothing. If I remember correctly Kim did mention a doctor saying the rates would be adjusted for patients. To me that is good news. I don't know anything
about the patients records being incorrect. That's between you and Kim.
Leave me out of that.

Re: Concern for the accuracy of the ESWT patient progress report database.

john h on 5/07/01 at 09:47 (046876)

kim: i myself have never considered anything on the board scientifically accurate. I use it all as a 'guide' in making decisions about my condition. you are correct in that there are people who may post something not to be factual and probably more than one. that is why scott puts his disclaimers on the board. there are probably some acceptable scientific studies in Germany on ESWT and the FDA conduted its study using the scientific method. I still like to talk to people who have been there and done that. ESWT is still very much in its infancy and the doctors and scientist are learning on the fly. As agent Scully says 'The Truth is Out There'.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at hrmin (046878)

Scott, I can tell you for sure it's not a typo. It's not outdated information that hasn't been updated either. It was incorrect the day it was entered and it was intentionally entered incorrectly. It may even seem like a minor iinfraction to some, but to me, and maybe others, it is an example of at least one instance that the integrity of your database was not respected. Who knows how many other infractions there are.

I wish there was some way of making sure that all the infromation was factual. The data base itself was a great idea if only the promise (assumption) of all the information being accurate had not been compromised. As you know, and others can see, incorrect answers affect all of your averaging.

This in mind, I see plently of opportunity and motivation for someone to 'fudge' the facts to make things more favorable for themself or someone that they are highly supportive of.

Would you like me to post what I know here, or email you back board? I assumed you would prefer it backboard, but your line of questioning gives me the impression that you want me to post what I know here.

Kim B.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at 10:03 (046881)

John, first allow me to Thank you for addressing my concern without biting my head off for posting what I know. It is a breath of fresh air. In response to your input, one of the reasons I felt I needed to bring this issue up is because some people here site the database as a source of factual information. It is misleading to do so. Many of us look at the information through 'oldtimer eyes'. However, Newbies will consider it factual information because that is what it is often represented as. My concern is for the people that are making important (and expensive) decisions based on what they learn here. It's sad that there may be a need for a disclaimer to be attached the database information as well. Personally, I wish it was a true and factual database. It would have been a very valuable resource of information had this been the case.

Regards, Kim B.

Re: To Scott Concern for the accuracy of the ESWT patient progress report database.

Pauline on 5/07/01 at 10:30 (046891)

Scott,
please see what I wrote on the heelspurs.com board before you ask Kim to post. I think a lot of hurt could and should be avoided.

Re: ossatron esw treatment update

cindy k h on 5/07/01 at 11:14 (046895)

Dr. Kosova...where are you located?

Re: What about the patients who had both PF and PTT or AT?

john h on 5/07/01 at 11:30 (046899)

dr. weil told me he gave himself a few shockwaves also. i am anxious to see what the shockwaves will feel like after the first 10 or so shocks without any ankle blocks. the ankle blocks were really painless and wore off in about 3 hours so if it is to bad i will just have dr. zuckerman give me some shots. if one tries to tough it out through pain they will tend to move their feet and not keep the foot against the head of the machine and lose some effectivness of the treatment. for those who have not had the treatment the shockwaves are very powerful. john w pointed out that the depth of the focal point and its width is controlled by the shape of the head. i should have know that from my training in radar. are there different heads that can be purchased for the machine if you wanted to change the focal point of the shockwave?

Re: To Scott Kosova re. Insurance coverage

Scott R on 5/07/01 at 11:35 (046901)

Sorry Pauline. I jump to the conclusion that you talking about Kim's other post.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 12:01 (046905)

Kim, stop slinging wild accusations about. Email me what you have to say and I'll look into it. If you were interested in the truth you could have emailed me to gather more information and look into it before attacking. As I said before, your 'informant' can correct the information online at anytime! So what's the point of an attack? You can't go about calling a doctor a fraud in a public forum and not expect a lawsuit for damages. I'll probably have to endure a supoena so that they can estimate damages. At the least they can estimate lost income from cancelled appointments. Your health insurance doesn't cover those appointments!

Re: Really glad that the results are going well

JudyS on 5/07/01 at hrmin (046915)

Dr. K - I am a film/video editor by education and former trade....I'd be happy to edit your CD per your requirements if you need a helping hand.

Re: To John

Pauline on 5/07/01 at 14:40 (046920)

Dornier's brochure says it has an ultrasound tranducer to scan an image to the monitor of the ultrasound system to indicate where the shock waves are being delivered. Do know if all the machines have this ultrasound system? I wonder if this means they can see on a screen then where the waves are being delivered. I haven't seen this machine yet although my doctor says he still has it. They a waiting for approval. He did say it can be used in the arch area as well as the insertion location. Maybe it's the ultrasound system that allows that, I don't know. Smart of Dornier not to remove it once they have it in a hospital. They are less likely to consider another machine if that one is already in place.

Re: FOUL #3 on Kim (pending review)

Scott R on 5/07/01 at 14:44 (046921)

Kim, consider this your 3rd foul (unless I retract based on your subsequent emails) and don't post anymore. Here is the problem: Defamation of character can occur even if a person isn't named but can be surmised from the given circumstances. We are all pretty sure Dr. Z is still at least a portion of your target. Truth is your only protector from legal action based on charges of libel. It is libel instead of slander because this is a written public forum, and more stringent evidence is required to demonstrate truth in the case of libel. Since I have signed documents from all Dr. Z's patients, it would require another signed document from that individual in order to protect you from legal action, if protection turns out to be necessary. That's entirely up to Dr. Z. Your posts have shown a clear sense of malicious which may make you subject to punitive in addition to actual damages. Since I have a 'be nice' rule, that may prevent Dr. Z from responding to your posts, I am in effect controlling content which makes me also liable for your malicious libel.

I don't make any warranties about the accuracy of the 6 databases at heelspurs.com. When designing them, I believed people would be able to think for themselves when reviewing the data and see that such open systems are for fun and interest more than proof of anything.

Re: To John

john h on 5/07/01 at 15:01 (046927)

i am sure it would take an engineer who designed the conical cone to figure out exactly where the focal point of the ESWT energy waves are concentrated. the reason i even bring up the subject is that if we have someone with dainty feet like canadian Kim and then bring in a 300 lb offensive lineman both who have PF you would probably want a different focal point in depth. it may be that the focal point is so large that it really makes no difference. we do know from most of the manufacturers that the size in area being treated is about the size of a dime so it is important to accurately direct the shockwave beam on your sore spot. I think dr zuckerman told me he now treats more than just one spot if the patient indicates the spot is bigger than the size of the beam. i do not know how wide the fascia is in a normal size foot (4'?) but could you treat 2' rather than a dime size spot without doing to much damage?

Re: To John

Pauline on 5/07/01 at 15:08 (046931)

Does that mean that the ultrasound that is on their machine would actually project on a screen the focal point depth while the patient is being treated. Shorter for smaller person, deeper for larger? Is it possible for a smaller person to have their pain localized at a deeper depth than a larger person? More involved tissue deeper depth of pain???

Re: FOUL #3 on Kim (final)

Scott R on 5/07/01 at 16:41 (046948)

After reviewing some legal information, I've come to the conclusion that at least 4 of Kim's posts are illegal and not defensible in court. The warnings and explanations I mentioned earlier to Kim apply doubly because Dr. Z's career depends on such things not being said so carelessly and publicly. In the future, I'll be more stringent about making sure posts are nice and not let claims to truthfulness override blocking such posts so easily. What made Kim's posts difficult to block is that part of her accusations against Dr. Z was that I was a part of his alleged .... misdeeds. I'm sure this figured into her calculations. I recommend that those who need kim's posts for legal reasons (evidence) save them now in case Dr. Z requests that I remove them.

Re: To Scott FOUL #3 on Kim (final)

Pauline on 5/07/01 at 16:52 (046950)

Scott,
I don't get it. Exactly who saves what. If your not on the patients report do we have to save anything? What happens if all this goes public in court? I want to save if I'm suppose to save but I don't know what I'm suppost to save. Help!

Re: To Dr. Kosova re. Insurance coverage

DeniseA on 5/07/01 at hrmin (046957)

Why is this good news? Intentional misreporting wouldn't be positive from any viewpoint.

Entry errors are possible from patients or someone keying in for them. Was the error reported and asked to be fixed? The database can be fixed at any time.

No doubt the survey is FYI. There is no control that would make it a 'study' type resource. This tool is still an excellent one for patient research. If an error happened, let's just fix it.

If it turns out that there was intentional misrepresentation that should be dealt with. Let's not just go all out here without breathing and handling this responsibly.

Re: To Scott Kosova re. Insurance coverage

DeniseA on 5/07/01 at hrmin (046959)

It was the order of the message Pauline. I also misunderstood. Sorry about that.

Re: Scott, Get a GRIP!

Kim B. on 5/08/01 at 01:07 (046990)

Scott,

I certianly didn't mean to imply that Dr. Z. himself had input any data incorrectly! (I don't know if he has or has not for that matter.) It was my understanding that Dr. Z didn't have to put all of the info in for his patients because each person could input their own data if they were computer literalte and wanted to do so.

Nor was I trying to 'attack' Dr. Zuckerman. I thought we were all back on track and posting as mature adults again. I had a legitmate concern based on first hand information and so I posted it here in the interest of newbies, and people like Dr. Kosova, who are being led to believe that the database is FACTUAL.

At first you seemed interested in my concern regarding the fact that some of the information in the database is contrary to what someone who posted in it has told me personally. You seemed genuinely intersted in knowing more about it, so that you check in to it. I simply hesitated and double checked with you, because I just didn't think it wise for me to post the specifics here at the board, as it seemed at first that you might have been expecting me to. (After thinking it over for myself, I realized THAT could easily be mistaken for slandor.)

Whatever the case, in the meantime, you do a 180 turn on me! Slap yourself 3 times!! Wake up!! Geeezee. I even said in my post that I suspect that YOU are unaware of the incorrect information. Where did you get that I am involving you in anything 'malice'? That car in your front yard must have rocked your house, and toppled a lamp on to your head. You are single handedly reading all kinds of things into this thread that simply weren't intended to be there.

It appears to me that you've decided that you don't even care what the incorrect information is anymore, you just don't want anything here to be pointed out as questionable for any reason, even if it has warrant. Have it your way. So much for the open forum idea.

Kim B.

Re: ossatron esw treatment update

Terrie on 5/13/01 at 17:07 (047659)

I don't trust a doctor who can't spell.
Terrie,R.N.

Re: ossatron esw treatment update

Dr. Zuckerman on 5/13/01 at 17:34 (047662)

Have no idea if you are talking about Dr. K or not. I am Dr. Z can't write or spell but I can cure heel pain. Been doing that for 22 years. I can't sing or dance either. Well singing that an opinion. So have a nice motherr days oh! it only one r I think!!

Re: ossatron esw treatment update

Julie on 5/14/01 at 01:40 (047683)

Terrie, first, why on earth not?

Second - there is one rule on this website. It is: Be Nice.

Re: ossatron esw treatment update

Kay S on 5/14/01 at 07:16 (047696)

What if it's just a problem with typing?
I am also a nurse, and if I didn't trust any docs who couldn't spell, I'd be out of a job. Some of them can't speak clearly either.
It's the same as saying no one would trust a nurse who wasn't dressed in white. Or pretty. Or smiled. Or could roller blade.
WHO CARES?
Thank you, Dr. Z and Dr. K and Dr. R and Dr. B for all the helpful information you give to us at heelspurs.com. Most of us appreciate all you do, whether or not you can spell. I have never had any trouble figuring out exactly what you mean. (years of practice!) I bet I could even read your writing!
Kay

Re: Re:Kay I bet your can't read my writing

Dr. Zuckerman on 5/14/01 at 19:16 (047745)

Want to take a bet. When your are in my office. We will have a translation contest. The winner will get. Well let's see how you do first. This is something I am willing really bet on!!!

Re: ossatron esw treatment update

Scott R on 5/05/01 at 16:18 (046701)

I'll make a link to Dr. Kosovo's update on the ESWT page.

Re: ossatron esw treatment update

Pauline on 5/05/01 at 16:26 (046702)

Dr.Kosova.
I greatly appreciate the fact that you and Dr. Reid are collecting data
that will eventually be turned into studies. I'm sure you wouldn't do
it if you didn't see the need. Now we all need to push for insurance coverage. I don't think it's too far off.

Re: What about the patients who had both PF and PTT or AT?

Beverly on 5/05/01 at 16:45 (046705)

Dr. Kosoova,

Thank you for that detailed report... very encouraging.

Did some of your EWST patients have both PTT and AT? I ask that because I have all three. I've been trying to clear up or at least improve the tendonitis before I do EWST for the PF. I'm afraid that if I do that before I get the tendonitis under control, I'll 'waste' the EWST.
At present, I'm in a very supportive ankle brace (Rocket Soc). I have all three of these things bilaterally (although the AT is a new development that came last month after having two months of semi-recovery.)
Thanks,
Beverly

Re: What about the patients who had both PF and PTT or AT?

Dr. Kosova on 5/05/01 at hrmin (046708)

Hi Beverly,
Many pts have what you have or combinations. I see this as more normal then not. Few pts have just isolated pf in my practice or maybe Im just looking for the other problems where their previous drs did not.

I agree with you to treat the other problems first. The pts that I am talking about have mild cases of those problems. And had tx to decrease those problems. Its funny though many pts tell me that after esw tx that those problems are alot better. I did Ossatron esw to myself without anesthesia and even though I could not get up to fda levels( do to pain)I could feel the shocks go up my achilles tendon and post.tibial somewhat 4-5cm above the ankle joint.

Good Luck.

Dr. Kosova

Re: Really glad that the results are going weel

Dr. Zuckerman on 5/05/01 at 17:50 (046709)

Glad that the results are coming along. Sure wish you would convert this to
the present progress report or ask patients to fill the heelspur.com .

Re: To Dr. Kosova re. Insurance coverage

Pauline on 5/05/01 at 19:07 (046718)

Dr.Kosova,
If I wanted to check out my own insurance company to see if they would
cover ESWT do I have to give them a special code for it or just ask under the treatment name?

Re: Really glad that the results are going well

Scott R on 5/05/01 at 19:14 (046719)

Dr Kosova probably doesn't need to post patient progress reports at heelspurs.com if they are planning to publish in a journal. Usually, one of the requirements for publishing is that they do not publish the results elsewhere. heelspurs.com may have an image problem (hopefully because it's patient rather than professionally focused).

Re: ossatron esw treatment update

john h on 5/05/01 at 19:39 (046722)

dr kosova: a very informative and positive post. i was unaware the healthrtonics had lowered their price significantly.

Re: Really glad that the results are going well

john h on 5/05/01 at 19:41 (046723)

scott: 'we have an image problem'? my image of heelspurs .com is that it is the best most informative and uplifting board i participate in or access.

Re: What about the patients who had both PF and PTT or AT?

john h on 5/05/01 at 19:44 (046724)

dr kosovo: have you ever noticed any correlation between PF and hallux limitus/rigidus. i developed hallux limitus in both feet before i developed PF which of course prevented the normal stretching of the fascia.

Re: Really glad that the results are going well

Dr. Zuckerman on 5/05/01 at 20:58 (046736)

Writing in journals I could do this . But my satisfaction will come from patients being cured at a fair price with ESWT.

Re: To Scott

Pauline on 5/06/01 at 07:42 (046753)

Are you making light of Dr. Kosova desire to publish in a journal. I feel you might have been encouraging negative responses to the idea that studies were being conducted. Hopefully I am wrong about your intent.

Re: To Dr. Z Really glad that the results are going well

Pauline on 5/06/01 at 07:51 (046754)

Everyone satisfaction comes is various ways I guess, but you know I never heard a researcher refer to their published studies as a form of personal satisfaction, but rather a contribution to science.

Re: Really glad that the results are going weel

Dr. Kosova on 5/06/01 at hrmin (046765)

David,

I tell all my pts about posting their results. We have them fill out our survey in the office. We were thinking about copying scotts survey and have them fill it out but how did you get all them to post or did your office do it for them. I dont have the time to do it myself. Even other drs. that are doing this alot dont have their pts results reported. Whats your secret. The last couple of months I have NOT told my pts to come to this site for obvoius reasons. Hopefully now I can.

Re: To Dr. Kosova re. Insurance coverage

Dr. Kosova on 5/06/01 at hrmin (046766)

Pauline,
If you do it yourself it will probably get denied. The approval process can take 2-3months. If you are a police officer or fireman it takes 1-2 weeks!! You can call my office 630-852-8650 and ask Rose for help. If you have a hmo forget it. Aetna is making their own code for the procedure. I dont treat insurance companies. I treat patients all the same no matter what Insurance or if they dont have insurance.

Dr. Kosova

Re: Really glad that the results are going well

Dr. Kosova on 5/06/01 at hrmin (046768)

Scott,

I am willing to have pts post and I do tell them to do so but it is up to them not me. We were concidering copying your information to do this. Do I need your approval first? Our web site is being tweaked could I copy it to there? My pts are using this site for various info about ankle and foot problems but it is not done and will change alot in the next several weeks.I do have the video of my personal esw experience but need to edit it from 13 minutes to 2-3 minutes,any suggestins. It is on cd-rom format using windows media to open it. I dont thick people want to see Marlene trying to put my foot on the Ossatron and me pulling away and our marital agruing about this.

Thanks,
Dr. Kosova

Re: To Pauline

Scott R on 5/06/01 at 09:56 (046769)

Pauline, what's the purpose of your post? Is it about ESWT or foot pain? Is it useful to anyone? Was it nice?

Re: Really glad that the results are going weel

Dr. Zuckerman on 5/06/01 at 10:02 (046770)

Good Question.

We have patients either fill out the survey with the help of one of my assistants( we copy the heelspurs.com
form). The survey is filled out either by mail, in the office (best place it is on the patients mind). We call pateints to follow up at least for one year. We ask them to fill this out during the follow up calls. They take place about once every two weeks.

I find that the Doctor must ask the patient to fill out the form. when in the office. I tell the patient why we are doiing this and I tell them about heelspurs.com This way the pateint will take the time then. I don't personally ask the questions i then finish with asking them if they don't mind if one of my assistants come in with this survey . The key is the doctor telling them why the form and that they don't have to use their name on the form

Yes it does take time but I really think this is important.

In my own opinion this form is equal if not better then alot of survies that I have seen used with article published in either the APMA journal or the ACFAFS journal and these are excellent journels.

Re: What about the patients who had both PF and PTT or AT?

Dr. Kosova on 5/06/01 at hrmin (046771)

John H,

I am amazed at your understanding of the issuses. There was a surgoen from Italy or France at the World congress ankle and foot meeting in Chicago In 1996 I believe,that would cut the pf at the high arch level for his pts that had limatation of motion at the first mpj.(Great toe joint). Yes I think their is a direct correlation do to the non stetch ablity of the pf. This would be a good study when we are examing are pts. I was actually thinking about doing this but never put it on paper per se. Since I have a young pt population I can tell you that I have not seen this with our ESWT pts. But I had a pt the other day with hallus limitus and I was amazed at how tight her pf was but she did not have heel pain.

It is my understanding that the total Ossatron tx is about $3500 including drs fee,room fee, anesthesia fee and machine fees. Lab fee not included or other test if needed. This came from Roy Brown President of Heathtronics. We have lowered are pricing to make this happen. I hope I am not misstating anything. They are trying to make it more accesible.

Dr. Kosova

Re: Really glad that the results are going well

Scott R on 5/06/01 at 10:24 (046774)

Dr Kosova, you probably should just make a link to the following page:
http://heelspurs.com/eswt/patients.cgi?go=add&id=78

And add any introductory information above the link (such as disclaimer or background informatino of some sort if you feel it's necessary).

If you simply save the above page and transfer it onto your website, it will work when they fill it out online, but I don't think there is any reason to do this instead of just making the link.

I think the best option is to print it out, make copies, and have them fill it out at the time of the first visit. On subsequent visits, they would fill out the other form. I'll work on getting the forms fixed specifically for this since the current form has some confusing aspects and it comes out on two pages instead of one.

Re: To Dr. Z Really glad that the results are going well

john h on 5/06/01 at 11:11 (046777)

I think 'personal satisfaction' to important in any endeavor! if you do not derrive some personal satisfaction out of any endeavor it is unlikely you will do it very well. this post appears to me to be a bullet aimed directly at dr zuckerman and serves no purpose other than to inflame emotions. i hope all my doctors receiver personal satisfaction in thier work and in particular treating me.

Re: To Scott

john h on 5/06/01 at 11:16 (046778)

pauline you seem to always be in the attack mode sometime subtile and sometimes not. do you derrive 'personal satisfaction' out of this. to offer up counter opinions can be productive but to do it in the manner you sometimes do borders on being just plain 'rude'. in the 3 years i have followed this board i have never made such a statement. of course, as i have said everyone has the right to post what they want and each of us has tthe right not to read the post.

Re: ossatron esw treatment update

JudyS on 5/06/01 at 11:48 (046781)

Thank you, Dr. Kosova, for your detailed report here. It will become one more tool in my collection for 'educating' my Pod(s) about ESW.

Re: What about the patients who had both PF and PTT or AT?

Pauline on 5/06/01 at 14:29 (046796)

Certainly better pricing than quotes that were out there. It's nice to
see this happening.

Re: Thanks for the new pricing information

Dr. Zuckerman on 5/06/01 at 15:19 (046803)

This is going to be very helpful for patients that want the hospitization.

Do you have a copy of this letter. I am still using the old pricing manuel and haven't received anything in writing. Would appreciate faxint any thing you mayb have at 1-856-848-5122 I was wondering if if is possible to use the short procedure unit instead of the OR . The short procedure unit is less expensive and is used for short procedures sucha s laser foot surgery and biopsy studies. Most ASC have this available. Many of my GI friends use this same room and use Demeral/versed instead of the anesthologist use of more sedation. This could be another way to bring the room charge down.

Re: To Dr. Kosova re. Insurance coverage

Kim B. on 5/07/01 at 02:31 (046847)

One Doctor I spoke with told me that in many cases, they will be adjusting the price downward for persons who are without any insurance coverage at all. I hope other generous doctors will follow this lead.

Regards, Kim B.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at hrmin (046850)

Unfortunately, some information in the ESWT patient progress report database is intentionally incorrect. I got this information directly from the patient for whom the information is about. Knowing about this has disturbed me for some time now, especially considering that some here choose to site the database as a source of factual information on a regular basis.

This intentional breech of truthfulness tarnishes the intire database in my opinion. Where there is smoke there is fire. What else is incorrect or skued? I'm sorry to have to say this, and if it was't true, there would be no need for me to post this. The fact is, that the database is unscientific, and the information is too easily manipulated to serve one or more persons hidden agenda(s).

I will not post the specifics here, as I am not informing the board members of this to inflame anyone, just to inform other PF suffereres about this, and to let Dr. Kosova know that he will be adding clean data to an already tairnished database if he has his patients particpate in this database in the future.

Scott, I suspect that you are unaware of this, and if you are interested in knowing specifically what I am refering to, I will revail them to you upon your request.

Sincerely, Kim B.

Re: To Dr. Kosova re. Insurance coverage

Pauline on 5/07/01 at 06:56 (046857)

Wow Kim, this is good news.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 07:39 (046859)

Kim, Yes, I would like to know if any portion of the database is incorrect. I need to know the name of your 'informant' to see if I have a signed copy of their information on file.

Re: To Dr. Kosova re. Insurance coverage

Scott R on 5/07/01 at 07:42 (046861)

Pauline, why would an innaccurate database of patient information be good news to you? Assuming a patient was not helped as much as reported, why would it be good news to you that a patient may have been hurt?

Re: To Dr. Kosova re. Insurance coverage

wendyn on 5/07/01 at 07:52 (046862)

Scott - I am guessing that she is referring to Kim's comment about the price being adjusted downward. Same thread. Different post.

Re: To Dr. Kosova re. Insurance coverage

Scott R on 5/07/01 at 07:55 (046863)

Thanks, oops.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 07:57 (046864)

Since all Dr. Z's patients have signed a form testifying to the accuracy of the information, we have to assume it's not one of his if you don't provide a name. Also, the patient can post a correction to the database anytime they want, with an explanation of whatever they've told you. I don't see any reason why they would want to hide unless they are lying.

Re: To Scott Kosova re. Insurance coverage

Pauline on 5/07/01 at 09:07 (046871)

Scott,
I was refering to the news about the rates being adjusted. Would you please correct your statement. You sure like to jump on me for nothing. If I remember correctly Kim did mention a doctor saying the rates would be adjusted for patients. To me that is good news. I don't know anything
about the patients records being incorrect. That's between you and Kim.
Leave me out of that.

Re: Concern for the accuracy of the ESWT patient progress report database.

john h on 5/07/01 at 09:47 (046876)

kim: i myself have never considered anything on the board scientifically accurate. I use it all as a 'guide' in making decisions about my condition. you are correct in that there are people who may post something not to be factual and probably more than one. that is why scott puts his disclaimers on the board. there are probably some acceptable scientific studies in Germany on ESWT and the FDA conduted its study using the scientific method. I still like to talk to people who have been there and done that. ESWT is still very much in its infancy and the doctors and scientist are learning on the fly. As agent Scully says 'The Truth is Out There'.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at hrmin (046878)

Scott, I can tell you for sure it's not a typo. It's not outdated information that hasn't been updated either. It was incorrect the day it was entered and it was intentionally entered incorrectly. It may even seem like a minor iinfraction to some, but to me, and maybe others, it is an example of at least one instance that the integrity of your database was not respected. Who knows how many other infractions there are.

I wish there was some way of making sure that all the infromation was factual. The data base itself was a great idea if only the promise (assumption) of all the information being accurate had not been compromised. As you know, and others can see, incorrect answers affect all of your averaging.

This in mind, I see plently of opportunity and motivation for someone to 'fudge' the facts to make things more favorable for themself or someone that they are highly supportive of.

Would you like me to post what I know here, or email you back board? I assumed you would prefer it backboard, but your line of questioning gives me the impression that you want me to post what I know here.

Kim B.

Re: Concern for the accuracy of the ESWT patient progress report database.

Kim B. on 5/07/01 at 10:03 (046881)

John, first allow me to Thank you for addressing my concern without biting my head off for posting what I know. It is a breath of fresh air. In response to your input, one of the reasons I felt I needed to bring this issue up is because some people here site the database as a source of factual information. It is misleading to do so. Many of us look at the information through 'oldtimer eyes'. However, Newbies will consider it factual information because that is what it is often represented as. My concern is for the people that are making important (and expensive) decisions based on what they learn here. It's sad that there may be a need for a disclaimer to be attached the database information as well. Personally, I wish it was a true and factual database. It would have been a very valuable resource of information had this been the case.

Regards, Kim B.

Re: To Scott Concern for the accuracy of the ESWT patient progress report database.

Pauline on 5/07/01 at 10:30 (046891)

Scott,
please see what I wrote on the heelspurs.com board before you ask Kim to post. I think a lot of hurt could and should be avoided.

Re: ossatron esw treatment update

cindy k h on 5/07/01 at 11:14 (046895)

Dr. Kosova...where are you located?

Re: What about the patients who had both PF and PTT or AT?

john h on 5/07/01 at 11:30 (046899)

dr. weil told me he gave himself a few shockwaves also. i am anxious to see what the shockwaves will feel like after the first 10 or so shocks without any ankle blocks. the ankle blocks were really painless and wore off in about 3 hours so if it is to bad i will just have dr. zuckerman give me some shots. if one tries to tough it out through pain they will tend to move their feet and not keep the foot against the head of the machine and lose some effectivness of the treatment. for those who have not had the treatment the shockwaves are very powerful. john w pointed out that the depth of the focal point and its width is controlled by the shape of the head. i should have know that from my training in radar. are there different heads that can be purchased for the machine if you wanted to change the focal point of the shockwave?

Re: To Scott Kosova re. Insurance coverage

Scott R on 5/07/01 at 11:35 (046901)

Sorry Pauline. I jump to the conclusion that you talking about Kim's other post.

Re: Concern for the accuracy of the ESWT patient progress report database.

Scott R on 5/07/01 at 12:01 (046905)

Kim, stop slinging wild accusations about. Email me what you have to say and I'll look into it. If you were interested in the truth you could have emailed me to gather more information and look into it before attacking. As I said before, your 'informant' can correct the information online at anytime! So what's the point of an attack? You can't go about calling a doctor a fraud in a public forum and not expect a lawsuit for damages. I'll probably have to endure a supoena so that they can estimate damages. At the least they can estimate lost income from cancelled appointments. Your health insurance doesn't cover those appointments!

Re: Really glad that the results are going well

JudyS on 5/07/01 at hrmin (046915)

Dr. K - I am a film/video editor by education and former trade....I'd be happy to edit your CD per your requirements if you need a helping hand.

Re: To John

Pauline on 5/07/01 at 14:40 (046920)

Dornier's brochure says it has an ultrasound tranducer to scan an image to the monitor of the ultrasound system to indicate where the shock waves are being delivered. Do know if all the machines have this ultrasound system? I wonder if this means they can see on a screen then where the waves are being delivered. I haven't seen this machine yet although my doctor says he still has it. They a waiting for approval. He did say it can be used in the arch area as well as the insertion location. Maybe it's the ultrasound system that allows that, I don't know. Smart of Dornier not to remove it once they have it in a hospital. They are less likely to consider another machine if that one is already in place.

Re: FOUL #3 on Kim (pending review)

Scott R on 5/07/01 at 14:44 (046921)

Kim, consider this your 3rd foul (unless I retract based on your subsequent emails) and don't post anymore. Here is the problem: Defamation of character can occur even if a person isn't named but can be surmised from the given circumstances. We are all pretty sure Dr. Z is still at least a portion of your target. Truth is your only protector from legal action based on charges of libel. It is libel instead of slander because this is a written public forum, and more stringent evidence is required to demonstrate truth in the case of libel. Since I have signed documents from all Dr. Z's patients, it would require another signed document from that individual in order to protect you from legal action, if protection turns out to be necessary. That's entirely up to Dr. Z. Your posts have shown a clear sense of malicious which may make you subject to punitive in addition to actual damages. Since I have a 'be nice' rule, that may prevent Dr. Z from responding to your posts, I am in effect controlling content which makes me also liable for your malicious libel.

I don't make any warranties about the accuracy of the 6 databases at heelspurs.com. When designing them, I believed people would be able to think for themselves when reviewing the data and see that such open systems are for fun and interest more than proof of anything.

Re: To John

john h on 5/07/01 at 15:01 (046927)

i am sure it would take an engineer who designed the conical cone to figure out exactly where the focal point of the ESWT energy waves are concentrated. the reason i even bring up the subject is that if we have someone with dainty feet like canadian Kim and then bring in a 300 lb offensive lineman both who have PF you would probably want a different focal point in depth. it may be that the focal point is so large that it really makes no difference. we do know from most of the manufacturers that the size in area being treated is about the size of a dime so it is important to accurately direct the shockwave beam on your sore spot. I think dr zuckerman told me he now treats more than just one spot if the patient indicates the spot is bigger than the size of the beam. i do not know how wide the fascia is in a normal size foot (4'?) but could you treat 2' rather than a dime size spot without doing to much damage?

Re: To John

Pauline on 5/07/01 at 15:08 (046931)

Does that mean that the ultrasound that is on their machine would actually project on a screen the focal point depth while the patient is being treated. Shorter for smaller person, deeper for larger? Is it possible for a smaller person to have their pain localized at a deeper depth than a larger person? More involved tissue deeper depth of pain???

Re: FOUL #3 on Kim (final)

Scott R on 5/07/01 at 16:41 (046948)

After reviewing some legal information, I've come to the conclusion that at least 4 of Kim's posts are illegal and not defensible in court. The warnings and explanations I mentioned earlier to Kim apply doubly because Dr. Z's career depends on such things not being said so carelessly and publicly. In the future, I'll be more stringent about making sure posts are nice and not let claims to truthfulness override blocking such posts so easily. What made Kim's posts difficult to block is that part of her accusations against Dr. Z was that I was a part of his alleged .... misdeeds. I'm sure this figured into her calculations. I recommend that those who need kim's posts for legal reasons (evidence) save them now in case Dr. Z requests that I remove them.

Re: To Scott FOUL #3 on Kim (final)

Pauline on 5/07/01 at 16:52 (046950)

Scott,
I don't get it. Exactly who saves what. If your not on the patients report do we have to save anything? What happens if all this goes public in court? I want to save if I'm suppose to save but I don't know what I'm suppost to save. Help!

Re: To Dr. Kosova re. Insurance coverage

DeniseA on 5/07/01 at hrmin (046957)

Why is this good news? Intentional misreporting wouldn't be positive from any viewpoint.

Entry errors are possible from patients or someone keying in for them. Was the error reported and asked to be fixed? The database can be fixed at any time.

No doubt the survey is FYI. There is no control that would make it a 'study' type resource. This tool is still an excellent one for patient research. If an error happened, let's just fix it.

If it turns out that there was intentional misrepresentation that should be dealt with. Let's not just go all out here without breathing and handling this responsibly.

Re: To Scott Kosova re. Insurance coverage

DeniseA on 5/07/01 at hrmin (046959)

It was the order of the message Pauline. I also misunderstood. Sorry about that.

Re: Scott, Get a GRIP!

Kim B. on 5/08/01 at 01:07 (046990)

Scott,

I certianly didn't mean to imply that Dr. Z. himself had input any data incorrectly! (I don't know if he has or has not for that matter.) It was my understanding that Dr. Z didn't have to put all of the info in for his patients because each person could input their own data if they were computer literalte and wanted to do so.

Nor was I trying to 'attack' Dr. Zuckerman. I thought we were all back on track and posting as mature adults again. I had a legitmate concern based on first hand information and so I posted it here in the interest of newbies, and people like Dr. Kosova, who are being led to believe that the database is FACTUAL.

At first you seemed interested in my concern regarding the fact that some of the information in the database is contrary to what someone who posted in it has told me personally. You seemed genuinely intersted in knowing more about it, so that you check in to it. I simply hesitated and double checked with you, because I just didn't think it wise for me to post the specifics here at the board, as it seemed at first that you might have been expecting me to. (After thinking it over for myself, I realized THAT could easily be mistaken for slandor.)

Whatever the case, in the meantime, you do a 180 turn on me! Slap yourself 3 times!! Wake up!! Geeezee. I even said in my post that I suspect that YOU are unaware of the incorrect information. Where did you get that I am involving you in anything 'malice'? That car in your front yard must have rocked your house, and toppled a lamp on to your head. You are single handedly reading all kinds of things into this thread that simply weren't intended to be there.

It appears to me that you've decided that you don't even care what the incorrect information is anymore, you just don't want anything here to be pointed out as questionable for any reason, even if it has warrant. Have it your way. So much for the open forum idea.

Kim B.

Re: ossatron esw treatment update

Terrie on 5/13/01 at 17:07 (047659)

I don't trust a doctor who can't spell.
Terrie,R.N.

Re: ossatron esw treatment update

Dr. Zuckerman on 5/13/01 at 17:34 (047662)

Have no idea if you are talking about Dr. K or not. I am Dr. Z can't write or spell but I can cure heel pain. Been doing that for 22 years. I can't sing or dance either. Well singing that an opinion. So have a nice motherr days oh! it only one r I think!!

Re: ossatron esw treatment update

Julie on 5/14/01 at 01:40 (047683)

Terrie, first, why on earth not?

Second - there is one rule on this website. It is: Be Nice.

Re: ossatron esw treatment update

Kay S on 5/14/01 at 07:16 (047696)

What if it's just a problem with typing?
I am also a nurse, and if I didn't trust any docs who couldn't spell, I'd be out of a job. Some of them can't speak clearly either.
It's the same as saying no one would trust a nurse who wasn't dressed in white. Or pretty. Or smiled. Or could roller blade.
WHO CARES?
Thank you, Dr. Z and Dr. K and Dr. R and Dr. B for all the helpful information you give to us at heelspurs.com. Most of us appreciate all you do, whether or not you can spell. I have never had any trouble figuring out exactly what you mean. (years of practice!) I bet I could even read your writing!
Kay

Re: Re:Kay I bet your can't read my writing

Dr. Zuckerman on 5/14/01 at 19:16 (047745)

Want to take a bet. When your are in my office. We will have a translation contest. The winner will get. Well let's see how you do first. This is something I am willing really bet on!!!