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Need advice on what to ask my pod when I see him next week...

Posted by Carmel M on 6/06/01 at 21:39 (050116)

Hi everyone,
I posted here over a week ago, and have been reading all posts religously since then. I have some questions for you all, so here goes...

I'm seeing my podiatrist next Tuesday and I don't know what to ask or what to expect when it comes to treatment. I've had pf for almost two years (August) and have had pain off and on. The two times the pain was excruciating, the doc did cortisone shots. I've since become aware (thanks to this site) that too many cortisone shots can be dangerous. My right heel has been hurting again since the beginning of May, and I've been babying it along...ice, as much rest as a mother of three can get, and ibuprofen. I have custom orthotics and have been wearing them in Avia walking shoes.

Question #1 Has anyone had an MRI or more than one x-ray? (maybe to rule out stress fracture? I did have an x-ray in Aug 99.)

Question #2 How many of you see an orthopedic doc and how many see a podiatrist? (I'm leaning towards orthopedist if podiatrist offers no help at next appt.)

Question #3 Maybe I just need a new pair of shoes?? I tried on a pair of New Balance 6 hundred something walking shoe and it felt soooo much better than these yucky old Avia's. I also had the girl order the 1121 and the 841. I don't have to pay for either if I don't like them. How many pairs of shoes do you have and how often do you get new ones? My thinking is if all I wear is my athletic shoes, then I need new ones often, but how often?

Ok, any other questions or suggestions from you all would be greatly apprieciated. Thanks very much.

Carmel

Re: Need advice on what to ask my pod when I see him next week...

Steve P on 6/07/01 at 09:33 (050140)

Hi Carmel --- Make sure the doctor you see is experienced in foot injuries. Sports Medicine is a good place to find one, typically an Orthopedic doc with a foot specialty.

Ask about Physical Therapy, a different anti-inflammatory (ibuprofen can irritate the stomach & may not be the best long term), & make sure he does a gait analysis to determine if your orthotics are right for you. Ask him to evaluate you shoes too.

I would not keep getting cortisone shots. If your PF doesn't settle down with conservative treatments you may want to look into ESWT.

best.........Steve

Re: Need advice on what to ask my pod when I see him next week...

Richard, C.Ped on 6/07/01 at 10:17 (050146)

Hi Carmel,
Your question about shoes caught my eye. People can wear out shoes at different times. It can depend on how ambulatory someone is as well as weight factor. When my New Balance start to feel 'very broken in' I usually get another pair.

As to the style to get, I am sure you will receive great responses from the people here. They have been through shoes and have wonderful knowledge about what works.

Richard, C.Ped

Re: Need advice on what to ask my pod when I see him next week...

Paula G. on 6/07/01 at 13:51 (050164)

Hi. I had an MRI which showed everything normal. NOT! So, my podiatrist figured he could not help me anymore after that. Amazing since I do have x-rays proving my heel spurs and the pain proving my PF.
I go back to an orthopedist in two weeks. I use night splints at night. I hate them and they make comfortable sleep impossible, but I sure notice a difference in the morning. Also, just getting up two hours before getting out of bed and putting them on helps too...
Are you using some kind of inserts in your shoes? I would be lost without mine. I got orthotics and what a waste. Made my feet worse. I have over the counter inserts that really help a lot! How do your shoes fit? I have noticed I need bigger shoes all the sudden.
Sad because you should not have to worry about what to ask the doctor.They should know by symptoms what to ask YOU!

Re: Thanks for advice

Carmel M on 6/07/01 at 21:20 (050205)

Thanks Paula, Richard and Steve. Yes Paula, I use custom made orthotics in my shoes, and I only wear athletic shoes and I never go barefoot! And I do need new shoes, so I'm waiting for the shoe store to call when the new balance 1121 comes in. I also find I need a bigger shoe.

I guess I'm at a loss as to what to do because when my PCP referred me to the first podiatrist, he said 'It should be cleared up in six to eight months.' And when we moved and I saw my current podiatrist, he said 'I can't figure out why it's still bothering you a year later?!' That's when he suggested the first cortisone shot. We did talk about surgery, but he did admit that surgery is not always the best option and could in fact make things worse in some cases. He also mentioned cast and crutches...do you know of anyone who has tried that option and did it work for them?

I guess my main question is this...is the pain I'm having now going to be as bad as it gets, or does it degenerate over time and get worse? I don't know what to expect anymore.

Thanks again...I hope I don't sound like too much of an idiot...i'm just trying to get all the information I can so the doc and I can figure this out.
Carmel

Re: forgot to ask something...

Carmel M on 6/07/01 at 21:30 (050206)

Has anyone tried the Foot trainer?

Re: Night splints

Julie on 6/08/01 at 02:51 (050231)

Paula, do a search on night splints, and also on Bob G's name. He had a lot to say about adjusting night splints to make them more comfortable, andeventually got to the point where he could sleep well with them on. You might find some help there.

I think we DO need to think carefully about what to ask the doctor. Ultimately, we are in charge, not the doctor, and the more responsibility we take for ourselves, the more we help doctors to help us.

Re: forgot to ask something...

Julie on 6/08/01 at 08:15 (050245)

I've just ordered the Foot Trainer, Carmel, and am waiting for it to arrive. Dr Z thinks highly of it and recommends it to all his patients. Have you looked at the website? It explains the theory well.

I always forget what I've said to whom, but have you tried taping?

I don't know why pod's promise recovery in such and such a time. They should know by now that every case is different. Recovery time depends on all sorts of things: how quickly one began dealing with the condition, one's age, one's job, and how much rest one is able to get. It's very much a 'how long is a piece of string?' question.

Don't be discouraged. Just explore all the options, and be patient.

Re: forgot to ask something...

Carlw on 6/08/01 at 10:15 (050263)

Hi Carmel,

I have owned a foot trainer for about a year. The exercises all intuitively make sense and the ability to do effective non weight bearing stretches. It definitely helped my original first step in the morning pain by using it to warm up before getting out of bed. However, I cant honestly say that it has been a 'miracle cure' for me as overall my PF is not that much better than it was a year ago. I diligently used it for 4 months. I believe if your PF is simply caused by weak foot muscles than it can help. I believe that my problem is more from an inability to heal properly.

Carl

Re: Need advice on what to ask my pod when I see him next week...

JudyS on 6/08/01 at 11:43 (050268)

Hi Carmel - about your questions....
I see a Podiatrist - I have to because my HMO doesn't allow us to see an orthopedist for foot problems.

Also, while you're shoe shopping, I've heard it said, even by my doc, that it can be helpful to change your shoes throughout the day - especially at that moment when your feet start aching.

Unless you have high arches, the New Balance 800 series seem to be the shoes of choice here. John h knows quite a bit about them.

Re: forgot to ask something...

Carmel M on 6/08/01 at 11:45 (050269)

Hi Julie,

I haven't tried taping yet although I have looked at Scott's pictures of taping and found one at emdicine.com called low-dye taping...and this is silly, but I haven't tried taping yet because I'm afraid I'll do it wrong!!

I think I'll talk to my doc about the foot trainer to get his opinion before I order it. Let me know how it works for you, OK? It does make sense to me to strengthen the opposing foot muscles so I hope it really works, but as Carlw says it may not be just a muscle problem and is not a cure all for all people. We each have our own individual problems and needs.

Thanks everyone!
Carmel

Re: forgot to ask something...

JudyS on 6/08/01 at 12:20 (050272)

I used the PFT last fall, didn't like it and returned it. Some folks like it a lot. Do a search here for PFT and you'll get lots of good information. I see too that Mike has changed it a bit since I tried it.

Re: forgot to ask something...

Julie on 6/08/01 at 13:16 (050279)

Carmel - don't be afraid about doing it wrong. You can't do yourself any harm with it, because you'll know instantly if it's too tight. Try - and I hope you get relief from it!

I'll let you know about the foot trainer. I think it does make sense.

Re: Need advice on what to ask my pod when I see him next week...

Steve P on 6/07/01 at 09:33 (050140)

Hi Carmel --- Make sure the doctor you see is experienced in foot injuries. Sports Medicine is a good place to find one, typically an Orthopedic doc with a foot specialty.

Ask about Physical Therapy, a different anti-inflammatory (ibuprofen can irritate the stomach & may not be the best long term), & make sure he does a gait analysis to determine if your orthotics are right for you. Ask him to evaluate you shoes too.

I would not keep getting cortisone shots. If your PF doesn't settle down with conservative treatments you may want to look into ESWT.

best.........Steve

Re: Need advice on what to ask my pod when I see him next week...

Richard, C.Ped on 6/07/01 at 10:17 (050146)

Hi Carmel,
Your question about shoes caught my eye. People can wear out shoes at different times. It can depend on how ambulatory someone is as well as weight factor. When my New Balance start to feel 'very broken in' I usually get another pair.

As to the style to get, I am sure you will receive great responses from the people here. They have been through shoes and have wonderful knowledge about what works.

Richard, C.Ped

Re: Need advice on what to ask my pod when I see him next week...

Paula G. on 6/07/01 at 13:51 (050164)

Hi. I had an MRI which showed everything normal. NOT! So, my podiatrist figured he could not help me anymore after that. Amazing since I do have x-rays proving my heel spurs and the pain proving my PF.
I go back to an orthopedist in two weeks. I use night splints at night. I hate them and they make comfortable sleep impossible, but I sure notice a difference in the morning. Also, just getting up two hours before getting out of bed and putting them on helps too...
Are you using some kind of inserts in your shoes? I would be lost without mine. I got orthotics and what a waste. Made my feet worse. I have over the counter inserts that really help a lot! How do your shoes fit? I have noticed I need bigger shoes all the sudden.
Sad because you should not have to worry about what to ask the doctor.They should know by symptoms what to ask YOU!

Re: Thanks for advice

Carmel M on 6/07/01 at 21:20 (050205)

Thanks Paula, Richard and Steve. Yes Paula, I use custom made orthotics in my shoes, and I only wear athletic shoes and I never go barefoot! And I do need new shoes, so I'm waiting for the shoe store to call when the new balance 1121 comes in. I also find I need a bigger shoe.

I guess I'm at a loss as to what to do because when my PCP referred me to the first podiatrist, he said 'It should be cleared up in six to eight months.' And when we moved and I saw my current podiatrist, he said 'I can't figure out why it's still bothering you a year later?!' That's when he suggested the first cortisone shot. We did talk about surgery, but he did admit that surgery is not always the best option and could in fact make things worse in some cases. He also mentioned cast and crutches...do you know of anyone who has tried that option and did it work for them?

I guess my main question is this...is the pain I'm having now going to be as bad as it gets, or does it degenerate over time and get worse? I don't know what to expect anymore.

Thanks again...I hope I don't sound like too much of an idiot...i'm just trying to get all the information I can so the doc and I can figure this out.
Carmel

Re: forgot to ask something...

Carmel M on 6/07/01 at 21:30 (050206)

Has anyone tried the Foot trainer?

Re: Night splints

Julie on 6/08/01 at 02:51 (050231)

Paula, do a search on night splints, and also on Bob G's name. He had a lot to say about adjusting night splints to make them more comfortable, andeventually got to the point where he could sleep well with them on. You might find some help there.

I think we DO need to think carefully about what to ask the doctor. Ultimately, we are in charge, not the doctor, and the more responsibility we take for ourselves, the more we help doctors to help us.

Re: forgot to ask something...

Julie on 6/08/01 at 08:15 (050245)

I've just ordered the Foot Trainer, Carmel, and am waiting for it to arrive. Dr Z thinks highly of it and recommends it to all his patients. Have you looked at the website? It explains the theory well.

I always forget what I've said to whom, but have you tried taping?

I don't know why pod's promise recovery in such and such a time. They should know by now that every case is different. Recovery time depends on all sorts of things: how quickly one began dealing with the condition, one's age, one's job, and how much rest one is able to get. It's very much a 'how long is a piece of string?' question.

Don't be discouraged. Just explore all the options, and be patient.

Re: forgot to ask something...

Carlw on 6/08/01 at 10:15 (050263)

Hi Carmel,

I have owned a foot trainer for about a year. The exercises all intuitively make sense and the ability to do effective non weight bearing stretches. It definitely helped my original first step in the morning pain by using it to warm up before getting out of bed. However, I cant honestly say that it has been a 'miracle cure' for me as overall my PF is not that much better than it was a year ago. I diligently used it for 4 months. I believe if your PF is simply caused by weak foot muscles than it can help. I believe that my problem is more from an inability to heal properly.

Carl

Re: Need advice on what to ask my pod when I see him next week...

JudyS on 6/08/01 at 11:43 (050268)

Hi Carmel - about your questions....
I see a Podiatrist - I have to because my HMO doesn't allow us to see an orthopedist for foot problems.

Also, while you're shoe shopping, I've heard it said, even by my doc, that it can be helpful to change your shoes throughout the day - especially at that moment when your feet start aching.

Unless you have high arches, the New Balance 800 series seem to be the shoes of choice here. John h knows quite a bit about them.

Re: forgot to ask something...

Carmel M on 6/08/01 at 11:45 (050269)

Hi Julie,

I haven't tried taping yet although I have looked at Scott's pictures of taping and found one at emdicine.com called low-dye taping...and this is silly, but I haven't tried taping yet because I'm afraid I'll do it wrong!!

I think I'll talk to my doc about the foot trainer to get his opinion before I order it. Let me know how it works for you, OK? It does make sense to me to strengthen the opposing foot muscles so I hope it really works, but as Carlw says it may not be just a muscle problem and is not a cure all for all people. We each have our own individual problems and needs.

Thanks everyone!
Carmel

Re: forgot to ask something...

JudyS on 6/08/01 at 12:20 (050272)

I used the PFT last fall, didn't like it and returned it. Some folks like it a lot. Do a search here for PFT and you'll get lots of good information. I see too that Mike has changed it a bit since I tried it.

Re: forgot to ask something...

Julie on 6/08/01 at 13:16 (050279)

Carmel - don't be afraid about doing it wrong. You can't do yourself any harm with it, because you'll know instantly if it's too tight. Try - and I hope you get relief from it!

I'll let you know about the foot trainer. I think it does make sense.