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Dr Z concerning Fellowships

Posted by john h on 8/26/01 at 19:31 (058048)

It would appear to me from the Fellowship openings for Foot and Ankle Surgery are one year in length and the Fellow spends his time in a wide variety of foot and ankle surgery. I would suspect that Plantar Fasciaitis is a very small portion of that traning. Following are URL's for two openings with a small list of what the Fellow will be doing. No mention of PF. This disease just does not get the attention it deserves:
http://www.utmem.edu/ortho/clinical/Footanklefel.htm
http://www.mayo.edu/mgsm/sfaos.htm

Re: Dr Z concerning Fellowships

Dr. Zuckerman on 8/26/01 at 19:59 (058050)

Hi John

Of interest was the very low surgical case load. A typical podiatric surgical case load in a two or three year program is somewhere between 5-10
surgical cases per day.

There are usually 15-20 podiatric surgeons on staff at the teaching hospital

At the mayo clinic they had two doctors and do about 35 cases per month

This is very low amount of surgical training to be called a fellowhip.

Re: Dr Z concerning Fellowships

john h on 8/26/01 at 20:03 (058051)

i bet they do very little in the way of PF.

Re: Dr Z concerning Fellowships

BGCPed on 8/26/01 at 20:15 (058054)

Seemed awful low to me also,there are guys that do that in 2 weeks by themselves. They didnt mention that there is also usually about 2 or 3 days wk in clinic that I would expect would see many pf cases. Cant forget that to do surg a Dr needs to see many that are non surgical each week also. And they need to know how to treat these people to cure them as well as the ones that need surgery. A few of the ortho foot/ankles I work with are very very busy with surgery but also send a ton of patients for conservative non surg treatment.

Re: Dr Z concerning Fellowships

Julie on 8/27/01 at 01:25 (058071)

It isn't very reassuring, is it? It would seem, then, that surgical competence must come from experience on the job. If that's so then it's vital for the individual patient to be informed to the eyeballs and to ask searching questions about the experience of any doctor who recommends surgery.

There are some worrying (possible) implications, one is that some doctors might be too eager to get the experience their training didn't deliver, i.e. too keen to perform surgery too soon.

Re: Dr Z concerning Fellowships

john h on 8/27/01 at 08:38 (058083)

Bullseye Julie! There is nothing that probably replaces experience when it comets to surgery. You of course need good hands. We have a heart surgeon in our city that performed over 1000 bypass surgeries in one year. He could do 3 a day and go through 3 sets of nurses and attendants. From the nurses i talked to who worked for him he was extremely efficient and could go through the procedure in much less time than other physicians. If you needed a bypass in this area ge was certainly the surgeon of choice. In my own experience as a pilot i can most assuredly tell you that you become a better pilot the more hours you fly. When you see that grey headed Captain sitting in the pilot's seat you should feel a bit more cofortable. With experience you have learned from your mistakes which is perhaps the best teacher of all. Current experience is also important. I was the best pilot i ever was when i was flying 120 hours a month for 3 straight years and routinely making 200' approaches into very bad weather.

Re: I once did the impossible......

Carmen H on 8/27/01 at 13:01 (058106)

I once got a man released from maximum security prison two and a half years earlier then he was supposed to be...he was wrongly convicted...long long story. I was told not to waste my time by many many lawyers, politicians etc. BUT, I did the leg work.....put my heart into it and out he came...WAY before his parole date.
So what I am getting to is this....I wonder if we could get the 'national' attention this problem deserves and maybe make some impression on insurance companies, doctors and the importance of their education of PF etc etc....
I know I NEVER had a clue what PF was or that it could happen to ANYONE until this happened to me and I found this site.
Passion for a subject or topic can really get you anywhere you want to go...I truly believe it could be done.
P.S. I am not a lawyer...nor do I have any education in law so you see....it just took a strong will and a heart of gold to make a huge difference in a man's life.

Re: If anyone can do it, you can.

Julie on 8/27/01 at 15:11 (058117)

Carmen, there's a project for you to put your considerable energy and your whole heart and soul into. National recognition and understanding of PF. Go for it!

Re: We could write Dear Abby and Ann Landers

Beverly on 8/27/01 at 15:32 (058121)

Like Carmen, I too had never heard of PF before I got it. I've had friends get knee replacements, hip replacements, and had my share of neck and shoulder woes and tendonitis in more than one place. But PF, that was a totally foreign word to me when the doctor told me that was what was wrong with my feet.

I bet if a bunch of us would write to Ann Landers and Dear Abby it might get printed. I've noticed the heartwarming/gut wrenching stories are the ones they tend to print. So, although a little technical info. would be needed, I think we'd be more likely to land a spot if we told how it has affected our lives.
What da ya think?
Beverly

Re: We could write Dear Abby and Ann Landers

Nancy N on 8/27/01 at 15:59 (058129)

She tends to print things that come from medical people, too. So maybe one of our docs could write something up about how many people he sees that are affected by PF, and how it is treatable especially if it's caught early, etc etc etc...

Re: there are all kinds of channels...

Carmen H on 8/28/01 at 07:12 (058203)

We have all kinds of opportunities for exposure.....What about Discovery Channel? 60 minutes? 48 hours? I watched Discovery health all day Sunday (laying around after shots giving my foot a break) and they had all kinds of information on feet...like specials, and health clips etc. about 'foot pain' but not once did I hear the words Plantar Fasciitis. They may have a recap on http://www.discovery.com in the health section. But...I agree we need to make this a KNOWN issue...Most of what they said on Discovery health was about wearing the right shoes.....and some guys making money on shoes that look cool and are comfortable but still nothing about PF or Heelspurs. Unless they mentioned it while I was out of the room..,
I tell people about it and they are like 'Oh so ANYONE can get this??'
I will probably do some looking for contacts and how to access the right people this weekend.....this subject deserves attention. While I am not the writer Julie is and have NO clue about the medical terminology I think I may be able to contribute.

Re: PF Awareness

Julie on 8/28/01 at 09:58 (058208)

But you can write, Carmen, and this is your baby. So go for it.

I also hope you'll write something about your experience of getting that guy released from maximum security. Start by telling us more about it. It was a great thing to do, a great achievement.

Re: PF Awreness

Carmen H on 8/28/01 at 10:52 (058214)

I think I will see what I can dig up and what can be done. Something needs to be so I will do my best. I am buying a house right now too so it may take some research time to get started.
About the release...
It's such a long story...it was one of my employee/best friends brothers. I went up to the prison to meet him one Saturday and over a period of about 9-10 months things unraveled. We started writing back and forth, I went to visit almost every weekend, I got the full story from him and from his friends and family, went to the courthouse and copied the court records, and actually found and went to see the girl who said he raped her turned out she had accused several other men and had her own stepfather put away for the same thing),I heard she was just 'easy' and was trying to get attention ( I am sure her own personal battles caused this behavior but it's inexcusable to take away another a persons life b/c of it). I started a several petitions around VA. and TN. and eventually the governor gave him early release based on researching the records, reading my letters, seeing the petitions and a lot of other information etc.
There's soo much more to it but this is a foot pain board and I am sure Scott doesn't appreciate me taking up all this space. Right Scott?
If anyone is interested in learning how murderers, rapists, convicted felons live...just ask me. I have been to one ofthose places moretimes then I can count. I have interesting stories....some I can't even believe myself.
what a life changing experience though. WOW.

Re: PF Awreness

BG CPed on 8/28/01 at 17:11 (058266)

And I would bet $100 that she is still walking around free. To wrongfully accuse a person and sit back while he rots in prison she should be in for 2x as long as he was

Re: yes she was....she didn't like me confronting her

Carmen H on 8/28/01 at 17:21 (058269)

She WAS still walking free but if what I did scared her enough to change her ways then I guess I should be fine with that. It still gets me fired up.....but I am definitely better aboutthinking about it then I was. Boy for awhile I couldn't sleep at all at night just trying to think of a way to get him out. One lawyer said 'I wouldn't waste my time on that one....that case is a done deal since he signed a plea bargain.'
I almost listened to him....

Re: A marvellous story, Carmen

Julie on 8/29/01 at 01:59 (058318)

Carmen, thank you very much for sharing this with us. You poured your heart and soul and all your considerable energy into doing something for someone, someone who isn't a relative or even a close friend, but simply because it was the right thing to do. In a situation in which lots of people might think 'I should do something' but then get on with their day's work, you went and did it.

You should write a book about it and I hope you will: a book that will show that one person really can make a difference.

Reading between the lines, trying to imagine the time and commitment and energy that task demanded of you, I know you could do a real PR job on PF. And maybe this is the answer to the question you asked a few months ago when you first got PF: What's the lesson here? You know my take on this, because we've talked about it - with any experience, the 'lesson' is: how do I use this? What do I do with it?

If awareness of PF were raised so that 'everyone' knew about it, and knew the warning signs as well as they know those for other diseases, more people would be successfully treated, because early diagnosis and treatment would appear to be the key factor. Judging by my own limited observation in talking to people about it, almost no-one has heard of it. And most people who experience the first symptoms of it walk or run or work through the pain until it becomes unbearable, and lose that vital opportunity to tackle it quickly.

So - get on with that research. And good luck with your house-buying.

Re: thanks Julie

Carmen H on 8/30/01 at 07:01 (058431)

I think as soon as my life calms down with the house hunt and stuff I will be on the move again with more things to conquer. The first would be the issue of PF. I laid awake last night for a long time thinking of all the things people don't know! Drives me nuts. I think I will consider writing the book as well....but I have to revisit a place that is in a box in my garage right now and that could be emotional. For right now....I will concentrate on getting one thing well....these FEET!
I will keep you posted....thank you for the encouragement.
We signed on the house last night and if the inspection goes well and the appraisal is legit we are moving in Oct.

Re: We could write Dear Abby and Ann Landers

Eric on 8/31/01 at 13:13 (058588)

Beverly. You were fortunate indeed. My doctor, here in the UK, did not have any idea what my problem was, in spite of my telling him all of my syptoms. As a result, I suffered for about 18 months having various forms of treatment which did no good at all. Eventually, I had a hunch that the problem might be due to the fact that I was about 22lbs over my ideal weight, so I cut out all dairy products and fats, lost 8lbs in a fortnight and could not believe the difference. I'm now working on the remaining 12lbs. At least I can now walk without pain. One thing I have noticed is that I do not tend to go over on my ankles as easily.
I realise that this would not work for everyone, but worth giving a try if a person finds they are overweight.
Good luck.
Eric

Re: Dr Z concerning Fellowships

Dr. Zuckerman on 8/26/01 at 19:59 (058050)

Hi John

Of interest was the very low surgical case load. A typical podiatric surgical case load in a two or three year program is somewhere between 5-10
surgical cases per day.

There are usually 15-20 podiatric surgeons on staff at the teaching hospital

At the mayo clinic they had two doctors and do about 35 cases per month

This is very low amount of surgical training to be called a fellowhip.

Re: Dr Z concerning Fellowships

john h on 8/26/01 at 20:03 (058051)

i bet they do very little in the way of PF.

Re: Dr Z concerning Fellowships

BGCPed on 8/26/01 at 20:15 (058054)

Seemed awful low to me also,there are guys that do that in 2 weeks by themselves. They didnt mention that there is also usually about 2 or 3 days wk in clinic that I would expect would see many pf cases. Cant forget that to do surg a Dr needs to see many that are non surgical each week also. And they need to know how to treat these people to cure them as well as the ones that need surgery. A few of the ortho foot/ankles I work with are very very busy with surgery but also send a ton of patients for conservative non surg treatment.

Re: Dr Z concerning Fellowships

Julie on 8/27/01 at 01:25 (058071)

It isn't very reassuring, is it? It would seem, then, that surgical competence must come from experience on the job. If that's so then it's vital for the individual patient to be informed to the eyeballs and to ask searching questions about the experience of any doctor who recommends surgery.

There are some worrying (possible) implications, one is that some doctors might be too eager to get the experience their training didn't deliver, i.e. too keen to perform surgery too soon.

Re: Dr Z concerning Fellowships

john h on 8/27/01 at 08:38 (058083)

Bullseye Julie! There is nothing that probably replaces experience when it comets to surgery. You of course need good hands. We have a heart surgeon in our city that performed over 1000 bypass surgeries in one year. He could do 3 a day and go through 3 sets of nurses and attendants. From the nurses i talked to who worked for him he was extremely efficient and could go through the procedure in much less time than other physicians. If you needed a bypass in this area ge was certainly the surgeon of choice. In my own experience as a pilot i can most assuredly tell you that you become a better pilot the more hours you fly. When you see that grey headed Captain sitting in the pilot's seat you should feel a bit more cofortable. With experience you have learned from your mistakes which is perhaps the best teacher of all. Current experience is also important. I was the best pilot i ever was when i was flying 120 hours a month for 3 straight years and routinely making 200' approaches into very bad weather.

Re: I once did the impossible......

Carmen H on 8/27/01 at 13:01 (058106)

I once got a man released from maximum security prison two and a half years earlier then he was supposed to be...he was wrongly convicted...long long story. I was told not to waste my time by many many lawyers, politicians etc. BUT, I did the leg work.....put my heart into it and out he came...WAY before his parole date.
So what I am getting to is this....I wonder if we could get the 'national' attention this problem deserves and maybe make some impression on insurance companies, doctors and the importance of their education of PF etc etc....
I know I NEVER had a clue what PF was or that it could happen to ANYONE until this happened to me and I found this site.
Passion for a subject or topic can really get you anywhere you want to go...I truly believe it could be done.
P.S. I am not a lawyer...nor do I have any education in law so you see....it just took a strong will and a heart of gold to make a huge difference in a man's life.

Re: If anyone can do it, you can.

Julie on 8/27/01 at 15:11 (058117)

Carmen, there's a project for you to put your considerable energy and your whole heart and soul into. National recognition and understanding of PF. Go for it!

Re: We could write Dear Abby and Ann Landers

Beverly on 8/27/01 at 15:32 (058121)

Like Carmen, I too had never heard of PF before I got it. I've had friends get knee replacements, hip replacements, and had my share of neck and shoulder woes and tendonitis in more than one place. But PF, that was a totally foreign word to me when the doctor told me that was what was wrong with my feet.

I bet if a bunch of us would write to Ann Landers and Dear Abby it might get printed. I've noticed the heartwarming/gut wrenching stories are the ones they tend to print. So, although a little technical info. would be needed, I think we'd be more likely to land a spot if we told how it has affected our lives.
What da ya think?
Beverly

Re: We could write Dear Abby and Ann Landers

Nancy N on 8/27/01 at 15:59 (058129)

She tends to print things that come from medical people, too. So maybe one of our docs could write something up about how many people he sees that are affected by PF, and how it is treatable especially if it's caught early, etc etc etc...

Re: there are all kinds of channels...

Carmen H on 8/28/01 at 07:12 (058203)

We have all kinds of opportunities for exposure.....What about Discovery Channel? 60 minutes? 48 hours? I watched Discovery health all day Sunday (laying around after shots giving my foot a break) and they had all kinds of information on feet...like specials, and health clips etc. about 'foot pain' but not once did I hear the words Plantar Fasciitis. They may have a recap on http://www.discovery.com in the health section. But...I agree we need to make this a KNOWN issue...Most of what they said on Discovery health was about wearing the right shoes.....and some guys making money on shoes that look cool and are comfortable but still nothing about PF or Heelspurs. Unless they mentioned it while I was out of the room..,
I tell people about it and they are like 'Oh so ANYONE can get this??'
I will probably do some looking for contacts and how to access the right people this weekend.....this subject deserves attention. While I am not the writer Julie is and have NO clue about the medical terminology I think I may be able to contribute.

Re: PF Awareness

Julie on 8/28/01 at 09:58 (058208)

But you can write, Carmen, and this is your baby. So go for it.

I also hope you'll write something about your experience of getting that guy released from maximum security. Start by telling us more about it. It was a great thing to do, a great achievement.

Re: PF Awreness

Carmen H on 8/28/01 at 10:52 (058214)

I think I will see what I can dig up and what can be done. Something needs to be so I will do my best. I am buying a house right now too so it may take some research time to get started.
About the release...
It's such a long story...it was one of my employee/best friends brothers. I went up to the prison to meet him one Saturday and over a period of about 9-10 months things unraveled. We started writing back and forth, I went to visit almost every weekend, I got the full story from him and from his friends and family, went to the courthouse and copied the court records, and actually found and went to see the girl who said he raped her turned out she had accused several other men and had her own stepfather put away for the same thing),I heard she was just 'easy' and was trying to get attention ( I am sure her own personal battles caused this behavior but it's inexcusable to take away another a persons life b/c of it). I started a several petitions around VA. and TN. and eventually the governor gave him early release based on researching the records, reading my letters, seeing the petitions and a lot of other information etc.
There's soo much more to it but this is a foot pain board and I am sure Scott doesn't appreciate me taking up all this space. Right Scott?
If anyone is interested in learning how murderers, rapists, convicted felons live...just ask me. I have been to one ofthose places moretimes then I can count. I have interesting stories....some I can't even believe myself.
what a life changing experience though. WOW.

Re: PF Awreness

BG CPed on 8/28/01 at 17:11 (058266)

And I would bet $100 that she is still walking around free. To wrongfully accuse a person and sit back while he rots in prison she should be in for 2x as long as he was

Re: yes she was....she didn't like me confronting her

Carmen H on 8/28/01 at 17:21 (058269)

She WAS still walking free but if what I did scared her enough to change her ways then I guess I should be fine with that. It still gets me fired up.....but I am definitely better aboutthinking about it then I was. Boy for awhile I couldn't sleep at all at night just trying to think of a way to get him out. One lawyer said 'I wouldn't waste my time on that one....that case is a done deal since he signed a plea bargain.'
I almost listened to him....

Re: A marvellous story, Carmen

Julie on 8/29/01 at 01:59 (058318)

Carmen, thank you very much for sharing this with us. You poured your heart and soul and all your considerable energy into doing something for someone, someone who isn't a relative or even a close friend, but simply because it was the right thing to do. In a situation in which lots of people might think 'I should do something' but then get on with their day's work, you went and did it.

You should write a book about it and I hope you will: a book that will show that one person really can make a difference.

Reading between the lines, trying to imagine the time and commitment and energy that task demanded of you, I know you could do a real PR job on PF. And maybe this is the answer to the question you asked a few months ago when you first got PF: What's the lesson here? You know my take on this, because we've talked about it - with any experience, the 'lesson' is: how do I use this? What do I do with it?

If awareness of PF were raised so that 'everyone' knew about it, and knew the warning signs as well as they know those for other diseases, more people would be successfully treated, because early diagnosis and treatment would appear to be the key factor. Judging by my own limited observation in talking to people about it, almost no-one has heard of it. And most people who experience the first symptoms of it walk or run or work through the pain until it becomes unbearable, and lose that vital opportunity to tackle it quickly.

So - get on with that research. And good luck with your house-buying.

Re: thanks Julie

Carmen H on 8/30/01 at 07:01 (058431)

I think as soon as my life calms down with the house hunt and stuff I will be on the move again with more things to conquer. The first would be the issue of PF. I laid awake last night for a long time thinking of all the things people don't know! Drives me nuts. I think I will consider writing the book as well....but I have to revisit a place that is in a box in my garage right now and that could be emotional. For right now....I will concentrate on getting one thing well....these FEET!
I will keep you posted....thank you for the encouragement.
We signed on the house last night and if the inspection goes well and the appraisal is legit we are moving in Oct.

Re: We could write Dear Abby and Ann Landers

Eric on 8/31/01 at 13:13 (058588)

Beverly. You were fortunate indeed. My doctor, here in the UK, did not have any idea what my problem was, in spite of my telling him all of my syptoms. As a result, I suffered for about 18 months having various forms of treatment which did no good at all. Eventually, I had a hunch that the problem might be due to the fact that I was about 22lbs over my ideal weight, so I cut out all dairy products and fats, lost 8lbs in a fortnight and could not believe the difference. I'm now working on the remaining 12lbs. At least I can now walk without pain. One thing I have noticed is that I do not tend to go over on my ankles as easily.
I realise that this would not work for everyone, but worth giving a try if a person finds they are overweight.
Good luck.
Eric