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Dr. Z & Carmens suggested web site

Posted by john h on 10/26/01 at 12:24 (063629)

Dr. Z: If you have not viewed this site you might take a look. It is wide ranging and has some results from Drs Weil. I noticed he was using an average of just over 19KV and pules from 2000-3000 per foot. He is using the ESWT for a number of things including Post Tibal Tendonitis which I was unaware of. Some of the German findings I also found to be interesting. All seem to agree that ESWT should be used before surgery and no one was found to be worse as a result of ESWT. One even suggested ESWT before cortisone shots which I find strange due to the relative cost of the procedures.

Re: Dr. Z & Carmens suggested web site

Dr. Zuckerman on 10/26/01 at 15:04 (063642)

Thanks

I have read the abstracts from this site. I know that he uses 19kv/ His approach is the one shot deal. One shot and if it doesn't work that is it.

I believe in the multiple treatment approach. This is the European approach. When doing ESWT in an expensive surgical center you have to work on a one shot approach. Dr. Weil is working on using ESWT for neuroma
This is could be a dramatic improvement in the treatment for this very painful condition.

Re: Dr. Z & Carmens suggested web site

Ed Davis, DPM on 10/28/01 at 13:48 (063730)

John:

The Germans may be looking at things from the standpoint of treatment efficacy vs. cost. Cost is now the issue that leads us to conclude that ESWT is a treatment reserved for 'intractable' cases or performed late in the course of treatment.

The question that needs to be asked is...'If cost was not an issue, where would we place ESWT in the sequence of treatments?' It is a bit too early to answer this question. Perhaps, 5 to 10 years from now, we will have a treatment protocol that moves ESWT back quite a bit in the sequence of things. ESWT is expensive and 'exotic' at this point. The expense issue is a combination of the cost of manufacture but more importantly due to the limited access to machines per FDA restrictions, not to mention the massive cost of bringing the machines to market due to the FDA approval process. We have some big regulatory issue problems in the US. It was my hope that the Bush administration would have done more in this area. They have a lot more to worry about at this point although the same regulatory problems have slowed vaccine production and have raised the price of drugs, including potentially needed antibiotics to very high levels.
Ed

Re: Dr ED

John h on 10/29/01 at 11:50 (063757)

I bet if an ESWT machine could zap Anthrax Dr Ed we could get the price down like Cipro.

Re: Dr. Z & Carmens suggested web site

Graham Wilson on 10/29/01 at 13:40 (063762)

Dr. Z you are wrong in stating that Drs. W only go for a one shot deal. I had a treatment there but did not listen to the doc and went back too early to running. We are considering a follow up procedure, and this option was explained before undertaking the first procedure. Please ensure before posting. Thanks Graham

Re: Dr. Z & Carmens suggested web site

Dr. Zuckerman on 10/29/01 at 15:31 (063766)

What I am saying is that he waits the full twelve weeks before giving a second treatment. This may have changed with his treatment protocol, since we lasted talked . I wasn't trying to say that he method is less effective. Multiple treatments can be very beneficial. . All ESWT if there is no response after the six to eight weeks period should be given the second and or third treatment option. This is textbook quoted and from experience.

So if you are having pain you still have a good chance of getting cured with a second or third treatment. Again this is textbook quoted and from my experience, so do the second it could help you.

Re: Correction

Dr. Zuckerman on 10/29/01 at 15:33 (063767)

I was quoting the method that the abstract from the web. This was the approach when that was written. Dr Weil and myself communicate about our treatment protocols. So get the second treatment ASAP if your are in pain

Re: Correction

GRaham Wilson on 10/31/01 at 09:22 (063873)

HI Dr. Z thank you for your advice and I am in communication with Lowell to discuss the next steps. It has been a long journey thus far. 26 months. Graham

Re: Dr. Z & Carmens suggested web site

Dr. Zuckerman on 10/26/01 at 15:04 (063642)

Thanks

I have read the abstracts from this site. I know that he uses 19kv/ His approach is the one shot deal. One shot and if it doesn't work that is it.

I believe in the multiple treatment approach. This is the European approach. When doing ESWT in an expensive surgical center you have to work on a one shot approach. Dr. Weil is working on using ESWT for neuroma
This is could be a dramatic improvement in the treatment for this very painful condition.

Re: Dr. Z & Carmens suggested web site

Ed Davis, DPM on 10/28/01 at 13:48 (063730)

John:

The Germans may be looking at things from the standpoint of treatment efficacy vs. cost. Cost is now the issue that leads us to conclude that ESWT is a treatment reserved for 'intractable' cases or performed late in the course of treatment.

The question that needs to be asked is...'If cost was not an issue, where would we place ESWT in the sequence of treatments?' It is a bit too early to answer this question. Perhaps, 5 to 10 years from now, we will have a treatment protocol that moves ESWT back quite a bit in the sequence of things. ESWT is expensive and 'exotic' at this point. The expense issue is a combination of the cost of manufacture but more importantly due to the limited access to machines per FDA restrictions, not to mention the massive cost of bringing the machines to market due to the FDA approval process. We have some big regulatory issue problems in the US. It was my hope that the Bush administration would have done more in this area. They have a lot more to worry about at this point although the same regulatory problems have slowed vaccine production and have raised the price of drugs, including potentially needed antibiotics to very high levels.
Ed

Re: Dr ED

John h on 10/29/01 at 11:50 (063757)

I bet if an ESWT machine could zap Anthrax Dr Ed we could get the price down like Cipro.

Re: Dr. Z & Carmens suggested web site

Graham Wilson on 10/29/01 at 13:40 (063762)

Dr. Z you are wrong in stating that Drs. W only go for a one shot deal. I had a treatment there but did not listen to the doc and went back too early to running. We are considering a follow up procedure, and this option was explained before undertaking the first procedure. Please ensure before posting. Thanks Graham

Re: Dr. Z & Carmens suggested web site

Dr. Zuckerman on 10/29/01 at 15:31 (063766)

What I am saying is that he waits the full twelve weeks before giving a second treatment. This may have changed with his treatment protocol, since we lasted talked . I wasn't trying to say that he method is less effective. Multiple treatments can be very beneficial. . All ESWT if there is no response after the six to eight weeks period should be given the second and or third treatment option. This is textbook quoted and from experience.

So if you are having pain you still have a good chance of getting cured with a second or third treatment. Again this is textbook quoted and from my experience, so do the second it could help you.

Re: Correction

Dr. Zuckerman on 10/29/01 at 15:33 (063767)

I was quoting the method that the abstract from the web. This was the approach when that was written. Dr Weil and myself communicate about our treatment protocols. So get the second treatment ASAP if your are in pain

Re: Correction

GRaham Wilson on 10/31/01 at 09:22 (063873)

HI Dr. Z thank you for your advice and I am in communication with Lowell to discuss the next steps. It has been a long journey thus far. 26 months. Graham