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How long should I wait before considering ESWT??

Posted by Paula T on 3/14/02 at 19:39 (076447)

I had arthroscopic surg. for my PF 7 weeks ago today. Very litle improvement so far. I'm also having the full range of P.T. along with it. I'm wandering, how long should I wait until I should consider having ESWT? My Dr. thinks I'm ready for this now (If ins. will cover it) and if my ins. wont cover it, he's recomending open surg.
Also, my Dr. says he's done approx. 10 ESWTs with about 50% success rate....he never mentioned possibly having the procedure multiple times. Does this sound like enough experience with the typical success rate?
I'd appreciate anyones input on this...and I'm so glad to have found this site...what a help!

Re: With your doc, I'd wait forever !!

BrianG on 3/14/02 at 21:20 (076453)

Hi Paula,

Were you tested for the TTS before your 1st surgery? If not, how do you know the 1st surgery didn't cause it? Seems to me I'd want to ask the doctor why your just getting TTS now, do you really think it's a coincidence? How much confidence do you have in this person? Just something to think about. Much too early to think about a 2nd surgery. I think I'd RUN to get a 2nd and 3rd opinion. There are many people here who started off with a simple PF surgery, went back for an open surgery, and are now worse than ever. I hope you don't join them.

Good luck
BrianG

Re: How long should I wait before considering ESWT??

DR Zuckerman on 3/14/02 at 21:40 (076455)

This is on the early side for doing ESWT but it isn't out of the question. Having TTS could be the cause of your present pain. I would need more information to determine if your pf release via the scope was a failure. Yes multiple ESWT are a very good possibility especially since you have foot surgery. I have always had to use ESWT at least twice on patients that had a release. The results can be very good in a failed pf releases if they are done for the right reason.

Re: How long should I wait before considering ESWT??

Julie on 3/15/02 at 02:34 (076464)

Paula, I can't believe your doctor is already thinking about a second surgery seven weeks after the first! Definitely you should get someone else to have a look at you. And if you do decide on ESWT, make sure you do your homework re doctors and find one who has plenty of experience in doing the procedure, because that's where they get their expertise.

I wouldn't trust my foot to anyone who had done only ten procedures - and 50% success sounds low compared to everything the doctors here have said about it.

Re: How long should I wait before considering ESWT??

dave on 3/15/02 at 07:11 (076469)

I agree, a second release sounds like trouble. I dont know a single person that has had any improvement from pf release. I bet that the tt syndrome that you are feeling is from scare tissue pressing on a nerve. But i should talk, i have had pf for five years. I refuse to have any type of pf release. Good luck with what ever you decide to do!

Re: With your doc, I'd wait forever !!

Paula T on 3/15/02 at 07:56 (076477)

BrianG
Thanks for responing. I don't think my tts is a result of the surg. but I guess it's a possibility. Strangly my results said I have tts slightly worse in my right foot when all my pain is in my left. Wonder if they could have mixed up my rt. and lt. I work in the medical field so I know how often this happens.
I am in no way ready for open surg., not yet and not without a 2nd or 3rd opinion. But I would consider eswt IF my insurance would pay and IF I can find someone with enough experience, and I'm not sure that is my Dr. with only 10 eswt's under his belt.

Paula

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:13 (076482)

Thanks julie
That's pretty much how I feel about it too. I'm not ready for more surg.
It's so hard to sort everything out...my physical therapists tell me that therapy is the answer...with time. My Dr. thinks eswt or surg. is the answer. But then I found this site and so many people end up worse after surg. It's so hard when your in pain every day and nothing seems to work. When I hear of a new option to try my first reaction is 'great, I'll try anything.' But I know I need to be patient...but I've never been patient..:-)

thanks again.Paula

Re: How long should I wait before considering ESWT??

Julie on 3/15/02 at 08:23 (076485)

Yes, that's the trouble, isn't it. Everyone thinks that what they do is 'the answer'. In the end all we can do is make the most informed decisions possible about what is right for us. Not easy to think or research, though, when you're in so much pain.

I posted a suggestion about a doctor for ESWT on your other thread - about 3 minutes before you posted this! Have a look. I think Drs Reid and Kosova would be excellent people to consult - for a second opinion, and/or for ESWT (which you should absolutely consider before even breathing the word surgery).

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:27 (076486)

Dr. Zuckerman
I know what the typical PF pain is like, but how is tts different from PF as far as symtoms go? How would I know if my PF is improving or not and if my pain could really be tts. My nerve test report said 'mild tts' in my left foot ( where all my pain is) and 'moderate tts' in my right foot (no pain there) Also, what steps should I be taking now with my right foot to avoid problems down the road.
Also, what do you think about my Dr. having done about 10 eswt's....do you think this is enough experience?

Thanks for your help...Paula T

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:28 (076487)

Thanks again..I'll check it out...Paula T

Re: TTS & Diagnosis

john h on 3/15/02 at 09:52 (076505)

Dr. Zuckerman and any of our other Doctors: Do you not think that TTS may be one of the more over diagnosed conditons out there for foot problems. The doctor who did my electrical studies was an orthopedic surgeon and he now does only electrical nerve studies as a full time profession so he is very experienced in his profession. He said that even with positive results there is no guarantee the surgeon will find a trapped nerve. My surgeon uttered the same words. Perhaps,if you have some sort of growth that can be identified on x-ray or MRI you could positively say that you have something pressing on a nerve but other wise it is very much a gamble. The TTS surgery may be beneficial in that you eliminate a possibility.

Re: How long should I wait before considering ESWT??

john h on 3/15/02 at 09:54 (076506)

A 2nd surgery so soon Paula really sounds over the top. Like Julie I would run not walk for a second or third opinion.

Re: How long should I wait before considering ESWT??

john h on 3/15/02 at 10:00 (076508)

Dave: You are right that TTS and PF release is risky business but there are thousands of people out there who have been cured by PF release. They never post on our board because they are well. Judy's husband had a PF release some years ago and runs, plays baseball and is cured. Carl Lewis was cured and back to running after a release. I think I read that only about 3% of the estimated 6 million new PF cases each year end up with surgery. I think that a correct diagnois and the skill of your doctor is 95% of the success of the surgery. I would also say that surgery should be the very very very last option because there is a whole lot that can go wrong and make you worse.

Re: How long should I wait before considering ESWT??

John S on 3/15/02 at 12:23 (076514)

I am one of the 'cured ones'. I had surgery to deal with my PF.I simply couldn't cope with the pain and the attendent hobbling. So I went for the knife as quickly as possible. A year of rehabilitation and I was back to running and playing sports. I certainly was not 100%, but I was back on the road doing what I really enjoy. I thought I was home free. Not so, I developed tibal tendonitis. Big drag! What next? Several months of trying to understand this new menace. I finally found a podiatrist that correctly analysed my problem. He prepared orthotics that relieved presseure on the offending tendon. Bottom line. This has permitted about 90% useage. I am running 1 hr 30 four times per week and playing competitve baseball on Sundays. I understand the need to go slow and exhaust less drastic measures. Had I been aware of this website, I may have indeed procedded with more caution. In my case--damn the torpedos and bring on the knife. Worked for me.

Re: How long should I wait before considering ESWT??

JudyS on 3/16/02 at 19:38 (076603)

Hi Honey!

Re: How long should I wait before considering ESWT??

Julie on 3/17/02 at 02:13 (076620)

Hi John S! It's nice to meet Judy's husband and to hear your success story.

(Maybe you've posted before and I didn't realize it was you? Judy's 'hi honey' tipped me off.)

Re: How long should I wait before considering ESWT??

John S on 3/19/02 at 12:06 (076836)

Julie

I don't feel that I can make much of a contribution to the website,therefore I rarely post.In fact, the post you read was my first and perhaps my last. I sometimes read some of the posts people make. I find the site to be informative, fun, gooofy and sometimes zany. It appears that many of you have grown close over time and I don't want to intrude inyour cyber-community. I do want to thank you for the time that you spent with Chris while he was in London. He speaks warmly of you and was thankful of the help that your provided him with his homework assignment. Maybe we will meet when you journey to San Diego? John

Re: John S

Julie on 3/19/02 at 16:11 (076857)

John, this cyber-community is a broad church and there's always room in it for one more, especially when it's Judy's husband and especially when it's a success story. So don't make that your last post. I would love to meet you both and am sorry you didn't make it to London. If I ever get to San Diego, you'll be the first to know!

Please give Chris my best wishes. We had a great talk.

Re: How long should I wait before considering ESWT??

nancy s. on 3/19/02 at 16:56 (076863)

hi, john s! see you in july?
nancy

Re: How long should I wait before considering ESWT??

John h on 3/19/02 at 17:59 (076874)

Your post about the success of your surgery provides a lot of hope for many people. All we usually hear on the board are about the failures. Laurie is about to have a PF release along with two other surgeries so your post will be double welcome by her.

Re: With your doc, I'd wait forever !!

BrianG on 3/14/02 at 21:20 (076453)

Hi Paula,

Were you tested for the TTS before your 1st surgery? If not, how do you know the 1st surgery didn't cause it? Seems to me I'd want to ask the doctor why your just getting TTS now, do you really think it's a coincidence? How much confidence do you have in this person? Just something to think about. Much too early to think about a 2nd surgery. I think I'd RUN to get a 2nd and 3rd opinion. There are many people here who started off with a simple PF surgery, went back for an open surgery, and are now worse than ever. I hope you don't join them.

Good luck
BrianG

Re: How long should I wait before considering ESWT??

DR Zuckerman on 3/14/02 at 21:40 (076455)

This is on the early side for doing ESWT but it isn't out of the question. Having TTS could be the cause of your present pain. I would need more information to determine if your pf release via the scope was a failure. Yes multiple ESWT are a very good possibility especially since you have foot surgery. I have always had to use ESWT at least twice on patients that had a release. The results can be very good in a failed pf releases if they are done for the right reason.

Re: How long should I wait before considering ESWT??

Julie on 3/15/02 at 02:34 (076464)

Paula, I can't believe your doctor is already thinking about a second surgery seven weeks after the first! Definitely you should get someone else to have a look at you. And if you do decide on ESWT, make sure you do your homework re doctors and find one who has plenty of experience in doing the procedure, because that's where they get their expertise.

I wouldn't trust my foot to anyone who had done only ten procedures - and 50% success sounds low compared to everything the doctors here have said about it.

Re: How long should I wait before considering ESWT??

dave on 3/15/02 at 07:11 (076469)

I agree, a second release sounds like trouble. I dont know a single person that has had any improvement from pf release. I bet that the tt syndrome that you are feeling is from scare tissue pressing on a nerve. But i should talk, i have had pf for five years. I refuse to have any type of pf release. Good luck with what ever you decide to do!

Re: With your doc, I'd wait forever !!

Paula T on 3/15/02 at 07:56 (076477)

BrianG
Thanks for responing. I don't think my tts is a result of the surg. but I guess it's a possibility. Strangly my results said I have tts slightly worse in my right foot when all my pain is in my left. Wonder if they could have mixed up my rt. and lt. I work in the medical field so I know how often this happens.
I am in no way ready for open surg., not yet and not without a 2nd or 3rd opinion. But I would consider eswt IF my insurance would pay and IF I can find someone with enough experience, and I'm not sure that is my Dr. with only 10 eswt's under his belt.

Paula

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:13 (076482)

Thanks julie
That's pretty much how I feel about it too. I'm not ready for more surg.
It's so hard to sort everything out...my physical therapists tell me that therapy is the answer...with time. My Dr. thinks eswt or surg. is the answer. But then I found this site and so many people end up worse after surg. It's so hard when your in pain every day and nothing seems to work. When I hear of a new option to try my first reaction is 'great, I'll try anything.' But I know I need to be patient...but I've never been patient..:-)

thanks again.Paula

Re: How long should I wait before considering ESWT??

Julie on 3/15/02 at 08:23 (076485)

Yes, that's the trouble, isn't it. Everyone thinks that what they do is 'the answer'. In the end all we can do is make the most informed decisions possible about what is right for us. Not easy to think or research, though, when you're in so much pain.

I posted a suggestion about a doctor for ESWT on your other thread - about 3 minutes before you posted this! Have a look. I think Drs Reid and Kosova would be excellent people to consult - for a second opinion, and/or for ESWT (which you should absolutely consider before even breathing the word surgery).

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:27 (076486)

Dr. Zuckerman
I know what the typical PF pain is like, but how is tts different from PF as far as symtoms go? How would I know if my PF is improving or not and if my pain could really be tts. My nerve test report said 'mild tts' in my left foot ( where all my pain is) and 'moderate tts' in my right foot (no pain there) Also, what steps should I be taking now with my right foot to avoid problems down the road.
Also, what do you think about my Dr. having done about 10 eswt's....do you think this is enough experience?

Thanks for your help...Paula T

Re: How long should I wait before considering ESWT??

Paula T on 3/15/02 at 08:28 (076487)

Thanks again..I'll check it out...Paula T

Re: TTS & Diagnosis

john h on 3/15/02 at 09:52 (076505)

Dr. Zuckerman and any of our other Doctors: Do you not think that TTS may be one of the more over diagnosed conditons out there for foot problems. The doctor who did my electrical studies was an orthopedic surgeon and he now does only electrical nerve studies as a full time profession so he is very experienced in his profession. He said that even with positive results there is no guarantee the surgeon will find a trapped nerve. My surgeon uttered the same words. Perhaps,if you have some sort of growth that can be identified on x-ray or MRI you could positively say that you have something pressing on a nerve but other wise it is very much a gamble. The TTS surgery may be beneficial in that you eliminate a possibility.

Re: How long should I wait before considering ESWT??

john h on 3/15/02 at 09:54 (076506)

A 2nd surgery so soon Paula really sounds over the top. Like Julie I would run not walk for a second or third opinion.

Re: How long should I wait before considering ESWT??

john h on 3/15/02 at 10:00 (076508)

Dave: You are right that TTS and PF release is risky business but there are thousands of people out there who have been cured by PF release. They never post on our board because they are well. Judy's husband had a PF release some years ago and runs, plays baseball and is cured. Carl Lewis was cured and back to running after a release. I think I read that only about 3% of the estimated 6 million new PF cases each year end up with surgery. I think that a correct diagnois and the skill of your doctor is 95% of the success of the surgery. I would also say that surgery should be the very very very last option because there is a whole lot that can go wrong and make you worse.

Re: How long should I wait before considering ESWT??

John S on 3/15/02 at 12:23 (076514)

I am one of the 'cured ones'. I had surgery to deal with my PF.I simply couldn't cope with the pain and the attendent hobbling. So I went for the knife as quickly as possible. A year of rehabilitation and I was back to running and playing sports. I certainly was not 100%, but I was back on the road doing what I really enjoy. I thought I was home free. Not so, I developed tibal tendonitis. Big drag! What next? Several months of trying to understand this new menace. I finally found a podiatrist that correctly analysed my problem. He prepared orthotics that relieved presseure on the offending tendon. Bottom line. This has permitted about 90% useage. I am running 1 hr 30 four times per week and playing competitve baseball on Sundays. I understand the need to go slow and exhaust less drastic measures. Had I been aware of this website, I may have indeed procedded with more caution. In my case--damn the torpedos and bring on the knife. Worked for me.

Re: How long should I wait before considering ESWT??

JudyS on 3/16/02 at 19:38 (076603)

Hi Honey!

Re: How long should I wait before considering ESWT??

Julie on 3/17/02 at 02:13 (076620)

Hi John S! It's nice to meet Judy's husband and to hear your success story.

(Maybe you've posted before and I didn't realize it was you? Judy's 'hi honey' tipped me off.)

Re: How long should I wait before considering ESWT??

John S on 3/19/02 at 12:06 (076836)

Julie

I don't feel that I can make much of a contribution to the website,therefore I rarely post.In fact, the post you read was my first and perhaps my last. I sometimes read some of the posts people make. I find the site to be informative, fun, gooofy and sometimes zany. It appears that many of you have grown close over time and I don't want to intrude inyour cyber-community. I do want to thank you for the time that you spent with Chris while he was in London. He speaks warmly of you and was thankful of the help that your provided him with his homework assignment. Maybe we will meet when you journey to San Diego? John

Re: John S

Julie on 3/19/02 at 16:11 (076857)

John, this cyber-community is a broad church and there's always room in it for one more, especially when it's Judy's husband and especially when it's a success story. So don't make that your last post. I would love to meet you both and am sorry you didn't make it to London. If I ever get to San Diego, you'll be the first to know!

Please give Chris my best wishes. We had a great talk.

Re: How long should I wait before considering ESWT??

nancy s. on 3/19/02 at 16:56 (076863)

hi, john s! see you in july?
nancy

Re: How long should I wait before considering ESWT??

John h on 3/19/02 at 17:59 (076874)

Your post about the success of your surgery provides a lot of hope for many people. All we usually hear on the board are about the failures. Laurie is about to have a PF release along with two other surgeries so your post will be double welcome by her.