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EPF Failure

Posted by EKC on 3/31/02 at 06:54 (078085)

Add an EPF failure to the database.
I had EPF done 9/2001 on one foot. Today is Easter, 3/2002.
It feels like the Fashia is pulling out of both heels. I can barely
walk around the house. The EPF was a failure. I do not belive
the EPF made me worse, and I belive I had a good doctor, but I simply belive not enough was cut or it simply grew back (the old way). When my
EPF foot is flexed, it is obvious the fashia is still there & tight.
I truely belived it was all getting better in Dec due to Physical
Therapy. But I've been going downhill since.

Re: EPF Failure

Dr. Zuckerman on 3/31/02 at 17:51 (078116)

Would you go thru another plantar fascia release ?

Re: Join the group

BrianG on 3/31/02 at 20:57 (078131)

Hi EKC, welcome to the EPF failure group. I believe you were right when you said not enough of the fascia was cut. Unfortuntaly, once a surgical method like this has been approved, there is no group keeping statistics on healing rates. What can we do about it? I don't know, do you have any ideas? I highly doubt that the healing rate is 80%, as was quoted to me. Seems like we could do something!

BrianG

PS Something is very wrong when a procedure like this is covered by insurance, but ESWT is not.

Re: Join the group

Dr. Zuckerman on 3/31/02 at 21:11 (078132)

It even has its own CPT code that pays a higher rate from the insurance companies. I still would consider either ESWT or another release only miminial incision incision but this is only if there isn't any nerve damage or entrapement

Re: Join the group

EKC on 4/01/02 at 08:02 (078138)

See my other posts on the message boards.
I would not get another EPF, simply becuase I don't feel it was adequate, *in my case*.
I am contemplating a full release (TTS/PF) by a podiatrist who so far, in my opinion, seems
to be very qualified. Stay tuned. Easter weekend was really bad for me. So I may get this done
very soon.

Re: Success/Failure Dbase

EKC on 4/01/02 at 08:09 (078139)

I did not find on heelspurs.com any strict-'success/failure rate' database.
I propose one, if 'Scott' can do it.

I propose the dbase contain the following fields (yes, I'm a computer geek who knows her way around a dbase):
Number of years of PF before surgery
Drs. Name/Location
Post-Op therapies (none, Ultrasound, etc)
Rate the pain/success after 3, 6 months, 1, 2 years.
Pre-op complications (diabeates, neuropathy)

I propose to leave out the miscelleanea like
Cause of PF
Conservative herapies tried

I think we should simply look at the population going into the surgeries, and their long-term outcomes.

Note: I think most would agree that 'pre-op' complications such as neuropathy, etc, might be correllated to outcome.

Re: Join the group

Pam B on 4/01/02 at 09:33 (078147)

I would thoroughly research a full release before having one......I had a partial release in Feb which is currently still healing.....I have other problems with my feet but already I can tell that my heel feels better than before surgery.......I had the open procedure after much research on the EPF which seems to have a very high failure rate as far as I am concerned......my pod would not do a full release......he stated that it usually creates more problems within a year or so with the outside of the foot......I have also seen many posts where people that had full releases have more pain now than when they started with their foot problems......good luck to you in whatever you decide and keep us posted

Re: EPF Failure

Ed Davis, DPM on 4/03/02 at 22:14 (078440)

I am less than enthusiastic about EPF and prefer other methods is surgery is to be done.
Ed

Re: Join the group

Ed Davis, DPM on 4/03/02 at 22:15 (078441)

Read John H.'s post in the ESWT board. He clearly states the politics of the situation.
Ed

Re: EPF Failure

Dr. Zuckerman on 3/31/02 at 17:51 (078116)

Would you go thru another plantar fascia release ?

Re: Join the group

BrianG on 3/31/02 at 20:57 (078131)

Hi EKC, welcome to the EPF failure group. I believe you were right when you said not enough of the fascia was cut. Unfortuntaly, once a surgical method like this has been approved, there is no group keeping statistics on healing rates. What can we do about it? I don't know, do you have any ideas? I highly doubt that the healing rate is 80%, as was quoted to me. Seems like we could do something!

BrianG

PS Something is very wrong when a procedure like this is covered by insurance, but ESWT is not.

Re: Join the group

Dr. Zuckerman on 3/31/02 at 21:11 (078132)

It even has its own CPT code that pays a higher rate from the insurance companies. I still would consider either ESWT or another release only miminial incision incision but this is only if there isn't any nerve damage or entrapement

Re: Join the group

EKC on 4/01/02 at 08:02 (078138)

See my other posts on the message boards.
I would not get another EPF, simply becuase I don't feel it was adequate, *in my case*.
I am contemplating a full release (TTS/PF) by a podiatrist who so far, in my opinion, seems
to be very qualified. Stay tuned. Easter weekend was really bad for me. So I may get this done
very soon.

Re: Success/Failure Dbase

EKC on 4/01/02 at 08:09 (078139)

I did not find on heelspurs.com any strict-'success/failure rate' database.
I propose one, if 'Scott' can do it.

I propose the dbase contain the following fields (yes, I'm a computer geek who knows her way around a dbase):
Number of years of PF before surgery
Drs. Name/Location
Post-Op therapies (none, Ultrasound, etc)
Rate the pain/success after 3, 6 months, 1, 2 years.
Pre-op complications (diabeates, neuropathy)

I propose to leave out the miscelleanea like
Cause of PF
Conservative herapies tried

I think we should simply look at the population going into the surgeries, and their long-term outcomes.

Note: I think most would agree that 'pre-op' complications such as neuropathy, etc, might be correllated to outcome.

Re: Join the group

Pam B on 4/01/02 at 09:33 (078147)

I would thoroughly research a full release before having one......I had a partial release in Feb which is currently still healing.....I have other problems with my feet but already I can tell that my heel feels better than before surgery.......I had the open procedure after much research on the EPF which seems to have a very high failure rate as far as I am concerned......my pod would not do a full release......he stated that it usually creates more problems within a year or so with the outside of the foot......I have also seen many posts where people that had full releases have more pain now than when they started with their foot problems......good luck to you in whatever you decide and keep us posted

Re: EPF Failure

Ed Davis, DPM on 4/03/02 at 22:14 (078440)

I am less than enthusiastic about EPF and prefer other methods is surgery is to be done.
Ed

Re: Join the group

Ed Davis, DPM on 4/03/02 at 22:15 (078441)

Read John H.'s post in the ESWT board. He clearly states the politics of the situation.
Ed