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Dr. Zuckerman...

Posted by Tom M on 4/13/02 at 20:50 (079565)

Are you familiar with Horizon PPO and how much they'd cover? What is the success rate of ESWT? I understand surgery is not always effective? I have the molded shoe inserts, but haven't seen any results. I've had 4 injection without benefit. My podiatrist uses a mixture of lidocaine, dexamethasone, and triamcinolone. As a pharmacist, I have doubts about the stability of this combination. Do you recommend a splint or special sock? I'm 6 feet tall 260lbs and haven't been able to run since October. I'd like to get back to my distance running. Is there any hope? Many thanks!

Re: ...or any of the MDs here

Tom M on 4/13/02 at 20:51 (079566)

thanks

Re: Dr. Zuckerman...

Dr. Zuckerman on 4/13/02 at 23:00 (079572)

Hi

I am very familiar with Horizon PPO. The sucess rate of ESWT is about 80%
We are getting coverage with Horizon for ESWT. If you would like our ESWT
informational packet . Please e-mail me at (email removed)

Re: Dr. Zuckerman...

Dr. Cozzarelli on 4/14/02 at 05:54 (079584)

Hi Tom:

I was previously a pharmacist and the cocktail injection is fine. This is quite common that a short acting steroid along with a long acting steroid be utilized. The problem is how many times are you qoing to be injected. ESWT is a better choice. The surgical procedures involved vary dpending on what the problem is. I think that Dr. Zuckerman is on the money suggesting ESWT. It is non-invasive, realitvely high success rate. Have you had physcial therapy? Niht splints do help quite a bit. There are anterior and posterior splints available.

Dr. John Cozzarelli

Re: C

paula on 4/14/02 at 12:09 (079611)

first i've heard there are anterior and posterior night splints. how do i find out more?

Re: C

paula on 4/14/02 at 12:10 (079612)

i mean Dr. C.

Re: C

Dr. Cozzarelli on 4/14/02 at 16:42 (079635)

In our practice wee use two types of splints. The anterior sits on the top of your leg which makes sleeping with it more comfortable. The posterior splint is your typical splint on the bac of your leg. The anterior splint is ABS plastic with velcro straps. It works quite effective. If your walk on it, it will crack.

Dr. John Cozzarelli

Re: Physical Therapy?

Tom M on 4/14/02 at 17:06 (079640)

The only excersize I do is at the gym on the Universal machine where you have shoulder pads connected to weight plates and raise up on your toes. PT would involve massage, whirlpool, ultrasound? What else?

Re: Eek! my post got messed up

Carole C in NOLA on 4/14/02 at 20:00 (079656)

I posted in answer to Judy on the Social/support section, saying this:

Thanks, Judy. I took that ladder photo just for my friends here at heelspurs.com . It amazes me still that I was scampering up and down those. I think the ship's motion makes it easier.

Carole C

But, it got posted three times and when I read them it's a post from Dr. Cozzarelli to Tom. Oh well!!! Just wanted to mention that wasn't exactly what i had in mind. LOL

Carole C

Re: injections

Tom M on 4/14/02 at 20:22 (079662)

Thanks, Dr. Cozzareli. I'm not sure if the ultrasound would benefit me, as I'm already taking the injections. Perhaps the steroid would be distributed better with the phonopheresis(it did help me for patelar tendonitis)? I will look into the electrical stimulation and paraffin therapies.

Re: injections

Dr. Cozzarelli on 4/15/02 at 05:06 (079680)

Tom:
The idea is to hit it hard conservatively but yet aggresive at the same time meaning take and anti-inflammatory, do PT, use a night splint, orthotics, shoe modification, stretching for two weeks, If you don't see some improvment you have to decide if the pain is tolerable or should something more aggresive be done.

Dr. John Cozzarelli

Re: ...or any of the MDs here

Tom M on 4/13/02 at 20:51 (079566)

thanks

Re: Dr. Zuckerman...

Dr. Zuckerman on 4/13/02 at 23:00 (079572)

Hi

I am very familiar with Horizon PPO. The sucess rate of ESWT is about 80%
We are getting coverage with Horizon for ESWT. If you would like our ESWT
informational packet . Please e-mail me at (email removed)

Re: Dr. Zuckerman...

Dr. Cozzarelli on 4/14/02 at 05:54 (079584)

Hi Tom:

I was previously a pharmacist and the cocktail injection is fine. This is quite common that a short acting steroid along with a long acting steroid be utilized. The problem is how many times are you qoing to be injected. ESWT is a better choice. The surgical procedures involved vary dpending on what the problem is. I think that Dr. Zuckerman is on the money suggesting ESWT. It is non-invasive, realitvely high success rate. Have you had physcial therapy? Niht splints do help quite a bit. There are anterior and posterior splints available.

Dr. John Cozzarelli

Re: C

paula on 4/14/02 at 12:09 (079611)

first i've heard there are anterior and posterior night splints. how do i find out more?

Re: C

paula on 4/14/02 at 12:10 (079612)

i mean Dr. C.

Re: C

Dr. Cozzarelli on 4/14/02 at 16:42 (079635)

In our practice wee use two types of splints. The anterior sits on the top of your leg which makes sleeping with it more comfortable. The posterior splint is your typical splint on the bac of your leg. The anterior splint is ABS plastic with velcro straps. It works quite effective. If your walk on it, it will crack.

Dr. John Cozzarelli

Re: Physical Therapy?

Tom M on 4/14/02 at 17:06 (079640)

The only excersize I do is at the gym on the Universal machine where you have shoulder pads connected to weight plates and raise up on your toes. PT would involve massage, whirlpool, ultrasound? What else?

Re: Eek! my post got messed up

Carole C in NOLA on 4/14/02 at 20:00 (079656)

I posted in answer to Judy on the Social/support section, saying this:

Thanks, Judy. I took that ladder photo just for my friends here at heelspurs.com . It amazes me still that I was scampering up and down those. I think the ship's motion makes it easier.

Carole C

But, it got posted three times and when I read them it's a post from Dr. Cozzarelli to Tom. Oh well!!! Just wanted to mention that wasn't exactly what i had in mind. LOL

Carole C

Re: injections

Tom M on 4/14/02 at 20:22 (079662)

Thanks, Dr. Cozzareli. I'm not sure if the ultrasound would benefit me, as I'm already taking the injections. Perhaps the steroid would be distributed better with the phonopheresis(it did help me for patelar tendonitis)? I will look into the electrical stimulation and paraffin therapies.

Re: injections

Dr. Cozzarelli on 4/15/02 at 05:06 (079680)

Tom:
The idea is to hit it hard conservatively but yet aggresive at the same time meaning take and anti-inflammatory, do PT, use a night splint, orthotics, shoe modification, stretching for two weeks, If you don't see some improvment you have to decide if the pain is tolerable or should something more aggresive be done.

Dr. John Cozzarelli