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So tired of doctors dogging other doctors orthotics

Posted by Carmen on 4/16/02 at 11:33 (079828)

What a drag! I am so tired of hearing 'Where'd you get 'THOSE' orthotics? We offer something so much better!'
POO! That's what I say! Poo to all of them...
I JUST got new rigid orthotics to help correct my pronation on Fri of last week....Monday I saw an ortho and he said that to me about my orthtoics. I sid 'You know what? I don't want to hear anything negative about these...I haven't even passed the break in period yet to say whether they DO suck or not...I need positivity right now...or I WILL break down and cry after what all I have been through adn the money I have spent!'
After listening for a few minutes (I told him I was tired of dr's running in and out without even caring about what I say) he said I am okay with those orthotics...they are actually fine they are just older models than we use. the footbed is harder as well...but if they help they are fine!'
ugh...just want to get all 8 docs together and say FIGURE IT OUT!

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 14:42 (079857)

Wow, Carmen! You have been to EIGHT doctors? Holy Smokes! That has got to take a lot of psychological fortitude. I don't think I'm that tough.

I haven't even had the nerve to get to my first DPM. My rheumatologist was the one that referred me to my C.Ped. What do they do? Do most of them do a gait analysis on a treadmill? That's what I would want if I went. A *good* gait analysis and appropriate smaller orthotics. Do they look at the soles of your shoes? Or do they do a lot of x-rays and then just send you home with pamphlets saying things you already know?

The idea of seeing a DPM is scary to me. After having PF, I'm acutely aware that doing the wrong things with my feet can be disastrous.

Carole C

Re: Also, imagine if you went in with no orthotics!

Carole C in NOLA on 4/16/02 at 15:08 (079861)

If they severely criticize brand new expensive orthotics made by another DPM of good repute, imagine what they'd say if you went in with no orthotics at all!

I think a good DPM should not try to hustle expensive orthotics, and I hope that when/if I see one, that I can trust him to tell me that I *DON'T* need expensive orthotics if that is the case.

But, since I've only lived in Metairie (New Orleans area) for a couple of years, I don't know anyone here who has foot problems or a DPM. I have no relatives here. So, the only way I know of to find a good ethical DPM is to ask about his certifications and then hope for the best. Maybe next year if I like my new internist I can ask him who is good.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Carmen on 4/16/02 at 17:43 (079877)

Ridiculous huh Carole? Let me see if I can give you a briefing...
1st doc-you have pf... taped my feet I asked what if it comes off he says when you come back in 6 days I guarantee this tape isn;t going anywhere it will still be here. Next morning? Tape? POOF gone!
No instructions to stretch, wear sheos at all times, ice etc.
Wrote him a letter about caring for his patients...mean ass. He barely saw me for 2 minutes.
2nd doc?-foot and ankle ortho-You're too young to have foot trouble here's a prescription for vicadin (sp?) for the pain. come back if you want a shot.
3rd-Shots of marcaine and lidocaine and 1% cortizone....tipped me backwards in a chair so I couldn't see the needle spiraling down into the side of my already painful arch. couldn't walk for a week...next visit to him tried to convince me I felt better before coming at me again. He got one foot nad I was out the door crying like a maniac vowing to never return.
4th doc-neurologist-EMG,NCV,Somato Sensory tests...needles, time and aggravation with a promiseto come back in two months if I haven't gotten better. Crying...came back was told it was probably MS....had IV treatment for MS brain MRI states clearly nothing wrong...ran away from him before Lumbar Puncture came.
5th-Back to the GP (he counts as two as I saw two DIFFERENT docs there that had nothing to offer me but depair.
6th-VERY nice Pod....famous Pod that travels around the world talking about surgery.....had no real understanding of plain old PF. Prescribed the dreaed orthotics that took 10 weeks to get here and provided NO support.
7th-NICE doc.....very smart and listened to everythign I said...didn't rush me....prescribed more PT for me and eventually went back for the CURRENT orhtotics I now have.
8th-Orthopedic had a 'gait analysis' done...whatever.....walked across a pad on the floor four tiems on each side what a joke.
OOPS.I saw another Ortho AND a Physiatrist back in the middle of all this...
Sigh....
now you can see why I am really tired of this?
ALL in all...not one of them said I pronated .....until I pointed out the way my ankles landed standing still....NOW three say I do.
Amazing.
;-)

Re: sorry for the terrible spelling...I type too fast. (nm)

Carmen on 4/16/02 at 17:44 (079878)

.

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 18:01 (079881)

AAAAAgh, Carmen! These docs sound like a total waste of your time and money. Do the orthotics that #7 made for you seem to be working out at all?

The 'gait analysis' of #8 doesn't sound like the thorough analysis Julie was describing. She said it is done on a treadmill, with photography I think, to show you why he thinks what he thinks. Or am I dreaming that she said that? I don't know.

Not to repeat myself, but... AAAAAAAAAAAAAAARGH! LOL

Carole C

Re: So tired of doctors dogging other doctors orthotics

Rich on 4/16/02 at 18:39 (079888)

Carmen, what a horrific ordeal. And that's usually the word I have reserved for the cortisone injection!

I lucked out with a great pod on the first try, at least for me. He's as direct as I am! He's explained in detail and sent me off to the internet as well....his mistake, cause I found all of you! He advised the athletics I wear and a good OTC insert and against custom orthos...so far. He recommended PT and finally, reluctantly the injection. That wasn't even as bad as I expected. He took his time and made sure I was comfortable through the whole thing. Of course, my second foot is confusing him and it's not as easy this time.

Carole....I never had my pod say anything about gait analysis?

Well....I'll be calling him tomorrow, I really messed up today!

Rich

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 19:31 (079899)

Sorry to hear that you messed up today, Rich! But I know that you really needed to get OUT and enjoy this beautiful weather and life today. With any luck, maybe you can do some damage control. Ice, ice, ice, and more ice, and any gentle stretching that has helped you too. You know the routine. I sure hope that you feel better soon.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Dr. Zuckerman on 4/16/02 at 20:14 (079910)

You just have to try my orthosis . They will even do all of your errands, clean the house, and rub your feet.

Re: Now THAT's an orthotic!!

Carole C in NOLA on 4/16/02 at 20:36 (079913)

(laughing)

Now Dr. Z, THAT sounds like a great orthotic! I want that one. If I pay extra, maybe I can get one that will do windows too. (giggle)

Carole C

Re: Doc: Oh dear who made those Me: You did!

sandy h on 4/17/02 at 02:53 (079943)

The funniest of all was when the orthotics maker said 'now what was done wrong in this adjustment was it doesn't give support all the way along the arch. Who did that?' and I had to answer 'You did!'' I think orthotics made my problem a lot worse.

Re: the positive side

Carmen on 4/17/02 at 08:15 (079958)

My PT 's are getting together to do a video and biomechanical analysis for me (on the side...as friends for free) and we are going to get everything evaluated by a lower extremities specialist in VA.
That includes a REAL Gait analysis....we're using my camera and all. If this goes well they may get funding for their facility to do these for the harder cases....

Re: sign me up Dr. Z

Carmen on 4/17/02 at 10:58 (079977)

I'll give you my house for those!

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/17/02 at 11:07 (079979)

I think most of the time, those of us who make the orthotics have different opinions about the materials used and how the patient was casted. I had a guy in here a couple of days ago who had orthotics made three months ago. The had him stand in the foam box to take the impression. This guys is flat footed as all get out, and they made him stand in the foam. I did not make fun of his orthotics, but I showed him how it was not supporting his arch like it should be.

I persoally get tired of seeing people bring in crap for an orthosis and tell me how much they paid for it. Drives me crazy. How this other company has been in business for over twenty years is beyond me.

Richard

Re: the positive side

Carole C in NOLA on 4/17/02 at 12:49 (079996)

Oh I am SOOOOOOO jealous!!!

At last you will have some answers.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/17/02 at 12:54 (079997)

Richard, I never even HEARD of PF until last October, and I know better than to accept an orthotic made while I'm standing in a foam box!!!!!!

Maybe more people would be willing to go to foot experts, and fewer people would have foot problems, if this type of moron just stuck to selling used cars. I think that guy should be refunded his money in full and give compensation for the pain and time wasted.

Hope this is not an over-reaction; I'm furious (livid, seeing red, FURIOUS) about something else at the moment and just happened to read this.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/17/02 at 16:15 (080024)

Richard:

I definitely feel the same as you on this matter. I certainly will not criticize any reasonably well made device. I will adjust, repair the device letting patients know that I am basically trying to make it more effective.

Unfortunately, a whole lot of untrained individuals have decided that this is an area they can make a fast buck and it is very unfortunate for the patient. There is a chain of retail store selling pre-fab devices as 'custom-fitted' for hundreds of dollars. There are weekend courses for physical therapists purporting to create two day orthotic 'experts.' There are companies who market 'computer' generated orthotics to unitiated practitioners, tempting them by telling them how much extra revenue they can generate.

I have always supported coming up with standards. The standards would be voluntary but would let the public know if such standards are being followed by a provider or not so they could make intelligent decisions.
Ed

Re: So, what is the "Do Suck or Don't Suck" time limit?

Ardee W. on 4/17/02 at 22:34 (080063)

Carmen, I was feeling bad and having tears for you AND laughing my head off at the same time. I read what you said to my husband and he laughed heartily also. Thanks for your candor and I understand your frustration even though I have limited visits with my POD. Sure hope your next action towards happy feet gives you good results with great options!

Also, are you moved and adjusted? Someone on another board here was looking for you and wondering about your move also. Blessings to you.

Re: Carole, Thanks

Ardee W. on 4/17/02 at 22:39 (080065)

Carole, just wanted to say how much I appreciate your posts and answers. You seem to really be aware of your feet and pay attention and adjust accordingly. I have learned much from that and all of your straight forward advice and humor. This thread was fun to read and informative!

Re: Sorry to hear of your "setback", Rich

Ardee W. on 4/17/02 at 22:42 (080067)

Hope that your feet recovered quickly and the phone call to dr. was encouraging. I am so praying and hoping the cast and splint are the final answer for you.... is it like after ESWT for waiting for better results in pain relief? Keep leaning on our Lord!!

Re: P.S. Carole

Ardee W. on 4/17/02 at 22:46 (080068)

I forgot to thank you also for your warnings about the recumbent bicycle NO NOs. I had just bought one to start cardio exercizing that didn't hurt my feet. I never put it past the 1 tension and I always wear my good tennis shoes.....thanks, again...

Re: Carole, Thanks

Carole C in NOLA on 4/17/02 at 22:51 (080069)

Wow, thank you! I am glad if anyone can benefit from my posts anywhere near as much as I've been helped by other posts on these message boards.

Carole C

Re: P.S. Carole

Carole C in NOLA on 4/17/02 at 22:57 (080071)

Good thinking! Then maybe you won't mess up your feet on it like I did last September.

Also, make sure the seat is far enough forward that your legs don't ever get completely straight or hyperextend. Otherwise the Achilles and other tendons seem to get kind of 'twanged' or strained on each go-around. I didn't realize that when I was first injuring my feet.

I'm riding mine again now, on the lowest tension (I forget if that's 0 or 1) and I wear only my New Balance or SAS tie-up shoes on it. I try to ride with good posture and form, and to keep my feet at a reasonable, steady angle as I ride too, so the Achilles tendon doesn't get strained from sudden jerking around of my ankles. So far, so good. It feels so great to be building these muscles back up, slowly. :)

Carole C

Re: Recumbent Bikes

Rich on 4/18/02 at 07:25 (080098)

I've been looking at these. Do you recommend a particular type? Because of my height, I know I need one fully adjustable. Thanks for the tip on leg extension. I wouldn't have thought about that.

It's a New Day,
Rich

Re: So, what is the "Do Suck or Don't Suck" time limit?

Carmen on 4/18/02 at 08:06 (080114)

Am I slow in the head? Who's your husband?? sigh...yes Ardee...it has been a 'fun' ride. I am learning something NEW every day...but the funny thing is the one lesson that keeps comng back to me over and over is 'Patience'
I have been running from that little bugger and he keeps coming back to me!
I am not moved yet...I wrote to Pam B and told her what was up with me...hopefully it will be in June. :-)

thanks for your thoughts...YOU take care of you!

Re: Recumbent Bikes

Carole C in NOLA on 4/18/02 at 11:16 (080129)

Sounds like you are feeling better! I'm keeping my fingers crossed and hoping that you didn't re-injure yourself much yesterday when your cast was off.

I don't have a particular type of bike in mind to recommend. When I bought mine, my main criteria were that it had to be EXTREMELY stable and able to handle a heavier person like me. Also, I wanted the read-out to have the distance and time for this session, and odometer, but most of them do. If you want it to measure your pulse rate that might cost a little more but it might be useful. Mine doesn't have that. I wanted it to be quiet so I could ride it and watch TV, but these days most of them are pretty quiet. I wanted it to be comfy while riding it, too.

I went to Sports Authority to buy my recumbent bike, because they carry a lot of them. What I did was try out those that cost less than the maximum price I had in mind, and then I tried some that were fancier just to see if I could be tempted to buy something more expensive. They were having a sale so I got the Excel 395 magnetic bike for a very low price. You can see it at

http://www.thesportsauthority.com/product/index.jsp?productId=223657&position=0&cp&searchId=120313929&keywords=Excel+395&parentPage=search

If that was too long, you might have to copy and paste it into your browser to make it work rather than clicking on it.

I'm completely satisfied with what I bought, though once I have become able to ride it more, I may want to get one of those pulse rate measuring gizmo's. My PF was not due to the bike itself, but how I used it (or mis-used it, to be more accurate). There are lots of other good recumbent bikes out there and the sale price helped me to decide on this one. Some of the other ones I tried did not feel comfortable to me at all, so I'd suggest trying different bikes in the store.

One bike that I almost bought had the handlebars that move in and out too so that you exercise your arms at the same time. Those are probably good too.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/18/02 at 15:16 (080164)

The Pedorthic Footwear Association just reported that congress put our effort of requiring only those with the proper certification to fill orthosis prescriptions. What a setback.
Richard

Re: Dr. Z, you so silly!!!

Mahatmelissama on 4/18/02 at 18:11 (080202)

I would settle for ones that kill pain ;)

Re: Recumbent Bikes

Rich on 4/18/02 at 20:20 (080220)

I looked at that same bike and liked it. On the same site, the other bike I like is the Pro Form 970ST. It's priced at $299 here at Academy. Your bike ran for $239 on sale recently.

Yeah, I did hurt myself the other day and been back in the boot ever since! Looks like I will be in this a little longer. I guess I lost some of my patience and jumped the gun. I did immediate icing and stretching and got some relief with Aleve. Haven't taken any more since Tues night.

Thanks for everything!
Rich

Re: Recumbent Bikes

Carole C in NOLA on 4/19/02 at 14:47 (080332)

The Pro Form 970ST looks like a great bike too, and it has the adaptability of being a weight lifting bench too. I am hoping to start some weight training, after reading what Wendy and Carmen are saying on the social board, so if I was shopping for a bike this week I'd definitely look at that one!

Hopefully when you try them out at the store, the best choice for you will be clear (whatever that choice is). Get the bike that seems like fun, that you feel you will ride the most. See how much space they take up compared with each other; I was really surprised that my bike takes up as much space as it does. It seems to take up a lot of space in my living room, but in the store it didn't look like it took much space at all! :)

I bought my bike on sale for less than $150, but that was last August before my PF and so probably the prices have gone up or else they undercharged me. I was surprised at how inexpensive it was. LOL

Carole C

Re: seat adjustment on recumbent bikes

Carole C in NOLA on 4/19/02 at 14:57 (080333)

I would also like to mention for those with PF who wish to ride recumbent bikes, that if your achilles tendon and calf muscle tend to be tight due to PF, you will want to adjust the bike so that your legs straighten out even less than they did before PF.

In other words, if you are tight I am thinking it would be easier to strain your Achilles tendon than when your feet were healthy, so make sure your knees do not straighten as much as they did then. At least, for my particular feet and tight tendons it seems like this helped.

Also, I did not ride my bike during the worse part of my PF so I have no advice for that time period. Since my PF was caused by my bike, I didn't dare risk experimenting with the bike when I was in agony. I'm talking about later on after healing had brought the pain level down to at least 2-3 on a scale of 1-10.

Carole C

Re: sorry you're back in the boot

Carole C in NOLA on 4/19/02 at 15:03 (080337)

Darn! I know that boot is driving you up the wall. It would me, anyway. Good for you to immediately ice and stretch and take your Aleve! You were right on top of things and probably that will help you a lot.

I've noticed that when I'm retaining water for any reason (like monthly cycle) my PF swell and hurt a little bit, and ice seems to help. Maybe it would help to keep icing even though it's been a few days. (?) Don't know.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/19/02 at 19:14 (080377)

Richard:

Do you have a reference on that action? Appreciate your time in looking it up.

It is really difficult to obtain legislation that can be percieved by some as restricting trade. That is why I favor voluntary standards by our industry. The public can then be educated to utilize the services of those who agree to abide by such standards. Additionally, insurance companies need to know exactly what they are paying for such that they are paying for legitimate products with therapeutic benefits. I have seen patients with insurance companies allowing one pair of orthotics per year have the benefit squandered on bogus orthotics. I am not an insurance company fan but it is to their benefit and to the benefit of their insured to know what constitute legitimate orthotic services.
Ed

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/19/02 at 19:20 (080378)

My post that answers this post brings up someone elses message-- oh well?

Will try again.

Richard:

Do you have a reference on that action?

It is difficult to solve this problem via legislative action. There is a perception that an effort to restrain trade exists, albeit incorrect in this case.

I feel that voluntary standards or certification is the way to go. The public can then be educated as to the providers who are willing to practice by such standards. The insurers, too, need to know what they are paying for, that is what constitutes a legitimate orthotic service.
Ed

Re: I am the one who feels slow in the head....

Ardee W. on 4/20/02 at 14:15 (080474)

whenever I try to keep up with these boards....I never know exactly the best way to look at them. I am not on everyday either, though. I do a lot more reading than posting....it is sometimes overwhelming trying to sift through all the information and make a decision for yourself. But, I am so thankful for everyone else's posts. Anyway, my husband isn't on the board, his name is Vernon and he has been pretty great about this whole PF thing. We were in the middle of building our son's home and ours...I mean doing ALL of it when I came down with this PF....so, I am practically no help at all to him now.....I went from tieing rebar and going up and down ladders to sitting in our fifth wheel sorting out screws.....really....

Hope things are well with you!

Re: sorry for the terrible spelling...I type too fast. (nm)

BGCPed on 4/21/02 at 12:44 (080564)

Man you have been through the mill. I dont understand why you are having such bad luck. Maybe I am lucky that the Doctors that refer to me are very skilled and are not too quick to do surgery or pump you full of cortisone.

The sad fact is that many people in the foot arena Cpeds, DPM, Ortho, PT etc. are not very skilled at doing gait or biomechanical evals. There are many tricks and tools to use. An example is a Coleman Block. It is basically a piece of wood, it is a way to evaluate if a high arch or cavus foot will correct with an orthotic. I bet that the majority of facilties dont own one or know what it is, or how to use it.

Many are also poor at giving shoe advice. I dont expect them to be a buyers guide of shoes BUT if they dont know send the PT to somebody that does.

I am so sick of seeing mostly women coming in with a pair of crappy easy spirits or keds, or worse some slip on low heel shoes. And they say that they have had pf for over a year and have had 3 or more injections. I ask if they have ever been told about footwear and most say, nobody has ever gone over that with me. or, All I was told was to not wear heels just lace up shoes.

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/22/02 at 08:23 (080636)

I was reading in the March issue of 'Current Pedorthics' where the PFA president wrote an article concerning this problem. Here is a quote from the article. 'we have not been invited to sit at CMS's negotiated rulemaking table. What this means is there will be nobody from PFA or BCP to voice opinions on who should be considered 'qualified providers' to dispense certain L code devices under the Benefits Improvement and Protection Acts.'

I know that there are a few doctors around here that believe our certificaton matters. There are others that seem to care less. I think it is because they just do not know the difference. The hard part is getting in their office to meet with them in order to let them know the difference.
Richard

Re: So tired of doctors dogging other doctors orthotics

BGCPed on 4/22/02 at 17:40 (080714)

Plus the Lobby from the big fast food dme providers want to keep it low to no skill. So when a person is done building a walker, unpacking a scooter,restocking shelves and delivering an oxygen canister to Mrs Smith he can dispense orthotics.

Re: the positive side

paula on 4/22/02 at 20:54 (080751)

who is this lower extremity expert. i would like to call him and see if he knows someone in atlanta

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 14:42 (079857)

Wow, Carmen! You have been to EIGHT doctors? Holy Smokes! That has got to take a lot of psychological fortitude. I don't think I'm that tough.

I haven't even had the nerve to get to my first DPM. My rheumatologist was the one that referred me to my C.Ped. What do they do? Do most of them do a gait analysis on a treadmill? That's what I would want if I went. A *good* gait analysis and appropriate smaller orthotics. Do they look at the soles of your shoes? Or do they do a lot of x-rays and then just send you home with pamphlets saying things you already know?

The idea of seeing a DPM is scary to me. After having PF, I'm acutely aware that doing the wrong things with my feet can be disastrous.

Carole C

Re: Also, imagine if you went in with no orthotics!

Carole C in NOLA on 4/16/02 at 15:08 (079861)

If they severely criticize brand new expensive orthotics made by another DPM of good repute, imagine what they'd say if you went in with no orthotics at all!

I think a good DPM should not try to hustle expensive orthotics, and I hope that when/if I see one, that I can trust him to tell me that I *DON'T* need expensive orthotics if that is the case.

But, since I've only lived in Metairie (New Orleans area) for a couple of years, I don't know anyone here who has foot problems or a DPM. I have no relatives here. So, the only way I know of to find a good ethical DPM is to ask about his certifications and then hope for the best. Maybe next year if I like my new internist I can ask him who is good.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Carmen on 4/16/02 at 17:43 (079877)

Ridiculous huh Carole? Let me see if I can give you a briefing...
1st doc-you have pf... taped my feet I asked what if it comes off he says when you come back in 6 days I guarantee this tape isn;t going anywhere it will still be here. Next morning? Tape? POOF gone!
No instructions to stretch, wear sheos at all times, ice etc.
Wrote him a letter about caring for his patients...mean ass. He barely saw me for 2 minutes.
2nd doc?-foot and ankle ortho-You're too young to have foot trouble here's a prescription for vicadin (sp?) for the pain. come back if you want a shot.
3rd-Shots of marcaine and lidocaine and 1% cortizone....tipped me backwards in a chair so I couldn't see the needle spiraling down into the side of my already painful arch. couldn't walk for a week...next visit to him tried to convince me I felt better before coming at me again. He got one foot nad I was out the door crying like a maniac vowing to never return.
4th doc-neurologist-EMG,NCV,Somato Sensory tests...needles, time and aggravation with a promiseto come back in two months if I haven't gotten better. Crying...came back was told it was probably MS....had IV treatment for MS brain MRI states clearly nothing wrong...ran away from him before Lumbar Puncture came.
5th-Back to the GP (he counts as two as I saw two DIFFERENT docs there that had nothing to offer me but depair.
6th-VERY nice Pod....famous Pod that travels around the world talking about surgery.....had no real understanding of plain old PF. Prescribed the dreaed orthotics that took 10 weeks to get here and provided NO support.
7th-NICE doc.....very smart and listened to everythign I said...didn't rush me....prescribed more PT for me and eventually went back for the CURRENT orhtotics I now have.
8th-Orthopedic had a 'gait analysis' done...whatever.....walked across a pad on the floor four tiems on each side what a joke.
OOPS.I saw another Ortho AND a Physiatrist back in the middle of all this...
Sigh....
now you can see why I am really tired of this?
ALL in all...not one of them said I pronated .....until I pointed out the way my ankles landed standing still....NOW three say I do.
Amazing.
;-)

Re: sorry for the terrible spelling...I type too fast. (nm)

Carmen on 4/16/02 at 17:44 (079878)

.

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 18:01 (079881)

AAAAAgh, Carmen! These docs sound like a total waste of your time and money. Do the orthotics that #7 made for you seem to be working out at all?

The 'gait analysis' of #8 doesn't sound like the thorough analysis Julie was describing. She said it is done on a treadmill, with photography I think, to show you why he thinks what he thinks. Or am I dreaming that she said that? I don't know.

Not to repeat myself, but... AAAAAAAAAAAAAAARGH! LOL

Carole C

Re: So tired of doctors dogging other doctors orthotics

Rich on 4/16/02 at 18:39 (079888)

Carmen, what a horrific ordeal. And that's usually the word I have reserved for the cortisone injection!

I lucked out with a great pod on the first try, at least for me. He's as direct as I am! He's explained in detail and sent me off to the internet as well....his mistake, cause I found all of you! He advised the athletics I wear and a good OTC insert and against custom orthos...so far. He recommended PT and finally, reluctantly the injection. That wasn't even as bad as I expected. He took his time and made sure I was comfortable through the whole thing. Of course, my second foot is confusing him and it's not as easy this time.

Carole....I never had my pod say anything about gait analysis?

Well....I'll be calling him tomorrow, I really messed up today!

Rich

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/16/02 at 19:31 (079899)

Sorry to hear that you messed up today, Rich! But I know that you really needed to get OUT and enjoy this beautiful weather and life today. With any luck, maybe you can do some damage control. Ice, ice, ice, and more ice, and any gentle stretching that has helped you too. You know the routine. I sure hope that you feel better soon.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Dr. Zuckerman on 4/16/02 at 20:14 (079910)

You just have to try my orthosis . They will even do all of your errands, clean the house, and rub your feet.

Re: Now THAT's an orthotic!!

Carole C in NOLA on 4/16/02 at 20:36 (079913)

(laughing)

Now Dr. Z, THAT sounds like a great orthotic! I want that one. If I pay extra, maybe I can get one that will do windows too. (giggle)

Carole C

Re: Doc: Oh dear who made those Me: You did!

sandy h on 4/17/02 at 02:53 (079943)

The funniest of all was when the orthotics maker said 'now what was done wrong in this adjustment was it doesn't give support all the way along the arch. Who did that?' and I had to answer 'You did!'' I think orthotics made my problem a lot worse.

Re: the positive side

Carmen on 4/17/02 at 08:15 (079958)

My PT 's are getting together to do a video and biomechanical analysis for me (on the side...as friends for free) and we are going to get everything evaluated by a lower extremities specialist in VA.
That includes a REAL Gait analysis....we're using my camera and all. If this goes well they may get funding for their facility to do these for the harder cases....

Re: sign me up Dr. Z

Carmen on 4/17/02 at 10:58 (079977)

I'll give you my house for those!

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/17/02 at 11:07 (079979)

I think most of the time, those of us who make the orthotics have different opinions about the materials used and how the patient was casted. I had a guy in here a couple of days ago who had orthotics made three months ago. The had him stand in the foam box to take the impression. This guys is flat footed as all get out, and they made him stand in the foam. I did not make fun of his orthotics, but I showed him how it was not supporting his arch like it should be.

I persoally get tired of seeing people bring in crap for an orthosis and tell me how much they paid for it. Drives me crazy. How this other company has been in business for over twenty years is beyond me.

Richard

Re: the positive side

Carole C in NOLA on 4/17/02 at 12:49 (079996)

Oh I am SOOOOOOO jealous!!!

At last you will have some answers.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Carole C in NOLA on 4/17/02 at 12:54 (079997)

Richard, I never even HEARD of PF until last October, and I know better than to accept an orthotic made while I'm standing in a foam box!!!!!!

Maybe more people would be willing to go to foot experts, and fewer people would have foot problems, if this type of moron just stuck to selling used cars. I think that guy should be refunded his money in full and give compensation for the pain and time wasted.

Hope this is not an over-reaction; I'm furious (livid, seeing red, FURIOUS) about something else at the moment and just happened to read this.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/17/02 at 16:15 (080024)

Richard:

I definitely feel the same as you on this matter. I certainly will not criticize any reasonably well made device. I will adjust, repair the device letting patients know that I am basically trying to make it more effective.

Unfortunately, a whole lot of untrained individuals have decided that this is an area they can make a fast buck and it is very unfortunate for the patient. There is a chain of retail store selling pre-fab devices as 'custom-fitted' for hundreds of dollars. There are weekend courses for physical therapists purporting to create two day orthotic 'experts.' There are companies who market 'computer' generated orthotics to unitiated practitioners, tempting them by telling them how much extra revenue they can generate.

I have always supported coming up with standards. The standards would be voluntary but would let the public know if such standards are being followed by a provider or not so they could make intelligent decisions.
Ed

Re: So, what is the "Do Suck or Don't Suck" time limit?

Ardee W. on 4/17/02 at 22:34 (080063)

Carmen, I was feeling bad and having tears for you AND laughing my head off at the same time. I read what you said to my husband and he laughed heartily also. Thanks for your candor and I understand your frustration even though I have limited visits with my POD. Sure hope your next action towards happy feet gives you good results with great options!

Also, are you moved and adjusted? Someone on another board here was looking for you and wondering about your move also. Blessings to you.

Re: Carole, Thanks

Ardee W. on 4/17/02 at 22:39 (080065)

Carole, just wanted to say how much I appreciate your posts and answers. You seem to really be aware of your feet and pay attention and adjust accordingly. I have learned much from that and all of your straight forward advice and humor. This thread was fun to read and informative!

Re: Sorry to hear of your "setback", Rich

Ardee W. on 4/17/02 at 22:42 (080067)

Hope that your feet recovered quickly and the phone call to dr. was encouraging. I am so praying and hoping the cast and splint are the final answer for you.... is it like after ESWT for waiting for better results in pain relief? Keep leaning on our Lord!!

Re: P.S. Carole

Ardee W. on 4/17/02 at 22:46 (080068)

I forgot to thank you also for your warnings about the recumbent bicycle NO NOs. I had just bought one to start cardio exercizing that didn't hurt my feet. I never put it past the 1 tension and I always wear my good tennis shoes.....thanks, again...

Re: Carole, Thanks

Carole C in NOLA on 4/17/02 at 22:51 (080069)

Wow, thank you! I am glad if anyone can benefit from my posts anywhere near as much as I've been helped by other posts on these message boards.

Carole C

Re: P.S. Carole

Carole C in NOLA on 4/17/02 at 22:57 (080071)

Good thinking! Then maybe you won't mess up your feet on it like I did last September.

Also, make sure the seat is far enough forward that your legs don't ever get completely straight or hyperextend. Otherwise the Achilles and other tendons seem to get kind of 'twanged' or strained on each go-around. I didn't realize that when I was first injuring my feet.

I'm riding mine again now, on the lowest tension (I forget if that's 0 or 1) and I wear only my New Balance or SAS tie-up shoes on it. I try to ride with good posture and form, and to keep my feet at a reasonable, steady angle as I ride too, so the Achilles tendon doesn't get strained from sudden jerking around of my ankles. So far, so good. It feels so great to be building these muscles back up, slowly. :)

Carole C

Re: Recumbent Bikes

Rich on 4/18/02 at 07:25 (080098)

I've been looking at these. Do you recommend a particular type? Because of my height, I know I need one fully adjustable. Thanks for the tip on leg extension. I wouldn't have thought about that.

It's a New Day,
Rich

Re: So, what is the "Do Suck or Don't Suck" time limit?

Carmen on 4/18/02 at 08:06 (080114)

Am I slow in the head? Who's your husband?? sigh...yes Ardee...it has been a 'fun' ride. I am learning something NEW every day...but the funny thing is the one lesson that keeps comng back to me over and over is 'Patience'
I have been running from that little bugger and he keeps coming back to me!
I am not moved yet...I wrote to Pam B and told her what was up with me...hopefully it will be in June. :-)

thanks for your thoughts...YOU take care of you!

Re: Recumbent Bikes

Carole C in NOLA on 4/18/02 at 11:16 (080129)

Sounds like you are feeling better! I'm keeping my fingers crossed and hoping that you didn't re-injure yourself much yesterday when your cast was off.

I don't have a particular type of bike in mind to recommend. When I bought mine, my main criteria were that it had to be EXTREMELY stable and able to handle a heavier person like me. Also, I wanted the read-out to have the distance and time for this session, and odometer, but most of them do. If you want it to measure your pulse rate that might cost a little more but it might be useful. Mine doesn't have that. I wanted it to be quiet so I could ride it and watch TV, but these days most of them are pretty quiet. I wanted it to be comfy while riding it, too.

I went to Sports Authority to buy my recumbent bike, because they carry a lot of them. What I did was try out those that cost less than the maximum price I had in mind, and then I tried some that were fancier just to see if I could be tempted to buy something more expensive. They were having a sale so I got the Excel 395 magnetic bike for a very low price. You can see it at

http://www.thesportsauthority.com/product/index.jsp?productId=223657&position=0&cp&searchId=120313929&keywords=Excel+395&parentPage=search

If that was too long, you might have to copy and paste it into your browser to make it work rather than clicking on it.

I'm completely satisfied with what I bought, though once I have become able to ride it more, I may want to get one of those pulse rate measuring gizmo's. My PF was not due to the bike itself, but how I used it (or mis-used it, to be more accurate). There are lots of other good recumbent bikes out there and the sale price helped me to decide on this one. Some of the other ones I tried did not feel comfortable to me at all, so I'd suggest trying different bikes in the store.

One bike that I almost bought had the handlebars that move in and out too so that you exercise your arms at the same time. Those are probably good too.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/18/02 at 15:16 (080164)

The Pedorthic Footwear Association just reported that congress put our effort of requiring only those with the proper certification to fill orthosis prescriptions. What a setback.
Richard

Re: Dr. Z, you so silly!!!

Mahatmelissama on 4/18/02 at 18:11 (080202)

I would settle for ones that kill pain ;)

Re: Recumbent Bikes

Rich on 4/18/02 at 20:20 (080220)

I looked at that same bike and liked it. On the same site, the other bike I like is the Pro Form 970ST. It's priced at $299 here at Academy. Your bike ran for $239 on sale recently.

Yeah, I did hurt myself the other day and been back in the boot ever since! Looks like I will be in this a little longer. I guess I lost some of my patience and jumped the gun. I did immediate icing and stretching and got some relief with Aleve. Haven't taken any more since Tues night.

Thanks for everything!
Rich

Re: Recumbent Bikes

Carole C in NOLA on 4/19/02 at 14:47 (080332)

The Pro Form 970ST looks like a great bike too, and it has the adaptability of being a weight lifting bench too. I am hoping to start some weight training, after reading what Wendy and Carmen are saying on the social board, so if I was shopping for a bike this week I'd definitely look at that one!

Hopefully when you try them out at the store, the best choice for you will be clear (whatever that choice is). Get the bike that seems like fun, that you feel you will ride the most. See how much space they take up compared with each other; I was really surprised that my bike takes up as much space as it does. It seems to take up a lot of space in my living room, but in the store it didn't look like it took much space at all! :)

I bought my bike on sale for less than $150, but that was last August before my PF and so probably the prices have gone up or else they undercharged me. I was surprised at how inexpensive it was. LOL

Carole C

Re: seat adjustment on recumbent bikes

Carole C in NOLA on 4/19/02 at 14:57 (080333)

I would also like to mention for those with PF who wish to ride recumbent bikes, that if your achilles tendon and calf muscle tend to be tight due to PF, you will want to adjust the bike so that your legs straighten out even less than they did before PF.

In other words, if you are tight I am thinking it would be easier to strain your Achilles tendon than when your feet were healthy, so make sure your knees do not straighten as much as they did then. At least, for my particular feet and tight tendons it seems like this helped.

Also, I did not ride my bike during the worse part of my PF so I have no advice for that time period. Since my PF was caused by my bike, I didn't dare risk experimenting with the bike when I was in agony. I'm talking about later on after healing had brought the pain level down to at least 2-3 on a scale of 1-10.

Carole C

Re: sorry you're back in the boot

Carole C in NOLA on 4/19/02 at 15:03 (080337)

Darn! I know that boot is driving you up the wall. It would me, anyway. Good for you to immediately ice and stretch and take your Aleve! You were right on top of things and probably that will help you a lot.

I've noticed that when I'm retaining water for any reason (like monthly cycle) my PF swell and hurt a little bit, and ice seems to help. Maybe it would help to keep icing even though it's been a few days. (?) Don't know.

Carole C

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/19/02 at 19:14 (080377)

Richard:

Do you have a reference on that action? Appreciate your time in looking it up.

It is really difficult to obtain legislation that can be percieved by some as restricting trade. That is why I favor voluntary standards by our industry. The public can then be educated to utilize the services of those who agree to abide by such standards. Additionally, insurance companies need to know exactly what they are paying for such that they are paying for legitimate products with therapeutic benefits. I have seen patients with insurance companies allowing one pair of orthotics per year have the benefit squandered on bogus orthotics. I am not an insurance company fan but it is to their benefit and to the benefit of their insured to know what constitute legitimate orthotic services.
Ed

Re: So tired of doctors dogging other doctors orthotics

Ed Davis, DPM on 4/19/02 at 19:20 (080378)

My post that answers this post brings up someone elses message-- oh well?

Will try again.

Richard:

Do you have a reference on that action?

It is difficult to solve this problem via legislative action. There is a perception that an effort to restrain trade exists, albeit incorrect in this case.

I feel that voluntary standards or certification is the way to go. The public can then be educated as to the providers who are willing to practice by such standards. The insurers, too, need to know what they are paying for, that is what constitutes a legitimate orthotic service.
Ed

Re: I am the one who feels slow in the head....

Ardee W. on 4/20/02 at 14:15 (080474)

whenever I try to keep up with these boards....I never know exactly the best way to look at them. I am not on everyday either, though. I do a lot more reading than posting....it is sometimes overwhelming trying to sift through all the information and make a decision for yourself. But, I am so thankful for everyone else's posts. Anyway, my husband isn't on the board, his name is Vernon and he has been pretty great about this whole PF thing. We were in the middle of building our son's home and ours...I mean doing ALL of it when I came down with this PF....so, I am practically no help at all to him now.....I went from tieing rebar and going up and down ladders to sitting in our fifth wheel sorting out screws.....really....

Hope things are well with you!

Re: sorry for the terrible spelling...I type too fast. (nm)

BGCPed on 4/21/02 at 12:44 (080564)

Man you have been through the mill. I dont understand why you are having such bad luck. Maybe I am lucky that the Doctors that refer to me are very skilled and are not too quick to do surgery or pump you full of cortisone.

The sad fact is that many people in the foot arena Cpeds, DPM, Ortho, PT etc. are not very skilled at doing gait or biomechanical evals. There are many tricks and tools to use. An example is a Coleman Block. It is basically a piece of wood, it is a way to evaluate if a high arch or cavus foot will correct with an orthotic. I bet that the majority of facilties dont own one or know what it is, or how to use it.

Many are also poor at giving shoe advice. I dont expect them to be a buyers guide of shoes BUT if they dont know send the PT to somebody that does.

I am so sick of seeing mostly women coming in with a pair of crappy easy spirits or keds, or worse some slip on low heel shoes. And they say that they have had pf for over a year and have had 3 or more injections. I ask if they have ever been told about footwear and most say, nobody has ever gone over that with me. or, All I was told was to not wear heels just lace up shoes.

Re: So tired of doctors dogging other doctors orthotics

Richard, C.Ped on 4/22/02 at 08:23 (080636)

I was reading in the March issue of 'Current Pedorthics' where the PFA president wrote an article concerning this problem. Here is a quote from the article. 'we have not been invited to sit at CMS's negotiated rulemaking table. What this means is there will be nobody from PFA or BCP to voice opinions on who should be considered 'qualified providers' to dispense certain L code devices under the Benefits Improvement and Protection Acts.'

I know that there are a few doctors around here that believe our certificaton matters. There are others that seem to care less. I think it is because they just do not know the difference. The hard part is getting in their office to meet with them in order to let them know the difference.
Richard

Re: So tired of doctors dogging other doctors orthotics

BGCPed on 4/22/02 at 17:40 (080714)

Plus the Lobby from the big fast food dme providers want to keep it low to no skill. So when a person is done building a walker, unpacking a scooter,restocking shelves and delivering an oxygen canister to Mrs Smith he can dispense orthotics.

Re: the positive side

paula on 4/22/02 at 20:54 (080751)

who is this lower extremity expert. i would like to call him and see if he knows someone in atlanta