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Can someone help me w/h SDO problem?

Posted by Jen L on 12/03/02 at 20:59 (101718)

I have a dilemma: I need orthotics for arch support as well as heel padding. My heel fat pad is very thin,which was diagonised by at least two doctors, and I think two injections I got in the summer for PF made it worse. I can not stand any orthotics which are not soft and cushionary. I e-mailed Dr. Kiper two weeks ago to ask him about whether he can install extra padding for me, and he promised to do so. But after I made the on line order, he's now reluctant to meet my need. The reason he gave is that getting the arch support fit first is the only way he knows to make the SDO's. But how can I get used to the feeling of the new rothotics with my heels burning pain? My heel conditions are already bad enough: I have to sit to brush my teeth and sit in shower since June.If I have to spend weeks breaking in SDO's, I might get closer to being confined in wheel chair, and he said on phone today 'this will happen if it's meant to be, but it's not because of my products'. Can you believe this doctor can be so cold?
Are there any other channels through which we can get SDO's? Or anyone know can I get really soft, cushionary orthotics through a C.Ped?
If you tried SDO's, could you tell me about the feeling on your heels?
Thanks a lot,

desperate Jenny

Re: Can someone help me w/h SDO problem?

Carole C in NOLA on 12/03/02 at 21:48 (101722)

Jen, I haven't tried SDO's, but I did get soft orthotics from my C.Ped. They worked very well and I believe that they helped a lot.

Before I got them, I felt sure that what I needed was a lot of cushioning. I bought gel heelpads and wore them in very cushiony shoes, but the pain just got worse! I couldn't understand why, and was distressed. I could hardly walk, despite all the cushioning.

A few weeks later when I got my soft custom orthotics made by my C.Ped, they cushioned my heels but also they held my foot in a position that really seemed to help. It didn't seem like that would make any difference, but it does. Meanwhile, the orthotics provided enough cushioning for my heels that I could manage them.

So anyway, I'd urge you to go to a good C.Ped and get soft orthotics made. They might help you too.

Some other people have said good things about SDO's here, although I have never had them. Whether it's Dr. Kiper and SDO's, or a C.Ped making you soft custom orthotics, I know you will communicate your wishes. But then, once they understand how your feet feel, and how they function, and so on, you may want to take advantage of their expertise so that they will make orthotics as best they know how to help you.

Good luck to you and I hope you can get some orthotics made that work for you. If you have not done so already, you may want to read through the heel pain book on this site which has a lot of ideas of things you can do to lessen heel pain. Rest is very important and a lot of rest may make the orthotics easier to handle. The same is true of frequent icing.

Carole C

Re: Can someone help me w/h SDO problem?

Richard, C.Ped on 12/04/02 at 09:44 (101749)

Hi Jen,
This is what I do for someone who requests or I think needs that extra cushion for their heel. I make a standard orthosis using 30 durometer 1/8' EVA for the shell and 40 durometer 1/2' EVA for the posting. I then cut out a hole in the heel area, and add visco elastic polymer, which can be mixed to either be very squishy (me and my technicial terms) or very dense. I judge it person to person. That will give you an excellent orthosis along with wonderful heel cushion.
Richard, C.Ped

Re: Can someone help me w/h SDO problem?

Jen L on 12/04/02 at 12:23 (101782)

Thank you very much Carole and Richard, C.Ped! Your valuble encouragement and information is what I need most now. It's amazing that we have such a nice support group on the site.
Hope you have a great holiday season!

Re: Can someone help me w/h SDO problem?

Dr Kiper on 12/04/02 at 13:19 (101789)

One of my patients notified me this morning of this post. I feel there is some things said which should be addressed.
The problem I often face is that there is so much information that I need to give in order to help someone be successful is that a lot is forgotten after we hang up. In addition it is not unusual for people to hear and perceive what they want to hear and perceive, rather than what was actually said.
In regards to the extra padding/cushioning, I am not reluctant to add materials, BUT I explained that it needs to be added AFTER we get the Rx correct. The reason is that anything that distorts the true feeling of the answers I need to hear to my questions may confuse the criteria of the fit.
The confusion for some people is that how can a patient respond if they are in pain. The answer is that the 'fit' that I am trying to achieve is seperate from the pain and believe me this is not always easy, because the patient often confuses their own answer with their level of pain rather than what I am asking specifically, but that is my job, to seperate the patients pain from their true neuro-muscular sensations which allows me to asses the criteria of the fit. I always explain that I am not going to alleviate any pain immediately (although in a minute # of patients this can occur), so that pain will continue and continue unabated until the healing process through alignment correction begins to reverse the years of accumulated microscopic inflammation that has accrued to the point of pain. To complicate matters, patients need to continue their daily life activities so that every step they take antagonizes the very problem we are treating.

As to the issue of 'thin fat pads', there are only 5 people with thin fat pads: (this is not universally so)
1-diabetics
2-vascular insufficiencies
3-certain forms of arthritis
4-alcoholics
5-overuse of steroid injections
(If I've missed any, please enlighten me)
If you don't have one of the above it is 'highly' unlikely that you have a thin fat pad, unless mother nature cheated you.
Saying someone has a thin fat pad is because they are frustrated in their inability to solve and help the case, so blame it on that.
How many times I have heard this and/or it's just 'arthritis' appalls me.

Jenny is a sweet person desperate for help after all the failed attempts previously. Quite frankly I am risking my reputation, time and money to try and help now that these posts have made it to heelspurs.com.
The odds are against us succeeding, because this is a very severe and complex case, well out of the ordinary. Anyone who has to sit to shower and brush their teeth is very far along in the problem. Additionally what makes this worse is that it may take more than 6 months just to 'begin' to start to feel some positive improvement. Couple that with a lack of patience and frustration that things are not happening as quickly as one hoped or wished or thought that was promised and failure is not far behind.

I am adament about how I do things. I believe that I know better than the patient. When I hear about other practitioners who say they comply by adding cushioning and padding and doing what the patient wants is missing the boat. Addressing the 'underlying condition' of overpronation first and not JUST addressing the symptoms is the way to success'. If I allow myself to be bulldozed by the patient I have lost my efficacy and best ability to help.

Re: Can someone help me w/h SDO problem?

Carole C in NOLA on 12/04/02 at 18:28 (101798)

My goodness, I didn't think that I was that far along just because I had to sit to shower and brush my teeth! I thought everyone with acute PF (as opposed to tired feet) was in that situation at one time or another, and not 'out of the ordinary'.

Just two or three months after I was in that condition, I was back to my normal activities, for the most part, with the help of stretching, icing, and good shoes. Guess I was lucky.

I never tried Dr. Kiper's orthotics, but I think his post demonstrates what I was trying to say; if you pay for someone's expertise in making your custom orthotics, you might as well work with him, communicating to him but letting him do what he knows how to do best.

Carole C

Re: What about a pain management clinic?

BrianG on 12/04/02 at 20:37 (101804)

Hi Jen L,

Are you aware that there are pain management doctors, and clinics? It would appear that you are a prime candidate. In most cases, they can make life tollerable for people in chronic pain, such as yourself. You should be able to get a referrel from your primary care physician. if not, check out this web site: http://www.pain.com
Near the bottom of the home page, there is a link to many pain clinics in each state. It might be something you want to consider until you get your heel problem under control.

Regards
BrianG

Re: Jenny

carmen h on 12/05/02 at 13:00 (101858)

I have been wearing the SDO's for over 4 months...and can honestly tell you that out of the 9 doctors I have seen for this Dr. Kiper has been the ONLY one that has taken the time to counsel me, call me and express his concern in a VERY efficient manner.
He has done everything I have asked.....reassured me when I needed it and answered all questions thoroughly.
I understand your pain....I know the frustration....and the burning etc.
I am not 100% better but I understand that this type of thing takes time.
Please give him the opportunity to do what he does best...and that is help his patients.
Good luck and please keep us posted....

Re: Can someone help me w/h SDO problem?

Mahatmelissama on 12/08/02 at 23:05 (102312)

I have used SDOs since July 2002. I am very pleased with them, minus my gripe about the left one bursting and leaking silicon oil stuff and the right one leaking a very small leak. Both were replaced and I am doing fine. (The manufactor felt bad and even sent me some bunion pads which I plan on giving to my chiropractor to give a patient of his...I don't have bunions thankfully).

I am improving but very s---l---o----w------l--l---y. As my late grandfather used to say 'slower than molasses on a cold winter day'. When I first got SDOs, I had many times sat down to put on make-up and finish blow drying hair. I also could not ever stand in my shower (OLD Willow Glen District of San Jose style house...sloping tub from the dark side...). Nowadays, unless I have a set back, I can stand sometimes in the shower (did this morning!) and I stand the rest of the time, blow drying hair and also putting on make up.

I am also though doing other things to help myself: massage therapy for 90 minutes about once a month (very expensive but I am worth it darn it), taking msn (a supplement supposed to help), squeezing feet weirdly from Dr. Kiper's video instructions...I am also getting friendly torture once a week from chiropractor. He does it with a smile...'so Melissa...tell me about your niece...' *grabs foot...twist...*...he does ultra sound and electrical stimulation too a lot. My feet usually feel better when I leave his office. My back also straightened out (I didn't know I had a problem, but my massage therapist noticed and demanded the name of my chiropractor, apparantly his back torture has helped me too. I love him, he rocks. I bought him and his receptionist gifts for Xmas. I also have lost 21.4 lbs. since 09/01, 11.4 of this since I started SDOs. That makes a difference.

There is hope darn it. There is hope!

Dr. Kiper and I have talked for hours and hours (with all the phone calls in the beginning). He is pretty anal about getting the Rx perfectly. I wanted more liquid but he made me test...and then later sent me higher SDOs. He also has put up with a bit of my whining. He rocks also.

Do not be discouraged...be warned though...it took a lot of time to get like this and it takes a long time for the feet to heal.

I now am able to walk around the block and also dance in my living room. Yes, I ended up with charley horses and inner ankle pain...and my mom forked over some vioxx samples (I am not sure they help anything but extreme flare ups for me). My right foot has healed so much that sometimes it feels like there is no PF in it...but my stubborn left foot is taking forever (it is much worse...maybe since I drive a clutch?)

I must add Dr. Kiper considered me a chronic case by me pain descriptions...and we are both amazed at how much healing I have had. He and my chiropractor have encouraged me to walk. That was something I could not have done much of back in July this year.

I am having someone create my success PF webpage hopefully early Q1 of 2003 (you can tell I am a sales person...Q1...hee hee). God willing I hope to have it up then, we will see. People need hope, there is so much discouragement. I don't want to do this webpage (I am lazy truthfully) but I feel that God put it upon my heart to have some good come out of my suffering. I don't even want to put my story on it until I am healed up in my left foot. Also, I don't care what methods/orthotics people used...I am not going to promote any one thing. We all just need some hope. Many of the former PF sufferers ride off on a horse into the sunset with tonto...gone forever (except Julie and Carole C ... plus some others I am too lazy to think of names right now...going to bed nighty night).

Re: Can someone help me w/h SDO problem?

Pauline on 12/13/02 at 21:40 (103015)

Unfortunately orthotics like just about everything else associated with P.F. seems to be a trial an error situation.

The one big draw back with orthotics is the huge amount of money invested for something that you may not be able to wear. Dr. Kiper does offer a money back guarantee within a specific period of time so you could try his product and if you feel your getting worse return them for your refund.

I'd certainly listen to my feet. Only you can feel your pain and although others may tell you there is a break in period if you feels your getting worse then stop using any orthotic. A break in period in my mind doesn't mean a huge increase in pain. Sorry, I don't buy that theory.

Re: Can someone help me w/h SDO problem?

Carole C in NOLA on 12/03/02 at 21:48 (101722)

Jen, I haven't tried SDO's, but I did get soft orthotics from my C.Ped. They worked very well and I believe that they helped a lot.

Before I got them, I felt sure that what I needed was a lot of cushioning. I bought gel heelpads and wore them in very cushiony shoes, but the pain just got worse! I couldn't understand why, and was distressed. I could hardly walk, despite all the cushioning.

A few weeks later when I got my soft custom orthotics made by my C.Ped, they cushioned my heels but also they held my foot in a position that really seemed to help. It didn't seem like that would make any difference, but it does. Meanwhile, the orthotics provided enough cushioning for my heels that I could manage them.

So anyway, I'd urge you to go to a good C.Ped and get soft orthotics made. They might help you too.

Some other people have said good things about SDO's here, although I have never had them. Whether it's Dr. Kiper and SDO's, or a C.Ped making you soft custom orthotics, I know you will communicate your wishes. But then, once they understand how your feet feel, and how they function, and so on, you may want to take advantage of their expertise so that they will make orthotics as best they know how to help you.

Good luck to you and I hope you can get some orthotics made that work for you. If you have not done so already, you may want to read through the heel pain book on this site which has a lot of ideas of things you can do to lessen heel pain. Rest is very important and a lot of rest may make the orthotics easier to handle. The same is true of frequent icing.

Carole C

Re: Can someone help me w/h SDO problem?

Richard, C.Ped on 12/04/02 at 09:44 (101749)

Hi Jen,
This is what I do for someone who requests or I think needs that extra cushion for their heel. I make a standard orthosis using 30 durometer 1/8' EVA for the shell and 40 durometer 1/2' EVA for the posting. I then cut out a hole in the heel area, and add visco elastic polymer, which can be mixed to either be very squishy (me and my technicial terms) or very dense. I judge it person to person. That will give you an excellent orthosis along with wonderful heel cushion.
Richard, C.Ped

Re: Can someone help me w/h SDO problem?

Jen L on 12/04/02 at 12:23 (101782)

Thank you very much Carole and Richard, C.Ped! Your valuble encouragement and information is what I need most now. It's amazing that we have such a nice support group on the site.
Hope you have a great holiday season!

Re: Can someone help me w/h SDO problem?

Dr Kiper on 12/04/02 at 13:19 (101789)

One of my patients notified me this morning of this post. I feel there is some things said which should be addressed.
The problem I often face is that there is so much information that I need to give in order to help someone be successful is that a lot is forgotten after we hang up. In addition it is not unusual for people to hear and perceive what they want to hear and perceive, rather than what was actually said.
In regards to the extra padding/cushioning, I am not reluctant to add materials, BUT I explained that it needs to be added AFTER we get the Rx correct. The reason is that anything that distorts the true feeling of the answers I need to hear to my questions may confuse the criteria of the fit.
The confusion for some people is that how can a patient respond if they are in pain. The answer is that the 'fit' that I am trying to achieve is seperate from the pain and believe me this is not always easy, because the patient often confuses their own answer with their level of pain rather than what I am asking specifically, but that is my job, to seperate the patients pain from their true neuro-muscular sensations which allows me to asses the criteria of the fit. I always explain that I am not going to alleviate any pain immediately (although in a minute # of patients this can occur), so that pain will continue and continue unabated until the healing process through alignment correction begins to reverse the years of accumulated microscopic inflammation that has accrued to the point of pain. To complicate matters, patients need to continue their daily life activities so that every step they take antagonizes the very problem we are treating.

As to the issue of 'thin fat pads', there are only 5 people with thin fat pads: (this is not universally so)
1-diabetics
2-vascular insufficiencies
3-certain forms of arthritis
4-alcoholics
5-overuse of steroid injections
(If I've missed any, please enlighten me)
If you don't have one of the above it is 'highly' unlikely that you have a thin fat pad, unless mother nature cheated you.
Saying someone has a thin fat pad is because they are frustrated in their inability to solve and help the case, so blame it on that.
How many times I have heard this and/or it's just 'arthritis' appalls me.

Jenny is a sweet person desperate for help after all the failed attempts previously. Quite frankly I am risking my reputation, time and money to try and help now that these posts have made it to heelspurs.com.
The odds are against us succeeding, because this is a very severe and complex case, well out of the ordinary. Anyone who has to sit to shower and brush their teeth is very far along in the problem. Additionally what makes this worse is that it may take more than 6 months just to 'begin' to start to feel some positive improvement. Couple that with a lack of patience and frustration that things are not happening as quickly as one hoped or wished or thought that was promised and failure is not far behind.

I am adament about how I do things. I believe that I know better than the patient. When I hear about other practitioners who say they comply by adding cushioning and padding and doing what the patient wants is missing the boat. Addressing the 'underlying condition' of overpronation first and not JUST addressing the symptoms is the way to success'. If I allow myself to be bulldozed by the patient I have lost my efficacy and best ability to help.

Re: Can someone help me w/h SDO problem?

Carole C in NOLA on 12/04/02 at 18:28 (101798)

My goodness, I didn't think that I was that far along just because I had to sit to shower and brush my teeth! I thought everyone with acute PF (as opposed to tired feet) was in that situation at one time or another, and not 'out of the ordinary'.

Just two or three months after I was in that condition, I was back to my normal activities, for the most part, with the help of stretching, icing, and good shoes. Guess I was lucky.

I never tried Dr. Kiper's orthotics, but I think his post demonstrates what I was trying to say; if you pay for someone's expertise in making your custom orthotics, you might as well work with him, communicating to him but letting him do what he knows how to do best.

Carole C

Re: What about a pain management clinic?

BrianG on 12/04/02 at 20:37 (101804)

Hi Jen L,

Are you aware that there are pain management doctors, and clinics? It would appear that you are a prime candidate. In most cases, they can make life tollerable for people in chronic pain, such as yourself. You should be able to get a referrel from your primary care physician. if not, check out this web site: http://www.pain.com
Near the bottom of the home page, there is a link to many pain clinics in each state. It might be something you want to consider until you get your heel problem under control.

Regards
BrianG

Re: Jenny

carmen h on 12/05/02 at 13:00 (101858)

I have been wearing the SDO's for over 4 months...and can honestly tell you that out of the 9 doctors I have seen for this Dr. Kiper has been the ONLY one that has taken the time to counsel me, call me and express his concern in a VERY efficient manner.
He has done everything I have asked.....reassured me when I needed it and answered all questions thoroughly.
I understand your pain....I know the frustration....and the burning etc.
I am not 100% better but I understand that this type of thing takes time.
Please give him the opportunity to do what he does best...and that is help his patients.
Good luck and please keep us posted....

Re: Can someone help me w/h SDO problem?

Mahatmelissama on 12/08/02 at 23:05 (102312)

I have used SDOs since July 2002. I am very pleased with them, minus my gripe about the left one bursting and leaking silicon oil stuff and the right one leaking a very small leak. Both were replaced and I am doing fine. (The manufactor felt bad and even sent me some bunion pads which I plan on giving to my chiropractor to give a patient of his...I don't have bunions thankfully).

I am improving but very s---l---o----w------l--l---y. As my late grandfather used to say 'slower than molasses on a cold winter day'. When I first got SDOs, I had many times sat down to put on make-up and finish blow drying hair. I also could not ever stand in my shower (OLD Willow Glen District of San Jose style house...sloping tub from the dark side...). Nowadays, unless I have a set back, I can stand sometimes in the shower (did this morning!) and I stand the rest of the time, blow drying hair and also putting on make up.

I am also though doing other things to help myself: massage therapy for 90 minutes about once a month (very expensive but I am worth it darn it), taking msn (a supplement supposed to help), squeezing feet weirdly from Dr. Kiper's video instructions...I am also getting friendly torture once a week from chiropractor. He does it with a smile...'so Melissa...tell me about your niece...' *grabs foot...twist...*...he does ultra sound and electrical stimulation too a lot. My feet usually feel better when I leave his office. My back also straightened out (I didn't know I had a problem, but my massage therapist noticed and demanded the name of my chiropractor, apparantly his back torture has helped me too. I love him, he rocks. I bought him and his receptionist gifts for Xmas. I also have lost 21.4 lbs. since 09/01, 11.4 of this since I started SDOs. That makes a difference.

There is hope darn it. There is hope!

Dr. Kiper and I have talked for hours and hours (with all the phone calls in the beginning). He is pretty anal about getting the Rx perfectly. I wanted more liquid but he made me test...and then later sent me higher SDOs. He also has put up with a bit of my whining. He rocks also.

Do not be discouraged...be warned though...it took a lot of time to get like this and it takes a long time for the feet to heal.

I now am able to walk around the block and also dance in my living room. Yes, I ended up with charley horses and inner ankle pain...and my mom forked over some vioxx samples (I am not sure they help anything but extreme flare ups for me). My right foot has healed so much that sometimes it feels like there is no PF in it...but my stubborn left foot is taking forever (it is much worse...maybe since I drive a clutch?)

I must add Dr. Kiper considered me a chronic case by me pain descriptions...and we are both amazed at how much healing I have had. He and my chiropractor have encouraged me to walk. That was something I could not have done much of back in July this year.

I am having someone create my success PF webpage hopefully early Q1 of 2003 (you can tell I am a sales person...Q1...hee hee). God willing I hope to have it up then, we will see. People need hope, there is so much discouragement. I don't want to do this webpage (I am lazy truthfully) but I feel that God put it upon my heart to have some good come out of my suffering. I don't even want to put my story on it until I am healed up in my left foot. Also, I don't care what methods/orthotics people used...I am not going to promote any one thing. We all just need some hope. Many of the former PF sufferers ride off on a horse into the sunset with tonto...gone forever (except Julie and Carole C ... plus some others I am too lazy to think of names right now...going to bed nighty night).

Re: Can someone help me w/h SDO problem?

Pauline on 12/13/02 at 21:40 (103015)

Unfortunately orthotics like just about everything else associated with P.F. seems to be a trial an error situation.

The one big draw back with orthotics is the huge amount of money invested for something that you may not be able to wear. Dr. Kiper does offer a money back guarantee within a specific period of time so you could try his product and if you feel your getting worse return them for your refund.

I'd certainly listen to my feet. Only you can feel your pain and although others may tell you there is a break in period if you feels your getting worse then stop using any orthotic. A break in period in my mind doesn't mean a huge increase in pain. Sorry, I don't buy that theory.