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Successful ESWT but a warning...

Posted by Julie C. on 12/20/02 at 05:13 (103585)

Hello,

I have been reading the postings and have gained quite a lot from this site over the past two months. I wanted to share my experience. On December 10th I had ESWT with the OssaTron in an Outpatient Surgery Center in Fayetteville, NC. My insurance company pre-approved me after a six-week wait. I have suffered from PF off and on over 7 years but most especially the last 3 years. I had a popliteal block and some local but declined sedation. It was overall a wonderful experience. Coincidentally, one of my former co-workers had it the same day and we had our post-op visits together and she was also amazed at the lack of discomfort post-op. I went back to work on December 13th in the Operating Room. By the end of the day, I was sore, but no worse than usual and a different kind of pain...more like a bruise. But here is the warning: be careful when 'hopping and propping' post-operatively. What I mean is, my leg was numb until the next day, necessitating that I 'hop' to the bathroom, etc. (If you have it done in an office, this is probably less of a problem because only your foot is numb.) I was also told to prop and ice my foot for the first 24 to 48 hours, which I did. I also noticed that even when the numbness wore off, my leg still felt a little weak. December 17th I went home from work with a spasm in my lower back the likes of which I cannot describe. My chiropractor tells me that I probably aggravated it with the propping (it hyperflexes your lower back if you prop it while sitting up which is what I did--a nurse like me should know better!) and the possibly the hopping and going back to work with the weakness in the leg. Of course, I already had a history of low back problems so I am NOT suggesting everyone could have this problem but it you do have back problems, be careful!! I am looking at the silver lining here and saying at least I can give my heel a better chance to heel because I'm at home lying on ice packs!! And I would still have the ESWT again because it is such a relief to be able to walk to the bathroom in the morning without screaming. I would have been more careful propping and would have stayed out longer too.

Good luck to all of you and thanks to many of you whose postings have been most helpful!

Julie C.

Re: Successful ESWT but a warning...

Dr. Z on 12/20/02 at 13:59 (103623)

Great to hear you are doing well. I guess one pair of crutches need to be ordered when you block the leg . How about a walker for one day. We use a ankle block which really makes the foot nice and numb.

Re: Successful ESWT but a warning...

Julie C. on 12/20/02 at 16:19 (103638)

Yes, a walker would have been great! Crutches are a menace to society! I think the blocks done in the office vs. would be less intrusive with fewer side effects. My pod was trying to get me the ESWT before the beginning of another deductible year or I would have had the procedure done in office with the Dornier which I understand has other advantages. Hindsight being 20/20, maybe I should have waited but it sure is nice to have the relief from the heel pain. I am sharing this info with my pod so maybe it will help someone else.

Re: Successful ESWT but a warning...

Carlyn B. on 12/26/02 at 10:57 (104026)

Like Julie, I had ESWT this month, Dec. 18th, before the beginning of another deductible year. I'm am one week post-procedure and I'm concerned that I may have returned to daily activity too soon following the procedure. I stayed off my feet for about 36 hours and then it was back to the usual. I didn't run or exercise, but I had a considerable amount of Christmas shopping to do which required walking and waiting in lines. What I am hoping to discover from my posts is that the healing process is likely to take weeks and that I am expecting relief too soon. Does anyone have an opinion???

Re: Successful ESWT but a warning...

BrianG on 12/26/02 at 18:01 (104059)

Hi Carlyn,

A lot of people have said it before me, 'you have to listen to you feet'! If it feels like you are doing too much, then you probably are.

Do you mind if I ask you where you had your Ossatron treatment? The reason I'm asking is that some of your questions have been very basic. They are question I would have thought would have been answered when you had your treatment. Was your treatment done by a new providor, by any chance?

Just wondering, and good luck
BrianG

Re: Successful ESWT but a warning...

Julie C. on 12/26/02 at 19:35 (104067)

Carlyn B.,

I was told that it could take up to 12 weeks to realize the full benefits of the treatment and that it would not be until that point that they would deem the treatment a success or failure. It's only been 2 weeks and 2 days and I still have a place on the inside of my heel that is numb (part of the reason my chiropractor theorizes that I have injured my back...I'm not realizing how I have altered my gait on the left because of the numbness). Everything I have heard claims that the amount of time you spend off your feet post-treament is not that critical but I tend to think the more you rest your foot/feet, the better. My pod reminds me that my PF didn't develop overnight and it is not going to be gone overnight either (although I understand some individuals do get immediate results). Good luck and hang it there!

Julie C.

Re: Successful ESWT but a warning...

Carlyn B. on 12/26/02 at 20:52 (104074)

Hi Brian,
Thanks for your response. I had my Ossatron treatment in Lake Charles, Louisiana. I'm not sure how long my physician, an orthopaedic surgeon, has been performing the procedure. He is well known in the area for treating back injuries/problems. He knows me well as he has treated me for bilateral carpal tunnel symdrome in addition to plantar fasciitis/heel spur. I had bilateral carpal tunnel release this fall after months of failed conservative measures. With regard to the ESWT, I feel that I did not go into the procedure as educated as should have been. I spoke at length with the Ossatron tech, but in hindsight, I realize that my questions focused on the mechanics of the procedure -- how the procedure worked -- and not what I should expect in the days/weeks following the procedure. I'm still amazed at the technology. My only concern prior to the procedure was what it would take to undergo the procedure, ie. time, discomfort, etc. I made the huge assumption that I would respond immediately to the procedure. I simply didn't consider the possibility that I may have discomfort after the procedure. Further, I was anxious to have the procedure before the year's end for insurance purposes. Thus, I was also focused on getting the procedure done and not as much on my recovery. I took the recovery for granted. Lastly, in my physician's defense, I'm certain that he assumed that I was well educated regarding all aspects of the procedure. Heck ... I thought that I was! I'm a medical professional, very curious, and I've always asked numerous questions. Upon learnoing that the procedure was non-invasive and that I could walk following same, I quit asking questions. Anyway, I truly appreciate your concern. I cringe at the ignorance of lay people receiving medical care for which they have absolutely no understanding -- especially with medications.

Re: Successful ESWT but a warning...

john h on 12/27/02 at 08:28 (104093)

We had a sports medicine clinc and orthopedic group obtain a new ossatron in my city recently. as i have posted before I went to vist the clinic and saw a MD foot and ankle surgeon. He really knew a lot less about ESWT than I did. I really would not want him performing this procedure on me until he receives further training and experience. There are Doctors and there are Doctors.

Re: Successful ESWT but a warning...

BrianG on 12/30/02 at 16:08 (104313)

Hi Carlyn,

Don't beat youself too bad, we can't all know the questions we'll be asking once the procedure is done. It just seemed to me that you may have been one of the 1st people this doc had treated. That in itself is not all bad, depending on how well they were trained. I don't think I'd want to be treated by someone who was performing their first few procedures. They may know the mechanics, like you, but wouldn't have the background to answer any of your post treatment questions. These treatments seemed like they took forever to get off the ground. Now everywhere you look, someone new is setting up shop.

Good luck
BrianG

Re: Successful ESWT but a warning...

john h on 12/30/02 at 18:13 (104330)

Seems to me Brian the most important thing is for the Doctor to get the vary narrow beam focused on the correct area. I would assume learning to read the ultra sound and what you observe there comes with experience. Since our Doctors who use the Dornier are trained by the Dornier people all should start somewhat on an equal footing when it comes to use of the machine. The more experienced Doctor may recognize other problems going on.

Re: Successful ESWT but a warning...

Dr. Z on 12/20/02 at 13:59 (103623)

Great to hear you are doing well. I guess one pair of crutches need to be ordered when you block the leg . How about a walker for one day. We use a ankle block which really makes the foot nice and numb.

Re: Successful ESWT but a warning...

Julie C. on 12/20/02 at 16:19 (103638)

Yes, a walker would have been great! Crutches are a menace to society! I think the blocks done in the office vs. would be less intrusive with fewer side effects. My pod was trying to get me the ESWT before the beginning of another deductible year or I would have had the procedure done in office with the Dornier which I understand has other advantages. Hindsight being 20/20, maybe I should have waited but it sure is nice to have the relief from the heel pain. I am sharing this info with my pod so maybe it will help someone else.

Re: Successful ESWT but a warning...

Carlyn B. on 12/26/02 at 10:57 (104026)

Like Julie, I had ESWT this month, Dec. 18th, before the beginning of another deductible year. I'm am one week post-procedure and I'm concerned that I may have returned to daily activity too soon following the procedure. I stayed off my feet for about 36 hours and then it was back to the usual. I didn't run or exercise, but I had a considerable amount of Christmas shopping to do which required walking and waiting in lines. What I am hoping to discover from my posts is that the healing process is likely to take weeks and that I am expecting relief too soon. Does anyone have an opinion???

Re: Successful ESWT but a warning...

BrianG on 12/26/02 at 18:01 (104059)

Hi Carlyn,

A lot of people have said it before me, 'you have to listen to you feet'! If it feels like you are doing too much, then you probably are.

Do you mind if I ask you where you had your Ossatron treatment? The reason I'm asking is that some of your questions have been very basic. They are question I would have thought would have been answered when you had your treatment. Was your treatment done by a new providor, by any chance?

Just wondering, and good luck
BrianG

Re: Successful ESWT but a warning...

Julie C. on 12/26/02 at 19:35 (104067)

Carlyn B.,

I was told that it could take up to 12 weeks to realize the full benefits of the treatment and that it would not be until that point that they would deem the treatment a success or failure. It's only been 2 weeks and 2 days and I still have a place on the inside of my heel that is numb (part of the reason my chiropractor theorizes that I have injured my back...I'm not realizing how I have altered my gait on the left because of the numbness). Everything I have heard claims that the amount of time you spend off your feet post-treament is not that critical but I tend to think the more you rest your foot/feet, the better. My pod reminds me that my PF didn't develop overnight and it is not going to be gone overnight either (although I understand some individuals do get immediate results). Good luck and hang it there!

Julie C.

Re: Successful ESWT but a warning...

Carlyn B. on 12/26/02 at 20:52 (104074)

Hi Brian,
Thanks for your response. I had my Ossatron treatment in Lake Charles, Louisiana. I'm not sure how long my physician, an orthopaedic surgeon, has been performing the procedure. He is well known in the area for treating back injuries/problems. He knows me well as he has treated me for bilateral carpal tunnel symdrome in addition to plantar fasciitis/heel spur. I had bilateral carpal tunnel release this fall after months of failed conservative measures. With regard to the ESWT, I feel that I did not go into the procedure as educated as should have been. I spoke at length with the Ossatron tech, but in hindsight, I realize that my questions focused on the mechanics of the procedure -- how the procedure worked -- and not what I should expect in the days/weeks following the procedure. I'm still amazed at the technology. My only concern prior to the procedure was what it would take to undergo the procedure, ie. time, discomfort, etc. I made the huge assumption that I would respond immediately to the procedure. I simply didn't consider the possibility that I may have discomfort after the procedure. Further, I was anxious to have the procedure before the year's end for insurance purposes. Thus, I was also focused on getting the procedure done and not as much on my recovery. I took the recovery for granted. Lastly, in my physician's defense, I'm certain that he assumed that I was well educated regarding all aspects of the procedure. Heck ... I thought that I was! I'm a medical professional, very curious, and I've always asked numerous questions. Upon learnoing that the procedure was non-invasive and that I could walk following same, I quit asking questions. Anyway, I truly appreciate your concern. I cringe at the ignorance of lay people receiving medical care for which they have absolutely no understanding -- especially with medications.

Re: Successful ESWT but a warning...

john h on 12/27/02 at 08:28 (104093)

We had a sports medicine clinc and orthopedic group obtain a new ossatron in my city recently. as i have posted before I went to vist the clinic and saw a MD foot and ankle surgeon. He really knew a lot less about ESWT than I did. I really would not want him performing this procedure on me until he receives further training and experience. There are Doctors and there are Doctors.

Re: Successful ESWT but a warning...

BrianG on 12/30/02 at 16:08 (104313)

Hi Carlyn,

Don't beat youself too bad, we can't all know the questions we'll be asking once the procedure is done. It just seemed to me that you may have been one of the 1st people this doc had treated. That in itself is not all bad, depending on how well they were trained. I don't think I'd want to be treated by someone who was performing their first few procedures. They may know the mechanics, like you, but wouldn't have the background to answer any of your post treatment questions. These treatments seemed like they took forever to get off the ground. Now everywhere you look, someone new is setting up shop.

Good luck
BrianG

Re: Successful ESWT but a warning...

john h on 12/30/02 at 18:13 (104330)

Seems to me Brian the most important thing is for the Doctor to get the vary narrow beam focused on the correct area. I would assume learning to read the ultra sound and what you observe there comes with experience. Since our Doctors who use the Dornier are trained by the Dornier people all should start somewhat on an equal footing when it comes to use of the machine. The more experienced Doctor may recognize other problems going on.