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Looking for info on Dr. Gould and his article on pf surgery

Posted by Dan D. on 5/01/03 at 18:17 (117584)

I have had pf for 6 years and have spent most of that time on crutches.
My orthopaedic dr. recently gave me an article by Dr. Gould from the Alababma Sports Medicine and Orthopaedic Center in Birmingham. In this article, Dr. Gould describes the surgery he does for chronic pf whereby he
releases the plantar fascia and the quadratus plantar fascia under the lateral plantar nerve. He claims his success rate is somewhere around 85%.
Any drs. out there read this article and have opinions on it? Do any of you know of Dr. Gould? Thanks!

Dan

Re: Looking for info on Dr. Gould and his article on pf surgery

Ed Davis, DPM on 5/02/03 at 00:46 (117637)

Dan:
I have not heard of Dr. Gould and have not read his article but will look for it. I cannot think of a good reason to cut the plantar fascia, an important supporting structure when we now have means of restoring the plantar fascia to health via ESWT. The plantar fascia acts as an important brace for the midtarsal joint of the foot, is involved in the foot's shock absorbtion function for the body and has a role in energy return in the process of propulsion. Sacrifice of such an important structure should be a rare event.

The other thing that is hard to envision is how someone could generate large enough numbers for a good study on this type of surgery when surgical treatment is indicated in such few cases. I see about 300 new cases of PF per year with only 3 to 4 patients (about 1 percent) requiring surgical treatment.
Ed

Re: Looking for info on Dr. Gould and his article on pf surgery

elliott on 5/02/03 at 09:10 (117651)

Thought I'd drop in and say hi to everyone. Been a while. Hope you're all doing well or at least as good as can be expected.

Gould is one of Baxter's three highly esteemed and individually accomplished proteges (the others being Schon and Sammarco). He has written extensively on PF, TTS and related topics. He is editor-in-chief of the new American Journal of Orthopaedics:

http://www.amjorthopedics.com/html/edi_boa/edi_boa.asp

Perhaps this is his PF article:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12580344&dopt=Abstract

Dr. Ed, ESWT would not necessarily render irrelevant the merit of Gould's technique or success rates obtained mostly before the advent of ESWT, which in any case is not 100% successful. Even at 4 surgeries a year, he would have a decent sample size in 10 years. As a protege of Baxter and a name in his own right, he's probably also a regional magnet for resistant PF cases, thus seeing (at least pre-ESWT) far more surgical candidates than another doc would at random.

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Re: Looking for info on Dr. Gould and his article on pf surgery

Henry C on 5/02/03 at 09:41 (117653)

As always, elliott has come through. I can not say this enough, but he seems to have all the answers. Good to see you back on the message board elliott!

Re: HI, ELLIOTT! Have you seen this?

Sharon W on 5/02/03 at 11:04 (117661)

Elliott,

It's good to see your name here again.

I was thinking of you just a few days ago, when I read the contents of this link that Pauline posted on the ESWT board:

http://www.ismst.com/events/2003_orlando_abstracts%20-%201.htm#Effect%20of%20Shock%20Wave%20on%20the%20Catalytic%20Activity%20of%20Endothelial%20Nitric%20Oxide%20Synthase%20in%20Human%20Umbilical%20Vein%20Endothelial%20Cells

Don't know why, but I thought of you and wondered what comments you would make about it...

Sharon

Re: Looking for info on Dr. Gould and his article on pf surgery

Suzanne D on 5/02/03 at 12:18 (117663)

Hi, Elliott! I know this isn't the social board, but I just wanted to speak to you and also ask if your article has appeared in the math publication yet. You mentioned that a few months ago, and I had wondered about it. My older daughter recently had something appear in a book which is published by the Chicken Soup people.

Hope you're doing well. I'm not 100% better - might never be - but I'm happy with the progress I've made and glad to be at least maintaining it.

Suzanne :)

Re: Looking for info on Dr. Gould and his article on pf surgery

Ed Davis, DPM on 5/02/03 at 13:04 (117672)

Elliott:
Thank you for the citation. I will need to read the actual article. Close attention needs to be paid to how 'success' is defined since the foot is functioning without an important structure after such surgery.

Since ESWT preserves the fascia it is something that should virtually always be considered before surgery.

Ed

Re: Hi, Sharon!

elliott on 5/02/03 at 13:39 (117680)

Looks like you've been busy selflessly educating people around here.

I think I've already seen most of those articles provided in the link and even provided a similar link a while back. The articles really look very familiar--perhaps rehashes of earlier versions, not so suprising.

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Re: Hi, Sharon!

Sharon W on 5/02/03 at 13:41 (117681)

Yeah, some of them looked familiar to me, too, and your past posts are probably the reason why...

Sharon
:D

Re: Hi, Suzanne!

elliott on 5/02/03 at 14:43 (117686)

Congrats to your daughter!

Yes, my article (two pages long) was published in the April issue (which is the current one until the next comes out in June) of Mathematics Magazine, an advanced-undergraduate-level general-interest math journal. Here is a link to the abstract (and no, it's not on ESWT :-)):

http://www.maa.org/pubs/mag_apr03_toc.html

I'm way at the bottom. If you'd like to see the actual article, you can

a) go to any university research library (95% of colleges offering a math program subscribe to this journal, so you should find it there)

b) give me a mailing address to send you a hard copy (signed, if you like!--not that it's worth anything)

c) give me an email address so I can instantly send you an exact pdf copy (all you lose is a drop of resolution in the diagrams) of the article as sent to me by the journal's editor for just such a use.

d) do b) or c) more securely by using an intermediary who already has my email address (my old AOL address hasbeen discontinued) and having him forward it to me.

Regarding feet, I'm still seeing doctors. It ain't over till it's over. It ain't over.

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Re: Henry C

elliott on 5/02/03 at 16:42 (117696)

Did the big-name docs you were supposed to see provide any last-minute insight into your problem?

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Re: Hi, Suzanne!

Suzanne D on 5/02/03 at 19:39 (117708)

I really would like to read the article, Elliott! My e-mail is sdennis @ hardin.k12.ky.us (without the spaces around the @, of course). Would you mind to e-mail it to me?

I also would love a signed copy and would pass it along to my son-in-law (of almost 4 weeks!) who is completing his first year teaching high school math and who also coaches cross-country. I think he would really be interested and impressed to have a signed copy! Just think how much he would think of his new mother-in-law! :) I am hesitant to post my mailing address, but if you don't mind to e-mail me, then I will e-mail back to you with the address. I will be glad to pay the postage for sending it.

Thanks!
Suzanne :)

Re: thanks for the advice

Dan D. on 5/02/03 at 20:02 (117716)

Dr. Davis,

Thanks for your thoughts on the matter. I just read today in Readers Digest that ESWT has recently been approved by the FDA. Do you think there is any chance insurance companies start covering it any time soon?
I think I would like to try ESWT before surgery but it is not an immediate option due to the expenses involved.

Re: thanks for the advice

Ed Davis, DPM on 5/03/03 at 11:23 (117742)

Dan:

Many insurance companies do cover ESWT.
If yours does not, there are lower cost alternatives such as use of the Siemen's Sonocur in the US or by going to Canada -- Bayshore Clinics if you are in the eastern US or Sonorex Treatment Center if in the Western US.
Ed

Re: Hi, Elliott!

Carole C in NOLA on 5/04/03 at 15:42 (117795)

Elliott, sorry to hear that you're not done with the doctors and pain.

But, congratulations on your article! :)

Carole C

Re: Henry C

Henry C on 5/05/03 at 09:43 (117827)

Nobody has been able to provide any additional information. I am scheduled to have the Neurostimulation System on May 15th. I am headed to Baltimore on Wednesday the 14th. I must say that of all the surgeries that I have had in the past, this one has me very nervous.

There seems to be plenty of information about Spinal Cord Stimulators (SCS), but very little on Peripheral Nerve Stimulators (PNS). I even went so far as to call Medtronics to get additional information. I could tell from the conversation that the person I was speaking to was reading information relating to a SCS. I had to correct her several times and repeat that I was going to having a PNS.