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Am I out of options?

Posted by Dee D on 7/24/03 at 15:45 (125157)

During the last year and a half, I have been struggling with heel spurs in both feet. I have pain on a scale 8-9 with first steps and after sitting for an hour or so. i am a 45 year old female, otherwise excellent health. Have to work from a home office as a 'commuter life' is not possible. I find myself extremely depressed -- will I ever be able to walk around the block again? When will I run with my niece and nephew? When can I stop worrying about going on a business trip or even going into the city for a meeting?
I started out with a pod who taped me and gave me cortisone on my first visit. During the course of 5 mo's we tried other methods of relief including mild anti-inflamitory drugs, a different type of taping, and more cortisone (5x). I was fitted for orthotics, which I have worn consistantly -- but now actually find no relief with them. Of course, I tried strethching exercises and icing -- which I still use if I can, instead of medicine.
When ESWT was suggested I went for a second opinion. I saw a Orthapedic MD who tried a night splint -- still no relief. I then opted for a six week hard cast on one foot, which also did not work well. He suggested a visit to a known institute that was doing FDA studies on ESWT and also thought a rheumatologist visit was a good idea.
I was fortunate enough to be part of one of the ESWT studies being conducted. I had the therapy in March '03. Fast forward to today, 12 weeks post ESWT, and you will find me taking heavier doses of anti-inflamatories just to survive. No success, did learn only one foot was done.
By nature, I do not like medicine therapy -- I am fearful of the side effects, long term. I am deathly afraid of more cortisone. Rheumatologist is suggesting a stronger drug for a 1-2 year period because it takes so long to start working. To me, this is scary stuff.
I am waiting for the ESWT doctor to call me and determine our next steps. I have a decent level of confidence in him, but I worry that is is because of his notoriaty in the field vs. results.
If I was your patient what would you have me do now? Please respond.

Re: Am I out of options?

Dr. Z on 7/24/03 at 16:55 (125161)

Hi
Sorry to hear you are still in pain. To help determine what course of treatment to take, possible 2nd ESWT treatment I need to know which machine you have your first treatment done with.

Re: Am I out of options?

Dee D on 7/24/03 at 19:07 (125166)

To be honest, I do not know, but I will find out. I was treated at the Weil Foot & Ankle Institute in Des Plaines, Il -- near Chicago, by Dr. Lowell Weil, Jr. I will contact them in the morning and then update the board here. Thanks for your response.

What I do know:
All participants were given the same treatment to one of two painful feet, at the same sonic pulse rate.
The study diary form I used in follow-up visits with doctors who were not involved in the procedure is titled 'Swiss DolorClast Study'. There is also a subtitle which says, 'Sponsor: EMS Electro Medical Systems'. In addition, there is a logo in the top right hand corner of the sheet that has the initials: mdt, with the words, 'medical device testing' above them. Lastly, there is a study number in the lower left hand corner of the sheet, ' Study No. 01k002.

I am not sure that the form necessarily coordinates with the exact study I participated in. They may just use the form because it best captures patient diary information. They are often involved in more than one study at a time. For example I know they were also doing a study with participants that only had one painful foot, vs. two.

I will post an update tomorrow. Thanks again, Dr. Z.

Re: Am I out of options?

Dr. Z on 7/25/03 at 08:50 (125197)

I know Drs Weil very well. IF this was the Dolorcast device,then this isn't true ESWT. Do you have the option of using the two other machines that they are using. 1. Orbasone 2. Wolf

Re: Am I out of options?

Dee D on 7/25/03 at 13:58 (125235)

My appt with Dr. Weil was moved up to this coming Monday (7-28). I found out that the machine used was an Ocitron (not sure of spelling.) I was unable to find out the amount of pulse administered, but will know more on Monday.

Could you explain to me what the difference is between a 'true ESWT' and the Dolorcast device use?

All your info is most appreciated.

Dee D

Re: Am I out of options?

Dr. Z on 7/25/03 at 14:54 (125238)

Do you mean orbasone ? Very important I can help you it this is the machine ?

Re: Am I out of options?

Elizabeth C. on 7/26/03 at 12:13 (125282)

Dee,
I live in Naperville, IL. How did you become a part of this study? I have had three treatments(May/June-03) at M&M Orthopedics in Oakbrook, IL and I am seeing some improvement. I was wondering how I could become a part of the study. My right foot is still in a lot of pain in the mornings and at the end of the day. My left is not too bad, but has it's moments. My neighbor said he was treated at that clinic as well, he had one treatment (Ossatron?)and has been pain free. He had this done about six years ago as a part of a study. I am so sorry you are not reponding to treatment, I am just as frustrated. I have had this for eight years as well. I am 37, but my feet feel like 87. I have four children that give me very little opportunity to rest. I wish there was a spa designed to help those with PF, two weeks away from kids, you are forced to rest, people pamper you, I bet a lot of us would recover faster. Plus, bonus...insurance covers it! Okay, I will stop dreaming. How many Cortizone shots did you get? Five? I thought three is the max. I received three in each foot, every six weeks and thats all I can receive. I heard or read that those overuse of cortizone shots can weaken the tissue and cause a ruptures. Hang in there. I hope the doctors can help you in your future treatment. I can totally relate.

Elizabeth

Re: Am I out of options?

Dee D on 7/28/03 at 11:31 (125437)

Dr. Z: The name of the machine was ossatron (still not sure of spelling). This is how it was written in a message from Elizabeth of Naperville.

Elizabeth: I became a part of the study at my first visit with Dr. Weil, Jr. I was referred to his institute by my orthapedic doctor at Rush Hospital in Chicago. Hope that helps.

Re: Am I out of options?

Dr. Z on 7/28/03 at 14:13 (125449)

I would discuss trying a second treatment. I have seen many patients respond to a second treatment when a first treatment failed to give any relief

Re: Am I out of options?

Dee D on 7/28/03 at 20:50 (125503)

Dr. Z:

Help me understand why? I saw the doctor (Weil) today and then had a good cry. He seemed to be out of ideas. I asked about a 2nd ESWT and he said it was very unlikely to work because the first had failed. Much of what I have read is different from his opinion.

The doctor was against PF surgery, and strongly suggested I do more reading about my anti inflamatory drug -- he just doubled the dosage, noting I was far from taking an 'extreme' level. I am adverse to taking medication -- I am fearful of the side effects.

The only other things mentioned were to go and get my back checked out. Possibly the fact that both feet have problems, combined with a failed ESWT may mean a back problem. Is this possible in your opinion? Another possiblity is some kind of nerve disorder....don't know how to go about checking that out.

All I can say is YIKES! I suggested to him that I feel more uncomfortable in my orthodics than when I am without them. He suggested getting fitted for a softer type, which I did today. My former pair was the very hard type. The Dr. suggested that if I wanted to I could come back a month after I had my new orthodics.

If I decided to get a second ESWT should I go somewhere else? Thanks for your help. I appear to be a very difficult case, but I need to get some positive action. DEE D

Re: Am I out of options?

Dr. Z on 7/28/03 at 21:09 (125506)

If you have pain at the insertional area of the plantar fascia. IF you have pain when your sit for any length of time and then get up, then ESWT would be the treatment I would offer you. I would also perform an ultrasound to confirm plantar fasciitis.