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Surgery update. Day 16

Posted by Bud P on 11/26/03 at 22:34 (138829)

To All,

I'm getting around pretty well right now with very little pain. Most of my pain is post op pain from the pot holes. At this time I feel real good about the surgery. I'm not experiencing any PF pain that I can tell. I'm limiting the amount of walking I do and the Dr say no impact exercise at all. He did say I can jog in place in the theraputic pool as long as my feet do not touch the bottom. I'm going to continue to take it easy. Happy Turkey Day to all. Bud

Re: Surgery update. Day 16

Bud P on 11/26/03 at 22:36 (138830)

That was port holes. In my younger years it may have been pot holes. LOL

Re: Surgery update. Day 16

Sher A on 11/27/03 at 20:59 (138857)

Bud, that's excellent to hear that you're doing alright. I really want to hear from someone who has had success with this surgery, as I may be considering it myself one of these days. What is the pain level like? Has it levelled off much since you had the surgery done? I'm pulling for you here, believe me!

Re: Surgery update. Day 16

Bud P on 11/28/03 at 07:58 (138862)

Sher,
At this time I don't feel any PF pain at all. There is a bit of surgery pain, but everyday it gets less. I imagine in a week or two I'll know if it was successful. At this time I feel good about my decision to have surgery. I'll keep you posted.

Bud

Re: Surgery update. Day 16

Sher A on 11/28/03 at 09:31 (138864)

I'd really appreciate it if you would. Would you mind exchanging email addresses? I have just a thought here. One of the reasons why people come to this board is because we came to it out of suffering, made friends, and continue staying here. Maybe, just maybe a lot of people have had this surgery, and it's been successful, so they don't know about this place or don't have the need to come here. I know I wouldn't be likely go to a board after I've gotten over something, in order to discuss it. What do you all think? I realize that the surgery has a high risk factor, but I really want to hear that someone got through it with flying colors. If my feet continue to hurt, the more desperate I'm going to get and the more likely I will be to take that risk. The ESWT is just plain unaffordable for me unless insurance covers a major portion of it. That is really a shame that it is only available to those who are well off enough to afford it. If it is a still somewhat unproven surgery, then I would think that the more people that the medical profession could get to try it out, the more they would learn about it, and the more money they would eventually make. But then I tend not to think like everyone else. Enjoy the weekend!

Re: Surgery update. Day 16

dave r on 11/28/03 at 12:29 (138872)

Hey Bud, do you know how much of the fascia was released?

Re: Surgery update. Day 16

John H on 11/28/03 at 18:17 (138895)

Problem is that the Doctor really does not know how much of the fascia is released during surgery. As Dr. Z told me it is done largely by 'feel' as he does not have a direct view of the fasica when he makes the cut. I think with an endoscope the Doctor has even less control over how much is released.

Re: Surgery update. Day 16

Bud P on 11/28/03 at 21:03 (138910)

Sher,
My computer is giving me some problems,so I've been having trouble staying online. Here is my email write and I can give you a great deal of info. I'll try and respond to the rest of the messages here that have been posted. My computer seems to lock up after about 5 minutes

Bud

Re: Surgery update. Day 16

Bud P on 11/28/03 at 21:15 (138913)

Sher,
I have made contact with a great deal of people who have had successful surgeries. You're right about this board, a great deal of these people have had bad experiences with surgery. Most people on this board are against surgery. I might add that I feel it should be the last thing.There are also a large number of podiatrist that do the EPF procedure. I would say that in the Southwest Florida area,there are more Podiatrist that do the surgery than don't. I talked to over 20 podiatrist in this area before I had the surgery and they all agreed I should have the procedure. The WAY I got to know these doctors was that I played in a basketball league with them ,so over the last 15yrs I became friends with them and was involced with different charities. I'll tell you more later . My computer is going bonkers. Bud

Re: Surgery update. Day 16

Bud P on 11/28/03 at 21:17 (138914)

Dave,
I believe it was one third release. When I go back in a couple weeks I'll ask again.

Bud

Re: Surgery update. Day 16

Bud P on 11/28/03 at 21:19 (138915)

John,
That is correct. They only guess at how much was cut. They can see it with the scope and the pictures. There was a video taken with my surgery.

Re: Surgery update. Day 16 Sher post are for you

Bud P on 11/28/03 at 21:22 (138917)

Sher,
I'm new at this message board thing,so I don't know how to respond directly to you or anyone.

Bud

Re: Surgery update. Day 16

Dr. Z on 11/29/03 at 01:42 (138922)

That is exactly the problem . The more you cut the more instablity your can develop from the release. Sometimes it goes away and then sometimes the pain never goes but increases. ESWT is affordable if you have a credit card or can afford $75 dollars per month. When this is a will there is a way. Sorry but if you can afford a computer or afford to go on line then re-think ESWT. Canada is also another option if you can't make those small $70 monthly payment. Please try cause once you cut you can't turn the pf release instability back.

Re: Surgery update. Day 16

Julie on 11/29/03 at 02:52 (138926)

Sher

You've asked what we think, so here is what I think. I know that surgery can be a tempting option: one thinks 'let's just cut to the chase, go for the surgery, get it over with and get on with life'. If I had not been one of the lucky ones, with a straightforwards case of PF that resolved with conservative treatment within a year, I might have been tempted too. But I hope you will think very, very carefully about it.

I am glad, as you are, as we all are, that Bud is getting on so well, two weeks post-op, and I hope that his recovery is complete and permanent. 'Permanent' is the key word here. I don't think any surgery, even one that has been uneventful and free of immediate post-operative problems, can be regarded as 'successful' until many years have passed without any of the long term ill effects that have so often been described here by the doctors and by those who have experienced them. The bottom line is that when you cut the plantar fascia you are weakening the main support structure of the foot. The more it is cut, as Dr Z has explained, the more instability you get and the greater the likelihood of problems in the longer term, some of which can be dealt with with orthoses, some not.

It simply has to be better to go for a treatment that does not create more problems either in the short or the long term. It makes sense. These are the only pair of feet you will ever have. ESWT on time, at $75 a month doesn't sound bad to me. It's the way most of us buy all our other big investments, like our cars, after all. What's more important than your health?

Re: Surgery update. Day 16

Pauline on 11/29/03 at 07:16 (138929)

Julie,
Great advice

Re: Surgery update. Day 16

Julie on 11/29/03 at 08:40 (138937)

Thanks, Pauline. It's something I've been wondering about lately.

Re: Surgery update. Day 16

Sher A on 11/29/03 at 12:18 (138961)

Yes, that is good advice and I appreciate it. When I bought my computer 3 years ago, my finances were in great shape. Things have happened since then that have seriously depleted them, and I have been trying to recover. If this computer goes, it will be awhile before I get another one. We are trying to get out of a suffocating credit card debt right now and I am putting absolutely nothing else on a credit card until that happens. While it may appear that one is well off enough to have a $5,000 surgical procedure by the fact that one has a computer and internet access, there are other circumstances in one's life that make that kind of a debt not possible right now. More than 1 of us are paying for that access here. While $75 a month may be completely affordable to one, that does not make it affordable to another, at least at this point in time. My job happens to be in jeopardy right now, and if it goes, so do a whole lot of other things, including being able to afford medical insurance on our own. Just go get another job right? Try it sometime. I am not going to be willing to incur a debt like that until I get out from under the burden that I'm currently under and the job outlook is more secure. I can't believe some of you can judge someone's ability to pay like this, especially when you don't know the hardships that one may be facing at the moment. A $5,000 ANYTHING is simply out of reach, as well as taking years to be able to pay it off. If this surgery is that risky and can have such repercussions, then why is ANY doctor even performing it? Something doesn't seem right here. Geez.

Re: Surgery update. Day 16

Sher A on 11/29/03 at 12:36 (138964)

I'm having problems with mine as well and am going to do a reformat tomorrow. My email is (email removed).

Re: Surgery update. Please read.

Sher A on 11/29/03 at 12:53 (138968)

Julie, I just re-read your post and can't tell you how much I appreciate it. You just made up my mind that the release surgery isn't worth the risk. The more I hear about it the lousier it sounds. I am going to consider ESWT, but up in Canada, where it may be within my means to figure a way to pay for it once I assess my job situation.

The thing I really want to know is what I ended the other post with. WHY is ANY doctor being allowed to perform the invasive surgery if there is such a high risk factor, especially over the longterm? Since this isn't a life or death surgery, I would think that in this country (USA) where the FDA approves any tiny thing and removes a drug from the market if one person gets sick from it, that this surgery would not be allowed at this time. I'm seriously missing the boat here and need help in understanding. I have a POD appt. in 2 weeks where the surgical options will be explained. I might have let myself be talked into that surgery had I not read your post. I have a serious distrust of doctors to start with, particularly in regards to pain, so any help is appreciated.

Re: Surgery update. Day 16

Julie on 11/29/03 at 12:56 (138969)

Sher, I don't know where you live, but I do know from reading these boards for the last three and a half years that $5,000 is a high fee for ESWT. I understand what you say about your financial difficulties, but your health is still the most important thing you have, and if money is a real problem I suggest you not limit your horizons to the area you live in, but investigate ESWT in other areas. Dr Z, for instance (and I am not 'spamming' here, but he hasn't offered the information himself) charges nothing like as much as that.

Fees vary wildly for ESWT. I don't live in the US so I haven't wholly understood the ins and outs of why this is so, but I think that if you do your research you will find affordable ESWT. And there is no question that - as long as you are a candidate for it - it is a safe alternative to surgery.

A number of people here have had ESWT done in Canada, where it is vastly cheaper.

Anyway, best of luck, whatever you decide - just try not to get too fixated on surgery before you have explored it and its alternatives thoroughly.

Re: Surgery update. Please read.

Julie on 11/29/03 at 13:10 (138971)

Hi Sher

We crossed.

Your question is a big one with lots of answers, and I don't know them all. I'm sure it has a lot to do with the insurance situation, but it's also historical. Until recently, surgery was the end of the line: there was nothing else after 'the failure of all conservative treatments' (that's in quotes because it means such different things to people, including podiatrists, some of whom appear to believe that 'all' means cortisone and NSAIDs). Now there is ESWT, but all new treatments take time to catch on and be generally accepted by practitioners (not to mention the FDA). All patients can do is take responsibility for researching all the options - and take an active part in their health care.

I'm glad my post has been useful, but don't rely completely on it - take some time to read back posts, especially by the doctors who know much more about it than I do. I only know what I've learned here, same as you - I've just been around a few years longer!

Re: Surgery update. Day 16

Dorothy on 11/29/03 at 17:14 (138989)

And just to add one comment to Julie's great post, because I found this point helpful and one that I keep in mind (have not had ESWT, but hold it out as a 'Plan B'..): we were told here that ESWT can only keep things the same/maintain status quo or make things better; it does not make things worse. That might help with any consideration.

Re: Surgery update. Day 16

BrianG on 11/29/03 at 18:20 (139004)

Hi Sher,

I know exactlly where you are coming from. When I was layed off from a job that I had for 18 years, there was no rainbow ahead for me. I have had both EPF surgery, and ESWT, without any healing. Which is why I had to do a lot of research, and got a couple lucky breaks along the way. We have to take resposibility for our own health, and with the internet, that can be much easier these days. Go to the library if you need internet access, it really is the fastest way to find information.

You might want to read up about low, and high powered ESWT. One may be better for you, than the other. Use search engines, the information is available. Would I go into debt for ESWT, without a guarantee, probably not. I still had to do something for my chronc pain though, and long acting pain medication is what I chose. I keep searching though, that break through could be just around the corner, and I surely would not want to have complications from surgery if that was to happen. RSD can be for life !!!!!

Good luck
BrianG

Re: Surgery update. Day 16

Laura on 11/29/03 at 19:02 (139006)

It is a hard decision. I had the surgery four months ago and am very glad I did. I am back at low impact slow aerobics. It was an open surgery with approximately 1/3 to 1/2 release. The doctor did not know for sure the percentage of release.

Re: Surgery update. Day 16

Dr. Z on 11/29/03 at 22:15 (139013)

I do know one thing and that is if you are under such finanical hardship you CAN't afford to take the risk of any type of foot surgery that can keep you out of work for months.
ESWT prices have come down in the past six months and shold be in the $2500 dollar range . Whether this changes your view I have no idea. PF surgery can and does work but when it doesn't the serious side effects are permenant. Good luck with what ever decision you make

Re: Surgery update. Day 16

Dr. Z on 11/29/03 at 22:20 (139014)

Hi Brian,
Are you saying that you wouldn't go into debt to ESWT or you have a choice between ESWT and pf release. ? Is that my understanding of your post?

Re: Surgery update. Day 16

BrianG on 11/29/03 at 22:32 (139016)

With my finances the way they are today, I would NOT go into debt for ESWT treatment. I'm speaking as someone with a very fixed income, and little chance that it will ever change. Sher sounded like she could end up in the same situation. I guess if you want something bad enough, you 'might' be able to get it, but just how far will you allow it to put you into debt?

BrianG

Re: Surgery update. Day 16 to Dr Z

Bud P on 11/30/03 at 15:05 (139055)

Dr. Z,
The ESWT is still pretty expensive here in SW Florida. It was quoted to me between $4000.00 and $5000.00. Plus in the Ft. Myers, Naples area there are only a couple doctors that do it,and there are about 60 podiatrist in this area.I did call a Tampa foot center and it was between $3000.00 and $4000.00. It may be that costly because of the few doctors that do it. You are right on the surgery point. If the surgery has complications then the ESWT doesn't seem to be that expensive.

Bud

Re: Surgery update. Day 16

John H on 11/30/03 at 15:44 (139057)

Dr. Z: Knowing what I know about PF surgery the only kind I would ever do is a Baxter procedure where no more than 10-15% of fascia is released. I really do not think in the true medical sense this is a fascia release since it is performed to relieve any pressure on the Baxter Nerve.

I would go into debt for ESWT before having PF surgery which I do not think I would do under any circumstance. I think my lucky stars I did not let the first Doctor I saw do a double PF endoscopic release both at the same time which is what he wanted to do. I found this board and then luckily found an Orthopedic Foot and Ankle Surgeon who had been trained in the Baxter Procedure. I am by no mean cured but compared to 8-9 years ago I have come a long way baby.Something I did must have helped. I am not sure what but you take what you can get and keep on trying.

Re: Surgery update. Day 16 to Dr Z

Dr. Z on 11/30/03 at 16:00 (139059)

Hi

We have many many patients from your neck of the woods in Florida. We charge $2500 for one foot. This includeds any 2nd treatment that may be needed. Patients fly in for the day or stay just that one day . We have used the dornier since it came out which is about 22 months ago. I have used ESWT since 1999 in over one thousand patients. Our experience and cost make us a very good choice for ESWT. If you would like any additinal informatoin about our ESWT program just e-mail Dr. Z at (email removed).

Dr Z

Re: Surgery update. Day 16 to Dr Z

Bud P on 11/30/03 at 19:43 (139069)

Dr. Z,
Where are you located?

Re: Surgery update. Day 16 to Dr Z

Dr. Z on 11/30/03 at 20:12 (139070)

Twenty minutes from Philadelphia, Pa. The airport is about twenty minutes from my office.

Re: Surgery update. Please read.

Janis on 12/02/03 at 17:35 (139186)

I had surgery and it has really helped. I did not have to pay anything and had a wonderful surgeon. Surgery can be the answer for many people, such as me.

Re: Surgery update. Please read.

Bud P on 12/03/03 at 08:16 (139251)

Janis good for you. It's nice to see someone post that has had a good result. How long ago did you have the surgery? I'm on day 23 post op. and I feel great.

Bud

Re: Surgery update. Please read.

Kathy L on 1/03/04 at 13:28 (141242)

Sher,
If you go to a surgeon it's likely he/she is going to recommend surgery... they don't make money otherwise. Ten years ago I visited a foot doctor for what is called a 'hammerhead' toe, he suggested surgery, nothing else. I had a friend who had two foot surgeries, and I watched her suffer so I did not go back to my doctor. Instead, I replaced my shoes with ones which fit better, and wore those little bunyon pads to protect my toes, and over time, it got better, it hasn't been a problem any longer.
I feel so lucky I accidently found MSM and other supplements which appear to have healed my recent PF. I'd suggest trying them.