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Dr. Z

Posted by Pauline on 1/16/04 at 19:58 (142236)

Do you think ESWT will eventually take the turn ESWL has taken for treating kidney stones?

The manufactures decided to cut costs and designed a water pillow machine. It's not as powerful as the older water bath machines nor as costly for the center or patient. The physician can use a lot less anesthesia. I believe only heavy sedation with some pain control.

I hear the end result for breaking up stones unfortunately is not a good using the new machines. Mayo has chosen to continue using the water bath and their success rate is about 98% where other centers using the water pillow have dropped in success.

Mayo can boast of their 98% for kidneys, because the proof is immediately seen in the x-rays, but we certainly haven't seen this much consistancy in success for P.F.

Re: Dr. Z

Dr. Zuckerman on 1/16/04 at 21:07 (142239)

Which manufactor is the Mayo clinic using.? I do know that Dornier invented the water bath system back in 1980. I am not sure of the success rate for the ESWL with the electromagnetic units. I do know that the Dornier Epos system is based on the Dornier Delta ESWL system.
There are studies showing ultrasound changing post ESWT for pf. This is visual proof that the pf has resolved.
I am not sure about other body parts but I do believe that ESWT will be used before any pf releases are done and that it will be the standard of care in the future.

Re: Dr. Z

Dr. Ed on 1/17/04 at 12:01 (142274)

I don't know if you remember a book entitled 'Future Shock' by Alvin Toffler. It was somwaht visionary in that he was demonstrating that the rate of change- technologically, socially, etc. had substantially accelerated over prior generations and that that rate of change would continue to accelerate. That acceleration basically caused a 'stress' on people and the system. I think that you are seeing some interesting manifestations of Toffler's theory occurring already. Those who got statrted in ESWL did so with the expectation that a long and bright future existed for that technology and change occurred in only about 15 to 20 years. The change from high energy to low energy ESWT, which has already occurred in Europe, Canada and Australia has come so quickly that those who invested in high energy ESWT in the US are already starting to panic --- they are dependent on the FDA to slow things down. Luckily for Dr. Z, the Dornier is capable of low energy, high and intermediate energy levels so that machine and its owners will do well irrespective of waht happens. Healthtronics/Ossatron which is purely high energy is already 'in trouble' and could be considered obsolescent (not obsolete).
It is my hope that somehow,the Ossatrons can be salvaged under a new treatment model at a lower cost that third parties can live with -- I hope so because the need of the public is tremendous and way too few people who need the treatment are getting it.

Re: Dr. Z

Dr. Zuckerman on 1/17/04 at 14:13 (142282)


I agree 100% that it is important to be able to have a machine that can deliver both high, medium and low energy. I have excellent short term results using low energy for non-insertional Achilles tendonitis.
Bring the unit to the doctors office may also become too expense down the road and the use of ESWT /physical therapy centers will be the wave of the future. The doctor will refer his patients to the center for treatment The doctor may or may not be an investor. This is how many ASC centers are run.