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What to try now?

Posted by John H. on 3/20/04 at 10:20 (147392)

I need an option from the doctors here. First a little history. After several month of heel pain I went to the ortho. This is how my
plantar fasciitis treatments have gone.

Mid June into July - Removable air boot followed by PT.
Late Sep. through late Oct. - Hard cast.
Late Oct. - I developed a blood clot after the cast was removed. Big clot from just below the groin to mid calf. I will finish my 6
month on coumadin and have another vein study done in late April.

I'm having more heel pain now than ever. I have visited a podiatrist and my orthpedic doctors for an optionsas as to what to do now.

This bring me to my questions:

1. Would the resent history of blood clots rule out surgery?
2. Would the resent history of blood clots rule out ESWT?

Thanks in advance for any help.

Re: What to try now?

Ed Davis, DPM on 3/20/04 at 19:23 (147427)

Blood clots don't necessarily rule out surgery but they make surgery even riskier. They are not a contraindication to ESWT although you may need to stop the coumadin 3 days before high energy ESWT, less for low energy ESWT. Based on Scott's Heel Pain Book, what other conventional treatments have you had? You have had somewhat too much immobilization, air boots and casts, relative to the spectrum of treatments generally used for plantar fasciitis unless you are yet to provide us with more details. Blood clots can be one of the consequences of immobilization.

Re: What to try now?

John H. on 3/21/04 at 06:51 (147441)

Thanks for the fast reply. I wasn't planing on doing anything till after I come off the coumadin.

I tried most other treatments (before the booting and cast). First thing I tried was to rest the heel, thinking if I stayed off of it it would get better. Also stretching (which I still do), icing, PT, costom orthothics, good shoes. I can't take aspirin now (I'm on coumadin) although I did use it at first. Also tried Celebrex. Ortho took me off that after it show no improvement. Helped very little. I also wear very good shoes. I've had 2 shots (no fun there).

It wasn't till I found this site that I hear of taping. I'm going to try that between now and when I get a release from the blood clot treatments.

I'm somewhat over weight. I haven't really tried to loose the weight......I'm sure you'll tell me to though.

My Pod said he wouldn't do surgery on me, however, he did say that there are a lot of doctors that would. He just didn't want to be the one to immobilize my foot/leg due to the blood clot issue. I think the Ortho might do the surgery. I have told him I'm checking out the ESWT and he agreed that that could be an option. He really didn't know much about it though.

I Think that about covers it. Thanks again Doctor.

John Haines

Re: What to try now?

Ed Davis, DPM on 3/22/04 at 17:43 (147536)

I would talk to a doctor that is experienced with ESWT. Look at the links to find a doc in your area: http://www.unitedshockwave.com and http://www.sonorex.com