Orthopedic Dr.Posted by Michael on 5/09/04 at 09:16 (150272)
Hi, I am going to an Orthopedic Dr. on Tues. What should I expect? Does anyone have any suggestions on what to ask? I have suffered from PF(don't know if that is really the problem) for 18 mo. Seems to be getting worse. I am almost bed ridden lately. Nothing seems to work. I have extreme pain that is almost unbearable. I am so frustrated. Dr.s are not doing anything except giving me pain killers which don't help much at all. I don't have tenderness at all. Just pain that runs along the arch to the toes. I have a very high arch. My walking mechanics are not good. Do you think this Dr. could be of any help? Thank you for your response. Michael
Re: Orthopedic Dr.Steve G on 5/09/04 at 11:46 (150276)
Michael - have you had an MRI and, if so, what did it show?
Re: Orthopedic Dr.R C on 5/09/04 at 12:39 (150277)
Among other options, talk about 4-8 weeks in a cast (+ crutches) followed by physical therapy. My orthopedic Dr. says he has a 90% success rate with that approach. I include myself as one of the successes.
Re: Orthopedic Dr.Dorothy on 5/09/04 at 12:50 (150278)
First, try very hard not to editorialize too much but instead to focus on your key points - and as I understand your key points (I am sorry if I have them at all wrong..):
1. you need/want an accurate diagnosis
2. what has been done is not doing any good
3. you want to address the cause(s) and not only pain
4. your pain, ability to walk, ability to function, mood, life have all gotten much worse - and you need/want better information for diagnosis and treatment based on that - and then
5. you need/want to know what you can expect
6. it is true that you are in pain but prescribing more pain meds is not making things any better and not addressing the problems; not even fixing the pain.
Be as specific as you can about where it hurts, how much, when, what it feels like, when it began, etc. Write it all down and organize it.
Maybe the doctors here can tell you what it is they would ask you if you walked into their examining rooms and what they would want to know from you - to help you prepare for your appt. next week.
Remember: you have to fight for yourself and for your own well being. If you have been reading here very long you will know about the experiences of a number of people who have had very tough times getting the help they need - but they keep at it. That is what you have to do. Is there anyone who can accompany you and help you convey to the doctor(s) what you are experiencing?? Good luck.
Re: Sound adviceSteve G on 5/09/04 at 13:52 (150283)
Dorthy has given you a great overview of the approach you should take to your visit
Re: Orthopedic Dr.Michael on 5/09/04 at 14:19 (150286)
No I have not had an MRI for this problem. The neuroligist, foot Dr., and GP don't feel it will show anything. Maybe the Orthopedic Dr. will. I can only hope. I feel like none of these people know much about the feet. My GP says he has PF and he has pain but heel cups work for him. I know he can't be having the same intensity as me, so I feel he can't understand fully. He can relate somewhat but he lives a normal life. I haven't been able to work, do anything physical like hiking or biking which I used to do or even go to get a bite to eat in peace. Can any explain the difference between PF and Plantar Fasciosis? It was mentioned by a Dr. on this board but he didn't elaborate. He sounded like without the tenderness which I don't have that is what I might have. It also sounded like there can't be much done for it and that scares me. Thank You Michael
Re: Orthopedic Dr.Michael on 5/09/04 at 14:23 (150287)
Thank You Dorothy, I will print your suggestion out. My wife will be coming with me. You are right I do have to fight for myself. This board is very helpful and I feel for all the people in such pain. Thank You Michael
Re: Orthopedic Dr.Carlos N. on 5/10/04 at 12:24 (150330)
PF and plantar fasciitis are the same thing. It is the pain you are experiencing in your feet. I know your pain because I have lived with it for many years. I'm truly sorry that it has become chronic. I don't know if this doctor can help you but I hope he can.
Also consider custom-made orthotics, plenty or rest, ice, night splint, stretching, and evaluate the shoes you commonly wear. Sometimes you have to see several doctors or podiatrists before you get the right formula for your problem. Surgery should your absolute last option.
Re: Orthopedic Dr.Ed Davis, DPM on 5/10/04 at 19:02 (150358)
There is an enourmous amount that can be done for the problem -- read Scott's Heel Pain Book on this site so you get a good overview. Taking pain pills for 18 months did not help matters. The one negative thing is time -- it is good to treat plantar fasciitis early and agressively with conservative means.
There are three components to plantar fasciitis which leads to what I refer to as the 'treatment triad.' That is something you may do a search on this site. Early on, the condition has a larger inflammatory component and, as such, tends to respond somewhat more favorably to anti-inflammatory medications. As the condition progresses -- it does so for a REASON -- things should eventually heal unless there is a factor causing progression and that factor is problematic foot mechanics, that is, mechanics of your foot placing too much stretch or strain on the plantar fascia. This 'phase' needs to be viewed and treated by modalities that deal with the problematic biomechanics --that can include, PT, night splints, orthotics. Finally, if PF fails to heal, it does so because there has occurred, over time, a deterioration of tissue quality in the fascia. We have not had a good term for this but the term 'fasciosis' is the best term because it states that the fascia is degenerating or has degenerated in quality. The fascia, if in that state, seems to respond poorly to many of the 'conventional' modalities and the only answer up until about 4 to 5 years ago was to surgically cut or release the fascia. We now have a way, in ESWT, to reverse the deterioration in tissue quality, restoring it.
Luckily, the information I have discussed is 'findable' in this site via the Heel Pain Book and the site search engine and is basic information to most podiatric physicians who are the only physicians exclusively trained in the diagnosis of foot and ankle problems. It is possible to find other specialists with this knowledge and some of the needed training.