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Dr believes that I tore my PF. Can ESWT still work for me?

Posted by DonnaG on 9/11/04 at 14:54 (159742)

After 1 1/2+ years with PF, I went to take a quick step forward last Mon and something snapped. Dr thinks I severed at least part of my PF. He went on to state that my PF may now finally heal and put me in a boot for at least the next 3 weeks. It is very bulky but I am learning to live with it. I guess I am being a pessimist, but if my PF does not heal, could I still be a candidate for ESWT? I don't know if my ins would pay (BC/BS fed employee), and (since I am retired) that would be a factor in whether or not I would have the procedure. I, like everyone on this board, am sick and tired of being in pain. It is depressing to know that I caused this by deciding to lose weight by walking. Now I weigh less but may be restricted from doing things I love by this constant pain. :(

Re: Dr believes that I tore my PF. Can ESWT still work for me?

Dr. Z on 9/11/04 at 15:17 (159743)

Hi
I have used ESWT for your exact problem. You want to see if it will heal on its own before you attempt a cours of ESWT. I would wait at least eight weeks before considering ESWT. The location of the tear is also a factor

Re: Dr believes that I tore my PF. Can ESWT still work for me?

Pat on 9/11/04 at 20:03 (159752)

I also have BC/BS Federal Employee and I know for a fact they don't pay - I guess they think Federal Employees aren't worth the extra money because I think the regular BC/BS pays. Supposedly they're working on getting it approved at a later date but I did all kinds of research and even found their policy meeting stuff where they said it was experimental and even called up doctor's who told me BC/BS Federal doesn't cover it. I have PF and I am sick of it myself. I'm in a plaster cast now because they think it'll help take the pressure off my foot and help it heal. My foot still hurts and I don't think it's doing anything. Yesterday I had a bone scan to rule out a stress fracture. Friday i go to the Podiatrist and he'll take off the plaster cast if there's no stress fracture and put on a foot cast. You're at least lucky that your plantar popped! At least it might have a chance of healing. Are you taking any anti-inflammatories or anything. I think if it were me and I came out of the boot I would ask for physical therapy for a month just to make sure my foot was feeling better.

Re: Dr believes that I tore my PF. Can ESWT still work for me?

DonnaG on 9/11/04 at 22:06 (159773)

Dr.Z, thank you for the advice. I really appreciate it.
Pat, I am taking the anti-inflammatory Bextra. At night when I take the boot off, my foot hardly hurts at all. I am aware that it could be the pain meds giving me a false sense that it is better. When I was first diagnosed with PF, the Dr that I went to see gave me a prescription for Vioxx, ordered me a set of orthodics, and told me I could continue to walk 2 miles a day. The Vioxx dulled the pain and I kept right on 'power walking' and punishing my PF. I am sure that I probably did additional damage to my foot. I finally got to the point that I quit walking and started riding a stationary bicycle for 30 minutes. I still do that 5 days a week. It doesn't seem to cause me any extra pain.
BTW, I'm not surprised about BC/BS Federal not paying. They are very 'selective' about what they will and won't pay for. Hopefully they will finally realize that it is not an experimental treatment and pay. Do you know if I have therapy whether or not they will they pay for it? Thanks. I am sorry for your pain. Unfortunately, I know exactly how you feel. :(

Re: Dr believes that I tore my PF. Can ESWT still work for me?

John on 9/12/04 at 11:23 (159785)

Pat,

What state are you in? Was denial of coverage from the local BCBS carrier, e.g. Anthem, or was it from BCBS Federal policy from the OPM?

Thanks

Re: Dr believes that I tore my PF. Can ESWT still work for me?

DonnaG on 9/12/04 at 14:48 (159787)

I am in Illinois. My dr is actually in Missouri, so the claim would be filed in Missouri. I haven't tried to get it covered, but according to Pat (another response above), BC/BS Federal denied a claim for the procedure. I am not surprised because I had a different type of surgery a couple of years ago and they would not tell me in advance whether or not they would cover the surgery. Fortunately they did.

Re: Donna

Pat on 9/12/04 at 21:11 (159797)

Hi Donna!
Yes, BCBS/Federal will pay for physical therapy and if you're not in Physical Therapy you should ask the doctor for a prescription. Sometimes it doesn't help but just the fact that you're forced to ice it, they use ultrasound or whatever it is and some other things may help. I already reached my deductible so every visit was only like $6 after BCBS paid their portion so it wasn't that bad. I think the doctor that told you to keep doing all that walking was nuts. He should have been telling you to rest it and stay off it until it started to try and heal. Is the Bextra any good? I think the Naproxin is making me eat, eat, eat - and that's something I don't need. Pat

Re: Dr believes that I tore my PF. Can ESWT still work for me?

Pat on 9/12/04 at 21:14 (159798)

I'm in Delaware and the denial is from BCBS Federal - not the local carrier. I pulled up BCBS Federal on the internet and also was able to find their site (I'm pretty sure it's connected with OPM) to state their reasons for denial and that they thought it was experimental.

Re: Dr believes that I tore my PF. Can ESWT still work for me?

Pat on 9/12/04 at 21:17 (159799)

Donna,
I would definitely ask your doctor to look into it first to make sure that they would deny it. And make sure you put in for the claim in Missouri (I'm not sure what you call it when the doctor gets pre-authorization). When I got my orthodics made I went to Pennsylvania (I'm in Delaware) and it was such a mess to get reimbursed for them it took me about 8 months. Then I find out that even though I'm in Delaware the fact that I filed the claim in Pennsylvania they had different standards. They even wanted to know exactly what the orthodic was made of and all this nonsense so just make sure your doctor submits the preauthorization thing to Missouri first.

Re: Dr believes that I tore my PF. Can ESWT still work for me?

John on 9/12/04 at 23:16 (159802)

Pat,

Can you post the link to the BCBS Federal statement? I haven't been able to find it.

Thanks