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upcoming ESWT

Posted by Cyndi A on 1/18/05 at 13:00 (167468)

I am scheduled for my first ESWT treatment in 2 days. I have been trying to read up on all of the information. The machine my Dr. uses is the Sonorex. I spoke with the girl in his office who does the treatment to see what I should or should not be doing after the treatments. She said I could do whatever I have been doing, ice, stretches, PT, splint, etc. I was wondering if there is a set protocol listed somewhere regarding this information. Should ice or heat be used? What about PT? Should I continue with it, and if so, anything work better over the other? Why stim or whirlpool? My PT doesn't seem to know to much about ESWT. Should taping be done, even though I have prescription orthotics? Should I continue with the night splint? Any help I can get would be appreciated. Especially since my insurance doesn't cover the procedure. I want to do everything I can to help it be successful. Thanks

Re: upcoming ESWT

Dr. Z on 1/18/05 at 16:55 (167488)

Cyndia,
Are you sure that there isn't going to be any superviser by your treating doctor?
All of your questions should be answered by your treating doctor. He will probaby review this with you that day of treatment.
Why did you pick the sonocur machine?

Re: to: Cyndia Re: upcoming ESWT

vince on 1/18/05 at 19:14 (167498)

My suggestion- Don't go the Sonorex route- opt for high energy that is FDA approved - The low energy didn't work for me and a few other people I came accross. They all repeated with high energy and they all are OK.

Re: upcoming ESWT

Cyndi A on 1/19/05 at 07:17 (167517)

Dr. Z
My doctor, a surgeon, will not be present. He has two offices and the machine is in his Phoenix office. He is the one who recommended the treatment, probably since he owns the machine. I spoke to both his assistant and the girl in his office who performs the treatments about my concerns. They both said to continue with whatever I've been doing. Not a lot of help. I have no follow-up with the surgeon, unless I want to be seen. The only reason I chose the Sonorex, is because this is what he has. The charge is $375 per visit, with 3 visits 1 week apart, each. I am only having the worst foot done at this time. Should I not do the Sonorex? How do I find a Dr. who does the other machines, and which do you think is better?

Re: to: Cyndia Re: upcoming ESWT

Dr. Wishnie on 1/19/05 at 08:17 (167520)

I agree. High energy is the way to go. I see too many failures with low energy.

Re: upcoming ESWT

Dr. Zuckerman on 1/19/05 at 08:53 (167521)

Cindi there are two FDA approved machines in the USA that are approved for Plantar fasciitis. The sonnex is one of that isn;t approved. Your surgeon is obligated to tell you that it isn't one of the approved ESWT machines for Plantar fasciitis
Having used the Dornier epos ultras since it came out over three years ago I perfer this the dornier epos ultras. It can used in any type of setting office, ASC etc. There is no need for IV and or general anesthesia.
I am not sure of providers in your areas. We have many patients that travel to our group in the philadelphia area due to our experience and very fair fees E-mail Dr. Z at (email removed)

Re: upcoming ESWT

Dr.Wishnie on 1/19/05 at 12:57 (167538)

Hi Cyndi:

I too have been using the Dornier-EPOS for the last three years. I work with Dr. Z and am in New Jersey. Between Dr. Z and I, we have done more ESWT than anyone else in the country. The machine makes a difference. Good luck. Dr. Wishnie

Re: to: Cyndia Re: upcoming ESWT

Ralph on 1/19/05 at 13:45 (167542)

Hey Vince did you read any of the posts from Sunny, the guy from Canada, that uses low energy? He doesn't seem to agree with you at all in his posts about low energy.

Re: to: Ralph Re: upcoming ESWT

vince on 1/19/05 at 18:24 (167556)

I know what they say about the Canada experience. I am stating from my own experience- and from that experience I can say IT DOESN'T WORK FOR VERY LONG.

Re: upcoming ESWT

Ed Davis, DPM on 1/19/05 at 21:00 (167570)

Cyndi A:
Sonorex is highly effective and is a great way to go. Nothing is 100% effective. The response to ESWT can and is often cumulative. I have seen people who had high energy ESWT with no response, only to be cured on the second go round with low energy (Sonorex) and vice versa. I am in a minority of docs who uses low and high energy so I have seen a broad perspective on this. I would ask Vince and Dr. Wishnie, in Vince's situation and Dr. Wishnies experience has each case mentioned been one round of low energy followed by high energy? How often did they see high energy followed by low energy?
Ed

Re: upcoming ESWT

Cyndi A on 1/19/05 at 21:46 (167575)

Well, I canceled my treatments that were supposed to start tomorrow. I feel that I need to check into it further. I called my surgeons office and his girl who does the treatment told me that she thought the Dr. would have told me that Sonorex is not FDA approved, and that she can't remember who she has given information to because she speaks to so many patients. Kind of scary. I have had chronic plantar fasciitis for 3 years, with pretty much eveything tried. All this conflicting information is confusing. I guess I'll just have to try to wade through it. Thank you all so much to everyone who has responded and tried to help me out.

Re: upcoming ESWT

Dr. Wishnie on 1/20/05 at 08:23 (167587)

The patients I have seen that had low energy ESWT had three rounds. When we perform ESWT and if the ESWT procedure is not successful, we will give a second treatment at no additional cost. At that moment, I must say, there are very few failures.

Re: upcoming ESWT

Cyndi A on 1/20/05 at 09:31 (167591)

I did check with my Dr. about that. They informed me that any additional treatments, past the original 3, would still be $375 for each additional treatment. This alone seems to me that they do not stand behind what they do.

Re: upcoming ESWT

Sharon B. on 1/20/05 at 17:26 (167629)

Is the Ossatron FDA approved?

Re: upcoming ESWT

Cyndi A on 1/20/05 at 20:43 (167646)

Dr. Z
I went to the Ossatron website and found quite a few Dr.s in my area that use it. I also checked for the Dornier epos at the aksm and the united shockwave website and neither listed any Dr.s in my area that use it. So I was wondering what your opinion was on the Ossatron since it seems to be the only option for where I live. Do you think it is an OK way to go. Also, their website states that anesthesia is necessary. Can't they do an ankle block like the Dornier web site states? Thanks again for your help.

Re: upcoming ESWT

Dr. Wishnie on 1/21/05 at 06:58 (167655)

yes it is.

Re: upcoming ESWT

Dr. Wishnie on 1/21/05 at 07:02 (167656)

The ossatron is approved to be used only in a surgery center. Most surgery centers, not all, require that an anesthesiologist is present and if an anesthesiologist is present, he/she must administer a sedation. So, most Ossatron cases are performed under local with sedation type of anesthesia. Yes, in actuality, the Ossatron only needs a local block.

Re: upcoming ESWT

Ed Davis, DPM on 1/21/05 at 14:28 (167687)

Cyndi:
Doctors routinely use a lot of things that are not FDA approved. For example the drug Neurontin is used for nerve pain even though it was approved by the FDA only as an anti-epileptic drug. This is known as 'off label' usage and is very common in the US.
Ed

Re: upcoming ESWT

Sharon B. on 1/22/05 at 13:00 (167716)

Thank you. I had the info but guess had forgotten..found it later. My husband is having both feet done on February 3. All self-pre-pay of course. *smacks Cigna* He is having general anesthesia with blocks as well. I tried to get only an IV sedate but the doctor wanted the general since both feet are being done at once. After $2500 or so what is $400 more?? *heavy sarcasm*