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ESWT questions for Dr.'s

Posted by Jennifer on 6/30/05 at 15:20 (177579)

I had ESWT 10 months ago. I had no prior nerve damage based on nerve testing 3 days before procedure, and actually had no inflammation of the fascia or surrounding tissues based on MRI - but my Dr. said it could help my chronic foot pain - that I'd be no worse for the wear if I did it. I had both feet done with high energy ossatron. I immediatly felt excruciating pain after anesthesia wore off. I was MRI'd a month after and nerves were tested using Neural Scan, showing significant bone edema and nerve damage of peroneal and sural nerve. 10 months post, and I still have inflammation of the bone tissue of calcaneous and all surrounding tissue, as well as muscle atrophy on bottom of foot. I'm having a difficult time finding information on whether this has ever occured to anyone else, and whether the ossatron is supposed to cause this. Also, are there any contraindications for very petite people and this machine - I'm 4-10 and 88 pounds - and 33 years old. The bony edema is very painful, and the nerve damage kept me off my feet for several months. I don't know that I will ever be the way I was before this procedure. Please help with any information.

Re: ESWT questions for Dr.'s

Dr. Zuckerman on 6/30/05 at 15:55 (177585)

Did the nerve damage pain finally stop? What kind of anesthesia was used? Was it a general, IV sedation, Epidural or ankle anesthetic block.?

Re: ESWT questions for Dr.'s

Jennifer on 6/30/05 at 18:41 (177593)

I had general anesthesia, and after reading the surgery notes, looks like I also had an injection (nerve block) into foot too. I had pretty severe brusing on bottom of right foot, and the Dr. who did the procedure said it was from the shot - it's also where it hurt the most after I came out from under the anesthesia. The nerve pain is still here, but not as intense. It's burning most the time, and shoes with higher heel - not flat - help to keep it from overstretching.I also take neurontin. They've gained back most of their function according to last neural scan, but I still have to get injections to keep it calmed down. My new Dr. is most concerned with bone edema, and keeping the nerves calmed down. I had to wear a ten's unit for a while it was so unbearable. Is my case totally atypical - because from what I hear, it is.

Re: ESWT questions for Dr.'s

Dr. Z on 6/30/05 at 20:32 (177604)

This is very usually from my experience wiht ESWT. I don't use the ossatron or use general anesthesia with a regional block. It sounds like a
Tarsal Tunnel problem

Re: ESWT questions for Dr.'s

Jennifer on 6/30/05 at 20:41 (177606)

Sorry, but do you mean un-usual?

Re: ESWT questions for Dr.'s

Dr. Zuckerman on 7/01/05 at 07:54 (177630)

You are correct it is very un-usual . Sorry

Re: ESWT questions for Dr.'s

PodinFla on 7/03/05 at 21:42 (177767)

You also could be developing Complex Regional Pain Syndrome or RSD for short. Is your foot cool and clammy? You state that you have bone edema. Do you have any plain film (regular xrays) demonstrating any signs of osteoporosis or washing out of the bony structures? I would definitely keep this in mind. RSD can come from anything. You can drop a can of soup on your foot and develop. Most people complain with pain out of proportion. Luckily, I've only seen one case and it was a second opinion case from a patient's family physician. RSD is a very rare risk factor for any surgical procedure. Good luck.

Re: ESWT questions for Dr.'s

Ralph on 7/03/05 at 22:15 (177770)

I heard it's possible to get this condition (RSD) from almost anything even having your blood drawn. Any truth to this?

Re: ESWT questions for Dr.'s

PodinFla on 7/04/05 at 22:47 (177821)

Very true. I know a lot of pain management physicians see these patients. I used to share office space with a pain specialist and he saw a quite a few RSD patients. Any form of trauma be it surgery, an injury, an injection can stimulate the onset of RSD. Although very rare, it should definitely be mentioned when consenting a patient for surgery.

Re: ESWT questions for Dr.'s

Jennifer on 7/06/05 at 23:27 (177985)

Thanks for the responses. My doctors don't think it is RSD. I'm under the care of a really good anesthesiologist for pain management. I had documented nerve damage 3 months after the ESWT - not present before. My new podiatrist speculates the inflammation may have caused it. The pain is very localized, and skin color and temperature normal. The bony edema was present 3 weeks after the ESWT - I have not had xrays since the procedure - but know my bone density was excellent just prior to the procedure, as I did have xrays several times of both feet, and no arthritis or thinning was present. The MRI report in October, 3 weeks post, said moderate bony edema of calcaneous, and MRI in May said same thing. My doctor thinks it could take a long time to heal. It's been very frustrating. We ruled out every possible underlying medical condition not to do the procedure - I was so much better off before.

Re: Jennifer, please write

BrianG on 7/07/05 at 07:44 (177993)

Hi Jennifer,

I'm sorry to hear all that you have been through. I have a couple suggestion's for you, if you'd like to write to me. I'm at (email removed).

Regards,
Brian

Re: ESWT questions for Dr.'s

Walkingirl on 7/07/05 at 10:36 (178002)

Jennifer:

I am not a doctor. I am a PF sufferer who has also had some nerve damage from wearing fins while swimming.

For the nerve pain, my doctor prescribed Foltex which is Folic Acid, Vitamin B6 and B12. I also take Wobenzyme (actually W-Zmyes by Michaels). The Vitamin Bs promote nerve health. The Wobenzymes are a natural anti-inflammatory (you can read about it online). Taking the Vitamin B supplements helped the nerve pain only. I took the Foltex about 2 months before I noticed a real difference in nerve pain. It did not help the PF. The Wobenzymes help the PF but does not cure it, it is just an aid.

My doctor said she cured a elderly woman who had a stroke and was left with nerve pain in her leg. The woman was in constant pain and was crying over it all the time. The doctor prescribed her Foltex and had her take L-Arginine. You can get L-Arginine at a health food or vitamin store. From what I have read, L-Arginine releases anti-oxidants into the body so you should take L-Lysine while taking L-Arginine to offset this side of it. A good vitamin supplement wouldn't hurt either.

At work a young man said that his wife had PF from overworking on a new dance routine (she's a professional dancer). The Dance company sent her to a person who performs Trigger Point Therapy. So, I ordered a book from the library on this subject. I just received it, and started reading it last night. I think it's called Trigger Point Therepy Workbook. Last night I had my husband do a few trigger points on me before a walk on one leg/foot. Then when we got to where we were going I noticed quite a difference in the way the treated foot felt and the way the untreated felt. The untreated foot felt tight in my steps. So I had him trigger the other foot/leg. The walk home was a lot more comfortable. It's not an overnight miracle. I think, in my case, that I will have to work with this therapy diligently for awhile before I start realizing lasting result because I have had PF for almost 9 years.

My best advise to you is educate to yourself on all your issues. Read, read, read.

I have never dealt with edema. I am not a doctor or any kind of medical professional. So, if you consider trying any of these things, speak with your doctor first. Good Luck to you Jennifer. Hang in there...something good is going to happen.

Re: ESWT questions for Dr.'s

Jennifer on 7/07/05 at 22:16 (178032)

Walkingirl,
I actually had ART before the ESWT, but now I can't massage the area due to the nerve damage - my Dr. said it would aggravate nerve possibly and to just leave it alone for now - which I am, since I notice massaging does aggravate the nerve, and I get the buzzing burning pain again. I also am on a Physical Thereapy modality called STS - which is supposed to effect the sympathetic nervous system, and how one feel pain - it's new therapy - but, luckily it's SAFE! I've been taking Wobenzyme for about 4 months now. I take acetyl-l-carnetine, and lysine, and lots of b-12, as well as b-complex. Luckily my anesthesiologist and homeopath MD are taking care of me on the nutritional end. I've read up on inflammation and eat a diet to combat inflammation - including all the supplements with omega 3 oils, and flaxseed oils - and lots of green tea. I wish I just had PF, believe me. There actually is no inflammation of the fascia, and it's of normal thickness - just nerve pain now and inflammation of surrounding tissues, muscle atrophy in right foot, and edema of the bone tissue. There's really nothing I can do but hope and pray over time my body will heal from the trauma this caused.

Re: ESWT questions for Dr.'s

Dr. Z on 7/07/05 at 23:18 (178037)

Jennifer,

What was the type of anesthetic in the nerve block. Lidocaine,Marcaine both just one?

Re: ESWT questions for Dr.'s

Jennifer on 7/07/05 at 23:25 (178038)

Regional nerve block using 1% plain lidocaine, in both feet, before procedure. Another additonal regional nerve block using 1% plain lidocaine to right extremity - post operative. My right foot hurt really bad as soon as I woke up - I don't know if they administered the second nerve block before I complained of the extreme pain, or after.

Re: Brian - please give deliverable email address

Jennifer on 7/07/05 at 23:33 (178039)

Thanks - I welcome suggestions - but I couldn't deliver a message to your address (?)

Re: ESWT questions for Dr.'s

connie on 7/08/05 at 12:42 (178059)

jennifer, do you have the pain only standing or sitting too?

Re: ESWT questions for Dr.'s

Jennifer on 7/08/05 at 23:29 (178083)

The pain is a constant, but does get much more intense as I stand or walk. Sometimes when I'm swimming in a cold lake, I don't feel my feet, and it's awesome - but that's about the only time.
When the nerve damage was the most severe, was when the pain was the worst. That was from about November to March. I still get burning, buzzing at night after a day of activity. I also have the achy feeling of my heels too - my Dr. thinks it's both the nerve, as well as the bone bruising. It feels different than the pain I had before the procedure - much more intense, and more of a constant.

Re: OK, try one more time please

BrianG on 7/10/05 at 12:00 (178127)

Hi Jen,

Sorry, I've been busy and had not checked the message board in a few days. That address I gave you should be good, I just did a test by sending myself an e-mail. Did you click on my e-mail address, that is in italics? That's probably the best way, as it may be easy to type a wrong letter, because of the way it appears on the screen. You can try this one, or got back to my previous message, and try again. If you still can't get through, it might be my system (WebTV), that doesn't want to recognise your's. I haven't had that problem though, so give it one more try, OK.

(email removed)

Regards,
Brian

PS: I'll try to check this thread daily, let me know if you still can't reach me.

Re: OK, try one more time please

Jennifer on 7/11/05 at 18:02 (178196)

Hi Brian. Nope, mailer-demon won't let me. Can you post suggestions here?
Jennifer

Re: OK, try one more time please

BrianG on 7/13/05 at 09:34 (178311)

Hi Jennifer,

I would have rather discussed this in an e-mail, but it doesn't look like that will happen. From what you have written, I do believe that you are a good candidate for for a medical malpractice case. Go to this web site, to see what type of cases are being taken at this time, http://www.footlaw.com . It is run by some Pod's, who are also trial lawyers that specialize in medical malpractice cases. I'd read the entire web site, including this page: http://footlaw.com/news/eswt.html

I don't know how you feel about a court case, but if you do not heal to your satisfaction, you only have 2-3 years to file, depending on the state you live in. I would prepare by getting copies of all your records from the company who performed the ESWT, and any docs who treated your feet in the past, and the future. You'll pay a small fee, but they will be necessary. When you get them, check to make sure they are accurate. I'd also start a daily 'pain journal'. It can contain numerous things beside your daily pain. I kept one when preparing for my SSD application, for PF. I noted things that I could no longer do, how I felt mentally and physically, and of course pain levels. I believe mine helped me quite a bit, when preparing my case (which I won).

Even if you do not think you'll want to litigate at this time, it's best to be prepared, as that 2-3 year time limit can come up fast, especially if you haven't healed to your satisfaction. The Pods at Foolaw.com have said they only take about one case, out of a hundred. If you talk with them, and they do not want to represent you, there are many qualified medical malpractice attorneys in every state.

Just remember, it wasn't your fault that you had complications after ESWT, as some professionals might lead you to believe. There are many, many nerves in the feet, that could be the cause of your injury, if the procedure was not done correctly. You were out, when you had the ESWT, there is no telling what may have happened, or who may have given you the treatment for that matter. It could have been someone who was not properly trained. Any number of things could have been done incorrectly, leading to your apparent nerve damage!

I wish you well, in your recovery, just don't forget that you do have rights when it comes to any medical procedures you have done.

Regards,
BrianG

Re: OK, try one more time please

Jennifer on 7/14/05 at 20:36 (178435)

Thanks Brian. This is something I have certainly considered - funny thing is I did email that site you mentioned, about a month ago, and never heard from them. I suppose it doesn't hurt to do it again. I've been dreading going through something like this, but I absolutely feel what happened was not my fault, and that it never should have. People have been reluctant to really get into much of this with me, it's frustrating. Thanks for your encouragement.

Re: OK, try one more time please

BrianG on 7/16/05 at 08:25 (178506)

Hi Jen,

I suppose it wouldn't hurt to write to footlaw.com again, they could have been on vacation, or just busy, the first time you tried. I can tell you that before they will make any kind of decision, they will want to see your records. If they don't want to take your case, they will return everything to you, and you can look for representation somewhere else.

It's not easy to prove neglegence, but from what you've already written, it sounds like you do have a case. Foot problems can be so hard to heal, as it's impossible to just not use our feet, I'd rather have a broken arm anyday!

It's time to call your doc's and get your records. When you get them, go over them to make sure nothing has been left out. Make sure there is some type of entry for every visit that you made. If the doc's ask you why you need them (and they shouldn't, as it's your right to get them), just tell them you are switching doc's, and you'd like the records to give to him. They might want to send them directly to the new doc, just tell them no, you want them.

Good luck
BrianG

Re: ESWT questions for Dr.'s

Laura G on 5/23/07 at 06:23 (230356)

I had this done by Ossatron a couple of years ago and have nerve damage as well. Doing this was a big mistake. I went back to the Dr. who did it, accusing him of causing this problem but of course, he denied that the procedure would have caused nerve damage. I actually signed a consent before the procedure that said ESWT could lead to such and such which included nerve damage.

I am wondering if the nerves will ever heal? Or is this for life?

Re: ESWT questions for Dr.'s

Dr. Z on 5/23/07 at 13:06 (230373)

Hi
Do you know what kind of nerve damage you have. Was it Tarsal Tunnel Snydrome ? Do they numb your foot as well as put you to sleep?

Re: ESWT questions for Dr.'s

BrianG on 5/23/07 at 17:55 (230406)

Hi Laura G,

Are you aware that you posted a reply to a thread that's 2 years old? This bulletin board will not bring new posts to the top, like most now do. There will be fewer people seeing it, the way you posted.

I have a couple suggestions for you. Read the entire post that you replied to. There is some good info there, including the website of some lawyers, that are also Podiatrists, http://www.footlaw.com They might be interested in your case.

Second, If you decide to post again, make a new post, so that everyone can see it.

Good luck
BrianG (not a doctor)