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UNC post was not anti-ESWT

Posted by Susan on 7/19/05 at 11:22 (178642)

so why the defensiveness and attacks? I can only think it's because it was a balanced article telling both sides, not just one.

excerpt from a post by Elyse that may not have been seen, and makes an excellent point:

'I am not quite sure why any of the doctors would respond in any negative way about the article from the UNC. We read the articles that you post about the positive studies on ESWT and this article was positive but it also suggested that their might be risks. Should we only be allowed to read positive studies about treatments and drugs? I think not.'

Re: UNC post was not anti-ESWT

Dr. Zuckerman on 7/19/05 at 11:42 (178645)

Susan,
You took my comments as negative? I made some clarifications as to the true meaning of these 'risks' . You were the one that accused myself of skipping over the pf rupture and the peripheral neuropathy. Both of which still have never been documented as being caused by an ESWT treatment.
Maybe the poster David can show me the one year follow up with the ossatron that confirmed that the ossatron ESWT produced a rupture.
This article as well as all others must be understood and not just placed on the board for review. Your comments and approach give the impression that black and blue and swelling are BAD and must be avoided. That is just not the case. When they occur and again I have never seen this in six years and thousands of ESWT procedures on the dornier are very short lived and CAUSED no long term effects. Remember there are other risks in this article that deal with the elbow and and we don't want posters to think that this is also risks for the foot.

What is amazing is there is a very true risk with ESWT that I pointed out that no one commented one or even asked for further explanation. I will repeat it again NEVER have a local regional nerve block for ESWT or any foot procedure after you have been put to sleep in an Ambulatory Surgical Center.

Re: UNC post was not anti-ESWT

Ralph on 7/19/05 at 12:14 (178651)

Dr. Z,
Would the risk of having a local regional nerve block after someone has been put to sleep be on the consent form???

Re: UNC post was not anti-ESWT

Dr. Zuckerman on 7/19/05 at 13:04 (178662)

I have no idea. I don't think the technique should be used period

Re: UNC post was not anti-ESWT

Ed Davis, DPM on 7/20/05 at 15:55 (178729)

David:
We often forget good old nitrous oxide. I use it. It is inexpensive, safe with current equipment -- many dentists use it. It, legally, is classified as analgesia since the mean alveolar concentration for anesthesia is 110% with nitrous which is impossible. Dentists, in the old days, occasionally got into trouble when using an occlusive mask with 100% nitrous largely becasue the patient was getting no oxygen. That cannpot happen with modern equipment which uses a nose piece only and will not let you go above 70% nitrous.
Ed

Re: UNC post was not anti-ESWT

elvis on 7/20/05 at 16:48 (178734)

I got a funny (or not so funny story) about nitrous oxide. It was probably in the late 1970s or ealry 1980s when a bunch of dental shool professors and students came down with a very rare form of pulmonary fibrosis. Very rare and clustered! Well they pretty much ruled out everything that they came in contact with in the labs and clinics until someone analyzed the nitrous oxide. It seems that there's a trace impurity that is quite toxic to lung tissue. It's not a probelm for a patient who gets treated once or maybe a few times over a couple of weeks. The exposure in that situation doesn't cause toxicity. Well, it appears that a bunch of professors and students were chronically taking a hit on the nitrous oxide where the impurity built up in their systems and caused the very rare pulmonary fibrosis. Case solved...........all before CSI!!