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Message Number 260797
Posted by john h on 9/23/09 at 14:28
Today is 23 September. The Wall Street Journal and USA Today finally have picked up on the problem with Honduras. WSJ had almost a full page. Neither, however, were able to explain why Obama is wanting to put the impeached President back into power but they do wonder. The only supporters of this guy are Daniel Ortega, Hugo Chavez, and other Communist nations in South America. Oh yes, the USA. Chavez thinks he should be President for life.
Even more bizarre! Elections for a new President are set by law to occur in November and the U.S. has indicated it will not recognize the outcome of the legal elections to be held under the laws of Honduras. Maybe we should just pull the troops out of Afghanistan and invade Honduras and install this bozo to be the President for life of Honduras. Will the President or Ms Clinton please step up to the plate and tell us all what is going on here. Why are we supporting setting up a Hugo Chavez Jr. as President? What on earth are we doing in the politics of Honduras? There just has to be more than we are reading.
Result number: 1
Posted by john h on 9/22/09 at 15:13
According to a left leaning think tank Charlie Rangel is the winner of the most corrupt politician in Washington. Is it an accident that he replaced the former most corrupt politician Senator Adam Clayton Powell Jr. who ran off to Bimni island to escape the long arm of the law after being thrown out of Congress for corruption. This organization list the top 15 most corrupt politicians. It looked like they were evenly split between Republicans and Democrats but really that makes no difference. If you are a corrupt guy it is not because of your party affiliation. Of course Senator Murtha was on there for having basically his own government supported Airport near his home. It has three flights a day and all are to Washington and most are not even half full. Two Senators tried to enter or attach to a bill a proposition to stop the tax payer subsidy of some very big dollars ever year to this private Murtha Airline. According to the Senators you could buy every passenger that travels on that airline a free train ticket to Washington. Of course their attempt was defeated. Are our leaders in Washington crazy or what? Sort of like the bridge to nowhere in Alaska. Why do other Congressmen/Congresswomen let them get away with it? A million dollars to any of us would be major, to say the least, but these men and women treat a million or a billion like chump change. No wonder our economy is falling apart. They are as big as thieves as people in jail when it comes to spending our tax money wisely. We talk about waste in healthcare. How about look under you desk Senators and Congressmen and see how much savings you can find.
Result number: 2
Posted by NajRellim on 8/09/09 at 14:38
Are you certain that it is a fungal infection? I have what looks absolutely like a fungal infection (mycosis)on all of my toes but it continually tests negative for fungus. My doctors won't tell me just exactly what it is, only what it isn't. And because of that, they won't give me an Rx for it.
I had it many years ago and a dermatologist gave me an Rx for 'fulvicin
Result number: 3
Posted by john h on 8/05/09 at 11:22
In 2008 H. Lee Scott Jr. the former CEO and President of Walmart made a total of $31,239,634.00 in total compensation (salary, stock options, bonus, etc). Walmart's net income was over 13 billion dollars.
ARod of the Yankees made around 27 milliion plus a large unknown amount in endorsements.
Both ARod and H. Lee Scott produced results for their owners. Wonder what the new Pay CZAR thinks of this?
What does all this mean? Only thing that quickly comes to mind is that they paid one heck of a lot of taxes. Especially ARod since he lives in NYC where the state,city, and federal taxes are probably the largest in the nation. One other thing is that I wish I had spent more time playing baseball as a kid.
Result number: 4
Posted by Dr. Z on 8/02/09 at 09:19
Take a look at Scott's articles for EWWT on this site. What is important when reading articles is what device/protocol was used and what period of time the follow up was for determining success. All FDA studies were 12 weeks but the one year or six month follow wil give you realistic results. Last year I lectured at the ISMST and gave two sets of one year follow with the Dornier Epos Ultra. The results were the following This included all body parts treated. I do have PF separated out but I am typing from memory
1 Patient pool about 850 patients. 50% returned mailed survey So we are talking about about 425 patient. These numbers are from memory.
2. Success rate including if they needed a 2nd treatment( about 20% will need this with Dornier) over 90% success rate using the R/M
scoring system
3. This outcome was duplicated one year later to look at a comparison
What we learned
1. High energy is very effective for excellent or good results
2. 2nd treatments are very important for excellenct or good results
3 Correct diagnosis is very important for excellent or good results. Maybe very difficult to rule out nerve entrapment
There is more to this study Go to www. ismst.com and type in my name to review the abstract . This site is very good. !!
The organization is the international ESWT group. We are very proud this year to have our VERY first American President Dr. Loweel Scott Weil Jr DPM. For all of the podiatrists interested in ESWT . The international seminar is going to be in CHICAGO this year.
Result number: 5
Posted by Patty M on 7/29/09 at 13:09
I too developed sesmoiditis after bunion surgery and am desparate as to what can be done. Too painful to walk or stand for any period of time. Removing the sesmoid sounds tricky. Can anyone help?
Result number: 6
Posted by john h on 7/27/09 at 13:03
According todays news Dancing With The Stars beat out the Presidents presentation on healthcare reform. Clearly this is a subject that is hard to make interesting for the public. The terminology is difficult for most Americans to understand. Following are what I think much of this bill will turn on and some perceptions American have about medical care. This is strictly my personal opinion. These type of questions are easy to attack and hard to defend no matter where they are right or wrong. Obama has really not given a speech that gave a lot of details which is what Americans are looking for. Wide sweeping statements are not going to sell this plan. There will have to be some bi-partinship to sell this plan. From what I read Democrats and Republicans agree on about 80% of a plan but that 20% has to include the government public option. Those words 'government run health care insurance' is a big turn off for many Americans and I think is perhaps the largest single sticking point.
1. Will my healthcare be as good as what I presently have.
2. Can I keep my present Doctor.
3. Will the government be making decisions on my health care?
4. How much (not will) my health care increase in cost. I think most Americans understand their cost over the long run will go up.
5. Is this a Socialistic type helath care system. 'Socialistic' is a hot buzz words for Americans even though Medicare is a form of it.
6. Will a 1-2 million dollar increase in our national budget break the bank or have long term negative consequences?
In trying to not get bogged down like President Bill Clinton in the '90s, Obama decided to take the health care fight to a prime-time audience last week. But perhaps the biggest story coming out of the press conference had nothing to do with health care. Instead, it was Obama's statement that the Cambridge, Mass., Police Department acted "stupidly" in its arrest of Harvard Professor Henry Louis Gates Jr.
Yet, save for his emotional response to a question about Gates in the event's final minutes, Obama got lukewarm reviews for his talking points on health care. "Snooze conference," was the Philadelphia Inquirer headline; "Snoozer conference" was the verdict from MSNBC's First Read.
That an undeniably charismatic president has trouble making this stuff interesting only underscores the challenge television executives face.
Read more: http://www.politico.com/news/stories/0709/25385_Page2.html#ixzz0MTxcoBUz
Result number: 7
Posted by Jan R. on 6/27/09 at 10:07
As has been reported:
Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study.
Gerdesmeyer L, Frey C, Vester J, Maier M, Weil L Jr, Weil L Sr, Russlies M, Stienstra J, Scurran B, Fedder K, Diehl P, Lohrer H, Henne M, Gollwitzer H.
Am J Sports Med 2008;36:2100-2109.
Gerdesmeyer at aol.com
BACKGROUND: Radial extracorporeal shock wave therapy is an effective treatment for chronic plantar fasciitis that can be administered to outpatients without anesthesia but has not yet been evaluated in controlled trials.
HYPOTHESIS: There is no difference in effectiveness between radial extracorporeal shock wave therapy and placebo in the treatment of chronic plantar fasciitis.
STUDY DESIGN: Randomized, controlled trial; Level of evidence, 1.
METHODS: Three interventions of radial extracorporeal shock wave therapy (0.16 mJ/mm(2); 2000 impulses) compared with placebo were studied in 245 patients with chronic plantar fasciitis. Primary endpoints were changes in visual analog scale composite score from baseline to 12 weeks' follow-up, overall success rates, and success rates of the single visual analog scale scores (heel pain at first steps in the morning, during daily activities, during standardized pressure force). Secondary endpoints were single changes in visual analog scale scores, success rates, Roles and Maudsley score, SF-36, and patients' and investigators' global judgment of effectiveness 12 weeks and 12 months after extracorporeal shock wave therapy.
RESULTS: Radial extracorporeal shock wave therapy proved significantly superior to placebo with a reduction of the visual analog scale composite score of 72.1% compared with 44.7% (P = .0220), and an overall success rate of 61.0% compared with 42.2% in the placebo group (P = .0020) at 12 weeks. Superiority was even more pronounced at 12 months, and all secondary outcome measures supported radial extracorporeal shock wave therapy to be significantly superior to placebo (P < .025, 1-sided). No relevant side effects were observed.
CONCLUSION: Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis.
Result number: 8
Posted by JudyS on 6/26/09 at 23:46
So.........today the US House of Representatives had a 'moment of silence' in honor of Michael Jackson.
'On behalf of a generation, thank God for letting us live in his generation and era,' Rep. Jesse Jackson, Jr., D-Ill, told the House.
I guess Ed McMahon and Farah Fawcett were just so-so in American pop culture......
Hope everyone is well......
Result number: 9
Posted by JrFlipp on 2/17/09 at 16:45
I have been using this medication for three weeks. Erik and I had similiar results. Foggy head, blurred vision and serious sleepiness. Took about 3 weeks but my foot finally stopped hurting!! Was off for 2 days and now I am back at square one. I'm not looking forward to having to take this medication for the rest of my life. I have 'no surgical solution' so hopefully it will work for you to get you to your surgery.
Result number: 10
Posted by john h on 2/11/09 at 11:24
Marie: These are musings from some famous and respected people. I think you could very well interject Messiah into most of these musings and not be disrespectful. Some refer to him as a Messiah and the rest put him on that level. He has been put on a higher level than any President in my life time and his expectations are likely to take a Messiah to accomplish. In the long run this is likely to be a problem for him unless he is who all these people think he is. Do you put him on the same level as these people? I do not. I think he is a mere mortal with uncommon speaking ability to almost hypmotize an audiance. He may turn out to be a great President or not. Time will tell. I certainly do not ascribe any of these type quotes below to any mortal man. Apparently some people see him as no mere mortal.
''No one saw him coming, and Christians believe God comes at us from strange angles and places we don't expect, like Jesus being born in a manger.'
--Lawrence Carter
'Many even see in Obama a messiah-like figure, a great soul, and some affectionately call him Mahatma Obama.'
-- Dinesh Sharma
'We just like to say his name. We are considering taking it as a mantra.'
-- Chicago] Sun-Times
'A Lightworker -- An Attuned Being with Powerful Luminosity and High-Vibration Integrity who will actually help usher in a New Way of Being'
-- Mark Morford
'What Barack Obama has accomplished is the single most extraordinary event that has occurred in the 232 years of the nation's political history'
-- Jesse Jackson, Jr.
'This was the moment when the rise of the oceans began to slow and our planet began to heal.'
-- Barack Obama
'Does it not feel as if some special hand is guiding Obama on his journey, I mean, as he has said, the utter improbability of it all?'
-- Daily Kos
'He communicates God-like energy...'
-- Steve Davis (Charleston, SC)
'Not just an ordinary human being but indeed an Advanced Soul'
-- Commentator at Chicago Sun Times
'I'll do whatever he says to do. I'll collect paper cups off the ground to make his pathway clear.'
-- Halle Berry
'A quantum leap in American consciousness'
-- Deepak Chopra
'He is not operating on the same plane as ordinary politicians. . . . the agent of transformation in an age of revolution, as a figure uniquely qualified to open the door to the 21st century.'
-- Gary Hart
'Barack Obama is our collective representation of our purest hopes, our highest visions and our deepest knowings . . . He's our product out of the all-knowing quantum field of intelligence.'
-- Eve Konstantine
'This is bigger than Kennedy. . . . This is the New Testament.' (PIPE) 'I felt this thrill going up my leg. I mean, I don't have that too often. No, seriously. It's a dramatic event.'
-- Chris Matthews
'[Obama is ] creative imagination which coupled with brilliance equals wisdom . . . [He is] the man for this time.'
-- Toni Morrison
'Obama's finest speeches do not excite. They do not inform. They don't even really inspire. They elevate. . . . He is not the Word made flesh, but the triumph of word over flesh . . . Obama is, at his best, able to call us back to our highest selves.'
-- Ezra Klein
'Obama has the capacity to summon heroic forces from the spiritual depths of ordinary citizens and to unleash therefrom a symphonic chorus of unique creative acts whose common purpose is to tame the soul and alleviate the great challenges facing mankind.'
-- Gerald Campbell
'We're here to evolve to a higher plane . . . he is an evolved leader . . . [he] has an ear for eloquence and a Tongue dipped in the Unvarnished Truth.'
-- Oprah Winfrey
"I would characterize the Senate race as being a race where Obama was, let's say, blessed and highly favored. That's not routine. There's something else going on. I think that Obama, his election to the Senate, was divinely ordered. . . . I know that that was God's plan.'
-- Bill Rush
Result number: 11
Posted by JRome on 1/23/09 at 14:27
It feels like to me that it is caused by some type of nerves in my legs from the knee down.. Also like somewhat of a circulation problem. I have been checked out for diabetes and was clear. Diabetes does not run in our family.
Thanks Doctors!
Result number: 12
Posted by JRome on 1/23/09 at 14:20
At 30 years of age I have a problem with my feet sweating all throughout the day. I am very active and eat a healthy diet. The sweat comes mostly from between and under the toes. What can this be from and what can I do about it?
Result number: 13
Posted by F.S. on 1/12/09 at 14:18
Dr. DSW: I went back to Dr. Haddad after a number of years since he did my initial surgery. He is a surgeon, a really lovely man, one of the best foot surgeons in the country they say. I wanted his feedback, etc. I guess I wondered who you might recommend for pain management ideas since Dr. Haddad is a surgeon. I have been to Dr. Weil Jr. a few years ago also. I prefer Haddad, but he is VERY busy with complicated foot reconstruction surgeries etc.
I am not sure what I am asking. Maybe I need pain management. A patch, someone to help me think outside the box - to cope.
FYI I am thin, no evidence of scar tissue to speak of. I am a health nut. I wear good shoes, have several pairs of othodics but soft ones due to my sensitive feet.
Can you ease my mind a bit about long term use of Neurontin. I have been taking 800 to 1000 mg. in the pm for over 7 years. Can this damage something, anything.
Thank you again. I realize there is no easy answer. I suppose I will bite the bullet and get the NCV test. Knowledge is power, right? Also, this is what Dr. Haddad recommends and I hesitate to go against what feels is prudent to do just because I am chicken. ha Also, I know from this board it is not the gold standard, be all in all, so I dread doing it.
Hanging on to anything you can share (:
Sorry, but one can get such anxiety over this crazy pain problem.
Result number: 14
Posted by Dr. DSW on 1/12/09 at 13:50
It may not be a bad idea to have the test to determine if it is TTS or a more proximal problem. However, an EMG/NCV is not always positive even when tarsal tunnel syndrome exists (I know that makes matters more confusing).
TTS can recur for a plethora of reasons including weight gain, scar tissue, biomechanical issues that may not have been addressed, medications, etc.
And I'm curious as to why you would want a referral to another doctor if you were happy with Dr. Haddad?? If you do not return to Dr. Haddad, Dr. Lowell Scott Weil(Sr. or Jr.) would be an excellent choice.
Result number: 15
Posted by Rick R on 1/08/09 at 07:56
In case the 'tombstone' label escapes you RB has taken a bit of ribbing for building his own enormous monument including his resume carved in stone.
For those of you that recal the Jeneanne Nicarico murder case Burris was the Illinois States Attorney that stonewalled the new trial for the wrongly convicted Renaldo Cruz despite the confession of Brian Dugan. Cruz was darned near put to death. DNA testing proved Dugan was the perp. This case cemented my opposition to the death penalty, at least without treating knowing and willing acts to wrongfully convict with death penalty consequences, as attempted murder or murder if it gets that far. In this case that struck so close to home for me (literally as well as figuratively, the primary 'bad guys' were prominant Repubs from DuPage county. It astounds me that these guys just keep moving on and up as our 'leaders.' For a while I was keeping track of the ratio (US total)of death row inmates set free based on proof of innocense vs those actually put to death and although it was close to even, more were freed. So I'm sure we got all the others right....right?
This is my big gripe with the new jr senetor from Illinois.
I suspect that most of the democratic opposition to Burris is more about his electibility in a couple of years opposed to the Badhairovich thing.
Result number: 16
Posted by john h on 12/09/08 at 16:16
Probably other such Governors, Congressman, are doing the same thing Marie. How can any human being hold up a Children's Hospital for a $100,000 donation and if they do not come through then in the Governors words 'F Them'. What kind of human being does these things and even worse how did he get where he was. He needed a lot of help along the way. He had already interviewed 4 candidates and had a scheduled meeting with Jessie Jackson Jr. for the Senate Seat. That proves nothing against Jackson but one has to assume he was only going to interview people who might succumb to his black mail. We likely have more people like this from both parties and we have only touched the surface. Representative Jefferson from LA who had all that money in his freezer would likely have been reelected on the coattails of Obama had the election gone off on time. Only a low turnout let Jefferson's opponent win. It seems we as citizens do not care much about the quality of who we are voting for but more about what the guy will do for you, race, or things that should not matter. This gets back to our people who elect these crooks. We all need to look in the window.
How can any CEO take a $10-$50 million bonus when his company losses hundreds of millions of dollars. Where in the h---- was the Boards of Directors? I guess the board figured he is the guy behind them being appointed to the board where they collect fat board fees. I am speaking of the CEO of Merrill Lynch who I think had declined to accept a bonus this year. Big deal dude! You should be tarred and feathered to have taken the bonus last year and the entire board should have been fired. We have bad people all over the place who live by the word GREED. Putting Congress or a Car Czar in charge of the auto industry is like having the fox guarding the chickens. What does the car Czar know about running an auto company. Lee Iaccoca managed to borrow money and dig Chrysler out and pay back all the money to the government with interest. He was what you might call a leader and also an auto expert and not a car czar. Car Czar is just another word for the often used 'Blue Ribbon Panel' which Congress often likes to appoint. To Fords credit they said they can get by next year. What did they do different? Draft some of these people and send them to the Khyber Pass for a year and let them taste some of the real world where a bonus is like $250 a month in combat pay just a little less than the millions paid to losers who manage companies. If you are a salesman your bonus is usually predicated on sales. If you are a CEO your bonus should be based on profits. When I ran a company owned by GE any bonus I got was 100% dependant on my profits and other goals.
Anymore I care less about a candidates political party than I do his honesty.
Result number: 17
Posted by Tim on 12/03/08 at 10:53
I know Dr. Lowell Scott Weil Jr and Dr. Lowell Scott Weill Sr in Illinois have also used ESWT for your problem and they are located closer to you. They deal with a lot of athletes. I just read an article that they are the team docs for the Chicago White Sox so you may want to look them up. I think they have their own machines.
Result number: 18
Posted by larry m on 11/21/08 at 13:16
Rick, you are above reproach on this. I appreciate your answer but don't expect a logical or rational response. That race card is getting faded fast. It's used to stifle people or gain favor. The jailed ex mayor of Detroit is a prime example. He ruined the city that was on it's way to ruin. It's population is 90% black and the entire school board and city council is black (one woman is white) He had 15 police as his private security force. he robbed, stole, cheated and lied. he gave a speech in front of a bunch of his sycophants where he claimed he was being persecuted due to his race. it was a black Prosecutor going after him. he claimed in the speech that it was a modern day lynching and that he had been called the N word and threatened.
That brought large applause from the crowd like he was some MLK Jr. Come to find out in his million text messages he used the word himself. He also shoved a white officer serving a warrant and told his black female partner she was 'messed' up and should be ashamed to ride with a white guy and hassling a black person. That is just an example of people that cried wolf and use the race card. It's funny because now they need a new excuse
Result number: 19
Posted by wendyn on 11/04/08 at 23:42
Let me be the first to congratulate all Americans on the selection of their new leader. My mom (just one generation ago!) went to a segregated school in a neighborhood just miles from where Obama spoke tonight. She still talks about the riots and the chaos after JFK and Martin Luther King Jr. were murdered.
The democratic process is often painful and difficult, but today is truly a remarkable day.
Result number: 20
Posted by tammy on 10/31/08 at 13:10
The following is an excerpt from a speech given by Dr. Alveda King. I would have posted the wonderful comments she mad about McCain but I didn't want to offend anyone.
The excitement of having a man on the presidential ballot whose skin is browner than any in recent American history is something to consider," said Dr. Alveda King, niece of Dr. Martin Luther King, Jr. "Many Black Americans are convinced that justice for those of us once known as Negroes in America will be done by electing a brown-skinned, African-European as President. Obviously, America is hungry for change, but America is looking in the wrong place," she said. "Barack cannot deliver America. The Senator's politics are neither a blessing nor praiseworthy."
Alveda King explained that Senator Obama's approach to solving social ills is dead wrong and can prove counterproductive to the African-American progress. "Senator Obama's answer to the ills of society, of higher government spending, weaker national defense, continued tax dollars to Planned Parenthood, and support of gay marriage are diametrically opposed to everything African-Americans truly believe and an anathema to the dream of Dr. Martin Luther King, Jr."
Result number: 21
Posted by DEPARTMENT OF INT'L AFFAIRS on 10/14/08 at 15:05
(Office of the Under Secretary)
1500 Pennsylvania Avenue NW,
Washington, D.C. 20220.
Attn: Beneficiary,
I am Mr. David H. McCormick, Under Secretary for International Affairs of the United States Treasury Department. I was sworn in by Secretary Henry M. Paulson, Jr. as Under Secretary for International Affairs In August 2007, see : http://www.treas.gov/organization/bios/mccormick-e.html
Following series of complains from Citizens of the United States as well as Citizens of Other Countries In Europe over the Discrepancies and fraudulent ways in which fund transfers are handled by Africans which has made it impossible for a lot of People to claim their Contract or Inheritance funds from most African Countries due to frauds and illegal activities, A decision was reached recently by the United States Treasury Department under the authority of the White House to compel African Financial bodies (Banks) to urgently release all funds of American and European citizens that are trapped in most Banks in Africa. It was discovered that some bureaucratic bottlenecks was put by these Banks to make it impossible for beneficiaries to claim their funds so that they will fraudulently divert those funds to their private accounts.
Consequent upon the aforementioned, I was personally mandated by the Secretary of the Treasury, Henry M. Paulson Jr. to handle this matter to ensure that all funds of our Citizens and others which are fraudulently being trapped in African Banks are urgently retrieved and paid to the actual Beneficiary under a legal manner. Our team of experts were delegated to Nigeria for this task and we discoverred your File NO: NG227/9005666/00 with your unclaimed fund of with the Central Bank of Nigeria.
It was discovered that officials of the Bank has only put up illegal requirements in order to make it diffucult for you to claim your fund.
The United States Department of Treasury has retrieved all Files of illegal transactions and we will be working under a legitimate arrangement to ensure that you follow the normal process to receive your fund.
You are requested to Re-confirm the following information to us by e-mail:
Be informed that the above information will only enable us to make due confirmation. We shall ensure that normal process is followed to ensure that your fund gets to you without delay.
Mr. David H. McCormick.
(Under Secretary)
E-mail: fundim at live.com
E-mail: usfund2008 at fastermail.com
Result number: 22
Posted by DEPARTMENT OF INT'L AFFAIRS on 10/14/08 at 15:04
(Office of the Under Secretary)
1500 Pennsylvania Avenue NW,
Washington, D.C. 20220.
Attn: Beneficiary,
I am Mr. David H. McCormick, Under Secretary for International Affairs of the United States Treasury Department. I was sworn in by Secretary Henry M. Paulson, Jr. as Under Secretary for International Affairs In August 2007, see : http://www.treas.gov/organization/bios/mccormick-e.html
Following series of complains from Citizens of the United States as well as Citizens of Other Countries In Europe over the Discrepancies and fraudulent ways in which fund transfers are handled by Africans which has made it impossible for a lot of People to claim their Contract or Inheritance funds from most African Countries due to frauds and illegal activities, A decision was reached recently by the United States Treasury Department under the authority of the White House to compel African Financial bodies (Banks) to urgently release all funds of American and European citizens that are trapped in most Banks in Africa. It was discovered that some bureaucratic bottlenecks was put by these Banks to make it impossible for beneficiaries to claim their funds so that they will fraudulently divert those funds to their private accounts.
Consequent upon the aforementioned, I was personally mandated by the Secretary of the Treasury, Henry M. Paulson Jr. to handle this matter to ensure that all funds of our Citizens and others which are fraudulently being trapped in African Banks are urgently retrieved and paid to the actual Beneficiary under a legal manner. Our team of experts were delegated to Nigeria for this task and we discoverred your File NO: NG227/9005666/00 with your unclaimed fund of with the Central Bank of Nigeria.
It was discovered that officials of the Bank has only put up illegal requirements in order to make it diffucult for you to claim your fund.
The United States Department of Treasury has retrieved all Files of illegal transactions and we will be working under a legitimate arrangement to ensure that you follow the normal process to receive your fund.
You are requested to Re-confirm the following information to us by e-mail:
Be informed that the above information will only enable us to make due confirmation. We shall ensure that normal process is followed to ensure that your fund gets to you without delay.
Mr. David H. McCormick.
(Under Secretary)
E-mail: fundim at live.com
E-mail: usfund2008 at fastermail.com
Result number: 23
Posted by 381 on 7/02/08 at 19:47
Follow up.
I just read your library on hallus limitus. Nice. I noticed you and Dr. DSW have different opinions on the implants. My doctor is of your opinions about the implants. Mine is the titanium implant- It's from a company in Michigan. It should also be noted that I had barely any cartilage left, and the cartilage that was left was I guess porous or some word the doctor used for no good.
Result number: 24
Posted by 381 on 7/02/08 at 19:33
Hi Dr. Ed.
First, thanks for your advise. It's hard for me to tell you the degrees- now. I know that I had 65 degrees going down. I have about 50 degrees going down now. That really bothers me. My doctor says that the range of motion will come back and that the trauma to tendons etc. is hampering that. My range of motion upwards was about 20 degrees beforehand. I do not see any difference now. I think it's the same. Positively speaking, I have no big bump anymore and that helps alot with shoes :)
The pain from the foot was bearable. The problem as I saw it was my gait. My shoes would wear out (the ones that I could wear) in about six weeks. I walked funny and people would notice. My shoes are wearing out in about three weeks. I know I need to wear different shoes everyday but I find that when I find a comfortable pair, I just love to wear them. I really just want to walk normal, that's it.
The other battle I've had is dermatitis on the surgical site. It started about three weeks after the surgery. It includes a flare of blisters all over. I had to go on Medrol. That worked but than it came back. I went to a dermatologist, she gave me a topical steroid which has been helpful. Now, I notice that the blisters only come on the toe or the pad of my foot. My trainer (physical) made a plausible comment to me the other day. Is it possible that the foot is clearing the ground finally and that the skin is so sensitive (because of years of not clearing the ground) that Im getting the blisters?
Another questions about working out. I like to circuit train which usually includes jumping around. I used to jump rope, jumping on one foot or both, lunge off of one foot to a higher surface. Is that appropriate with an implant?
I know I am all over the place. I am going to return to my doctor in a few weeks and I will ask him about range of motion so I can report back to you. I really hope this is not something you just volunteer to do because you might never respond to this LONG WINDED email. Thanks.
Result number: 25
Posted by Dr. Ed on 6/29/08 at 20:58
I am referring to return to normal physiologic function. Why do you say you feel worse after the surgery? Apparently, you have a different perspective from your surgeon but we would need to look at objectively measurable items in order to attempt to comment. What was the range of motion of your big toe joint before the surgery? Now?
Dr. Ed
Result number: 26
Posted by Sonia on 6/29/08 at 08:46
Thanks for your reply.
My doctor says that I am doing phenomenol. That my recovery is great compared to most. But nothing specific. He is very general about everything. He made the orthotics for my shoes, but those are very unrealistic. It's just not practical.
When you say normalizing, do you mean compared to a normal person's foot or is there a normal for someone with my condition? Thanks again. More than anything, I am active person and wanted to be able to be active without my foot posing a problem. So far, I wish I would have objected to the surgery and had the spur removed. It seems to me Im in a worse position than before the surgery.
Result number: 27
Posted by Dr. Ed on 6/27/08 at 06:20
The healthcare professionals on this board have not and cannot examine your feet so we do not know what the function of your big toe joint is like after surgery. It would be my expectation that your gait is normalizing at 3 months post surgery. What reasons are provided by your surgeon for that not happening?
Dr. Ed
Result number: 28
Posted by sonia on 6/26/08 at 15:56
I am thirty six years old and had a total joint replacement in my right big toe. I consulted two doctors before my surgery and both agreed that the cartilage damage was extraordinary for my age and that I would require a tjr or fusion. I was told by both that tjr (titanium implant) would suit my active lifestyle.
Three months post surgery, I continue to walk on the outside of my right foot. Is that normal? I try to make an effort to walk on my foot normally but it's not natural for me. I think my range of motion is slightly improved upwards but regressed downwards. I find that odd since I had no problems bending it down before. Can you give me your opinion on this issue. Thank You Beforehand.
Result number: 29
Posted by Susan on 6/15/08 at 09:31
Tim Russert was under the care of a physician when he died, and given his prominence, his physician was assuredly one of the 'best.' According to news reports, Russert was following doctor's orders, exercising on a treadmill and taking medications, that his doctor even today still says is the best way to deal with heart disease. What good was this doctor to Russert? Why did this doctor, like almost all other doctors, not give Russert truly life-saving advice about how to change his diet, instead of taking the easy, un-time-consuming and money-making way out of just prescribing pharmaceuticals (and some exercise) like he most likely does with all of his other heart patients?
Caldwell Esselstyn wrote a great book on preventing and even reversing heart disease:
'Prevent and Reverse Heart Disease
Caldwell B. Esselstyn, Jr., M.D.
A groundbreaking program backed by the irrefutable results from Dr. Esselstyn's 20-year study proving changes in diet and nutrition can actually cure heart disease
Heart disease remains the leading cause of death in the United States for men and women. But, as Dr. Caldwell B. Esselstyn, Jr., a former internationally known surgeon, researcher and clinician at the Cleveland Clinic, explains in this book it can be prevented, reversed, and even abolished. Dr. Esselstyn argues that conventional cardiology has failed patients by developing treatments that focus only on the symptoms of heart disease, not the cause.
Based on the groundbreaking results of his 20-year nutritional study—the longest study of its kind ever conducted—this book explains, with irrefutable scientific evidence, how we can end the heart disease epidemic in this country forever by changing what we eat. Here, Dr. Esselstyn convincingly argues that a plant-based, oil-free diet cannot only prevent and stop the progression of heart disease, but also reverse its effects.'
Result number: 30
Posted by Dr. DSW on 3/09/08 at 10:30
Without an evaluation, it is difficult to determine if you have plantar fasciitis, tarsal tunnel syndrome (it would not be carpal tunnel syndrome since your carpal tunnel is in your hands) or a localized nerve entrapment.
I can recommend an excellent doctor outside of Chicago, Dr. Lowell Scott Weil (Jr. or Sr.).
And please, in the future, do not type your responses in all capital letters. Thanks.
Result number: 31
Posted by Dr. DSW on 3/07/08 at 08:04
Actually 'Dr.' Scott, I have to respectfully disagree with you on this issue. In my 'few' years of practice, I have definitely seen many patients that benefit from the use of NSAID's in the early stages of plantar fasciitis.
I've had many patients that refused an injection, were allergic to tape, etc., so I had them take NSAID's, wear supportive shoes, and they had significant relief. Additionally, if you read most articles written by any of the Weil's (Jr. or Sr.), part of their protocol has always been NSAID's for those that can take them.
I do admit that I do NOT utilize NSAID's as much as a lot of my colleagues, but over the years I have seen many patients that have had significant relief when taking NSAID's. However, even if NSAID's provide relief, it's my opinion that the mechanical issues still have to be addressed to prevent the problem from becoming chronic or recurring.
Result number: 32
Posted by Dr. DSW on 3/06/08 at 18:40
Sorry David, I could have sworn that in an earlier article, prior to using the Dolorcast, Weil Jr. had discussed his preference for the Dornier unit.
Result number: 33
Posted by Dr. Z on 3/06/08 at 16:57
The Weil's never used the Dornier ( personal communication with Weil Jr) . They used the orbasone, ossatron and now the dolorclast. I have no opinion for this board as to their preferences and reasons.
Result number: 34
Posted by Dr. Z on 3/06/08 at 16:57
The Weil's never used the Dornier ( personal communication with Weil Jr) . They used the orbasone, ossatron and now the dolorclast. I have no opinion for this board as to their preferences and reasons.
Result number: 35
Posted by Dr. DSW on 2/26/08 at 08:18
I find this extremely interesting, and Dr. Z had mentioned this position/statement in one of his posts in a thread below.
I think it's also very interesting that I recently read an article by Dr. Lowell Scott Weil, Jr. regarding their office's protocol for heel pain. For plantar fasciosis, their office treatment (in addition to utilizing Topaz) is almost exclusively the Dolorcast Unit when choosing a 'shockwave' treatment, and I believe that the article stated that their center has 2 or 3 units.
I know that Weil's center had been using the Ossatron (Dr. Z will correct me if I'm wrong!) and I know they were using the Dornier unit, but now they are using the Dolorcast unit exclusively and claiming that the results are excellent and as good as, if not better than any of the other units.
Their protocol is 3 visits without anesthesia. I'm wondering IF the reason they really chose the Dolorcast unit is because of the simplicity, since no anesthesia is required, the actual treatment time is much quicker and less complicated. Less time, less complicated equals quicker turn around and happier patients and ultimately more patients being treated!
Most patients would rather NOT have several needles in the foot/ankle to have the area anesthetized if possible, so it may also be an easier 'sell' to the patient.
However, Dr. Weil has an excellent reputation, and if the unit wasn't efficacious, I'm sure he wouldn't be utilizing it and would find something better.
Regardless, it's definitely interesting.
Result number: 36
Posted by mjr on 2/23/08 at 22:21
Being 35 has nothing do with it unless you are 'out of shape' (in my book) I will be 38 in May. In Sept at Boot camp class, I fell doing a lateral foot raise drill. Between Weight lifting, jogging outside, Jazzercise, Boot camp, pilates and yoga--I work out ~14 times per week. I laid off cardio and lower body weights for 1 month. Went back to working out and ended up with excruciating pain when 'turning left' or crossing my legs. One Dr said bruise to accessory navicular. After 3 MONTHS of pain, I saw a surgeon. End up having surgery in January, apparently, I had ripped my posterior tendon and broke my accessory navicular off. Had surgery for removal of accessory, repair of tendon and shaving of navicular. In a cast for weeks 3-5. Now in walking moon boot for at least 3 weeks. Also, in therapy and therapist telling me to slow down as I am pushing to hard. (Also, I do not wear moon boot alot as it has rubbed my incision open--yuck. Hang in there-it will get better!!! Here's to being 37 years young and more active than most people 10 years younger than me!!!!!!!!!!!!!!!!!
Result number: 37
Posted by marie:) on 2/14/08 at 16:34
OMG you don't know who Cornel West is???? Have you heard of the 'Million Man March'? Trust me Jackson and Sharpton very much look up to him. He is a very famous philosopher to the African American Community. He was the first to openly criticize gangsterization of Black America. Bill Cosby was so moved by his philosophy he spoke out about it.
Here is his lecture at Brown University on MLK day Feb. 2nd.
Author Cornel West argues that the most basic threat to Black America is the nihilistic threat to its very existence (West, 12). Until the early 1970s Black Americans had the lowest suicide rate in America; however, today young Black people lead the nation in suicides. One is lead to ask what has changed? What went wrong? One factor that has changed is Black leadership. Although the "hip-hop generation" escaped a time in American history where Blacks and Whites were segregated by the law, they missed the peace and wisdom preached by leader Martin Luther King Jr. and others during the Civil Rights era. The leaders that the hip-hop generation hears and sees are the hip-hop artists (gangsta rappers included) themselves. Gangsta rap and its early focus on murder and mayhem made sense; "it emerged in an era where young Black men were known as endangered species." However, today, violence and crime in Black communities has declined, but the lyrics of gangsta rap show nothing of this progress (Smiley). Music is a powerful means by which one can convey a message and the message that gangsta leaders send to young America is one that says it's O.K. to degrade women (surely a nihilism from within) and homosexuals and guns and violence are a way to solve problems. This message in turn perpetuates the stereotypes (stereotypes that Civil Rights generation fought to eliminate) that all Blacks are abusive towards women, violent, and carry guns.
Result number: 38
Posted by john h on 2/04/08 at 13:54
Would electing Barrack Hussein Obama Jr. to the Presidency improve relations with Muslim countries? Most Muslims in the streets of the world have not idea what Obama stands for so to see the U.S. elect a man with this name would seem to present a problem for the radical Islamist who picture the U.S. as the Evil Satin. After all, Obama's father was a Muslim and he has a Muslim name. It would be interesting to see the spin the Muslim leaders would put on this. In particular the radicals like in Iran or Saudi Arabia.
Of course, it could spin the other way as often a person who is Muslim and defects to some other religion has a contract put out on him/her. Obama has not been a Muslim but you can bet the average street person has no idea.
This subject has been discussed on TV and no one really knows how this would fall out. I am a little surprised that some of the Muslim states have not come out as to who they hate or hate less. They are smart enough to know if the person they support gets their support he is or she is a sure loser. I have written before that if Obama is the nominee he will face a number of voters who will not vote for him simply because of his name. No one has a clue as to how many that might be. Hillary will have a large number not vote for her simply because she is Hillary. The political Sunday talk show gurus could not come to any conclusions whether Hillary and Obama could be on the same ticket. Obama is young and could easily run again in 4 years so he might not be interested in being on a ticket with Hillary. If he is not on the ticket I think there will be somewhat of a Black backlash against the Demos. Many may just not vote. If Hillary is not the candidate who will all the females who are supporting Hillary going to vote for? Not necessarily Obama IMHO. There is some talk that Huckabee could be the VP candidate as he will without question bring the religious right with him. Actually, the guy is a smart fellow who I think will try and do the right thing. I am thinking McCain will about have it sewed up after Tuesday.
Marie please tell me where Jesse Jackson and Al Sharpton are hiding out. Why have they not come forward to support someone? You are on top of these things usually. My guess remains that Jesse has been asked politely to stay under cover as his support in Obama's case could be negative for Obama. Jesse is out front on things like this 99.9% of the time so this is beyond strange. Not only that but he is from Chicago which is Obama's home state.
What a political year. A woman, a Black, and a White all running for President and all having not just a chance at victory but one will be the President.
Result number: 39
Posted by Tim M. on 1/11/08 at 09:09
Wiki site:
Politicians, all over the world, are always demonizing the other guy; don't forget Reagan's 'Evil Empire' and Bush's 'Axis of Evil.'
Like our own homegrown American politicians, Ahmadinejad is a product of his culture and his religious beliefs. The Mormon founder Joseph Smith, Jr., originally supported the laws regarding slavery, and it wasn't until 1978 that blacks could become LDS ministers. So for all of his formative years, Mitt Romney was taught, and believed, that blacks were inferior to whites.
I would tend to be more excited about Mitt's world view than I would about Mahmoud 's.
Result number: 40
Posted by john h on 1/10/08 at 16:13
It is apparently age related Marie. Men like women can change their minds. It only takes one little mistake for a candidate to make a fatal mistake. I think to see a man, your potential Commander in Chief, crying on television can do you in and be exploited to the fullest by the opposing party. They can pose the question 'what are you going to do when faced with a real life and death crisis for the nation?' That is a legitimate question. If he cries for an appropriate reason such as losing a loved one or such it will not be questioned. Hillary cried for something far less but apparently being a Woman it is not only acceptable but helpful. For a man it is not. Even among children, young boys among their peers will be ridiculed for crying. This subject is being discussed widely as you know. Here is an interesting article on showing emotion. Times are changing but it buried Senator Edmund Muskie many years ago. The context under which you cry is much to do with how it is perceived. Hillary is still the iron maiden in my mind cry or not. I imagine I will cry (in private of course if Hillary is our next President. Obama I can deal with I hope.) It is going to take some getting used to calling our President 'President Barack Hussein Obama Jr.' Would Hillary ever consider putting him on her ticket as VP? Would he accept? That would seem like an unbeatable combo. Barack is still young and can get another shot. Would Barack put Hillary on his ticket as VP. I doubt it as 8 years down the road would be her next shot and Hillary has waited all she wants to. She would turn that down as she wants to live in the White House again.
Result number: 41
Posted by Dr. DSW on 1/09/08 at 13:58
Below is some information taken from an article to inform patients on the dangers of smoking. I did NOT author this article.
This is information for ALL patients that smoke and are considering foot/ankle surgery.
Smoking and foot surgery
Smoking increases the risk of an adverse outcome in surgery. The oxygen carrying capacity of blood is lower in smokers and therefore less oxygen is available to operative site. Additionally nicotine causes shrinkage of the small blood vessels throughout the body and, at the operative site, further reducing the amount of oxygen reaching the operative site. The foot is not as well supplied with blood vessels as other parts of the body and is particularly sensitive to anything which reduces the blood supply. A good blood supply to carry nutrients and oxygen to the operative wound is essential. Any factor which reduces the blood supply will compromise healing. Additionally the chemical in cigarettes can have a direct toxic (poisonous) effect on the cells which are necessary for healing of the bones, soft tissues and wounds. For an osteotomy (breaking and realigning of bones), and fusion (removal of worn joint and permanent stiffening of the joint) to be successful bone cells must be able to produce bone which then leads to union (joining of the cut or prepared bone surfaces). These bone cells are affected by chemicals in cigarettes, in particular nicotine.
If the bones fail to heal, the procedure may need to be repeated. Bones cells from elsewhere may need to be used to help the local bones to knit together. This is known as bone graft and can be harvested from different parts of your skeleton (top & bottom of your shin bone, iliac crest – the ridge of bone upon which you trousers / belt rests); this adds further complexity to your operation. The worst case scenario is a smoker with a poor blood supply needing foot surgery. There have been reports of poor healing and infection resistant to treatment resulting ultimately in amputation of the leg. This is a rare occurence but the risk is higher in patients who smoke.
Please consult your general practitioner for help to stop smoking.
Haverstock BD, Mandracchia VJ: Cigarette smoking and bone healing: implications in foot and ankle surgery. J Foot Ankle Surg. 1998 Jan-Feb;37(1):69-74;
Sherwin MA, Gastwirth CM: Detrimental effects of cigarette smoking on lower extremity wound healing. J Foot Surg. 1990 Jan-Feb;29(1):84-7.
Silverstein P: Smoking and wound healing. Am J Med. 1992 Jul 15;93(1A):22S-24S.
Sorensen LT, Karlsmark T, Gottrup F: Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003 Jul;238(1):1-5.
Kwiatkowski TC, Hanley EN Jr, Ramp WK: Cigarette smoking and its orthopedic consequences. Am J Orthop. 1996 Sep;25(9):590-7.
Result number: 42
Posted by ronrutjr on 12/17/07 at 23:53
I guess this is a scam also. here is something that is approved by the FDA you still have something to say. Unbelievable. You have not heard of Infrared light therapy?
Result number: 43
Posted by ronrutjr on 12/17/07 at 23:50
It was more than she felt good. Her left lower leg was black from lose of circulation. It was also swollen. 3 days later her lower leg was restored to its natural color and the swelling was reduced. I have done my homework, don't you worry. I would not come to this site that is full of doctors to try to scam people. As I said before we can agree to disagree. I can respect how you feel because of your experiences and you should be able to respect my point of view because of my experience. Just because something did not work for you doesn't mean it doesn't work. It just didn' for you. I ask anyone to find out for themselves. Get both sides of the story. Contact me and lets see if we can find someone near you to let you try the product. please for further contact, you can email me at ronrutjr at mynikken.net
Result number: 44
Posted by ronrutjr on 12/17/07 at 10:26
No prescription is needed for this device, it is an FDA approved Class II medical device.
Infrared Treatment System
(shop products, rest and relaxation,specialty)
Result number: 45
Posted by ronrutjr on 12/17/07 at 10:04
I can agree to disagree and I will leave it at that. But don't tell me stories have no value. Well, maybe your right. A TRUE story has value. I hope you have continued success with your practice.
Research: http://www.nikken.com/magnetictechnology/
Medical panel: http://medicalpanel.visionforwellness.com
access code:1011127425
Result number: 46
Posted by Dr. DSW on 12/17/07 at 06:16
Please, 'ronrutjr', anecdotal stories are of no value and no significance. NONE.
And YES, I did try products from several magnet companies, including NIKKEN. A friend of mine was a NIKKEN 'distributor' and was convinced that everyone needed these products. So, in an attempt to be open minded I tried these NIKKEN magnetic insoles on many, many of my patients with heel pain, diabetes, etc., with no benefit.
My friend almost lost his entire life's savings because he believed in this product and offered people their money back, and ended up refunding almost everyone that he sold.
So yes, I DO have experience with this product, it's been around for a VERY long time and you're not the first one to discuss this 'miracle' cure on this website.
As I stated before, I am in practice to help patients and also to make a profit. If I honestly felt this product was of value to my patients, I would be HAPPY to dispense them from my office while at the same time putting some money in the bank.
As far as the patients that you have cured. Well, you are just one miracle worker. But I will always go back to the patient that walked into my office with HER cure for heel pain. She went to several well known specialists, and HER cure for heel pain was placing a Kotex 'maxi-pad' in her shoes.
So, does that mean that's the 'miracle' cure for heel pain? I think not.
I'm not close minded, I HAVE tried your product AND it has failed legitimate studies despite your individual success stories. It's no different than patients that wear copper bracelets for arthritis 'swearing' that it works.
The bottom line is don't come on here with your holier than thou attitude telling me that you've got this spectacular product. This piece of GARBAGE has been around for many, many years and it's something that I have tried on my patients, since I give all new products the benefit of the doubt. But it has failed my patients and legitimate studies. And I resent anyone trying to hawk a useless product on vulnerable patients on this website.
You're not the first, nor will you be the last to attempt to sell a product with no value and no proven LEGITIMATE study to support it's claims.
Result number: 47
Posted by ronrutjr on 12/17/07 at 02:14
Wow, a sham. Tell that to the lady who came to my house and regained full circulation in her leg in 3 days. Free Advertising? I came to share and if you could get the insoles from Walmart I would tell you to do so. But you can't. Have you tried them yourself? Where are you located? I will have someone bring you a pair and you can do your own test. No there is not a specific study for PF that was done but I know what my experience has been and I have more testimonies than you have studies of people saying the same thing. I know all magnets are not created equal and those studies were probably not done on NIKKEN insoles.
Do you make your own decisions are do you only rely on someone elses opinion? You probably won't go to see a movie because Siskel and Ebert gave it a thumbs down even though you wanted to see it for yourself? What is the worst thing that could happen? They don't help. But what if they do. Hmm.
Result number: 48
Posted by ronrutjr on 12/17/07 at 01:05
I had a lady come to house about 2 months ago and her left leg was black from poor circulation. The doctor said it was serious and she should go and buy the medical stockings to help with circulation. He told her gangreen (?) would set in if she did not do something quick. Her son knew that I had these insoles and he told her to call me. Why, because he bought a magnetic shoulder wrap from me that prevented him from having to have surgery. I gave her a pair of insoles and told her to wear them 24/7, put them in your socks and wear them to bed. It was a Saturday morning when she got them and Tuesday she regained full color and circulation in her leg. All the swelling was gone. What a coincidence. She introduced me to her friend who has not slept more than 3 hours during the night in years. She is taking all kinds of medication and it still is not helping her get any more sleep. I loaned her a mattress pad to see if it would help. By the 2nd night she had slept for 6 hours and the 3rd night 7. She was skeptical and did not think it was the mattress at all. I took back the pad after 6 days and her sleep routine had returned to 3 hours. Guess what, she bought a mattress a couple of weeks later and is now sleeping normally. What a coincidence. I could go on but I will digress. It is unfortunate that you will not even explore for yourself. Every doctor involved in our company was just like you until they had a product experience and did the research on their own.
Result number: 49
Posted by ronrutjr on 12/16/07 at 02:16
These insoles helped me with PF and I have never had another problem. Studies have shown what they do for neuropathy as well. I have been using these insoles for almost 10 years. Nikken Magsteps or Magstrides is the actual products. here is my website.
http://www.mynikken.net/ronrutjr (shop product,rest & relaxation)
This is not about financial gain, I can show you how to buy at wholesale and the same discount I get. These are the best for pain and healing. I use these while I played professional basketball in Europe and still continue to use them today. Medical professionals have tried to disprove that they work and actually proved that they do more than were claimed. I will email you any information or studies that you need to see. Money Back Guarantee is also attached.
Dr. Weintraub
Result number: 50
Posted by ronrutjr on 12/16/07 at 02:07
These insoles helped me with PF and I have never had another problem. Studies have shown what they do for neuropathy as well. I have been using these insoles for almost 10 years. Nikken Magsteps or Magstrides is the actual products. here is my website.
http://www.mynikken.net/ronrutjr (shop product,rest & relaxation)
This is not about financial gain, I can show you how to buy at wholesale and the same discount I get. These are the best for pain and healing. I use these while I played professional basketball in Europe and still continue to use them today. Medical professionals have tried to disprove that they work and actually proved that they do more than were claimed. I will email you any information or studies that you need to see. Money Back Guarantee is also attached.
Dr. Weintraub
Result number: 51
Posted by Amy on 11/09/07 at 08:01
Thank you so much
I will call him and take a road trip
Result number: 52
Posted by Dr. DSW on 11/09/07 at 07:51
I practice in Philadelphia, but live in South Jersey. Although I practice in Philly, I refer many of patients over the bridge to South Jersey to a great store in Moorestown, New Jersey called 'Carl's Shoes'. Moorestown (NOT to be confused with Morristown) is close to Cherry Hill. One of the owner's name is Dennis Higman and he is a Cped that I have a LOT of confidence in, and he's a great guy.
It's not THAT far from where you live, so it may be worth your while. Dr. Z practices in South Jersey and I'm sure that he also has sent patients to Dennis at Carl's Shoes.
Dennis also teaches a course at the Temple University School of Podiatric Medicine, so if you decide to take a ride down, I would HIGHLY recommend that you call Carl's Shoes and attempt to make an actual appointment to see Dennis to make sure he'll be there.
Please feel free when you call to tell Dennis that I (Dr. David Wander) highly recommended him.
He's honest, ethical and knowledgeable. Some of the local professional sports teams in Philadelphia even utilize Dennis for his knowledge and expertise.
Result number: 53
Posted by Dr. DSW on 11/09/07 at 07:44
I thought that Merrell has been owned by Wolverine for the past several years. It's a shame that you've noticed the decrease in quality of Merrell's, because in the past, I was a big fan of some of their products.
In particular, a lot of my patients found relief with a combination of the Jungle Moc combined with a pair of PowerSteps, and in the summer a lot of my female patients loved the Primo Breeze combined with a pair of PowerSteps. They were a very lightweight shoe that patients found very comfortable and accommodated the PowerSteps nicely.
The Merrell/PowerStep combination provided relief for a significant amount of my patients, combined with stretching or the use of a Strassburg Sock.
I know that on the East Coast Merrell's gained tremendous popularity over the past few years, and maybe in an effort to keep up productivity, they cut costs somewhere.
Have you noticed that the decrease in quality is with all their products or just with certain new product lines?
Result number: 54
Posted by Amy on 11/09/07 at 07:38
Got to wonder why there seems to be so many more people functining with foot, knee and back pain!!!!! Any relationship between the shoe trend and pain cycle??
I work full time and also have 4 private clients despite having lived with foot, knee, back pain (without narcotics)for at least 15 years. Boy it is mentally exhausting. I would be willing to spend money on shoes that REALLY will help.
I had posted the question below a while ago...maybe someone could jump in
DOES ANYONE KNOW OF SOMEONE WHO REALLY KNOWS ABOUT SHOES AND COULD DIAGNOSE MY GAIT AND NEEDS PROPERLY AND THEN PROVIDE ME WITH THE CORRECT SHOES? I live in central NJ (Somset county)
Result number: 55
Posted by Jeremy L, C Ped on 11/09/07 at 06:56
To be a little more specific on MBT, the entire concept of the shoe is to de-stabilize the foot. For those who can tolerate this kind of radical change, the brand's philosophy is that you strengthen lower extremity muscle groups to achieve better posture and reduce pain. The brand is gaining popularity, but you already discovered it is not a brand tolerated by everyone. For that matter, no single shoe brand is tolerated by everyone (although most try to advertise the opposite).
Result number: 56
Posted by Jeremy L, C Ped on 11/09/07 at 06:52
Ed, the thing is that this paradigm of product degradation is not occurring directly from the people who built their reputation. Most of the venerable, mass-recognized shoe brands have been purchased by conglomerates who want to milk as much profit per shoe as possible. More times than not, this means they strip the shoes themselves of the features that made them consumer favorites. Merrell has actually changed hands several times in the past 20 years; they don't come close to resembling the benchmark of quality they once were. And don't get me started on Clarks and Rockport!
Result number: 57
Posted by larrym on 11/09/07 at 06:05
Long story short on stores that stock widths and the companies that dont make them. We have stores that offer less service than the old days, not just shoes but hardwares close and Home Depot opens etc. They dont want to pay people extra that have the skill to fit shoes and they dont want to pay to stock and carry extra inventory that they 'dont think' they will sell (cant sell if you dont have). Many shoe companies would rather you decide if you dont like the fit of the size 8, then settle on the 7.5 or the 8.5 and like it. That way they and the lazy shoe store can carry less stock and in many cases let you wait on yourself.
It is kind of self feeding problem and due to both, many people accept poor choices and no service and they wait on themselves.
As for the MBT, it is a over priced cam walker or post op shoe. It is just a big stiff shoe with a exagerated rocker bottom. It works for some pople and some conditions but many people dont like them. The price is piracy IMHO for what it is and they are not some ancient miracle technology. I dont care for the hype and sales that go along with many of the MBT shoes
Result number: 58
Posted by Amy on 11/09/07 at 00:03
Why have so many companies discontinued wide width shoes????????
Also, I have heard so much about MBT's but when I tried them on in the store, after three or four minutes, my knees and back were hurting. Is this a common experience?
Result number: 59
Posted by Amy on 11/09/07 at 00:00
One of the pedorthists tried to adjust them three times. He finally gave me my money back. One just handed them to me and that was all. The other on, i wen back for one adjutment and just got fed up with the whole idea of custom othotics. Ifithe brooks ariel to be pretty comfortable, but am so tired of wearing snakers. I have pair of Drew shoes that are about three years old and a klogs (leather line) THey are not bad, but definitely less comfortable than the sneakrs. I could wear the Drews for day and then have to go back to the sneakers for two days
Result number: 60
Posted by Dr. Ed on 11/08/07 at 21:10
Thanks for the post. It is hard to keep track of shoe quality in this rapidly changing market. It is too bad that some companies appear willing to compromise their reputation by bringing inferior products into their line.
Dr. Ed
Result number: 61
Posted by Jeremy L, C Ped on 11/08/07 at 20:38
I have been meaning to post on this topic. When I was at a colleagues store last weekend, I was alarmed at how poor so many of the current Merrell shoes are. What little midfoot support their models did possess are now mostly stripped. I strongly suggest using extreme caution when looking into this brand, and make sure that the both the fit and function really are adequate for your needs. There is currently far better product integrity with the Ahnu brand. There are similar styles, and they tend to have a fuller volume, more oblique toe shape.
On a kinder note, I found the new Patagonia models very interesting. Some are just plain excellent shoes. Some are made with the intent to be extremely versatile both for the wearer and a thoughtful pedorthist.
Result number: 62
Posted by Dr Kiper on 11/08/07 at 19:20
Amy, did you go back and let any of the pedorthotists adjust your prescription? Or did they say you were good to go?
Result number: 63
Posted by Amy on 11/08/07 at 18:16
Does anyone have any feedback about Merrell, Encore Grove for plantar fasciitis. I tried the Jungle moc on but the toe box of the Encore feels a bit wider. Is it really wider?
Has anyone tried Superfoot Blue inserts? I had tried powersteps awhile ago but found the arch to be very uncmfortable. Is the arch in the Superfoot Blue lower than the powerstep? Over the past 5 years, I have tried custom orthotis from 3 different pedorthists and have pretty much given up on those. I guess that I would rather have a $30.00 failure than a $350 to $400 failure.
Result number: 64
Posted by john h on 10/29/07 at 13:31
BobG I did not see the turning dancer but reminds me of something we did ever 4 years as a pilot. We went to a 2 day school to receive high altitude training where you were placed in a chamber and taken up to 40,000 + feet and then had a explosive decompression. The other part of this training was much about vertigo. You would be placed in a chair blindfolded in a semi dark room. The chair was very smooth and on ball bearings so you could hear no noise and not detect motion by your eyes(blind folded) or hearing. The chair would be put into motion slowly and gently and you would use your thumb to indicate the direction you were turning. After a few minutes you would detect with in your inner ear a change in direction when you actually had stopped. In the same chair you could start in spinning while blindfolded and have your head laying on your arm which was on an arm rest. This would create the sensation of tumbling head over heel to such an extent that some people would get sick or fight to get out of the chair. You had to be buckled in for this one. There is a very practical side to this maneuver. When the F-84 first came out we had a series of crashes in weather that they could find no cause for. In this F-84 the primary communications radio was located to the right and slightly back of the pilot so when he changed frequencies he turned his head to the right and down much like in the chair and in weather you could easily get your self into the tumbling feeling. All radios were eventually moved to a more logical position and the weather crashes ended. On a clear day this problem would not be evident as your eyes would immediately tell your brain you were not tumbling.
Another goodie was for a group of pilots to be placed in a totally black room. A small red dot would appear in front of the room (I think on a screen) and after about 5 minutes you would be asked which way it was moving. You would get all sorts of answers including in a circle, sideways, etc. When the lights were finally turned on you found that it was in fact not moving at all it was fixed. It is a natural phenomena for the light to appear to move after staring at it for a while. You can do this in a totally dark room in your home and get the same results. On a dark night in a fighter in weather starring at some particular instrument can get you in trouble. I was in a two seater fighter one night over the Okefenokie swamps. I was in the back seat where there were no controls. The sky was very clear with out a cloud and the starts were bright. Somehow the pilot got inverted and thought the stars were towns and the swamp the sky. I thought he was just showing off by flying upside down at night straight and level. His instruments would not look off unless he pushed the nose down or up and then the plane would go the wrong way. Your brain and eyes and really play tricks on you in an aircraft. I think that is what happened to JFK Jr. He was way over his head as he was not even instrument qualified flying in a hazy area with no horizon. This has killed many a pilot.
Now back to your spinning ballerina which I did not even see.
Result number: 65
Posted by JR RN on 10/17/07 at 20:00
I was diagnosed w/ PF in the mid 90's. Taping,icing,rest,stretching etc.and orthotics seemed to do the trick. I returned to MD in Feb 07. Xrays taken. I didn't follow up b/c after the taping etc. it was feeling great. The last few months it has been getting progressively worse (was considering amputation!!!)so went back to the MD today and low and behold I have a very large heel spur.
I received a cortisone shot. How many is the max and what is the frequency? He gave me a few options 1) repeat shot 2) surgery.
I would appreciate any advice!!! Thanks Judy RN
Result number: 66
Posted by marie on 10/05/07 at 22:59
Today, Senator Joseph R. Biden, Jr., Chairman of the Senate Foreign Relations Committee, met with Iraqi President Jalal Talabani. President Talabani welcomed the Senate's approval of the Biden-Brownback amendment last week supporting federalism in Iraq, on a bipartisan vote of 75-23. He expressed his strong belief that the amendment promotes the unity and territorial integrity of Iraq and is not, as some have mischaracterized it, a call for partition. He also emphasized that the amendment is completely consistent with the decision Iraqis have made to adopt a federal form of government in their Constitution.
Result number: 67
Posted by Dr. David S. Wander on 10/01/07 at 17:11
Actually, ESWT IS being used for neuromas now with excellent success. And ESWT is non invasive, however there aren't many doctors presently using ESWT for this indication. If you happen to be in the Chicago area, Dr. Lowell Scott Weil (Jr. & Sr.) are using this and I believe have recently published a study on this topic.
I would discuss your concerns regarding cryosurgery with your particular surgeon. I would ask him/her about his/her individual experience regarding cryosurgery following a previous surgery.
Everyone's experience differs, so if someone on this site had a terrible experience or someone had a wonderful experience, it really has no impact on YOU. That's why it's best to speak with your surgeon about your concerns and address any issues you may have with him/her PRIOR to the procedure, to make sure that your expectations are realistic before anything is done.
Result number: 68
Posted by Dr. Z on 9/18/07 at 13:44
You can mention this site. He knows about it and I believe Jr has posted years ago on this site. I know him fairly well and he will be very nice and give you a great work up with a very honest opinion
Result number: 69
Posted by Julie R. on 9/18/07 at 06:28
It appears there are two Lowell Scott Weils -- Jr. and Sr. -- that work together in Chicago. Were you thinking of the father (Sr.)?
Result number: 70
Posted by marie on 9/08/07 at 17:39
Since most of my favorite foods are from this region of the world this was good news to me. :) I haven't ever heard of a link between diet arthritis before so this article caught my interest.
The traditional diets of people in the Mediterranean region tend to be high in fruits, vegetables, fish and olive oil, and comparatively low in red meat. A number of studies have linked this style of eating to a lower risk of heart disease, but there has also been some evidence that it's beneficial for people with rheumatoid arthritis, or RA.
Result number: 71
Posted by Kevin L on 8/28/07 at 17:48
Dr DSW
Below are all the Podiatry providers that take my insurance within 30 miles of my zip 11223 (Brooklyn NY) In alphabetical order…then with detailed info address…etc etc..
Abady, Robert, DPM 1
Abeles, Jay, DPM 11
Abrahamson, Hal, DPM 11
Alfieri, Donna M., DPM 1
Alongi, Maryanne, DPM 11
Amante, Gregory, DPM 5
Amato, Richard, DPM 11
Amico, Susan G., DPM 5
Archer, Jean V., DPM 5
Aronica, Frank R., DPM 5
Asaro, Carlo S., DPM 1
Assini, Joseph, DPM 5
Axman, Wayne R., DPM 11
Babayev, Emil, DPM 5
Bagner, Jerome E., DPM 11
Baird, William T., DPM 5
Balboa, Henry M., DPM 11
Barbaro, Thomas, DPM 11
Bar-David, Tzvi, DPM 1
Barkoff, Matthew W., DPM 11
Barkoff, Steven L., DPM 5
Barlizo, Sharon R., DPM 1
Barone, Salvatore A., DPM 5
Barragan, Juan C., DPM 1
Bartol, David M., DPM 5
Bass, Elliot L., DPM 5
Bass, Fara D., DPM 5
Bautista, Debbie P., MD 1
Bayerbach, Frank, DPM 1
Becker, Jack S., DPM 11
Bell, Burt L., DPM 5
Bendeth, Marc L., DPM 11
Benzakein, Ralph, DPM 5
Berlin, Kim, DPM 11
Bienenfeld, Jay D., DPM 5
Biller, Bob S., DPM 11
Bilotti, Mary A., DPM 11
Birch, Gregory M., DPM 5
Bover, Elina, DPM 5
Braun, Suzanne G., DPM 5
Breitman, Debra, DPM 11
Breth, Evan G., DPM 5
Bubbers, Linda A., DPM 11
Buenahora, Joseph A., DPM 11
Burzotta, John L., DPM 11
Bushansky, Abe A., DPM 1, 5
Butters, Marva, DPM 5
Butts, Bryon G., DPM 1
Buxbaum, Frederick D., DPM 5
Buzermanis, Steven Z., DPM 5
Caimano, Francis X., DPM 11
Campbell, Andrew, DPM 1
Campbell, Douglas E., DPM 5
Caprioli, Russell, DPM 11
Caprioni, Enrico P., DPM 5
Carlton, Lawrence S., DPM 5
Castillo, Dennis E., DPM 5
Catanese, Dominic J., DPM 1
Charlot, Giznola J., DPM 1, 5
Cheng, Tung W., DPM 6
Chernick, Stephen B., DPM 11
Chionis, Anthony, DPM 1
Chopra, Jaideep, DPM 1, 6
Cicio, Gary, DPM 6
Ciment, Avraham Y., DPM 1
Cohen, Greg E., DPM 6
Cohen, Richard B., DPM 6
Cohen, Robert J., DPM 1, 11
Dacher, Jeffrey, DPM 6
D'Amato, Theodore A., DPM 6
D'Angelo, Nicholas A., DPM 6
Daniel, Lawrence B., DPM 6
Davies, Daniel A., DPM 11
Davies, Gregory F., DPM 11
De Bello, John A., DPM 1
DeCicco, John J., DPM 11
DeLeon, Jose L., DPM 1
Dellolio, Joseph A., DPM 1
DeMeo, James R., DPM 6
Dennis, Lester N., DPM 6
DeSantos, Pasquale, DPM 6
Dhandari, Angeleta, DPM 1
Dharia, Sumit S., DPM 6
Dixit, Chaitanya V., DPM 6
Donovan, Glenn J., DPM 6
Dorazi, Stephen T., DPM 6
Dubov, Spencer F., DPM 11
Edelstein, Michael C., DPM 1
Ehrlich, Josh C., DPM 6
Einhorn, Jill L., DPM 6
Elsinger, Elisabeth C., DPM 1
Fagen, Leonard, DPM 6
Falcone, Jeffrey J., DPM 6
Feldman, Gary B., DPM 11
Ficke, Henry, DPM 6
Finkelstein, Barry I., DPM 1
Fiorenza, Dominic, DPM 11
Fox, Corey, DPM 11
Fox, Roberta A., DPM 11
Frankel, Bruce, DPM 1
Freiser, Mark A., DPM 1
Fridman, Robert, DPM 1
Friedlander, Bruce W., DPM 6
Fuchs, David B., DPM 11
Ganjian, Afshin, DPM 6
Garcia, Sandra P., DPM 1
Garofalo, Alfred A., DPM 6
Garofalo, Gail F., DPM 11
Gasparini, Mark C., DPM 11
Gaudino, Salvatore C., DPM 2, 6
Geiger, Arthur, DPM 6
George, Thomas, DPM 2, 6, 11
Gertsik, Vladimir V., DPM 6
Gervasio, Joseph, DPM 11
Giammarino, Philip A., DPM 6
Ginsberg, Steven E., DPM 2
Giordano, Richard S., DPM 2
Gitlin, David, DPM 2
Glockenberg, Aaron, DPM 2, 6
Goez, Emilio A., DPM 2, 11
Goldenberg, Perry Z., DPM 2
Goldman, Gershon A., DPM 6
Goldstein, Harold L., DPM 2
Goldstein, Israel, DPM 7
Golub, Cary M., DPM 12
Gonzalez, Ivan, DPM 7
Goodman, Warren J., DPM 7
Gottlieb, Robert J., DPM 12
Gramuglia, Vincent J., DPM 2
Greenbaum, Bruce R., DPM 7
Greenbaum, Mitchell A., DPM 12
Greiff, Lance, DPM 2, 12
Grossman, Myles, DPM 12
Guberman, Ronald M., DPM 7
Gutierrez, David, DPM 2
Gventer, Mark, DPM 7
Habib, Henry, DPM 7
Harris, Carl F., DPM 2
Heller, David P., DPM 7
Herbert, Scott E., DPM 12
Herman, Craig P., DPM 2, 7
Hershey, Paul E., DPM 12
Herzberg, Abraham, DPM 12
Hickey, John, DPM 12
Honore, Lesly S., DPM 12
Horl, Lawrence, DPM 12
Horowitz, Mitchell L., DPM 7, 12
Iorio, Anthony R., DPM 2
Irwin, Robert A., DPM 12
Isaacson, Ernest, DPM 2
Ivanovs, Ray, DPM 7
Jackalone, John A., DPM 12
Jacobs, Louis W., DPM 2
Jarbath, John A., DPM 7, 12
Joshi, Pradip M., DPM 2
Jusma, Francoise D., DPM 7
Kaiser, Craig A., DPM 7
Kapadwala, Imtiyaz I., DPM 7
Karpe, David E., DPM 12
Kashefsky, Helene P., DPM 12
Kasminoff, June G., DPM 12
Katz, Alex S., DPM 7
Katzman, Barry, DPM 7
Kessler, Howard N., DPM 12
Kisberg, Stephen, DPM 12
Kitton, Stuart E., DPM 12
Klein, Michael S., DPM 12
Klirsfeld, Jeffrey S., DPM 12
Knobel, Jeffrey, DPM 7
Kohn, Arlene F., DPM 12
Kolberg, John J., DPM 2, 12
Koslow, Paul M., DPM 12
Kumrah, Praveen, DPM 2
Lafferty, William A., DPM 7
Lai, Katherine M., DPM 2
Landau, Laurence D., DPM 12
Landy, Robert J., DPM 2, 12
LaRocca, Albert, DPM 12
Larsen, Joseph A., DPM 12
LaSalle, Michael, DPM 2
Lepore, Frank L., DPM 7
Levine, Stanley, DPM 12
Levitsky, David A., DPM 12
Levitz, Steven J., DPM 7
Levy, Brian K., DPM 7
Levy, Denise A., DPM 2
Levy, Paul J., DPM 2
Liswood, Paul J., DPM 7
Livingston, Douglas W., DPM 12
Livingston, Leon B., DPM 13
Livingston, Michael D., DPM 13
Locastro, Robert M., DPM 2
Lok, Jonat, DPM 2
Lopiano, Steven N., DPM 2
Losyev, Sergey, DPM 7
Lucido, Jeffrey V., DPM 7
Lynn, Brian P., DPM 2, 13
Mahgerefteh, David, DPM 7, 13
Makower, Bryan L., DPM 7
Mandato, Mark, DPM 7
Mantzoukas, Argirios, DPM 7
Marcelonis, Debra A., DPM 7
Marchese, Nicholas A., DPM 13
Marville, Jillion, MD 3, 7
Masani, Farhan, DPM 13
Matthews, Frederick, DPM 8
McElgun, Terence M., DPM 13
Mckay, Douglas J., DPM 8
Mcshane, William J., DPM 13
Meliso, Vincent D., DPM 8
Meller, Edward P., DPM 8
Meshnick, Joel A., DPM 8, 13
Micallef, Joseph, DPM 8, 13
Moazen, Ali, DPM 13
Mollica, Peter W., DPM 8
Mollica, Raymond J., DPM 8
Montag, Richard M., DPM 13
Montalvo, Luis, DPM 8
Morreale, Edward, DPM 8
Nachmann, Dennis S., DPM 3
Naik, Hetal B., DPM 8
Nekritin, Vadim, DPM 8
Nester, Elizabeth M., DPM 13
Nester, Matthew J., DPM 13
Newmark, Alan J., DPM 8
Nezaria, Yehuda, DPM 13
Novofastovsky, Raisa, DPM 8
Odinsky, Michael E., DPM 8
Odinsky, Wayne Z., DPM 13
Oliva, Imelda A., DPM 3, 8
Orlando, Anthony, DPM 8
Oropall, Robert, DPM 3
Owusu, Stephen E., DPM 8
Pace, George N., DPM 8
Pace, John F., DPM 8
Pannell, Richard, DPM 3
Papa, Philip M., DPM 8
Passik, Arthur L., DPM 8
Pawson, John F., DPM 8
Pecora, Maria, DPM 8
Pedro, Helder F., DPM 8, 13
Perez, Walter H., DPM 8
Peterson, Donald T., DPM 13
Pierre, Nadja M., DPM 8
Pierre, Nedjie, DPM 9
Plotka, Steven D., DPM 3
Posner, Jonathan, DPM 3
Prince, Steven L., DPM 9, 13
Purvin, Jay M., DPM 13
Rabiei, Payman, DPM 9
Radler, Bruce L., DPM 9
Rampino, Robert, DPM 3
Ransom, Sherry M., DPM 3
Raskin, Simon, DPM 9
Reifer, Howard J., DPM 9
Richardson, Hugh L., DPM 13
Richman, Tara, DPM 3
Romano, Constance A., DPM 9
Rosen, Alan J., DPM 9
Ross, Charles F., DPM 3
Saadvandi, Terence M., DPM 9
Sande, Hervey, DPM 9
Scheiner, David M., DPM 9
Schikman, Lana, DPM 9
Schneidermesser, Susan G., DPM 9
Schulman, Leonard B., DPM 3
Scotti, Lorenzo, DPM 3
Shapiro, Eugene, DPM 9
Shechter, David Z., DPM 9
Shechter, Stuart B., DPM 9
Sherman, Gary, DPM 9
Silberstein, Jeffrey, DPM 9
Silverstein, Alan B., DPM 9
Snyder, Robert S., DPM 3
Spector, Donald, DPM 3
Spellman, Dean S., DPM 3
Spielfogel, William D., DPM 9
Spilken, Terry, DPM 3
Spindler, Harlan, DPM 9
Stanimirov, Catherine, DPM 9
Steiner, Richard M., DPM 3, 9
Stern, Stuart M., DPM 3
Strassman, David, DPM 3
Strassman, Lawrence, DPM 3
Stuto, Joseph C., DPM 9
Tabari, Issac, DPM 3
Tajerstein, Alan R., DPM 9
Tanenbaum, Mark, DPM 9
Tartack, Ira, DPM 9
Tavroff, Clifford D., DPM 9
Thompson, Michael, DPM 3
Trepal, Michael J., DPM 9
Trivlis, Maryann Z., DPM 9
Unger, Leslie M., DPM 9
Vader, Bonnie, DPM 9
Velasco, Debra, DPM 3
Vincetic, Anto, DPM 3
Vitale, Thomas, DPM 3
Waiss, Samuel M., DPM 9
Wallach, Jacob B., DPM 9
Walter, Eric G., DPM 3
Wexler, Craig, DPM 3
Winston, Wayne, DPM 4
Wolstein, Lewis, DPM 4
Wolstein, Peter D., DPM 4
Woltman, Robert T., DPM 4, 10
Zonenashvili, Merabi, DPM 10
Zwiebel, Neil S., DPM 10
Abady, Robert, DPM
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
Burnside Medical Center
165 E Burnside Ave
Bronx, NY 10453
(718) 563-0003
St Barnabas Hospital
Alfieri, Donna M., DPM
4206 Barnes Ave
Bronx, NY 10466
(718) 325-6487
Mount Vernon Hospital, Our
Lady of Mercy Medical Center
Asaro, Carlo S., DPM
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-7224
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
Jacobi Medical Center, North
Central Bronx Hospital
Speaks Italian
Bar-David, Tzvi, DPM
3616 Henry Hudson Pkwy E
Bronx, NY 10463
(718) 548-5757
Medical Center
Speaks HebrewSpanish
Barlizo, Sharon R., DPM
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Speaks FrenchSpanish
Barragan, Juan C., DPM
St. John's Medical Center
1561 Westchester Ave
Bronx, NY 10472
(718) 328-6200
Speaks Spanish
Bautista, Debbie P., MD
St. Barn Ambulatory Care
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
Union Comm Hlth Ctr
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
CCDC/Burnside Med Ctr
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
Our Lady of Mercy Medical
Center, St Barnabas Hospital
Bayerbach, Frank, DPM
Mercy Community Care
4234 Bronx Blvd
Bronx, NY 10466
(347) 341-4300
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
2371 Arthur Ave
Bronx, NY 10458
(718) 364-6199
Brunswick General Hospital,
Brunswick Hospital Center, Inc,
Good Samaritan Hospital,
Good Samaritan Hospital (West
Bushansky, Abe A., DPM
1715 University Ave
Bronx, NY 10453
(718) 960-5616
1963 Grand Concourse
Bronx, NY 10453
(718) 294-5000
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Parkway
Butts, Bryon G., DPM
421 E 149th St
Bronx, NY 10455
(718) 401-3668
The Mount Sinai Hospital of
Speaks Spanish
Campbell, Andrew, DPM
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-9000
Union Community Health Ct
260 E 188 St
Bronx, NY 10458
(718) 220-2020
St. Barnabas Ambulatory C
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
Bronx Park Medical Pavill
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
St Barnabas Hospital
Catanese, Dominic J., DPM
Orthopedic Surgery Dept.
1695 Eastchester Rd
Bronx, NY 10461
(718) 405-8430
Albert Einstein College of
Medicine, Community Hospital
at Dobbs Ferry, Montefiore
Med Ctr (Henry & Lucy Moses
Div), SAINT MARYS
Charlot, Giznola J., DPM
HHC-Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-6610
HHC-North Central Bx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-2108
Jacobi Medical Center, Kings
County Hospital Center, North
Central Bronx Hospital
Chionis, Anthony, DPM
1725 Edison Ave
Bronx, NY 10461
(718) 892-5542
Parkway Hospital, St John's
Episcopal Hospital - Far
Speaks Greek, Modern
Chopra, Jaideep, DPM
NY Westchester Square Med
2475 Saint Raymonds Ave
Bronx, NY 10461
(718) 792-1100
Staten Island University
Hosp-North, University
Hospital of Brooklyn
Speaks Hindi
Ciment, Avraham Y., DPM
Soundview Healthcare ntwk
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
Diallo Medical Center
1760 Westchester Ave
Bronx, NY 10472
(718) 892-8474
Jessica Guzman Med Ctr
616 Castle Hill Ave
Bronx, NY 10473
(718) 239-9013
Burnside Medical Center
165 E Burnside Ave
Bronx, NY 10453
(718) 563-0003
Our Lady of Mercy Medical
Center, St Barnabas Hospital,
Westchester Medical Center
Speaks Hebrew
Cohen, Robert J., DPM
140-1 Elgar Pl
Bronx, NY 10475
(718) 671-0400
Our Lady of Mercy Medical
Center, Parkway Hospital
Speaks French
De Bello, John A., DPM
New York Foot Care Srvc
3635 E Tremont Ave
Bronx, NY 10465
(718) 409-0400
New York Foot Care Svc
421 E 149th St
Bronx, NY 10455
(718) 365-6363
New York Foot Care Svc
3201 Grand Concourse
Bronx, NY 10468
(718) 365-6363
Montefiore Med Ctr (Henry &
Lucy Moses Div), Mount Sinai
Hospital of Queens, North
Shore University Hospital, Our
Lady of Mercy Medical Center,
Parkway Hospital
Speaks Spanish
DeLeon, Jose L., DPM
625 E Fordham Rd
Bronx, NY 10458
(718) 933-1900
2111 Williamsbridge Rd
Bronx, NY 10461
(718) 828-6060
Our Lady of Mercy Medical
Speaks Spanish
Dellolio, Joseph A., DPM
4362 White Plains Rd
Bronx, NY 10466
(718) 994-7054
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), Our
Lady of Mercy Medical Center,
Westchester Medical Center
Speaks Spanish
Dhandari, Angeleta, DPM
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-5700
Jacobi Medical Center, North
Central Bronx Hospital
Edelstein, Michael C., DPM
3224 Grand Concourse
Bronx, NY 10458
(718) 561-0041
Our Lady of Mercy Medical
Speaks Spanish
Elsinger, Elisabeth C.,
MAP-Dept of Ortho Sgy
3400 Bainbridge Ave
Bronx, NY 10467
(718) 920-2060
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Speaks German
Finkelstein, Barry I.,
3327 Bainbridge Ave
Bronx, NY 10467
(718) 881-7990
NY Podiatry & Foot Surg
2425 Eastchester Rd
Bronx, NY 10469
(718) 881-7990
Wilson Orthopedics
75 E Gun Hill Rd
Bronx, NY 10467
(718) 798-1000
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), United
Hospital Medical Center (NY)
Speaks HebrewYiddish
Frankel, Bruce, DPM
Lincoln Medical & Mental
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Freiser, Mark A., DPM
Bronx Footcare
421 E 149th St
Bronx, NY 10455
(718) 292-5045
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital
Speaks SpanishFrench
Fridman, Robert, DPM
3616 Henry Hudson Pkwy
Bronx, NY 10463
(718) 548-5757
Medical Center
Garcia, Sandra P., DPM
Happy Feet
953 Southern Blvd
Bronx, NY 10459
(718) 542-0472
Board Certified
Male Female
Wheelchair Accessible
Uptown Healthcare Mgmt In
930 E Tremont Ave
Bronx, NY 10460
(718) 860-1111
Forest Hills Hospital
Speaks Spanish
Gaudino, Salvatore C.,
71 Metropolitan Oval
Bronx, NY 10462
(718) 829-6436
Mount Sinai Medical Center,
Parkway Hospital, Queens
Hospital Center
George, Thomas, DPM
3219 E Tremont Ave
Bronx, NY 10461
(718) 792-8115
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Ginsberg, Steven E., DPM
2391 Arthur Ave
Bronx, NY 10458
(718) 365-4141
SVCMC-St Marys Hospital
Brooklyn, St Joseph's Hospital
Division, CMC
Giordano, Richard S.,
1217 Castle Hill Ave
Bronx, NY 10462
(718) 828-6982
Northern Westchester Hospital
Center, Our Lady of Mercy
Medical Center
Gitlin, David, DPM
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Metropolitan Hospital Center
Glockenberg, Aaron,
Lincoln Med & Mental Hlth
234 E 149th St
Bronx, NY 10451
(718) 579-4900
2445 Arthur Ave
Bronx, NY 10458
(718) 733-1999
Kings County Hospital Center,
Lincoln Medical & Mental
Health Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital, Union
Hospital of the Bronx (closed)
Speaks PolishHebrew
Goez, Emilio A., DPM
Union Comm Hlth Ctr
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
St Barn Ambulatory Care
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-6105
Bronx Park Med Pavilion
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
Nassau University Medical
Center, Saint Catharines
General Hospital, St Barnabas
Speaks Spanish
Goldenberg, Perry Z.,
3250 3rd Ave
Bronx, NY 10456
(718) 328-3668
St Barnabas Hospital
Goldstein, Harold L.,
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-6105
St Barnabas Ambulatory C
4487 3rd Ave
Bronx, NY 10457
(718) 960-6488
Union Community Health Ct
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
Union Community Health Ct
260 E 188th St
Bronx, NY 10458
(718) 220-2020
St Barnabas Hospital, United
Hospital Medical Center (NY),
White Plains Hospital Center
Speaks SpanishItalian
Gramuglia, Vincent J.,
Mercy Community Care
4234 Bronx Blvd
Bronx, NY 10466
(347) 341-4300
AllMed Medical & Rehab
4377 Bronx Blvd
Bronx, NY 10466
(718) 325-0700
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
3795 E Tremont Ave
Bronx, NY 10465
(718) 828-3333
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks SpanishItalian
Greiff, Lance, DPM
3333 Henry Hudson Pkwy
Bronx, NY 10463
(718) 601-2100
Brooklyn Hospital Center
(Downtown Campus), New
York Flushing Hospital &
Medical Center, Parkway
Gutierrez, David, DPM
2100 Bartow Ave
Bronx, NY 10475
(718) 320-0200
Our Lady of Mercy Medical
Speaks Spanish
Harris, Carl F., DPM
Lincoln Med & Mental Hlth
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Harlem Hospital Center,
Lincoln Medical & Mental
Health Center
Herman, Craig P., DPM
Advanced Foot Care
3396 E Tremont Ave
Bronx, NY 10461
(718) 409-2121
Bronx Health Center
975 Westchester Ave
Bronx, NY 10459
(718) 991-9250
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Iorio, Anthony R., DPM
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Isaacson, Ernest, DPM
Parkchester Family Foot
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Beth Israel Medical Center
(Petrie Campus), Our Lady of
Mercy Medical Center
Speaks Hebrew
Jacobs, Louis W., DPM
4240 Hutchinson River Pkwy
Bronx, NY 10475
(718) 671-2233
Speaks SpanishHungarian
Joshi, Pradip M., DPM
1963A Daly Ave
Bronx, NY 10460
(718) 617-6141
1650 Selwyn Ave
Bronx, NY 10457
(718) 590-1800
Bronx-Lebanon Hospital
Center - Fulton Division, Our
Lady of Mercy Medical Center
Speaks Spanish
Kolberg, John J., DPM
1387 Grand Concourse
Bronx, NY 10452
(718) 992-9918
New Island Hospital
Speaks Spanish
Kumrah, Praveen, DPM
2015 Grand Concourse
Bronx, NY 10453
(718) 299-7295
Uptown HealthCare Mgmt
1778 Jerome Ave
Bronx, NY 10453
(718) 764-1661
1807 Randall Ave
Bronx, NY 10473
(718) 617-2468
New York Westchester Square
Me, Our Lady of Mercy
Medical Center
Speaks HindiPunjabi
LaSalle, Michael, DPM
Lincoln Medical & Mental
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Lai, Katherine M., DPM
Center for Podiatric Care
1500 Astor Ave
Bronx, NY 10469
(718) 882-6881
Beth Israel Medical Center
(Petrie Campus), Mount Sinai
Medical Center, Our Lady of
Mercy Medical Center
Landy, Robert J., DPM
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Massapequa General Hospital,
Our Lady of Mercy Medical
Center, Parkway Hospital,
Southside Hospital, Winthrop
University Hospital
Speaks Spanish
Levy, Denise A., DPM
Hyperbaric Unit
111 E 210th St
Bronx, NY 10467
(718) 920-6655
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Speaks Spanish
Levy, Paul J., DPM
2545 Wallace Ave
Bronx, NY 10467
(718) 231-2500
2539 Fish Ave
Bronx, NY 10469
(718) 231-2500
Brooklyn Hospital Center
(Downtown Campus), Our Lady
of Mercy Medical Center
Speaks Spanish
Locastro, Robert M.,
731 White Plains Rd
Bronx, NY 10473
(718) 893-7773
Southside Hospital, St
Barnabas Hospital, St
Catherine of Siena, St
Catherine of Sienna Medical
Lok, Jonat, DPM
East Tremont Medical Ctr
930 E Tremont Ave
Bronx, NY 10460
(718) 860-1111
New York Downtown Hospital
(Beekman), Our Lady of Mercy
Medical Center
Lopiano, Steven N., DPM
3108 Kingsbridge Ave
Bronx, NY 10463
(718) 548-1102
Our Lady of Mercy Medical
Speaks SpanishItalian
Board Certified
Male Female
Wheelchair Accessible
Lynn, Brian P., DPM
Ctr for Ortho Specialty
1695 Eastchester Rd
Bronx, NY 10461
(718) 405-8430
MAP - Dept. of Ortho Surg
3400 Bainbridge Ave
Bronx, NY 10467
(718) 920-2060
Long Island Jewish Medical
Center, Montefiore Med Ctr
(Henry & Lucy Moses Div)
Speaks Spanish
Marville, Jillion, MD
Morris Heights Hlth Ctr
625 E 137th St
Bronx, NY 10454
(718) 401-6578
Morris Heights Hlth Cntr
85 W Burnside Ave
Bronx, NY 10453
(718) 716-4400
Nachmann, Dennis S.,
Urgent Foot Care,PC
3594 E Tremont Ave
Bronx, NY 10465
(718) 597-5800
Urgent Foot Care PC
3058 E Tremont Ave
Bronx, NY 10461
(718) 409-0500
1216 Beach Ave
Bronx, NY 10472
(718) 597-1107
326 E 204th St
Bronx, NY 10467
(718) 655-3410
1387 Grand Concourse
Bronx, NY 10452
(718) 992-9918
Bronx-Lebanon Hospital
Center - Fulton Division,
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Oliva, Imelda A., DPM
HHC Morrisania D & T Ctr
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Kings County Hospital Center,
Metropolitan Hospital Center,
Morrisania Hospital
Speaks TagalogSpanish
Oropall, Robert, DPM
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
820 Lydig Ave
Bronx, NY 10462
(718) 792-5900
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks German
Pannell, Richard, DPM
HHC-Morrisania D &TC
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
Harlem Hospital Center,
Metropolitan Hospital Center
Plotka, Steven D., DPM
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Mount Sinai
Medical Center, Raritan Bay
Medcal Center, Robert Wood
Johnson University Hosp.
Speaks Spanish
Posner, Jonathan, DPM
Jonathan Posner, DPM
360 E 193rd St
Bronx, NY 10458
(718) 933-2400
Jonathan Posner, DPM
1621 Eastchester Rd
Bronx, NY 10461
(718) 405-8040
305 E 161st St
Bronx, NY 10451
(718) 579-2500
2532 Grand Concourse
Bronx, NY 10458
(718) 960-1500
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Rampino, Robert, DPM
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3630
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-5700
Coney Island Hospital
Ransom, Sherry M., DPM
Derm & Surgery Associates
3620 E Tremont Ave
Bronx, NY 10465
(718) 792-4700
Mount Vernon Hospital
Richman, Tara, DPM
Tej Podiatric Group P.C.
1963-A Daly Ave
Bronx, NY 10460
(718) 617-6141
Bronx-Lebanon Hospital
Center - Fulton Division
Ross, Charles F., DPM
HHC-Lincoln Med & Mntl HC
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Schulman, Leonard B.,
MMC-Family Care Center
3444 Kossuth Ave
Bronx, NY 10467
(718) 920-2273
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Scotti, Lorenzo, DPM
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-7224
Coney Island Hospital, Jacobi
Medical Center, North Central
Bronx Hospital
Speaks ItalianSpanish
Snyder, Robert S., DPM
3867 E Tremont Ave
Bronx, NY 10465
(718) 792-8790
Forest Hills Hospital, Parkway
Speaks Spanish
Spector, Donald, DPM
Cambridge Podiatry Center
259 W 231st St
Bronx, NY 10463
(718) 548-3080
St Joseph's Medical
Spellman, Dean S., DPM
Middletown Podiatry Assoc
1200 Waters Pl
Bronx, NY 10461
(718) 863-5511
New York Westchester Square
Medical Center
Spilken, Terry, DPM
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Steiner, Richard M., DPM
3530 Henry Hudson Pkwy E
Bronx, NY 10463
(718) 548-3550
Kingsbridge Community Med
170 W 233rd St
Bronx, NY 10463
(718) 543-0700
SVCMC-St Vincents Manhattan
Stern, Stuart M., DPM
Morris Park Podiatry
1015 Morris Park Ave
Bronx, NY 10462
(718) 863-3737
New Island Hospital, Plainview
Hospital, Syosset Hospital
Strassman, David, DPM
MMC - Dept of Surgery
111 E 210th St
Bronx, NY 10467
(718) 920-6603
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Methodist Hospital, New
York Westchester Square
Medical Center
Strassman, Lawrence,
MMC - Eastern Vascular
1825 Eastchester Rd
Bronx, NY 10461
(718) 792-8115
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Westchester Square
Medical Center
Tabari, Issac, DPM
108 E 183rd St
Bronx, NY 10453
(718) 295-4600
Lutheran Medical Center,
Nassau University Medical
Speaks FARSI,
Thompson, Michael, DPM
2574 Frisby Ave
Bronx, NY 10461
(718) 892-8382
Brooklyn Hospital Center
(Downtown Campus), Our Lady
of Mercy Medical Center
Velasco, Debra, DPM
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Segundo Ruiz Belvis DTC
545 E 142nd St
Bronx, NY 10454
(718) 579-4000
HHC-Morrisania D &TC
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Speaks Spanish
Vincetic, Anto, DPM
3635 E Tremont Ave
Bronx, NY 10465
(718) 409-0400
Montefiore Med Ctr (Henry &
Lucy Moses Div), Mount
Vernon Hospital
Speaks Croatian
Vitale, Thomas, DPM
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Walter, Eric G., DPM
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
1619 Pelham Pkwy N
Bronx, NY 10469
(718) 665-3410
Bronx Foot Rehab Assoc.
326 E 204th St
Bronx, NY 10467
(718) 655-3410
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center, SJRH -
St Johns Division, St Barnabas
Speaks German
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Wexler, Craig, DPM
2391 Arthur Ave
Bronx, NY 10458
(718) 365-4141
Newton Memorial Hospital,
Our Lady of Mercy Medical
Winston, Wayne, DPM
Signature Health Center
220 E 161st St
Bronx, NY 10451
(718) 537-1100
Forest Hills Hospital
Wolstein, Lewis, DPM
100-1 De Kruif Pl
Bronx, NY 10475
(718) 671-7226
New York Westchester Square
Medical Center, United
Hospital Medical Center (NY),
White Plains Hospital Center
Speaks Spanish
Wolstein, Peter D., DPM
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Speaks SpanishTagalog
Woltman, Robert T., DPM
1488 Metropolitan Ave
Bronx, NY 10462
(718) 823-6239
Wellness Medical Asso
1180 Morris Park Ave
Bronx, NY 10461
(718) 863-8465
Long Island Jewish Medical
Center, New York Westchester
Square Me, Peninsula Hospital
Board Certified
Male Female
Wheelchair Accessible
Amante, Gregory, DPM
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks Spanish
Amico, Susan G., DPM
SL Quality Care Diagnosti
9708 Seaview Ave
Brooklyn, NY 11236
(718) 444-0520
SL Quality Care Diagnosti
1902 86th St
Brooklyn, NY 11214
(718) 621-9400
SL Quality Care Diagnosti
1220 Avenue P
Brooklyn, NY 11229
(718) 376-1004
9731 4th Ave
Brooklyn, NY 11209
(718) 836-1800
SVCMC-St Vincents Staten
Island, Staten Island University
Hosp-North, Victory Memorial
Speaks ItalianSpanish
Archer, Jean V., DPM
Brookdale Family Care Ctr
2554 Linden Blvd
Brooklyn, NY 11208
(718) 240-8600
Jamaica Hosp Medical Ctr
3080 Atlantic Ave
Brooklyn, NY 11208
(718) 647-0240
Jamaica Hospital
Speaks Spanish
Aronica, Frank R., DPM
20 Plaza St E
Brooklyn, NY 11238
(718) 638-6387
Catholic Medical Center (NY),
Long Island College Hospital
Speaks SpanishItalian
Assini, Joseph, DPM
8616 3rd Ave
Brooklyn, NY 11209
(718) 948-3838
Doctors Hosp. of Staten Island,
Lutheran Medical Center,
Staten Island University
Hosp-North, Victory Memorial
Speaks Italian
Babayev, Emil, DPM
Perloff Medical PC
2626 E 14th St
Brooklyn, NY 11235
(718) 368-2626
Professional Medical Plaz
2269 Ocean Ave
Brooklyn, NY 11229
(718) 339-8200
421 Ocean Pkwy
Brooklyn, NY 11218
(718) 287-4200
Lutheran Medical Center, New
York Methodist Hospital
Speaks Russian
Baird, William T., DPM
Plaza Foot Care, PC
5412 Kings Plz Mall
Brooklyn, NY 11234
(718) 377-1212
Peninsula Hospital Center
Barkoff, Steven L., DPM
248 Roebling St
Brooklyn, NY 11211
(718) 599-0505
Brooklyn Hospital Center
(Downtown Campus), New
York Methodist Hospital
Speaks Spanish
Barone, Salvatore A.,
1601 Voorhies Ave
Brooklyn, NY 11235
(718) 646-5553
Lutheran Medical Center
Speaks SpanishGerman
Bartol, David M., DPM
North Star Orthopedics
1408 Ocean Ave
Brooklyn, NY 11230
(718) 338-0909
North Star Orthopedics
2615 E 16th St
Brooklyn, NY 11235
(718) 745-8787
North Star Orthopedics
26 Court St
Brooklyn, NY 11242
(718) 935-0311
1000 Church Ave
Brooklyn, NY 11218
(718) 826-4000
740 64th St
Brooklyn, NY 11220
(718) 439-2000
Parkway Hospital
Bass, Elliot L., DPM
2381 E 29th St
Brooklyn, NY 11229
(718) 743-1400
Elliot L Bass, MD
2 W End Ave
Brooklyn, NY 11235
(718) 743-2900
Bass, Fara D., DPM
2 W End Ave
Brooklyn, NY 11235
(718) 743-1400
2381 E 29th St
Brooklyn, NY 11229
(718) 743-1400
New York Methodist Hospital
Speaks Yiddish
Bell, Burt L., DPM
7608 20th Ave
Brooklyn, NY 11214
(718) 837-8003
3065 Brighton 5Th St
Brooklyn, NY 11235
(718) 332-2722
New York Community Hospital
of Brooklyn
Benzakein, Ralph, DPM
2241 Ocean Ave
Brooklyn, NY 11229
(718) 998-1375
New York Community Hospital
of Brooklyn
Bienenfeld, Jay D., DPM
165 Taylor St
Brooklyn, NY 11211
(718) 599-0753
Peninsula Hospital Center
Birch, Gregory M., DPM
6419 Bay Pkwy
Brooklyn, NY 11204
(718) 232-6737
Staten Island University
Bover, Elina, DPM
A. Amerimed Physician P.C
1655 E 13th St
Brooklyn, NY 11229
(718) 339-3100
A. Amerimed Physician P.C
1100 Coney Island Ave
Brooklyn, NY 11230
(718) 434-7533
New York Methodist Hospital
Speaks AbkhazianAfam
Braun, Suzanne G., DPM
2171 Nostrand Ave
Brooklyn, NY 11210
(718) 758-8920
710 Parkside Ave
Brooklyn, NY 11226
(718) 270-2075
University Hospital of Brooklyn
Speaks SpanishItalian
Breth, Evan G., DPM
Evan G. Breth, DPM
2352 Ralph Ave
Brooklyn, NY 11234
(718) 251-0200
263 7th Ave
Brooklyn, NY 11215
(718) 369-8080
United Medical Assoc
9001 3rd Ave
Brooklyn, NY 11209
(718) 748-2900
7124 18th Ave
Brooklyn, NY 11204
(718) 234-3333
Lutheran Medical Center, New
York Methodist Hospital
Bushansky, Abe A., DPM
734 Pennsylvania Ave
Brooklyn, NY 11207
(718) 493-5986
711 Eastern Pkwy
Brooklyn, NY 11213
(718) 493-5986
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Parkway
Butters, Marva, DPM
158 Clarkson Ave
Brooklyn, NY 11226
(718) 783-4780
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center
Buxbaum, Frederick D.,
1501 W 6th St
Brooklyn, NY 11204
(718) 837-0442
New York Community Hospital
of Brooklyn, New York
Methodist Hospital, Parkway
Buzermanis, Steven Z.,
1230 Neptune Ave
Brooklyn, NY 11224
(718) 615-3200
3245 Nostrand Ave
Brooklyn, NY 11229
(718) 615-3777
345 Schermerhorn St
Brooklyn, NY 11217
(718) 858-6300
Campbell, Douglas E.,
(718) 283-7593
4801 Fort Hamilton Pkwy
Brooklyn, NY 11219
(718) 853-7469
241 Willoughby St
Brooklyn, NY 11201
(718) 853-7469
Maimonides Medical Center
Caprioni, Enrico P., DPM
326 7th St
Brooklyn, NY 11215
(718) 369-7192
New York Methodist Hospital
Speaks ItalianSpanish
Carlton, Lawrence S.,
1981 Flatbush Ave
Brooklyn, NY 11234
(718) 338-8715
Brooklyn Hospital Center
(Downtown Campus)
Castillo, Dennis E., DPM
345 Clinton Ave
Brooklyn, NY 11238
(718) 783-7300
450 Clarkson Ave
Brooklyn, NY 11203
(718) 783-7300
SUNY Downstate Med Ctr
840 Lefferts Ave
Brooklyn, NY 11203
(718) 783-7300
SUNY Downstate Med Ctr
445 Lenox Rd
Brooklyn, NY 11203
(718) 783-7300
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Kingsbrook
Jewish Medical Center,
University Hospital of Brooklyn
Speaks Spanish
Board Certified
Male Female
Wheelchair Accessible
Charlot, Giznola J., DPM
HHC-Kings County Hospital
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Jacobi Medical Center, Kings
County Hospital Center, North
Central Bronx Hospital
Cheng, Tung W., DPM
299 Livingston St
Brooklyn, NY 11217
(718) 624-2150
Speaks Chinese
Chopra, Jaideep, DPM
Medical Office
462 Ocean Pkwy
Brooklyn, NY 11218
(718) 856-6010
1324 Bergen St
Brooklyn, NY 11213
(718) 774-5224
710 Parkside Ave
Brooklyn, NY 11226
(718) 270-2045
University Phys of Bklyn
450 Clarkson Ave
Brooklyn, NY 11203
(718) 270-2045
Staten Island University
Hosp-North, University
Hospital of Brooklyn
Speaks Hindi
Cicio, Gary, DPM
142 Joralemon St
Brooklyn, NY 11201
(718) 624-3003
Beth Israel Med Ctr (Kings
Hwy Division), Long Island
College Hospital, New York
Downtown Hospital (Beekman)
Cohen, Greg E., DPM
142 Joralemon St
Brooklyn, NY 11201
(718) 624-3003
Cabrini Medical Center, Long
Island College Hospital
Cohen, Richard B., DPM
1331 E 16th St
Brooklyn, NY 11230
(718) 375-3400
Brooklyn Hospital Center
(Downtown Campus)
D'Amato, Theodore A.,
9731 4th Ave
Brooklyn, NY 11209
(718) 745-3177
Staten Island University
Hosp-North, Victory Memorial
D'Angelo, Nicholas A.,
6511 20th Ave
Brooklyn, NY 11204
(718) 837-7300
New York Methodist Hospital
Speaks Italian
Dacher, Jeffrey, DPM
3901 Nostrand Ave
Brooklyn, NY 11235
(718) 648-9104
Woodhull Medical & Mental
Health Ctr
Speaks Yiddish
Daniel, Lawrence B.,
2832 Linden Blvd
Brooklyn, NY 11208
(718) 240-2000
Lawrence B. Daniel, DPM
1576 E 66th St
Brooklyn, NY 11234
(718) 241-3803
Brooklyn Hospital Center
(Downtown Campus),
Montefiore Med Ctr (Henry &
Lucy Moses Div), Montefiore
Med Ctr (Jack D Weiler Hosp
of A Einst)
DeMeo, James R., DPM
1545 Atlantic Ave
Brooklyn, NY 11213
(718) 613-4856
Cabrini Medical Center,
Interfaith Medical Center,
Mount Vernon Hospital, SJRH -
St Johns Division
DeSantos, Pasquale, DPM
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks ItalianSpanish
Dennis, Lester N., DPM
746 Manhattan Ave
Brooklyn, NY 11222
(718) 389-4404
Catholic Medical Center (NY),
New York Flushing Hospital &
Medical Center, New York
Hospital Medical Center of
Queens, St Joseph's Hospital
Division, CMC, United
Hospital Medical Center (NY),
Wyckoff Heights Medical
Dharia, Sumit S., DPM
552 Saint Marks Ave
Brooklyn, NY 11238
(516) 359-3339
Speaks Gujarati
Dixit, Chaitanya V., DPM
NY Medical Associates
98 Avenue U
Brooklyn, NY 11223
(718) 372-0500
1700 Flatbush Ave
Brooklyn, NY 11210
(718) 692-1120
2235 W 9th St
Brooklyn, NY 11223
(718) 372-0400
Jamaica Hospital, New York
Methodist Hospital, Our Lady
of Mercy Medical Center
Speaks SpanishHindiItalian
Donovan, Glenn J., DPM
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Dorazi, Stephen T., DPM
374 Stockholm St
Brooklyn, NY 11237
(718) 963-7233
Franklin Hospital, New York
Hospital Medical Center of
Queens, New York United
Hospital Medic, Sound Shore
Medical Center of Westchester,
Wyckoff Heights Medical
Speaks Spanish
Ehrlich, Josh C., DPM
Astrocare Medical Center
1669 Bedford Ave
Brooklyn, NY 11225
(718) 467-7200
1651 Coney Island Ave
Brooklyn, NY 11230
(718) 382-2221
1535 51st St
Brooklyn, NY 11219
(718) 436-8886
Maimonides Medical Center,
Staten Island University
Einhorn, Jill L., DPM
2616 Avenue U
Brooklyn, NY 11229
(718) 891-2706
Beth Israel Med Ctr (Kings
Hwy Division), Maimonides
Medical Center
Fagen, Leonard, DPM
1390 Pennsylvania Ave
Brooklyn, NY 11239
(718) 642-2088
Brookdale Hospital Medical
Speaks Spanish
Falcone, Jeffrey J., DPM
8012 3rd Ave
Brooklyn, NY 11209
(718) 745-5600
New York Methodist Hospital
Ficke, Henry, DPM
2875 W 8th St
Brooklyn, NY 11224
(718) 266-3131
444 Avenue X, Ste 1E
Brooklyn, NY 11223
(718) 375-1616
2015 Bath Ave
Brooklyn, NY 11214
(718) 375-1616
Long Beach Memorial Hospital
Friedlander, Bruce W.,
567 9th St
Brooklyn, NY 11215
(718) 840-0220
Long Island College Hospital
Speaks SpanishFrench
Ganjian, Afshin, DPM
146 Sheridan Ave
Brooklyn, NY 11208
(718) 235-6100
Coney Island Hospital, St
Joseph's Hospital Division,
Garofalo, Alfred A.,
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Bellevue Hospital Center,
Gouverneur Hospital, Woodhull
Medical & Mental Health Ctr
Gaudino, Salvatore C.,
Boro Medical, PC
540 Atlantic Ave
Brooklyn, NY 11217
(718) 855-4900
Bensonhurst Fam. Foot Ctr
7819 18th Ave
Brooklyn, NY 11214
(718) 234-7054
Bensonhurst Family Foot
420 74th St
Brooklyn, NY 11209
(718) 836-1017
Mount Sinai Medical Center,
Parkway Hospital, Queens
Hospital Center
Geiger, Arthur, DPM
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center
George, Thomas, DPM
888 Fountain Ave
Brooklyn, NY 11208
(718) 235-0574
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Gertsik, Vladimir V., DPM
Gertsik Podiatry< PC
415 Ocean View Ave
Brooklyn, NY 11235
(718) 934-4842
New York Methodist Hospital
Speaks Russian
Giammarino, Philip A.,
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
HHC-Sheepshead Bay Ctr
3121 Ocean Ave
Brooklyn, NY 11235
(718) 646-9190
8607 21st Ave
Brooklyn, NY 11214
(718) 266-1986
Coney Island Hospital,
Lutheran Medical Center
Speaks SpanishItalian
Glockenberg, Aaron,
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Lincoln Medical & Mental
Health Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital, Union
Hospital of the Bronx (closed)
Speaks PolishHebrew
Board Certified
Male Female
Wheelchair Accessible
Goldman, Gershon A.,
Fayn Medical PC
1517 Voorhies Ave
Brooklyn, NY 11235
(718) 648-2491
Forest Hills Hospital, Parkway
Goldstein, Israel, DPM
Ezra Medical Center
571 McDonald Ave
Brooklyn, NY 11218
(718) 686-7600
468 Ocean Pkwy
Brooklyn, NY 11218
(718) 693-0578
Gonzalez, Ivan, DPM
East New York D & TC
2094 Pitkin Ave
Brooklyn, NY 11207
(718) 240-0400
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center, St
Joseph's Hospital Division,
CMC, University Hospital of
Goodman, Warren J., DPM
Kings Highway Podiatry
380 Avenue U
Brooklyn, NY 11223
(718) 376-3077
Victory Memorial Hospital
Speaks FrenchSpanish
Greenbaum, Bruce R.,
3000 Ocean Pkwy
Brooklyn, NY 11235
(718) 265-2600
Staten Island University
Hosp-North, Staten Island
University Hosp-South
Guberman, Ronald M.,
Wound Healing & Hyperbar
374 Stockholm St
Brooklyn, NY 11237
(718) 381-8402
MEDICAL CENTER, Franklin
Hospital, Jackson Heights
Hospital Division (closed),
Sound Shore Medical Center of
Westchester, Wyckoff Heights
Medical Center
Speaks Spanish
Gventer, Mark, DPM
434 3rd St
Brooklyn, NY 11215
(718) 499-7583
New York Community Hospital
of Brooklyn
Speaks RussianSpanish
Habib, Henry, DPM
8000 4th Ave
Brooklyn, NY 11209
(718) 833-8136
SVCMC-St Vincents Manhattan
Speaks ItalianArabic
Heller, David P., DPM
843 Utica Ave
Brooklyn, NY 11203
(718) 345-8923
2124 Knapp St
Brooklyn, NY 11229
(718) 743-4121
Interfaith Medical Center
Herman, Craig P., DPM
94-98 Manhattan Avenue
Brooklyn, NY 11206
(718) 388-0390
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Horowitz, Mitchell L.,
Quality Health Center Inc
138 Division Ave
Brooklyn, NY 11211
(718) 387-2408
Ivanovs, Ray, DPM
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Woodhull Medical & Mental
Health Ctr
Jarbath, John A., DPM
2051 Flatbush Ave
Brooklyn, NY 11234
(718) 677-1000
Forest Hills Hospital, New York
Hospital Medical Center of
Queens, Parkway Hospital,
Peninsula Hospital Center
Speaks FrenchCreoles and
pidgins, French-based
Jusma, Francoise D., DPM
Cumberland D & T Ctr
100 N Portland Ave
Brooklyn, NY 11205
(718) 260-7500
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
100 Parkside Ave
Brooklyn, NY 11226
(718) 940-5288
Brooklyn Hospital Center
(Downtown Campus), Woodhull
Medical & Mental Health Ctr
Speaks FrenchCreoles and
pidgins, French-based
Kaiser, Craig A., DPM
1220 Avenue P
Brooklyn, NY 11229
(718) 376-1004
19-02 86th St
Brooklyn, NY 11214
(718) 621-9400
9708 Seaview Ave
Brooklyn, NY 11236
(718) 444-0520
465 Ocean Pkwy
Brooklyn, NY 11218
(718) 941-3796
Maimonides Medical Center,
New York Methodist Hospital
Kapadwala, Imtiyaz I.,
220 A. Saint Nicholas Ave
Brooklyn, NY 11237
(718) 418-8540
2848 Church Ave
Brooklyn, NY 11226
(718) 703-3000
Kingsbrook Jewish Medical
Center, Wyckoff Heights
Medical Center
Speaks UrduHindi
Katz, Alex S., DPM
2797 Ocean Pkwy
Brooklyn, NY 11235
(718) 615-4444
New York Community Hospital
of Brooklyn
Katzman, Barry, DPM
233 Nostrand Ave
Brooklyn, NY 11205
(718) 826-5900
New York Flushing Hospital &
Medical Center, New York
Hospital Medical Center of
Queens, Parkway Hospital
Speaks Spanish
Knobel, Jeffrey, DPM
1636 E 14th St
Brooklyn, NY 11229
(718) 336-1800
662 Bedford Ave
Brooklyn, NY 11211
(718) 336-1800
Beth Israel Medical Center
(Petrie Campus), Brookdale
Hospital Medical Center,
Jamaica Hospital
Speaks RussianYiddish
Lafferty, William A., DPM
858 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5574
SVCMC-St Vincents Staten
Island, Staten Island University
Lepore, Frank L., DPM
349 Henry St
Brooklyn, NY 11201
(718) 780-8104
Catholic Medical Center (NY),
Long Island College Hospital,
Wyckoff Heights Medical
Speaks ItalianSpanish
Levitz, Steven J., DPM
3010 Avenue L
Brooklyn, NY 11210
(718) 258-1820
Brooklyn Hospital Center
(Downtown Campus), Wyckoff
Heights Medical Center
Levy, Brian K., DPM
1390 Pennsylvania Ave
Brooklyn, NY 11239
(718) 642-2088
Brookdale Hospital Medical
Center, Kingsbrook Jewish
Medical Center
Speaks Spanish
Liswood, Paul J., DPM
Comprehensive Podiatry Sv
7212 4th Ave
Brooklyn, NY 11209
(718) 745-0256
506 6th St
Brooklyn, NY 11215
(718) 780-5850
Lutheran Medical Center, New
York Methodist Hospital
Speaks RussianSpanish
Losyev, Sergey, DPM
2005 Ocean Ave
Brooklyn, NY 11230
(718) 645-4324
Lutheran Medical Center
Speaks Russian
Lucido, Jeffrey V., DPM
441 77th St
Brooklyn, NY 11209
(718) 745-3800
150 55th St
Brooklyn, NY 11220
(718) 630-7095
Doctors Hosp. of Staten Island,
Lutheran Medical Center
Speaks ItalianSpanish
Mahgerefteh, David, DPM
4405 16th Ave
Brooklyn, NY 11204
(718) 633-8662
Parkway Hospital
Speaks Yiddish
Makower, Bryan L., DPM
Downstate Foot &Ankle Pod
121 Dekalb Ave
Brooklyn, NY 11201
(718) 250-8753
176 Fenimore St
Brooklyn, NY 11225
(718) 940-0400
100 Parkside Ave
Brooklyn, NY 11226
(718) 768-1906
Downstate Foot & Ankle Po
322 Linden Blvd
Brooklyn, NY 11226
(718) 768-1906
Brooklyn Hospital Center
(Downtown Campus), New
York Methodist Hospital
Speaks SpanishFrench
Mandato, Mark, DPM
HHC-Kings County Hospital
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Metropolitan Hospital Center
Mantzoukas, Argirios,
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks Greek, Modern
Marcelonis, Debra A.,
465 New Lots Ave
Brooklyn, NY 11207
(718) 240-8900
Jamaica Hospital
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Marville, Jillion, MD
353 Empire Blvd
Brooklyn, NY 11225
(718) 221-9244
Matthews, Frederick, DPM
Frederick Matthew DPM
1641 Bergen St
Brooklyn, NY 11213
(718) 778-2938
Interfaith Medical Center
Speaks Spanish
Mckay, Douglas J., DPM
1704 Mermaid Ave
Brooklyn, NY 11224
(718) 265-0900
Staten Island University
Meliso, Vincent D., DPM
1029 Manhattan Ave
Brooklyn, NY 11222
(718) 383-3377
Lorimer Foot Care
411 Graham Ave
Brooklyn, NY 11211
(718) 383-2518
New York Methodist Hospital
Speaks Italian
Meller, Edward P., DPM
Ambulatory Care Clinic
1 Brookdale Plz
Brooklyn, NY 11212
(718) 240-5045
Urban Strategies
1873 Eastern Pkwy
Brooklyn, NY 11233
(718) 240-8700
Jamaica Hospital, St Joseph's
Hospital Division, CMC
Meshnick, Joel A., DPM
Kings Country Medical Doc
2705 Mermaid Ave
Brooklyn, NY 11224
(718) 265-2222
2876 W 27th St
Brooklyn, NY 11224
(718) 265-2222
ODA Primary Health Care
14-16 Heyward St
Brooklyn, NY 11211
(718) 260-4600
Lutheran Medical Center,
Staten Island University
Micallef, Joseph, DPM
1095 Flatbush Ave
Brooklyn, NY 11226
(718) 240-8800
Brookdale Hospital Medical
Center, Forest Hills Hospital,
Jamaica Hospital, New York
Hospital Medical Center of
Mollica, Peter W., DPM
8223 14th Ave
Brooklyn, NY 11228
(718) 875-9357
410 Clinton St
Brooklyn, NY 11231
(718) 875-9357
585 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5481
Interfaith Medical Center,
Kingsbrook Jewish Medical
Center, New York Methodist
Speaks Italian
Mollica, Raymond J.,
8223 14th Ave
Brooklyn, NY 11228
(718) 236-2871
Raymond J Mollica, MD
410 Clinton St
Brooklyn, NY 11231
(718) 875-1105
Catholic Medical Center (NY),
Kingsbrook Jewish Medical
Center, Lutheran Medical
Center, New York Methodist
Montalvo, Luis, DPM
7523 Fort Hamilton Pkwy
Brooklyn, NY 11228
(718) 745-7266
Lutheran Medical Center,
Wyckoff Heights Medical
Speaks Spanish
Morreale, Edward, DPM
736 Ocean Pkwy
Brooklyn, NY 11230
(718) 437-9343
SVCMC-St Vincents Manhattan
Speaks ItalianSpanish
Naik, Hetal B., DPM
Lafayette Med Office PC
468 Lafayette Ave
Brooklyn, NY 11205
(718) 399-6234
1417 Foster Ave
Brooklyn, NY 11230
(718) 421-6300
121 Dekalb Ave
Brooklyn, NY 11201
(718) 250-8753
Brooklyn Hospital Center
(Downtown Campus), Lutheran
Medical Center, Maimonides
Medical Center
Nekritin, Vadim, DPM
2306 Avenue U
Brooklyn, NY 11229
(718) 769-8210
St John's Episcopal Hospital
Speaks Russian
Newmark, Alan J., DPM
34 Plaza St E
Brooklyn, NY 11238
(718) 857-9004
372 Kingston Ave
Brooklyn, NY 11213
(718) 604-0675
Brooklyn Hospital Center
(Downtown Campus)
Novofastovsky, Raisa, DPM
1812 Quentin Rd
Brooklyn, NY 11229
(718) 382-1773
3066 Brighton 6
Brooklyn, NY 11235
(718) 382-1773
8622 Bay Pkwy
Brooklyn, NY 11214
(718) 333-2121
All Medical Care L.L.P.
8622 Bay Pkwy
Brooklyn, NY 11214
(718) 333-2121
Lutheran Medical Center, New
York Community Hospital of
Speaks Russian
Odinsky, Michael E.,
200 Montague St
Brooklyn, NY 11201
(718) 422-8000
546 Eastern Pkwy
Brooklyn, NY 11225
(718) 604-4800
Oliva, Imelda A., DPM
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Metropolitan Hospital Center,
Morrisania Hospital
Speaks TagalogSpanish
Orlando, Anthony, DPM
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital, Forest
Hills Hospital, Lutheran
Medical Center, North Shore
University Hospital
Owusu, Stephen E., DPM
434 Rockaway Ave
Brooklyn, NY 11212
(718) 346-2628
Mount Zion Podiatry,PC
106 Pennsylvania Ave
Brooklyn, NY 11207
(718) 385-2085
Jamaica Hospital, St Joseph's
Hospital Division, CMC
Pace, George N., DPM
Manhattan Footcare
133 Smith St
Brooklyn, NY 11201
(718) 330-1117
Cabrini Medical Center, Long
Island College Hospital, New
York Downtown Hospital, New
York Downtown Hospital
Speaks Spanish
Pace, John F., DPM
John F. Pace, MD
398 Court St
Brooklyn, NY 11231
(718) 834-0909
Long Island College Hospital,
SVCMC-Bayley Seton
Papa, Philip M., DPM
Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Passik, Arthur L., DPM
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital,
Massapequa General Hospital,
Plainview Hospital, Syosset
Speaks SpanishItalianGreek,
Modern (1453-)
Pawson, John F., DPM
9229 Flatlands Ave
Brooklyn, NY 11236
(718) 257-1444
Bay Park Medical, PC
6403 18th Ave
Brooklyn, NY 11204
(718) 621-0800
New York Community Hospital
of Brooklyn
Pecora, Maria, DPM
3245 Nostrand Ave
Brooklyn, NY 11229
(718) 615-3777
Forest Hills Hospital, Jamaica
Hospital, New York Hospital
Medical Center of Queens, St
Joseph's Hospital, St Joseph's
Hospital Division, CMC
Speaks Spanish
Pedro, Helder F., DPM
Family Physician FHC
5616 6th Ave
Brooklyn, NY 11220
(718) 439-5440
Caribbean American FHC
3414 Church Ave
Brooklyn, NY 11203
(718) 940-9425
Sunset Park Family Health
150 55th St
Brooklyn, NY 11220
(718) 630-7208
Long Island Jewish Medical
Center, Lutheran Medical
Perez, Walter H., DPM
Advanced Walkin Foot CAre
2146 Beverley Rd
Brooklyn, NY 11226
(718) 675-1100
2919 Avenue T
Brooklyn, NY 11229
(718) 336-4390
Advanced WalkIn Foot Care
1214 Coney Island Ave
Brooklyn, NY 11230
(718) 677-7700
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Jamaica
Pierre, Nadja M., DPM
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Brooklyn Hospital Center
(Downtown Campus), Woodhull
Medical & Mental Health Ctr
Speaks French
Pierre, Nedjie, DPM
552 Saint Marks Ave
Brooklyn, NY 11238
(718) 398-8700
3400 Snyder Ave
Brooklyn, NY 11203
(718) 693-4060
The Brooklyn Hospital Cen
121 Dekalb Ave
Brooklyn, NY 11201
(718) 488-3708
Brooklyn Hospital Center
(Downtown Campus)
Speaks FrenchCreoles and
pidgins, French-based
Prince, Steven L., DPM
JHMC DTC - East New York
3080 Atlantic Ave
Brooklyn, NY 11208
(718) 647-0240
Jamaica Hospital, V A Hospital
- St. Albans
Rabiei, Payman, DPM
Metropolitan Foot Care PC
94-13 Flatlands Ave
Brooklyn, NY 11236
(718) 649-6464
Metropolitan Foot Care PC
3309 Church Ave
Brooklyn, NY 11203
(718) 209-0013
Kingsbrook Jewish Medical
Center, Long Island Jewish
Medical Center, Parkway
Speaks HebrewPersian
Radler, Bruce L., DPM
6416 17th Ave
Brooklyn, NY 11204
(718) 236-2821
Staten Island University
Raskin, Simon, DPM
Simon Raskin, DPM, P.C.
1409 Gravesend Neck Rd
Brooklyn, NY 11229
(718) 332-7771
Reifer, Howard J., DPM
1670 E 17th St
Brooklyn, NY 11229
(718) 382-9200
2433 86th St
Brooklyn, NY 11214
(917) 974-8726
3059 Brighton 13Th St
Brooklyn, NY 11235
(917) 974-8726
Quentin Medical, PC
280 Quentin Rd
Brooklyn, NY 11223
(718) 336-4499
157 York St
Brooklyn, NY 11201
(718) 222-0333
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center
Speaks Spanish
Romano, Constance A.,
386 Graham Ave
Brooklyn, NY 11211
(718) 389-9870
Cabrini Medical Center,
Interfaith Medical Center
Speaks Italian
Rosen, Alan J., DPM
5402 Flatlands Ave
Brooklyn, NY 11234
(718) 444-3338
Brookdale Hospital Medical
Saadvandi, Terence M.,
Physicare Multi Services
150 55th St
Brooklyn, NY 11220
(718) 253-3900
Nostrand Community Medica
220 13th St
Brooklyn, NY 11215
(718) 769-4988
Brighton Community Medica
9000 Shore Rd
Brooklyn, NY 11209
(718) 646-5500
Lutheran Medical Center
Speaks Arabic
Sande, Hervey, DPM
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center
Scheiner, David M., DPM
Good Health Medical, P.C.
3019 Brighton 1St St
Brooklyn, NY 11235
(718) 743-9700
Brunswick Hospital Center Inc,
South Nassau Comm. Hospital,
South Nassau Communities
Hosp., South Nassau
Communities Hospital,
Winthrop University Hospital
Speaks RussianSpanish
Schikman, Lana, DPM
Kingsbrook Jewish Med Ctr
585 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5388
Kingsbrook Jewish Medical
Speaks Russian
Schneidermesser, Susan
18 Prospect Park W
Brooklyn, NY 11215
(718) 398-7593
894 Eastern Pkwy
Brooklyn, NY 11213
(718) 778-7311
Kingsbrook Jewish Medical
Speaks Spanish
Shapiro, Eugene, DPM
301 Ocean View Ave
Brooklyn, NY 11235
(718) 332-2582
New York Community Hospital
of Brooklyn
Speaks Russian
Shechter, David Z., DPM
3066 Brighton 6Th St
Brooklyn, NY 11235
(718) 743-0111
New York Hospital Medical
Center of Queens, St Joseph's
Hospital Division, CMC,
Wyckoff Heights Medical
Shechter, Stuart B., DPM
Stuart B Shechter, MD
3066 Brighton 6Th St
Brooklyn, NY 11235
(718) 743-0111
Island Medical Center (NY)_
Sherman, Gary, DPM
7902 Bay Pkwy
Brooklyn, NY 11214
(718) 236-7520
Maimonides Medical Center,
New York Downtown Hospital
(Beekman), SVCMC-St Vincents
Staten Island
Silberstein, Jeffrey, DPM
1367 51st St
Brooklyn, NY 11219
(718) 438-4305
Speaks YiddishSpanish
Silverstein, Alan B., DPM
1185 Dean St
Brooklyn, NY 11216
(718) 774-2740
Interfaith Medical Center
Spielfogel, William D.,
Hamilton Podiatry PC
369 93rd St
Brooklyn, NY 11209
(718) 680-6276
Medical Center
Spindler, Harlan, DPM
5412 Kings Plz
Brooklyn, NY 11234
(718) 377-1212
Peninsula Hospital Center,
Wyckoff Heights Medical
Stanimirov, Catherine,
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Ida G Irael Comm Hlth Ctr
2201 Neptune Ave
Brooklyn, NY 11224
(718) 946-3400
Coney Island Hospital
Speaks Spanish
Steiner, Richard M., DPM
2811 Ocean Ave
Brooklyn, NY 11229
(718) 648-5609
SVCMC-St Vincents Manhattan
Stuto, Joseph C., DPM
100 Remsen St
Brooklyn, NY 11201
(718) 624-7537
Brooklyn Hospital Center
(Downtown Campus), Long
Island College Hospital, New
York Community Hospital of
Tajerstein, Alan R., DPM
1335 54th St
Brooklyn, NY 11219
(718) 972-5000
Brooklyn Hospital Center
(Downtown Campus)
Speaks YiddishHebrew
Tanenbaum, Mark, DPM
1648 E 14th St
Brooklyn, NY 11229
(718) 627-0585
Tartack, Ira, DPM
Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
New York Community Hospital
of Brooklyn, Our Lady of Mercy
Medical Center
Tavroff, Clifford D., DPM
233 Nostrand Ave
Brooklyn, NY 11205
(718) 826-5900
Trepal, Michael J., DPM
115 Henry St
Brooklyn, NY 11201
(718) 624-8022
Long Island College Hospital,
Metropolitan Hospital Center,
New York Downtown Hospital
(Beekman), SVCMC-St Vincents
Trivlis, Maryann Z., DPM
248 Avenue P
Brooklyn, NY 11204
(718) 945-0770
Brooklyn Hospital Center
(Downtown Campus)
Speaks Greek, Modern
Unger, Leslie M., DPM
1405 46th St
Brooklyn, NY 11219
(718) 438-8717
Lesie M Unger, MD
2315 Mermaid Ave
Brooklyn, NY 11224
(718) 373-1820
Maimonides Medical Center
Speaks SpanishYiddish
Vader, Bonnie, DPM
621 Amboy St
Brooklyn, NY 11212
(718) 345-2935
Brookdale Hospital Medical
Center, Forest Hills Hospital
Speaks Spanish
Waiss, Samuel M., DPM
2223 Coney Island Ave
Brooklyn, NY 11223
(718) 375-6096
New York Community Hospital
of Brooklyn
Speaks HebrewYiddish
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Wallach, Jacob B., DPM
2108 Avenue P
Brooklyn, NY 11229
(718) 951-6399
Maimonides Medical Center
Woltman, Robert T., DPM
Lyudmila Cavalier Physici
9014 Flatlands Ave
Brooklyn, NY 11236
(718) 209-5353
Long Island Jewish Medical
Center, New York Westchester
Square Me, Peninsula Hospital
Zonenashvili, Merabi,
201 Kings Hwy
Brooklyn, NY 11223
(718) 621-1811
Staten Island University
Zwiebel, Neil S., DPM
420 Fulton St
Brooklyn, NY 11201
(718) 797-3668
Cabrini Medical Center, Long
Island College Hospital
Abeles, Jay, DPM
4136 Hicksville Rd
Bethpage, NY 11714
(516) 796-2900
Massapequa General Hospital,
New Island Hospital, Syosset
Abrahamson, Hal, DPM
100 Manetto Hill Rd
Plainview, NY 11803
(516) 822-9595
Catholic Medical Center (NY),
Forest Hills Hospital
Speaks Hebrew
Alongi, Maryanne, DPM
226 7th St
Garden City, NY 11530
(516) 248-9680
Franklin Hospital ,
Massapequa General Hospital,
New Island Hospital
Amato, Richard, DPM
R.A. Podiatry, P.C.
2116 Merrick Ave
Merrick, NY 11566
(516) 378-9191
New Island Hospital
Axman, Wayne R., DPM
70 Maple Ave
Rockville Centre, NY 11570
(516) 536-3336
1420 Broadway
Hewlett, NY 11557
(516) 374-8600
Long Beach Memorial
Hospital, Long Island Jewish
Medical Center, Mount Sinai
Hospital, Mount Sinai of
Queens, New York Hospital
Medical, South Nassau
Communities Hospital
Speaks SpanishGreek,
Modern (1453-)
Bagner, Jerome E., DPM
30 Hempstead Ave
Rockville Centre, NY 11570
(516) 764-6800
165 N Village Ave
Rockville Centre, NY 11570
(516) 746-6800
New Island Hospital
Balboa, Henry M., DPM
100 Manetto Hill Rd
Plainview, NY 11803
(516) 822-9595
Forest Hills Hospital, New
Island Hospital, Syosset
Barbaro, Thomas, DPM
706 Jericho Tpke
New Hyde Park, NY 11040
(516) 326-7979
Long Island Jewish Medical
Center, North Shore University
Speaks Italian
Barkoff, Matthew W.,
2900 Hempstead Tpke
Levittown, NY 11756
(516) 579-2800
Glen Cove Hospital, New
Island Hospital, North Shore
University Hospital, Plainview
Hospital, Syosset Hospital
Speaks Spanish
Becker, Jack S., DPM
178 E Rockaway Rd
Hewlett, NY 11557
(516) 596-1700
Jack S Becker, MD
3000 Hempstead Tpke
Levittown, NY 11756
(516) 579-1700
Franklin Hospital, Franklin
Hospital , Nassau University
Medical Center, South Nassau
Communities Hosp., South
Nassau Communities Hospital
Bendeth, Marc L., DPM
1226 W Broadway
Hewlett, NY 11557
(516) 374-4444
Berlin, Kim, DPM
830 Atlantic Ave
Baldwin, NY 11510
(516) 623-4580
Long Beach Memorial
Hospital, South Nassau
Communities Hospital
Speaks Spanish
Biller, Bob S., DPM
756 E Park Ave
Long Beach, NY 11561
(516) 432-7470
Bilotti, Mary A., DPM
Long Island Podiatry Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
Long Island Podiatry Grp
375 N Central Ave
Valley Stream, NY 11580
(516) 825-4070
Franklin Hospital , Long Island
Jewish Medical Center
Speaks Spanish
Breitman, Debra, DPM
250 Broadway
Lawrence, NY 11559
(516) 239-4700
Peninsula Hospital Center, St
John's Episcopal Hospital, St
John's Episcopal Hospital -
Far Rockaway
Speaks Spanish
Bubbers, Linda A., DPM
Sunrise Foot Care
4880 Sunrise Highway
Massapequa Park, NY 11762
(516) 795-6255
Syosset Hospital
Speaks Spanish
Buenahora, Joseph A.,
477 Newbridge Rd
East Meadow, NY 11554
(516) 679-1338
Brunswick General Hospital,
Brunswick Hospital Center Inc,
New Island Hospital, Plainview
Hospital, Syosset Hospital,
Wyckoff Heights Medical
Speaks SpanishYiddish
Burzotta, John L., DPM
2419 Jericho Tpke
Garden City Park, NY 11040
(516) 294-9540
Pro Health Care
2800 Marcus Ave
Garden City Park, NY 11042
(516) 622-6040
Long Island Jewish Medical
Center, North Shore University
Speaks Italian
Caimano, Francis X.,
Francis X Caimano
495 S Broadway
Hicksville, NY 11801
(914) 555-1212
350 S Broadway
Hicksville, NY 11801
(516) 938-0100
Syosset Hospital
Speaks Spanish
Caprioli, Russell, DPM
1999 Marcus Ave
New Hyde Park, NY 11042
(516) 555-1212
Long Island Podiatry Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
Franklin Hospital, Franklin
Hospital , Long Beach
Memorial Hospital, Long
Island Jewish Medical Center
Speaks ItalianSpanish
Chernick, Stephen B.,
175 Fulton Ave
Hempstead, NY 11550
(516) 489-2261
Parkway Hospital, St John's
Episcopal Hospital - Far
Speaks SpanishHebrew
Cohen, Robert J., DPM
72 Covert Ave
Garden City, NY 11530
(516) 354-7222
Our Lady of Mercy Medical
Center, Parkway Hospital
Speaks French
Davies, Daniel A., DPM
6 Scranton Ave
Lynbrook, NY 11563
(516) 596-0022
Cabrini Medical Center, Good
Samaritan Hospital, Good
Samaritan Hospital (West Islip)
Speaks Italian
Davies, Gregory F., DPM
Syosset Medical Building
175 Jericho Tpke
Syosset, NY 11791
(516) 496-7676
Glen Cove Hospital, North
Shore University Hospital,
Plainview Hospital, Syosset
Speaks Spanish
DeCicco, John J., DPM
875 Old Country Rd
Plainview, NY 11803
(516) 681-8866
New Island Hospital, Plainview
Hospital, Syosset Hospital
Speaks SpanishGreek,
Modern (1453-)Italian
Dubov, Spencer F., DPM
New Island Hospital
4295 Hempstead Tpke
Bethpage, NY 11714
(631) 858-0011
Mary Immaculate Hospital,
Massapequa General Hospital
Inc., NY Hospital Medical
Center of Queens, Plainview
Feldman, Gary B., DPM
5 Sunrise Plz
Valley Stream, NY 11580
(516) 825-6825
St Joseph's Hospital Division,
Fiorenza, Dominic, DPM
350 S Broadway
Hicksville, NY 11801
(516) 938-0100
Fox, Corey, DPM
Massapequa Podiatry Assoc
4160 Merrick Rd
Massapequa, NY 11758
(516) 541-9000
Brunswick General Hospital,
Brunswick Hospital Center Inc,
New Island Hospital, Plainview
Hospital, Syosset Hospital
Fox, Roberta A., DPM
410 Lakeville Rd
New Hyde Park, NY 11042
(516) 488-5050
Long Island Jewish Medical
Fuchs, David B., DPM
855 Cynthia Dr
East Meadow, NY 11554
(516) 292-2372
New Island Hospital, Syosset
Garofalo, Gail F., DPM
NS Podiatric Med & Surger
410 Lakeville Rd
New Hyde Park, NY 11042
(516) 326-4709
Long Island Jewish Medical
Center, St Catherine of Siena,
St Catherine of Sienna Medical
Center, Winthrop University
Hospital, Winthrop-University
Gasparini, Mark C., DPM
119 New York Ave
Massapequa, NY 11758
(516) 804-9038
Speaks Italian
George, Thomas, DPM
1029 Bellmore Rd
North Bellmore, NY 11710
(516) 679-4636
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Gervasio, Joseph, DPM
1000 Park Blvd
Massapequa Park, NY 11762
(516) 799-0550
156 Post Ave
Westbury, NY 11590
(516) 334-8208
Massapequa General Hospital,
Massapequa General Hospital
Inc., New Island Hospital,
Plainview Hospital, Southside
Goez, Emilio A., DPM
Long Island Foot Care
294 W Merrick Rd
Freeport, NY 11520
(516) 378-8383
Nassau University Medical
Center, Saint Catharines
General Hospital, St Barnabas
Speaks Spanish
Golub, Cary M., DPM
854 E Broadway
Long Beach, NY 11561
(516) 889-2200
Long Beach Medical Center,
South Nassau Communities
Speaks Hebrew
Gottlieb, Robert J., DPM
188 W Main St
Oyster Bay, NY 11771
(516) 922-0502
Glen Cove Hospital, Good
Samaritan Hospital (West Islip)
Speaks Spanish
Greenbaum, Mitchell A.,
111 Mineola Ave
Roslyn Heights, NY 11577
(516) 484-1444
525 Woodbury Rd
Plainview, NY 11803
(516) 433-3353
Glen Cove Hospital, Long
Island Jewish Medical Center,
New Island Hospital, North
Shore University Hospital,
Plainview Hospital, Syosset
Speaks Spanish
Greiff, Lance, DPM
29 Barstow Rd
Great Neck, NY 11021
(516) 829-1028
Brooklyn Hospital Center
(Downtown Campus), New
York Flushing Hospital &
Medical Center, Parkway
Grossman, Myles, DPM
2174 Hewlett Ave
Merrick, NY 11566
(516) 379-2560
156 Post Ave
Westbury, NY 11590
(516) 334-8208
New Island Hospital, Plainview
Speaks SpanishHebrew
Herbert, Scott E., DPM
49 Church St
Freeport, NY 11520
(516) 378-0184
St Catherine of Siena
Hershey, Paul E., DPM
2110 Northern Blvd
Manhasset, NY 11030
(516) 627-5775
Long Island Jewish Medical
Center, Saint Francis Hospital -
Speaks SpanishYiddish
Herzberg, Abraham, DPM
300 Franklin Ave
Valley Stream, NY 11580
(516) 561-1617
833 Northern Blvd
Great Neck, NY 11021
(516) 622-7900
Franklin Hospital, Jamaica
Speaks Yiddish
Hickey, John, DPM
2870 Hempstead Tpke
Levittown, NY 11756
(516) 735-4545
New Island Hospital, Plainview
Hospital, Syosset Hospital
Honore, Lesly S., DPM
Podiatry Services of New
905 Uniondale Ave
Uniondale, NY 11553
(516) 565-5666
981 Rosedale Rd
Valley Stream, NY 11581
(516) 295-6307
Cabrini Medical Center, Mercy
Medical Center,
Winthrop-University Hospital
SpanishFrenchCreoles and
pidgins (Other)
Horl, Lawrence, DPM
61 N Park Ave
Rockville Centre, NY 11570
(516) 766-5550
Forest Hills Hospital,
Hempstead General Hospital
Med Ctr., Mercy Medical
Center, Peninsula Hospital
Center, South Nassau
Communities Hospital, St
John's Episcopal Hospital -
Far Rockaway
Speaks Spanish
Horowitz, Mitchell L.,
2720 Jerusalem Ave
North Bellmore, NY 11710
(516) 679-2720
Irwin, Robert A., DPM
143 Merrick Ave
Merrick, NY 11566
(516) 623-2800
NY Hospital Medical Center of
Queens, New Island Hospital,
New York Hospital Medical
Center of Queens, Syosset
Speaks SpanishItalianGreek,
Modern (1453-)
Jackalone, John A., DPM
Podiatry Offices
4295 Hempstead Tpke
Bethpage, NY 11714
(516) 579-3500
Catholic Medical Center (NY),
Forest Hills Hospital, Long
Beach Memorial Hospital, St
Vincents Medical Center Of
New York
Speaks Spanish
Jarbath, John A., DPM
50 Hempstead Ave
Lynbrook, NY 11563
(516) 599-0302
Forest Hills Hospital, New York
Hospital Medical Center of
Queens, Parkway Hospital,
Peninsula Hospital Center
Speaks FrenchCreoles and
pidgins, French-based
Karpe, David E., DPM
Howard Kessler & Assoc PC
200 N Village Ave
Rockville Centre, NY 11570
(516) 764-0434
Franklin Hospital, Franklin
Hospital , Peninsula Hospital
Center, South Nassau Comm.
Hospital, South Nassau
Communities Hosp.
Speaks Spanish
Kashefsky, Helene P., DPM
2201 Hempstead Tpke
East Meadow, NY 11554
(516) 572-0123
Nassau University Medical
Speaks Spanish
Kasminoff, June G.,
666 Old Bethpage Rd
Old Bethpage, NY 11804
(516) 777-3668
Massapequa General Hospital,
New Island Hospital, Syosset
Kessler, Howard N., DPM
200 N Village Ave
Rockville Centre, NY 11570
(516) 764-0434
Franklin Hospital, Franklin
Hospital , Mercy Medical
Center, Nassau University
Medical Center, South Nassau
Communities Hosp., South
Nassau Communities Hospital
Kisberg, Stephen, DPM
11 Franklin Pl
Woodmere, NY 11598
(516) 295-2121
St John's Episcopal Hospital -
Far Rockaway
Kitton, Stuart E., DPM
41 Woods Dr
Roslyn, NY 11576
(516) 626-3999
MEDICAL CENTER, Mount
Sinai Medical Center,
SVCMC-St Vincents
Manhattan, The Mount Sinai
Hospital of Queens
Speaks Spanish
Klein, Michael S., DPM
East Norwich Podiatry
898 Oyster Bay Rd
East Norwich, NY 11732
(516) 624-2101
Oceanside Podiatry
3105 Lawson Blvd
Oceanside, NY 11572
(516) 766-8500
Glen Cove Hospital, Long
Beach Memorial Hospital,
Syosset Hospital
Klirsfeld, Jeffrey S.,
2870 Hempstead Tpke
Levittown, NY 11756
(516) 731-3300
Massapequa General Hospital,
New Island Hospital, Syosset
Speaks Spanish
Kohn, Arlene F., DPM
Family Footcare
120 Bethpage Rd
Hicksville, NY 11801
(516) 938-6000
Mercy Medical Center, New
Island Hospital, Syosset
Speaks Spanish
Kolberg, John J., DPM
320 Post Ave
Westbury, NY 11590
(516) 338-8802
New Island Hospital
Speaks Spanish
Koslow, Paul M., DPM
Great Neck Podiatry Asso
29 Barstow Rd
Great Neck, NY 11021
(516) 829-1028
Maimonides Medical Center,
New York Hospital Medical
Center of Queens, New York
Methodist Hospital
LaRocca, Albert, DPM
2 Raemar Ct
Bethpage, NY 11714
(516) 935-0111
New Island Hospital
Speaks ItalianGerman
Landau, Laurence D., DPM
86 George St
Roslyn Heights, NY 11577
(516) 731-1900
160 Hicksville Rd
Bethpage, NY 11714
(516) 731-1900
New Island Hospital, Plainview
Landy, Robert J., DPM
120 Bethpage Rd
Hicksville, NY 11801
(516) 827-4500
530 Hicksville Rd
Bethpage, NY 11714
(516) 937-5000
Massapequa General Hospital,
Our Lady of Mercy Medical
Center, Parkway Hospital,
Southside Hospital, Winthrop
University Hospital
Speaks Spanish
Larsen, Joseph A., DPM
National Foot Care
2419 Jericho Tpke
Garden City Park, NY 11040
(516) 294-9540
North Shore University
Levine, Stanley, DPM
4725 Merrick Rd
Massapequa, NY 11758
(516) 799-8545
Brunswick General Hospital,
Brunswick Hospital Center Inc,
Hempstead General Hospital
Med Ctr., Massapequa General
Hospital, New Island Hospital,
Syosset Hospital
Levitsky, David A., DPM
161 Orchard St
Plainview, NY 11803
(516) 822-9666
Board Certified
Male Female
Wheelchair Accessible
Livingston, Douglas W.,
Livingston Foot Care Spec
1685 Newbridge Rd
North Bellmore, NY 11710
(516) 826-0103
Brunswick Hospital Center Inc,
Massapequa General Hospital
Inc., Nassau University Medical
Center, New Island Hospital,
Plainview Hospital, Syosset
Livingston, Leon B., DPM
Livingston Foot Care Spec
1685 Newbridge Rd
North Bellmore, NY 11710
(516) 826-0103
New Island Hospital, Plainview
Hospital, Syosset Hospital
Livingston, Michael D.,
Livingston Foot Care Spec
1685 Newbridge Rd
Bellmore, NY 11710
(516) 826-0103
Brunswick Hospital Center Inc,
Nassau University Medical
Center, New Island Hospital,
Plainview Hospital, Syosset
Lynn, Brian P., DPM
Comprehensive Podiatric
2110 Northern Blvd
Manhasset, NY 11030
(516) 627-5775
Comprehensive Podiatric
935 Northern Blvd
Great Neck, NY 11021
(516) 627-5775
Long Island Jewish Medical
Center, Montefiore Med Ctr
(Henry & Lucy Moses Div)
Speaks Spanish
Mahgerefteh, David, DPM
230 Middle Neck Rd
Great Neck, NY 11021
(516) 829-2560
Parkway Hospital
Speaks Yiddish
Marchese, Nicholas A.,
1000 Park Blvd
Massapequa Park, NY 11762
(516) 799-0550
New Island Hospital, Southside
Masani, Farhan, DPM
530 Old Country Rd
Westbury, NY 11590
(516) 334-7642
Nassau University Medical
Center, Syosset Hospital,
Wyckoff Heights Medical
McElgun, Terence M.,
520 Franklin Ave
Garden City, NY 11530
(516) 746-4732
1135 N Broadway
Massapequa, NY 11758
(516) 756-0091
N. Shore Hosp., Plainview
888 Old Country Rd
Plainview, NY 11803
(516) 796-1313
New Island Hospital, Plainview
Hospital, Syosset Hospital
Speaks SpanishItalian
Mcshane, William J., DPM
Harbor Podiatry PC
131 Main St
East Rockaway, NY 11518
(516) 593-2233
54 Main St
Hempstead, NY 11550
(516) 538-4531
Franklin Hospital, Island
Medical Center (NY)_
Meshnick, Joel A., DPM
2574 Hewlett Ln
Bellmore, NY 11710
(516) 781-5440
Lutheran Medical Center,
Staten Island University
Micallef, Joseph, DPM
101st Avenue Foot Care PC
287 Northern Blvd
Great Neck, NY 11021
(516) 773-4001
Brookdale Hospital Medical
Center, Forest Hills Hospital,
Jamaica Hospital, New York
Hospital Medical Center of
Moazen, Ali, DPM
226 Clinton St
Hempstead, NY 11550
(516) 483-2020
Speaks Persian
Montag, Richard M.,
528 Bellmore Ave
East Meadow, NY 11554
(516) 483-7386
Island Medical Center (NY)_,
Plainview Hospital, Syosset
Speaks Spanish
Nester, Elizabeth M., DPM
3 Walnut Rd
Glen Cove, NY 11542
(516) 674-9661
Nester Podiatry Associate
267 Lincoln Blvd
Long Beach, NY 11561
(516) 889-0969
East Coast Podiatry PLLC
680 Merrick Rd
Baldwin, NY 11510
(516) 889-0969
Glen Cove Hospital, Long
Beach Medical Center
Speaks Spanish
Nester, Matthew J., DPM
Nester Poadiatry Assoc
3227 Long Beach Rd
Oceanside, NY 11572
(516) 431-1600
Nester Podiatry Asso.
3 Walnut Rd
Glen Cove, NY 11542
(516) 674-9661
Long Beach Medical Center,
Long Beach Memorial
Hospital, St John's Episcopal
Hospital, St John's Episcopal
Hospital - Far Rockaway
Speaks Spanish
Nezaria, Yehuda, DPM
7 Franklin Ave
Lynbrook, NY 11563
(516) 887-2820
2053 Bellmore Ave
Bellmore, NY 11710
(516) 887-2820
Franklin Hospital, Franklin
Hospital , Huntington Hospital
Speaks Hebrew
Odinsky, Wayne Z., DPM
2035 Lakeville Rd
New Hyde Park, NY 11040
(718) 343-0600
New York Hospital Medical
Center of Queens, Parkway
Hospital, Rockaway Beach
Hospital (closed)
Pedro, Helder F., DPM
Helder F. Pedro, DPM
1 Willow Pl
Albertson, NY 11507
(516) 621-3721
Long Island Jewish Medical
Center, Lutheran Medical
Peterson, Donald T.,
8029 Jericho Tpke
Woodbury, NY 11797
(516) 496-0900
Plainview Hospital, Syosset
Prince, Steven L., DPM
78 Marina Rd
Island Park, NY 11558
(516) 432-1332
Jamaica Hospital, V A Hospital
- St. Albans
Purvin, Jay M., DPM
467 Merrick Ave
East Meadow, NY 11554
(516) 489-1950
New Island Hospital, Plainview
Richardson, Hugh L., DPM
L.I. Podiatric Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
L.I. Podiatric Grp
375 N Central Ave
Valley Stream, NY 11580
(516) 825-4070
1999 Marcus Ave
New Hyde Park, NY 11042
(516) 555-1212
Franklin Hospital, Franklin
Hospital , Long Island Jewish
Medical Center, Long Island
Jewish, Manhasset (closed)
Speaks Spanish
Bronx Kings Nassau
Result number: 72
Posted by Dr. Z on 8/20/07 at 10:18
Could you e-mail or call me. I would like to know more about his study. What machine, protocol. etc. I think this might be the same study that Lowell Scott Jr did in Vienna a few years ago. It was done with palpation and the ossatron. I believe 2000 pulses single session under MAC. Is this the lecture. I wanted to go the lecture but Josi wanted me to walk her and I promised her I would.
Result number: 73
Posted by Dr. DSW on 8/20/07 at 06:14
So, the bottom line is that Dr. Wishnie, Dr. Z and myself have not had the same experience as Dr. Goldstein when it comes to patients experiencing pain during/after alcohol injections. Dr. Goldstein did experience pain HIMSELF following these injections, but we don't know who injected him!
Dr. Goldstein brings up the point of alcohol injections not being as effective when there is abundant scar tissue, though a true neuroma is a fibrosis of the nerve tissue. However, abundant scar tissue should not be present when prior surgery was not performed. If no surgery was performed, I believe the results with alcohol injections can be excellent with very little discomfort.
Additionally, if time/travel/expense is not an issue, Dr. Lowell Scott Weil Jr. in Chicago is reporting excellent results with ESWT for neuroma pain. I attended a lecture by him yesterday and his double blinded study had impressive results.
Result number: 74
Posted by marie on 6/28/07 at 23:12
Preditor'. I have no problem with these types of stings but has reality television maybe gone to far?
It is the first time in nine "Dateline NBC: To Catch a Predator" stings across the country in the past year and a half that prosecutors did not pursue charges.
Louis Conradt Jr., an assistant prosecutor from neighboring Kauffman County, who allegedly engaged in a sexually explicit online chat with an adult posing as a 13-year-old boy.
Result number: 75
Posted by Hope on 3/30/07 at 09:50
Hi Ralph,
You are not going to believe this, I was awake because of my pain but he phone rang at 1:10 this morning and it was the hospital calling asking if I had a son by the name of Scott and I said yes but I was scared and gave the phone to Scott. They are Jr. and Sr. after there name. On the way home from his girlfriends house a deer ran out in front of him and he hit it. The deer hit the hood and went into the windshield. We have a lot of deers around here. We got to the hospital and we got to see him and Thank GOD!! He was just cut up on his face,arms and hands. He is sore but he is just fine. He was driving his brothers car because his brother can't drive right now because the foot he injuried is his right. He Was
comming home from work last night and his oil light came on so he asked his brother if he could take his car and of coures he said yes. I have not seen the car yet because it was towed to M & S collision where we have had work done before. Scott and I pay for the insurance for the boys because they are both are still in school. Scott is going to a local college and the other one is still in H.S. So, they don't make much money right now becaue school is more important. After we know how much it's going to cost to fix it, we will determine if we are going to make a claim on our insurance. We have a few weeks to get is fixed because our son can't drive for a few week. He does not get his cast off for more xrays until 2 weeks from this monday. Scott feels really bad that, that hapened but I told him what could you do?? He is lucky that all he was cuts and bursies. He said he was going the speed limit which was 30. He said he was doing 25 sometimes because he knew how the deers are. He said that there were 2 of them and he thinks it a mom deer he hit and it was with a baby her. He said the deer slid back off the windshield and hit the ground and it took a few seconds and it got up and ran away. Then he used his phone and called for help. I'm so glad that we got all the kids kids cell phones. With the boys if they go over there minutes they have to pay the overage but we pay for the cell phones because they don't make a lot money. They are really good with there phones. We have nextel service and it works great for us. My mom is on our plan also. Just in case of an emergencey. She hardly ever uses her phone but it has come in handy a few times for her.
When it rain it pours!! This bad luck streak has got to end soon. I can say this, Thank God that everything that has happened, no one has been seriously hurt!! I guess I have that to be thankful for but, don't you think I have has enough bad luck and it's time for things to change for me?? I keep waiting for this to happen or even just some answer to my question from WC would be nice. I think I have waited long enough don't you? I really need a break from all of this right now. I did fall asleep for a couple hours last night until the phone rang and I have been up every since because my pain would not let me sleep and it is alittle higher today because I think it was from having to be at the hospital last night. I'm really swollen.
I'm going to try and call that doctor again when I get back from my doctor appointment (GP). It's at 11:00. I know he is not going to be happy.
I remember you saying that you had thought you had RSD also because of all the buring pain that you had but you doctor told you no that you did not have it. I was a bit suprised because it did sound like it to me, that you have all the classic signs of RSD/CRPS. The only thing was my buing pain never goes away it calms down a bit. Then when it flars up you know it. I cried most of the day yesterday because I hurt so bad. I don't think that I have anymore tears left to cry today. Scott is calling the attorney to see if I can get in soon to see my PM if the pain keeps up like this. Everything has to be approved with WC. I have an appointment to see him 2 weeks from yesterday. I'm trying to hang in there. I never call unless I absolutely have too.
You described the pain I feel right on the money. There is no other way of saying how bad I hurt other than it feels like someone is sticking a hot branding iron on my ankle/leg, but what you said fits it the best. I know you know how I feel because you have felt it.
To be honest with you I do want to go back to rehab. but I'm scared because it has been so long and my leg and ankle are so stiff. My calf muscle is so small. There is just nothing there anymore. I do still get muscle spasams there, but it also it so week. I'm afraid to walk except for very few steps because I will fall because my ankle does not bend like it should. The most thing I'm afraid if causing more pain. I don't think I could handle that at all. I do think you are so right when they pulled me out of PT and took my CPM unit. That they messed up big time. I have read a couple things about how important PT is to person with RSD. That is one thing that my attorney is working on right now. He wants me back in PT.
I have got to go for now and I will let you know how my GP appointment went. I'm glad you got all of you water in. You have to make sure you get it all in again today.
Chat later
Take Care
Result number: 76
Posted by Dr. Ed on 3/15/07 at 12:06
JRA usually is bilateral although, a unilateral presentation early in the disease process may occur.
Result number: 77
Posted by Dr. David on 3/15/07 at 02:20
Wouldn't you agree JRA would be a bilateral complaint Dr. Ed? Considering the area of involvement you mention is right-sided I would be seeing big black stripes on a white horse. RA is sytemic Kelly, meaning it is almost exclusively bilateral (affects joints on both sides of the body).
Result number: 78
Posted by jim on 3/07/07 at 18:47
I cannot reveal my source or it my get deleted if Dorthy complains.
Sept. 4, 2006 issue - In the early morning of Oct. 1, 2003, Secretary of State Colin Powell received an urgent phone call from his No. 2 at the State Department. Richard Armitage was clearly agitated. As recounted in a new book, "Hubris" Armitage had been at home reading the newspaper and had come across a column by journalist Robert Novak. Months earlier, Novak had caused a huge stir when he revealed that Valerie Plame, wife of Iraq-war critic Joseph Wilson, was a CIA officer. Ever since, Washington had been trying to find out who leaked the information to Novak. The columnist himself had kept quiet. But now, in a second column, Novak provided a tantalizing clue: his primary source, he wrote, was a "senior administration official" who was "not a partisan gunslinger." Armitage was shaken. After reading the column, he knew immediately who the leaker was. On the phone with Powell that morning, Armitage was "in deep distress," says a source directly familiar with the conversation who asked not to be identified because of legal sensitivities. "I'm sure he's talking about me."
Armitage's admission led to a flurry of anxious phone calls and meetings that day at the State Department. (Days earlier, the Justice Department had launched a criminal investigation into the Plame leak after the CIA informed officials there that she was an undercover officer.) Within hours, William Howard Taft IV, the State Department's legal adviser, notified a senior Justice official that Armitage had information relevant to the case. The next day, a team of FBI agents and Justice prosecutors investigating the leak questioned the deputy secretary. Armitage acknowledged that he had passed along to Novak information contained in a classified State Department memo: that Wilson's wife worked on weapons-of-mass-destruction issues at the CIA. (The memo made no reference to her undercover status.) Armitage had met with Novak in his State Department office on July 8, 2003—just days before Novak published his first piece identifying Plame. Powell, Armitage and Taft, the only three officials at the State Department who knew the story, never breathed a word of it publicly and Armitage's role remained secret.
Armitage, a well-known gossip who loves to dish and receive juicy tidbits about Washington characters, apparently hadn't thought through the possible implications of telling Novak about Plame's identity. "I'm afraid I may be the guy that caused this whole thing," he later told Carl Ford Jr., State's intelligence chief. Ford says Armitage admitted to him that he had "slipped up" and told Novak more than he should have. "He was basically beside himself that he was the guy that f---ed up. My sense from Rich is that it was just chitchat," Ford recalls in "Hubris," to be published next week by Crown and co-written by the author of this article and David Corn, Washington editor of The Nation magazine.
Result number: 79
Posted by larrym on 2/25/07 at 10:00
Not saying it is or int but he will win tonight anyway due to political sway that got Michael Moore's fictional movie a documentary award
Result number: 80
Posted by dr g. on 2/13/07 at 17:34
Do a combination of hot and cold therapy 1-2 min cycles (hot-cold-hot cold etc) for 15 min. Do passive range of motion exercises (non wt. bearing). Partial wt bear with the crutches. You can increase your ibuprofen to 800 mg every 8 hrs if pain warrants it. The more you take the more chances of side effects. Use a good topical antiinflammatory ( I 'm partial to biofreeze and absorbine jr. arthritis).
good luck
Result number: 81
Posted by marie on 2/09/07 at 18:12
Oh yeah her job........
The RNC, GOP if you will, has wasted 2 weeks playing politics and lying about nancy Pelosi who Bush has now given his full support. I can understand why Republicans may not respect or believe George W. Bush because little he has said in the past has been truthful either but this rukis has hurt their party perhaps beyond repair. You see the American people are sick of lies, deceipt, corruption and most of all they are sick of this CRAP!
Lets see what Pelosi was doing..........
Pelosi Names Members for House Committee on Standards of Official Conduct
Washington, D.C. – Speaker Nancy Pelosi announced today the Members of the House Committee on Standards of Official Conduct. With their commitment to the highest ethical standard, this group of Members will serve with integrity, building on our bipartisan efforts to restore accountability, honesty, and openness to the House of Representatives. Pelosi said.
From a commitment on tackling global warming, the Iraq War and National Security Nancy has been a busy lady doing the job the American people elected her to do.
Republicans had nothing to share after the first 100 hours so they played their distraction card once again. The GOP counts on it's followers to fall for this stunt over and over again. Using the Washington Post, who pitched the Iraq War to the American people via reporters like Judith Miller (gag) and is owned by the MOONIES they sprang into action thinking no one would find them out. But the GOP was outed once again. Most of the Republicans have figured this game out and jumped ship.......now declaring themselves as independents. My advice for the GOP is stop playing this game you basically suck at and serve the American people that elected you. Your independents are anxiously awaiting the return of the REAL Republican Party.
What went on this week.......I didn't find much at the RNC just a bunch of blathering Dem hate talk.
(202) 225-3130
First Vote of The Week… Last Vote Predicted…
Monday 6:30 p.m. Friday p.m.
Legislative Program - 51600 (PIPE) Floor Information - 57400 (PIPE) Whip Information - 63210
The House will meet at 12:30 p.m. for morning hour and at 2:00 p.m. for legislative business.
Votes will be postponed until 6:30 p.m.
Suspensions (9 bills):
1) H.Res. 134 - Recognizing and honoring the employees of the Department of Homeland
Security for their efforts and contributions to protect and secure the Nation (Reps. Carney,
Bilirakis – Homeland Security)
2) H.R. 437 - To designate the facility of the United States Postal Service located at 500 West
Eisenhower Street in Rio Grande City, Texas, as the "Lino Perez, Jr. Post Office" (Rep. Cuellar –
Oversight and Government Reform)
3) H.R. 414 - To designate the facility of the United States Postal Service located at 60 Calle
McKinley, West in Mayaguez, Puerto Rico, as the "Miguel Angel Garcia Mendez Post Office
Building" (Rep. Fortuño – Oversight and Government Reform)
4) H.R. 34 - To establish a pilot program in certain United States district courts to encourage
enhancement of expertise in patent cases among district judges (Reps. Issa, Schiff – Judiciary)
5) H.Con.Res. 44 - Honoring and praising the National Association for the Advancement of
Colored People on the occasion of its 98th anniversary (Rep. Al Green – Judiciary)
6) H.Res. 122 - Recognizing the significance of the 65th anniversary of the signing of Executive
Order 9066 by President Franklin D. Roosevelt and supporting the goals of the Japanese
American, German American, and Italian American communities in recognizing a National Day
of Remembrance to increase public awareness of the events surrounding the restriction,
exclusion, and internment of individuals and families during World War II (Rep. Honda –
7) H.Res. 109 - Recognizing the historical significance of the Pinedale Assembly Center, the
reporting site for 4,823 Japanese Americans who were unjustly interned during World War II
(Rep. Costa – Judiciary)
8) H.R. 342 - To designate the United States courthouse located at 555 Independence Street,
Cape Girardeau, Missouri, as the "Rush Hudson Limbaugh, Sr., United States Courthouse" (Rep.
Emerson – Transportation and Infrastructure)
9) H.R. 798 - To direct the Administrator of General Services to install a photovoltaic system for
the headquarters building of the Department of Energy (Rep. Oberstar - Transportation and
On Tuesday, the House will meet at 9:00 a.m. for Morning Hour and at 10:00 a.m. for legislative
business. On Wednesday and Thursday, the House will meet at 10:00 a.m. for legislative business.
On Friday, the House will meet at 9:00 a.m.
H.R. 976 – Small Business Tax Relief (Reps. Rangel, McCrery - Ways and Means)
Iraq War Resolution (Subject to a Rule)
I wonder what the GOP will be doing next week.....apologising to Nancy Pelosi? I doubt it. That would take courage and if they would be in Iraq along side our troops.
Result number: 82
Posted by larrym on 1/31/07 at 11:48
Biden should pray to God that he is a Dem because the MSM will let this slip away. If he was conservative Jesse and Al would be on a bus right now demanding he resign or get impeached.
I found a memo from Biden that supports the article above
From: Honorable Senator Joesph Biden Jr.
To: Honorable President Jimmy Carter cc: Robert Byrd
RE: Meeting at Carters farm
Hey fellas, just wanted to know if we are still on for Friday night? Byrd you still going to invite a few of those coloreds and trick them to come to the farm? Let me know cause I got a few of them Jews I'm gonna bring along so Jimmy can put a good scare into them. A good time should be had by all so dont forget the sheets and the kerosene
Result number: 83
Posted by Dr. Ed on 1/27/07 at 20:59
That site is a good find -- lots of good articles and links. This link that discusses Carter's Saudi financiers is a good one: http://nrd.nationalreview.com/article/?q=NmVlNzc4OWI5YTc4MDY1MzhiMDM2OWRhNjgzYzk0ZTk=JRA
Result number: 84
Posted by Dr. Ed on 1/17/07 at 12:56
The US does not have 750,000 troops available and probably not even 500,000. The US Army has fewer men than the Pakistani Army. Bush Sr. entered the Middle East with the Reagan military. Bush Jr. entered the conflict with the Clinton military. I was astounded when Bush Jr. did not seek to expand the military after elected, seemingly feeling that he could apply advanced technology to a very small fighting force to ensure success.
Result number: 85
Posted by Dr Ed on 12/27/06 at 15:44
Right Marie. Here is what Martin Luther King had to say about your perspective:
(It is not a link so I hope you are happy...)
- Dr. Martin Luther King Jr.
". . . You declare, my friend, that you do not hate the Jews, you are merely 'anti-Zionist.' And I say, let the truth ring forth from the high mountain tops, let it echo through the valleys of God's green earth: When people criticize Zionism, they mean Jews--this is God's own truth.
"Antisemitism, the hatred of the Jewish people, has been and remains a blot on the soul of mankind. In this we are in full agreement. So know also this: anti-Zionist is inherently antisemitic, and ever will be so.
"Why is this? You know that Zionism is nothing less than the dream and ideal of the Jewish people returning to live in their own land. The Jewish people, the Scriptures tell us, once enjoyed a flourishing Commonwealth in the Holy Land. From this they were expelled by the Roman tyrant, the same Romans who cruelly murdered Our Lord. Driven from their homeland, their nation in ashes, forced to wander the globe, the Jewish people time and again suffered the lash of whichever tyrant happened to rule over them.
"The Negro people, my friend, know what it is to suffer the torment of tyranny under rulers not of our choosing. Our brothers in Africa have begged, pleaded, requested--DEMANDED the recognition and realization of our inborn right to live in peace under our own sovereignty in our own country.
"How easy it should be, for anyone who holds dear this inalienable right of all mankind, to understand and support the right of the Jewish People to live in their ancient Land of Israel. All men of good will exult in the fulfilment of God's promise, that his People should return in joy to rebuild their plundered land.
This is Zionism, nothing more, nothing less.
"And what is anti-Zionist? It is the denial to the Jewish people of a fundamental right that we justly claim for the people of Africa and freely accord all other nations of the Globe. It is discrimination against Jews, my friend, because they are Jews. In short, it is antisemitism.
"The antisemite rejoices at any opportunity to vent his malice. The times have made it unpopular, in the West, to proclaim openly a hatred of the Jews. This being the case, the antisemite must constantly seek new forms and forums for his poison. How he must revel in the new masquerade! He does not hate the Jews, he is just 'anti-Zionist'!
"My friend, I do not accuse you of deliberate antisemitism. I know you feel, as I do, a deep love of truth and justice and a revulsion for racism, prejudice, and discrimination. But I know you have been misled--as others have been--into thinking you can be 'anti-Zionist' and yet remain true to these heartfelt principles that you and I share.
Let my words echo in the depths of your soul: When people criticize Zionism, they mean Jews--make no mistake about it."
From M.L. King Jr., "Letter to an Anti-Zionist Friend," Saturday Review_XLVII (Aug. 1967), p. 76.
Reprinted in M.L. King Jr., "This I Believe: Selections from the Writings of Dr. Martin Luther King Jr."
Okay, Marie, lets go over how you feel my position on Iran means that I am not placing the interest of the US first. You still have failed to answer most of the counterpoints to your original post. WHY?
My children are 7,7 and 10 years old. You know that. Why do you insist on bringing them into the discussion over a potential US attack on Iran?
You don't even understand where I stand on Iran and what I think our strategy should be. First of all, the radical regime in Iran would not be there if not for Carter's blunder in opposing the Shah. Second, I have always felt that the US should covertly support the various movements within Iran: the Azeris, the pro-Democracy students, the Arabs in South Iran and the Kurds in the north in order to help bring down the oppressive radical regime of the Mullahs. The military option is prominent now due to a failure of prior administrations covert efforts. We are not talking about and Iraq style invasion nor total war but a strike on the nuclear capabilities of Iran.
Result number: 86
Posted by Dr Ed on 12/27/06 at 14:51
You have made some good points. There were two distinct objectives of the Bush administration in the Iraq War. The first objective was achieved, getting rid of the brutal regime of Saddam Hussein. The second objective was nation building, to achieve a democracy in Iraq. That objective was not well planned as I see it.
I have to again, resort to the historical perspective. Iraq was a new nation carved out by the allied powers after defeat of the Ottoman Empire after WW1. In fact, much of the map of the region was the result of that war. Certainly, there was a historic Babylon but after thousands of years, we had regions with diverse ethnic interests. Iraq included Shiites, Sunnis, Kurds and Chaldeans. Iraq was a nation, much like Yugoslavia, which was kept in one piece by a heavy handed leadership. Once such leadership was removed, like Yugoslavia, the various factions had a difficult road to autonomy or unity. Certainly, Northern Iraq, with its Kurdish majority has undergone a very favorable transformation, ie., the "other" Iraq: http://www.theotheriraq.com/ That had a chance to occur, in large part because the Turks, who opposed an independent Kurdistan were warned to stay out of the way. The Turks refused to join the Coalition of the Willing and, at the last moment, refused to allow US troops a base of operation at the Turkish-Iraq border such that the invasion had to proceed from the south only.
The southern portion of Iraq encountered a very different situation. The US had insufficient manpower and, as a consequence military materiel continued and continues to flow across the Syrian-Iraq and Iran-Iraq borders. The US continued to fail to deal with the support of insurgencies from Syria and Iran despite Bush's rhetoric about the Axis of Evil and how he was going to go after the nations that harbored and supported terrorists after 9-11. The situation has been exaccerbated by such failures in strategies so the solution now is certainly more difficult than it would have been 2 to 3 years ago. Staying the current course is a type of defeatism. Bringing in Baker to appease the Syrians is a worse form of defeatism yet. Perhaps a wiser option would be to attempt to form two autonomous regions, Sunni and Shiite while focusing on the instigators of the conflict, Syria and Iran. The bottom line is that we will have to face Syria and Iran at some point in the near future irrespective of our decision now. The question is whether we can face those two nations from a position of strength.
Bush Jr. inherited the Clinton military while Bush Sr. inherited the Reagan military. There is a big difference. It was my expectation that Bush Jr., especially after 9-11, realizing the geoploitical challenges to the US would substantially restore the size of the US military. Bush committed the US military to the Iraq conflict, the War on Terror, potential conflicts with Iran and North Korea without what seems like adequate consideration as to how the US military could effectively handle multiple conflicts in its current size. Bush did enter office during a recession and had to maintain a budget deficit in order to continue social programs. Further expansion or restoration of the military would have expanded the deficit in a manner that may have been difficult under the economic circumstances at the time. Nevertheless, there have been enough good economic years and it was incumbent upon Bush as leader to effectively communicate the requirements of a wartime footing to the public and Congress.
Result number: 87
Posted by larrym on 12/13/06 at 14:10
Officers say U.S. soldiers 'abused' by al Qaeda inmates
In this photo, reviewed by a U.S. Dept of Defense official, one detainee leads a group as they bow during Islamic prayer, at Camp Delta detention center, Guantanamo Bay U.S. Naval Base in Cuba on Dec. 4. (AP Photo/Brennan Llinsley)
Al Qaeda might be on the run in Afghanistan, but Osama bin Laden's agents are in the driver's seat at the U.S. military prison in Guantanamo Bay, Cuba.
Officers tell of daily attacks by al Qaeda inmates against U.S. military personnel, who are ordered not to respond. The officers have also been ordered to fulfill the religious, cultural and even entertainment needs of the inmates, including providing Arabic translations of Harry Potter.
"I have never once since I've been down here ever heard of a detainee being abused, but I've seen the soldiers and sailors get abused," Staff Sgt. Thomas Garcia said. "[Detainees] throw some of the most unmentionable cocktails. They urinate on [the guards]. They spit. They call them names."
On Dec. 7, the U.S. military transferred the first group of al Qaeda detainees to a new $37 million 178-cell maximum-security prison designed to prevent attacks on guards. The facility has been reserved for prisoners deemed by the military to be the least compliant.
"As a commander, I don't like my folks being in danger every day," U.S. Navy Cmdr. Kris Winter said.
Guards have been routinely pelted with feces by inmates and face physical attacks from al Qaeda detainees. In May, al Qaeda detainees organized an ambush to stop a search of cells for contraband medication following two suicide attempts. Prison authorities have responded by providing inmates with a huge Arabic library, a modern hospital, sporting facilities and satellite television. Officials said Harry Potter in Arabic was one of the most popular books in Camp Delta.
Sgt. Garcia of the Maryland Army National Guard's 2nd Battalion, 110th Field Artillery, said guards maintain a professional attitude in the face of provocations by al Qaeda inmates. He said the al Qaeda operatives then send messages that they were being tortured. The Pentagon has been allowing guards at Guantanamo to discuss their work in an effort to combat the image of Camp Delta, which has been visited by 1,000 journalists. Officials said independent investigations have not confirmed allegations of misconduct and often Guantanamo has been confused with Camp X-Ray, which was open for four months in 2002.
"There's always the misconception that we're somehow beating these detainees and doing heinous things to them, and that is simply not the case," said Navy Rear Adm. Harry Harris Jr., commander of JTF-GTMO.
Much of the allegations about Guantanamo have been spread by human rights activists. Aryeh Neier, president of the New York-based Open Society Institute and former executive director of Human Rights Watch, termed Guantanamo "one of America's worst violations."
A U.S. sailor and block guard, who could not be identified for security reasons, said prison staff members are ordered to fill a range of dietary requests that seek to adapt to the religion and culture of the inmates.
"If a guy's salad isn't right, I'll make a phone call to try and get him the correct salad," said the 28-year-old guard, who is also a member of a task force.
The block guard recalled being attacked by a "cocktail" of feces, semen, blood and urine thrown by an inmate. He said guards are ordered to walk away.
"It's humiliating," the guard said. "A guy throws feces on you, and you've got to turn right back around and walk down a block that might have 40 people on it. They're making their little comments, and you go home and you change and you come back to work. Take a shower. Go to medical, get your screening."
Officials said al Qaeda inmates have attacked American guards on a daily basis. During the 12-month period that ended in August 2006, authorities reported 3,232 incidents of detainee misconduct. They included 432 assaults with bodily fluids, 227 physical assaults and 99 efforts to incite a disturbance or riot.
"This is serious stuff," Adm. Harris said. "And yet the guard force and the intelligence people maintain a remarkable degree of restraint and equilibrium. The young Americans that work here are doing a spectacular job in a dangerous place."
Officials said most guards are not allowed to handle Korans or other religious and cultural items for the inmates. The Korans, prayer beads and Islamic rugs are stored in a 300-foot long building similar to a small aircraft hangar.
Al Qaeda inmates have been taught to lie about Camp Delta and claim torture. Officials cited a terrorist training manual known as the Manchester Document and seized by British authorities in 2000. The manual directs al Qaeda operatives to make false claims of torture and mistreatment. More than 340 people have been released from Camp Delta.
"They're out there walking around spewing forth all manner of lies and evil things and distortions, but the fact is that they're released," Adm. Harris said.
Result number: 88
Posted by Dr. Ed on 12/06/06 at 18:14
Was the solution to Iraq ever really that complicated? The Bush/Rumsfeld plan to invade Iraq with what many would consider to be a historically small invasion force was successful only as far as the capture of Baghdad and Saddam. Use of the military for "police" actions or to supress insurrections or for "pacification" has always been fraught with more difficulties. Look at the number of men the Soviet Union poured into Afghanistan unsuccessfully.
Bush Sr. inherited the Reagan military.
Bush Jr. inherited the Clinton military and to my suprise, did not increase the size of our military relative to the stated goals of the Bush Administration. Our military is spread relatively thin relative to the strategy of deterring North Korea, pacifiying Iraq,and deterring Iran, not to mention any other areas of hostility that may arise.
The bottom line is there are far to few US troops in Iraq to do the job and the US has not taken a strong enough stand against the spoilers of pacification, ie. Syria and Iran.
It may be late in the game to try to compensate for what was not done but if our boys are not to have died in vain, we will need to significantly increase troop levels in Iraq including use of troops to help close the Syrian and Iranian borders with Iraq as well as up the ante for Syria and Iran in terms of being ready to take military action against them in response to their interference in Iraq. Many are concerned about enlarging the war but, lets face it, many of the insurgent groups already shooting at our men are little more than proxies for Iran and Syria.
Result number: 89
Posted by momB on 11/18/06 at 10:49
Is it possible to do both feet. I'm prepared to be my daughters full time nurse, tutor, whatever! She is emotionally a wreck after the last 8 months and giving up everything she enjoys. As a jr in HS she can't miss a day, let alone be out for 2 surgeries. Thoughts?
Result number: 90
Posted by momB on 11/18/06 at 08:19
My 16 yr old has been diagnosed with TTS after 8 long painful months and 6 different orthopedic docs, including sports med specialists, ankle spec, etc. PF was the first diag, several other guesses followed, months of PT, ionophoresis, hydrotherapy, painful injections. Nothing worked. Her condition was sudden onset, she never had tingling/numbness, her pain is sharp and nearly constant, both feet, worse in right. She pronates, has worn custom inserts for a few years. A Varsity athlete, it came on in the OFF season. So it was atypical I guess. But NO ONE took it seriously, most said PF after 10 min and offered a new treatment regime. Guts told us to pursue further! She has suffered a great hit to her quality of life and at such a young age. Cannot run, stay on her feet for too long...Finally found an Ortho team to help. They did not recommend the conduction/pressure tests. They are unreliable in TTS and painful.I would have to go out of town for it too. Did have MRIs, tons of xrays (both weight bearing and not), etc. Nothing showed.
Finally I am waiting to hear her surgery date, last resort. We desperately want to do both feet together. It's her Jr year, she has many events, tests, etc. She is interested in Military academy, HAS to do some running. I can manage a wheelchair, school has elevator.
Any experience out there?
Result number: 91
Posted by marie on 11/06/06 at 15:53
Not that polls are necessarily the total predicter but here is the final run down. All are still very close. Please add any polls you find. I don't have a dog in the Senate fight so I'm living vicarously through other states. I'm sticking with my original prediction. The House will go Democratic and Dems will pick up 4 seats in the Senate. Although 6 would be very ok!
Democrat Jim Webb has surged ahead of Republican George Allen in the last poll of the campaign, conducted for News-7 by SurveyUSA.
The survey shows Webb with 52% of the likely voters, with 44% going to Allen.
In Tennessee, Republican Mayor Bob Corker now leads Democratic Congressman Harold Ford 51% to 47%
In the Senate race, Independent Senator Joseph Lieberman leads Democrat Ned Lamont 48% to 40% (see crosstabs). Early this month, Lieberman led 50% to 40%.
The most recent survey, conducted by Reuters/Zogby, shows Mr. DeWine trailing Mr. Brown, 49 percent to 42 percent. Mr. DeWine's seat has been targeted by Democrats as one of the six they hope to pick up Tuesday in order to gain control of the Senate.
The latest Rasmussen Reports election survey shows incumbent Jim Talent (R) "leading" challenger Claire McCaskill (D) by a single point, 49% to 48%
NBC 10's Bill Rappleye reported that the last time Chafee led in a public poll was June. But in the survey of the Senate race conducted last week, he was one point up on Democratic challenger Sheldon Whitehouse -- 46 percent to 45 percent. Nine percent said they were undecided.
Now, our final Montana poll shows Tester leading by just two points--50% to 48%
according to the final The Morning Call/Muhlenberg College poll before Tuesday's election.
Democrat Bob Casey Jr. holds an eight point lead over Republican Santorum, the statewide survey showed.
In the latest Rasmussen Reports election poll of New Jersey's Likely Voters, appointed Democratic Senator Menendez is now leading Republican Tom Kean, Jr. 48% to 43%
Result number: 92
Posted by Carla on 11/02/06 at 22:15
Have you tried J. Rubio shoes(www.jrubio.us)? They have a spring in heel which is awesome and they helped me tremendously. I've worn their sandals almost 10 years now, got my first pairs in Europe and been hooked ever since!
Good luck - I hope you find some shoes that work for you and don't cost a ton!
Result number: 93
Posted by Carla on 10/26/06 at 11:58
I just posted about some shoes that sound like they might be just what you're looking for. J. Rubio - they're awesome and not too flexible but they have a spring in the heel that absorbs impact. I'm hooked! Good luck.
You can see them at: www.jrubio.us
Result number: 94
Posted by Carla on 10/26/06 at 11:56
Hi, I've been reading the posts and thought I'd share. I found a comfort brand that has a springy heel from Spain. It's J. Rubio and they're awesome...I guess they've been in Europe for years but weren't here. Anyhow, I now own 6 pairs...they only make clogs & sandals but wish they would make athletic shoes too! They really help my heel spurs and my knees as well. :)
Check them out at: www.jrubio.us
Result number: 95
Posted by Dr. Z on 10/08/06 at 20:53
GloboTec, Jr.
I use the globotec Jr. orthosis in children with excessive pronation. I can't be sure if this is what your son needs due not watching him walk but this is a pretty good pre-fab orthosis for excessive pronation for children. I will still have a podiatrist watch him walk to determine exactly what the deformity is and if ANY orthosis will work
Result number: 96
Posted by marie on 10/06/06 at 21:35
Get off your Republiperv soap box! Gotcha politics will be the ruin of your party. Gotcha politics is the very reason the 109th and Bush are noting but lame ducks. Republicans are in power in ALL 3 sections of our government would fail our nation as they have. They cannot get anything done. Their to busy playing GOTCHA politics. The Republican party has many outstanding members but this week we've seen that some of the people Democrats have been complaining about for years are anything but outstanding. It's time to clean house. It's time Republicans take responsibility for their decisions and their behavior. Join us. Many Republicans are beginning to stand up......not to be a Republican or a Democrat but Americans. We are all in this together. My U.S. Senator told us "It's not about Red or Blue it's about Red, White and Blue." That's why I back him!
* Republican Congressman Mark Foley abruptly resigned from Congress after "sexually explicit" emails surfaced showing him flirting with a 16-year old boy.
* Republican executive Randall Casseday of the conservative Washington Times newspaper was arrested for soliciting sex from a 13-year old girl on the internet.
* Republican chairman of the Oregon Christian Coalition Lou Beres confessed to molesting a 13-year old girl.
* Republican County Constable Larry Dale Floyd was arrested on suspicion of soliciting sex with an 8-year old girl. Floyd has repeatedly won elections for Denton County, Texas, constable.
* Republican judge Mark Pazuhanich pleaded no contest to fondling a 10-year old girl and was sentenced to 10 years probation.
* Republican Party leader Bobby Stumbo was arrested for having sex with a 5-year old boy.
* Republican petition drive manager Tom Randall pleaded guilty to molesting two girls under the age of 14, one of them the daughter of an associate in the petition business.
* Republican County Chairman Armando Tebano was arrested for sexually molesting a 14-year-old girl.
* Republican teacher and former city councilman John Collins pleaded guilty to sexually molesting 13 and 14 year old girls.
* Republican campaign worker Mark Seidensticker is a convicted child molester.
* Republican Mayor Philip Giordano is serving a 37-year sentence in federal prison for sexually abusing 8- and 10-year old girls.
* Republican Mayor Tom Adams was arrested for distributing child pornography over the internet.
* Republican Mayor John Gosek was arrested on charges of soliciting sex from two 15-year old girls.
* Republican County Commissioner David Swartz pleaded guilty to molesting two girls under the age of 11 and was sentenced to 8 years in prison.
* Republican legislator Edison Misla Aldarondo was sentenced to 10 years in prison for raping his daughter between the ages of 9 and 17.
* Republican Committeeman John R. Curtain was charged with molesting a teenage boy and unlawful sexual contact with a minor.
* Republican anti-abortion activist Howard Scott Heldreth is a convicted child rapist in Florida.
* Republican zoning supervisor, Boy Scout leader and Lutheran church president Dennis L. Rader pleaded guilty to performing a sexual act on an 11-year old girl he murdered.
* Republican anti-abortion activist Nicholas Morency pleaded guilty to possessing child pornography on his computer and offering a bounty to anybody who murders an abortion doctor.
* Republican campaign consultant Tom Shortridge was sentenced to three years probation for taking nude photographs of a 15-year old girl.
* Republican racist pedophile and United States Senator Strom Thurmond had sex with a 15-year old black girl which produced a child.
* Republican pastor Mike Hintz, whom George W. Bush commended during the 2004 presidential campaign, surrendered to police after admitting to a sexual affair with a female juvenile.
* Republican legislator Peter Dibble pleaded no contest to having an inappropriate relationship with a 13-year-old girl.
* Republican advertising consultant Carey Lee Cramer was sentenced to six years in prison for molesting two 8-year old girls, one of whom appeared in an anti-Gore television commercial.
* Republican activist Lawrence E. King, Jr. organized child sex parties at the White House during the 1980s.
* Republican lobbyist Craig J. Spence organized child sex parties at the White House during the 1980s.
* Republican Congressman Donald "Buz" Lukens was found guilty of having sex with a female minor and sentenced to one month in jail.
* Republican fundraiser Richard A. Delgaudio was found guilty of child porn charges and paying two teenage girls to pose for sexual photos.
* Republican activist Mark A. Grethen convicted on six counts of sex crimes involving children.
* Republican campaign chairman Randal David Ankeney pleaded guilty to attempted sexual assault on a child and was arrested again five years later on the same charge.
* Republican Congressman Dan Crane had sex with a female minor working as a congressional page.
* Republican activist and Christian Coalition leader Beverly Russell admitted to an incestuous relationship with his step daughter.
* Republican Judge Ronald C. Kline was placed under house arrest for child molestation and possession of child pornography.
* Republican congressman and anti-gay activist Robert Bauman was charged with having sex with a 16-year-old boy he picked up at a gay bar.
* Republican Committee Chairman Jeffrey Patti was arrested for distributing a video clip of a 5-year-old girl being raped.
* Republican activist Marty Glickman (a.k.a. "Republican Marty"), was taken into custody by Florida police on four counts of unlawful sexual activity with an underage girl and one count of delivering the drug LSD.
* Republican legislative aide Howard L. Brooks was charged with molesting a 12-year old boy and possession of child pornography.
* Republican Senate candidate John Hathaway was accused of having sex with his 12-year old baby sitter and withdrew his candidacy after the allegations were reported in the media.
* Republican preacher Stephen White, who demanded a return to traditional values, was sentenced to jail after offering $20 to a 14-year-old boy for permission to perform oral sex on him.
* Republican talk show host Jon Matthews pleaded guilty to exposing his genitals to an 11 year old girl.
* Republican anti-gay activist Earl "Butch" Kimmerling was sentenced to 40 years in prison for molesting an 8-year old girl after he attempted to stop a gay couple from adopting her.
* Republican Party leader Paul Ingram pleaded guilty to six counts of raping his daughters and served 14 years in federal prison.
* Republican election board official Kevin Coan was sentenced to two years probation for soliciting sex over the internet from a 14-year old girl.
* Republican politician Andrew Buhr was charged with two counts of first degree sodomy with a 13-year old boy.
* Republican legislator Keith Westmoreland was arrested on seven felony counts of lewd and lascivious exhibition to girls under the age of 16 (i.e. exposing himself to children).
* Republican anti-abortion activist John Allen Burt was found guilty of molesting a 15-year old girl.
* Republican County Councilman Keola Childs pleaded guilty to molesting a male child.
* Republican activist John Butler was charged with criminal sexual assault on a teenage girl.
* Republican candidate Richard Gardner admitted to molesting his two daughters.
* Republican Councilman and former Marine Jack W. Gardner was convicted of molesting a 13-year old girl.
* Republican County Commissioner Merrill Robert Barter pleaded guilty to unlawful sexual contact and assault on a teenage boy.
* Republican City Councilman Fred C. Smeltzer, Jr. pleaded no contest to raping a 15 year-old girl and served 6-months in prison.
* Republican activist Parker J. Bena pleaded guilty to possession of child pornography on his home computer and was sentenced to 30 months in federal prison and fined $18,000.
* Republican parole board officer and former Colorado state representative, Larry Jack Schwarz, was fired after child pornography was found in his possession.
* Republican strategist and Citadel Military College graduate Robin Vanderwall was convicted in Virginia on five counts of soliciting sex from boys and girls over the internet.
* Republican city councilman Mark Harris, who is described as a "good military man" and "church goer," was convicted of repeatedly having sex with an 11-year-old girl and sentenced to 12 years in prison.
* Republican businessman Jon Grunseth withdrew his candidacy for Minnesota governor after allegations surfaced that he went swimming in the nude with four underage girls, including his daughter.
* Republican campaign worker, police officer and self-proclaimed reverend Steve Aiken was convicted of having sex with two underage girls.
* Republican director of the "Young Republican Federation" Nicholas Elizondo molested his 6-year old daughter and was sentenced to six years in prison.
* Republican president of the New York City Housing Development Corp. Russell Harding pleaded guilty to possessing child pornography on his computer.
* Republican benefactor of conservative Christian groups, Richard A. Dasen Sr., was found guilty of raping a 15-year old girl. Dasen, 62, who is married with grown children and several grandchildren, has allegedly told police that over the past decade he paid more than $1 million to have sex with a large number of young women.
BTW: There is a whole lot more where this came from.........please, please keep playing this game. I do so delight in sharing the truth.
Result number: 97
Posted by larrym on 10/05/06 at 16:07
More hate from the party of tolerance
Democratic Organizer Quits After Calling Allen 'Macacawitz'
Thursday, October 5, 2006; B02
A field organizer for Democratic congressional candidate Al Weed resigned yesterday after it was discovered that she referred to Sen. George Allen (R-Va.) as "Macacawitz."
In an e-mail sent last night, Meryl Ibis asked Democratic supporters to protest "George 'Macacawitz' Allen" during a Republican rally in Danville.
The term "Macacawitz" is an apparent reference to Allen's use of the word "macaca" and the recent discovery that he has Jewish heritage.
Weed spokesman Kurt Gleeson said the staffer "made a mistake in her language that was not sanctioned by the campaign." Weed is challenging Rep. Virgil H. Goode Jr. (R-Va.) in the Southside district.
Dick Wadhams, Allen's campaign manager, said Ibis's e-mail "fits a pattern of anti-Semitic behavior" by Democrats. Wadhams said Allen's opponent, Democrat James Webb, should be held accountable for Ibis's e-mail because she also was one of his volunteer organizers.
Kristian Denny Todd, a Webb spokeswoman, said Wadhams sounds desperate.
"I've never heard her name," Todd said. "She is a Weed for Congress staffer, and they took care of it right away."
Result number: 98
Posted by marie on 10/04/06 at 17:57
I hate gotcha politics it's just dumb but since the conservatives here seem to enjoy the game I guess I'll play along. And please ask me for links to all of these for varification because I so have them.
* Republican Congressman Mark Foley abruptly resigned from Congress after "sexually explicit" emails surfaced showing him flirting with a 16-year old boy.
* Republican executive Randall Casseday of the conservative Washington Times newspaper was arrested for soliciting sex from a 13-year old girl on the internet.
* Republican chairman of the Oregon Christian Coalition Lou Beres confessed to molesting a 13-year old girl.
* Republican County Constable Larry Dale Floyd was arrested on suspicion of soliciting sex with an 8-year old girl. Floyd has repeatedly won elections for Denton County, Texas, constable.
* Republican judge Mark Pazuhanich pleaded no contest to fondling a 10-year old girl and was sentenced to 10 years probation.
* Republican Party leader Bobby Stumbo was arrested for having sex with a 5-year old boy.
* Republican petition drive manager Tom Randall pleaded guilty to molesting two girls under the age of 14, one of them the daughter of an associate in the petition business.
* Republican County Chairman Armando Tebano was arrested for sexually molesting a 14-year-old girl.
* Republican teacher and former city councilman John Collins pleaded guilty to sexually molesting 13 and 14 year old girls.
* Republican campaign worker Mark Seidensticker is a convicted child molester.
* Republican Mayor Philip Giordano is serving a 37-year sentence in federal prison for sexually abusing 8- and 10-year old girls.
* Republican Mayor Tom Adams was arrested for distributing child pornography over the internet.
* Republican Mayor John Gosek was arrested on charges of soliciting sex from two 15-year old girls.
* Republican County Commissioner David Swartz pleaded guilty to molesting two girls under the age of 11 and was sentenced to 8 years in prison.
* Republican legislator Edison Misla Aldarondo was sentenced to 10 years in prison for raping his daughter between the ages of 9 and 17.
* Republican Committeeman John R. Curtain was charged with molesting a teenage boy and unlawful sexual contact with a minor.
* Republican anti-abortion activist Howard Scott Heldreth is a convicted child rapist in Florida.
* Republican zoning supervisor, Boy Scout leader and Lutheran church president Dennis L. Rader pleaded guilty to performing a sexual act on an 11-year old girl he murdered.
* Republican anti-abortion activist Nicholas Morency pleaded guilty to possessing child pornography on his computer and offering a bounty to anybody who murders an abortion doctor.
* Republican campaign consultant Tom Shortridge was sentenced to three years probation for taking nude photographs of a 15-year old girl.
* Republican racist pedophile and United States Senator Strom Thurmond had sex with a 15-year old black girl which produced a child.
* Republican pastor Mike Hintz, whom George W. Bush commended during the 2004 presidential campaign, surrendered to police after admitting to a sexual affair with a female juvenile.
* Republican legislator Peter Dibble pleaded no contest to having an inappropriate relationship with a 13-year-old girl.
* Republican advertising consultant Carey Lee Cramer was sentenced to six years in prison for molesting two 8-year old girls, one of whom appeared in an anti-Gore television commercial.
* Republican activist Lawrence E. King, Jr. organized child sex parties at the White House during the 1980s.
* Republican lobbyist Craig J. Spence organized child sex parties at the White House during the 1980s.
* Republican Congressman Donald "Buz" Lukens was found guilty of having sex with a female minor and sentenced to one month in jail.
* Republican fundraiser Richard A. Delgaudio was found guilty of child porn charges and paying two teenage girls to pose for sexual photos.
* Republican activist Mark A. Grethen convicted on six counts of sex crimes involving children.
* Republican campaign chairman Randal David Ankeney pleaded guilty to attempted sexual assault on a child and was arrested again five years later on the same charge.
* Republican Congressman Dan Crane had sex with a female minor working as a congressional page.
* Republican activist and Christian Coalition leader Beverly Russell admitted to an incestuous relationship with his step daughter.
* Republican Judge Ronald C. Kline was placed under house arrest for child molestation and possession of child pornography.
* Republican congressman and anti-gay activist Robert Bauman was charged with having sex with a 16-year-old boy he picked up at a gay bar.
* Republican Committee Chairman Jeffrey Patti was arrested for distributing a video clip of a 5-year-old girl being raped.
* Republican activist Marty Glickman (a.k.a. "Republican Marty"), was taken into custody by Florida police on four counts of unlawful sexual activity with an underage girl and one count of delivering the drug LSD.
* Republican legislative aide Howard L. Brooks was charged with molesting a 12-year old boy and possession of child pornography.
* Republican Senate candidate John Hathaway was accused of having sex with his 12-year old baby sitter and withdrew his candidacy after the allegations were reported in the media.
* Republican preacher Stephen White, who demanded a return to traditional values, was sentenced to jail after offering $20 to a 14-year-old boy for permission to perform oral sex on him.
* Republican talk show host Jon Matthews pleaded guilty to exposing his genitals to an 11 year old girl.
* Republican anti-gay activist Earl "Butch" Kimmerling was sentenced to 40 years in prison for molesting an 8-year old girl after he attempted to stop a gay couple from adopting her.
* Republican Party leader Paul Ingram pleaded guilty to six counts of raping his daughters and served 14 years in federal prison.
* Republican election board official Kevin Coan was sentenced to two years probation for soliciting sex over the internet from a 14-year old girl.
* Republican politician Andrew Buhr was charged with two counts of first degree sodomy with a 13-year old boy.
* Republican legislator Keith Westmoreland was arrested on seven felony counts of lewd and lascivious exhibition to girls under the age of 16 (i.e. exposing himself to children).
* Republican anti-abortion activist John Allen Burt was found guilty of molesting a 15-year old girl.
* Republican County Councilman Keola Childs pleaded guilty to molesting a male child.
* Republican activist John Butler was charged with criminal sexual assault on a teenage girl.
* Republican candidate Richard Gardner admitted to molesting his two daughters.
* Republican Councilman and former Marine Jack W. Gardner was convicted of molesting a 13-year old girl.
* Republican County Commissioner Merrill Robert Barter pleaded guilty to unlawful sexual contact and assault on a teenage boy.
* Republican City Councilman Fred C. Smeltzer, Jr. pleaded no contest to raping a 15 year-old girl and served 6-months in prison.
* Republican activist Parker J. Bena pleaded guilty to possession of child pornography on his home computer and was sentenced to 30 months in federal prison and fined $18,000.
* Republican parole board officer and former Colorado state representative, Larry Jack Schwarz, was fired after child pornography was found in his possession.
* Republican strategist and Citadel Military College graduate Robin Vanderwall was convicted in Virginia on five counts of soliciting sex from boys and girls over the internet.
* Republican city councilman Mark Harris, who is described as a "good military man" and "church goer," was convicted of repeatedly having sex with an 11-year-old girl and sentenced to 12 years in prison.
* Republican businessman Jon Grunseth withdrew his candidacy for Minnesota governor after allegations surfaced that he went swimming in the nude with four underage girls, including his daughter.
* Republican campaign worker, police officer and self-proclaimed reverend Steve Aiken was convicted of having sex with two underage girls.
* Republican director of the "Young Republican Federation" Nicholas Elizondo molested his 6-year old daughter and was sentenced to six years in prison.
* Republican president of the New York City Housing Development Corp. Russell Harding pleaded guilty to possessing child pornography on his computer.
* Republican benefactor of conservative Christian groups, Richard A. Dasen Sr., was found guilty of raping a 15-year old girl. Dasen, 62, who is married with grown children and several grandchildren, has allegedly told police that over the past decade he paid more than $1 million to have sex with a large number of young women.
BTW: There is a whole lot more where this came from.........please, please keep playing this game. I do so delight in sharing the truth.
Result number: 99
Posted by marie on 9/24/06 at 18:55
Oh so Delay wasn't the house majority leader? Who was that guy that looked just like him? Delay was ousted? LOL.......oh yeah the Republicans all jumped up and said lets get rid of tha bottom feeding low life money laundering briber.
Did Byrd break the law? Which ones? Do I like Byrd? Not really. Don't pay much attention to him. Is he the icon of the Dem Party........LOL. That's beyond hysterical.
Lets see we all know he's way better then say Harry Truman or John F. Kennedy. Yeah Dems hold him way over Barak Obama. What a hoot.
Result number: 100
Posted by marie on 9/24/06 at 09:14
I can play the link game too. Here's a few. Have several thousand more. What does that solve?
Delay and the rest of the gang
Congressman resigns after bribery plea
2002 Election NH "Phone Jamming" Case
I. Lewis ("Scooter") Libby: The Nexus of Washington's Neocon Network
Publisher to reissue I. Lewis Libby's novel
The Apprentice, a thriller set in Japan that includes references to bestiality, pedophilia and rape, have been offered for as high as $2,400 on Amazon.com.
Bill Frist (aka "the Cat Killer")
"And I was totally schizoid about the entire matter. By day, I was little Billy Frist, the boy who lived on Bowling Avenue in Nashville and had decided to become a doctor because of his gentle father and a dog named Scratchy. By night, I was Dr. William Harrison Frist, future cardiothoracic surgeon, who was not going to let a few sentiments about cute, furry little creatures stand in the way of his career. In short, I was going a little crazy."
Republican Cheats
A Blog Suspects That an Aide to Kean Posted Jabs at Menendez
More fraud allegations against Davison
Frist Medical License Renewal Questioned
George Allen Recieves Donations from Porn/Sex Phone Serivices
Top GOP leaders sending message to Big 3: Drop dead
Menendez Campaign Files Ethics Complaint against Kean Jr.
FBI Investigating Yet Another Burns Donor
Adwatch: DeWine's Desperate Distortions
A Few Republican Watch Blogs
Result number: 101
Posted by marie on 9/06/06 at 15:40
Some things never change like this administrations effort to divide our country. Are Republicans stepping up to the plate and declaring ENOUGH?
Well at least one candidate is, Republican challenger Tom Kean Jr. in New Jersey.
"Kean also reiterated his call for Defense Secretary Donald Rumsfeld to resign. Menendez also has called for Rumsfeld's resignation."
Result number: 102
Posted by Dr. B on 8/17/06 at 04:46
hi kkade,
i have been debating whether or not to buy a DRX. i appreciate the offer to email me the info and i will take you up on it. my email is jrbaumdc at yahoo.com. i would appreciate any feedback and or documentation from anyone with actual true reliable sources. i have been in practice for a year and have seen 2 DRX practices. within these 2 clinics well over 200 patients have used the DRX9000. only 1 has asked for a refund. i have seen patients barely able to walk with 20 yr chronic pain with foot drop, walk with a minor limp in 2 weeks (6 treatments). it has been inspirational. i have never witnessed a cervical unit, but i have had an overwhelming success with cervical pathologies including cervicogenic headaches which includes the "migraine" headaches by my own hands, using classic chiropractic methods. to anyone who is reading this, please note: not all chiropractors are alike. just like dentist, massage therapists, or even MD's. out of the 60 plus chiros i graduated with i would recommend less then 10. one of my best friends is a dentist and he concurs even in his profession. few are born with the gift, others take time or manipulate a living out of the philosophy (no pun intended). medical advice should not feel like a sales pitch, yet all medical professionals rely on it. mostly surgeons and MD's perscribing meds. that is all they have to offer, the pen or the knife. this is the scary part of choosing your health. My advice is do the least advacive but legitimate. if it feels like a pitch, it probably is. find a doc who you trust even if it is the same treatment as the salesman. doctors who believe in their treatments are much more successful. sorry about the rant.
Result number: 103
Posted by Dr. Ed on 8/16/06 at 01:39
Great to see the political discussion board back.
The Democrat Party's Long and Shameful History of Bigotry and Racism
A common attack upon conservatives and republicans by the ultra left is to engage in what has come to be known as "playing the race card" but is more accurately described as racial McCarthyism. Hardly a day goes by without a member of the far left wing falsely accusing conservatives of racism, bigotry, and a wide array of similar nasty things. They are not only dishonest, but they often border on the absurd, as in NAACP leader and hyper bigot Julian Bond's recent implication to his organization that Bush administration officials supported confederate slavery. Amazingly, Bond's statements went without condemnation from the radical Democrat party or others in his organization.
Not surprisingly, in all the lies and accusations of racism by the radical left wing, the truth becomes distorted not only about the Republicans but also the Democrats who make these accusations themselves. For instance, you may or may not have heard Democrat Senator Robert Byrd's outburst of racist bigoted slurs, more specifically the "n-word," on national television in March of 2001. Amazingly, this incident of blatant racism on national television drew barely a peep from the NAACP, Jesse Jackson, Julian Bond, Mary Frances Berry, or any of the other ambulance chasers who purport themselves to be the leaders of the civil rights movement. In contrast, the main source of well deserved criticism for Byrd's racist outburst came not from any of the so called leaders of the civil rights movement but from from Republican Majority Leader Dick Armey (source). The race hustlers Jackson, Mfume et al turned a blind eye towards this act of racism by one of their own party, at most issuing an unpublicized slap on the wrist, or, as was more often the case, making not a peep. But where the race hustlers turn a blind eye and spew their lies, it is up to conservatives to set the record straight with the truth.
In response to the growing practice of racial McCarthyism by prominent left wing Democrats, it is necessary to expose the truth about the Democrat Party's record on Civil Rights:
I. Acts of Bigotry by Prominent Democrats and Leftists:
Franklin Delano Roosevelt: Franklin Roosevelt, the long time hero and standard bearer of the Democrat Party, headed up and implemented one of the most horrible racist policies of the 20th Century – the Japanese Internment Camps during World War II. Roosevelt unilaterally and knowingly enacted Japanese Internment through the use of presidential Executive Orders 9066 and 9102 during the early years of the war. These orders single-handedly led to the imprisonment of an estimated 120,000 law abiding Americans of Japanese ancestry, the overwhelming majority of them natural born second and third
generation American citizens. Countless innocents lost their property, fortunes, and, in the case of an unfortunate few, even their lives as a result of Roosevelt's internment camps, camps that have been accurately described as America's concentration camps. Perhaps most telling about the racist nature of Roosevelt's order was his clearly expressed intention to apply it almost entirely to Japanese Americans, even though America was also at war with Germany and Italy. In 1943, Roosevelt wrote regarding concerns of German and Italian Americans that they t0o would share in the fate of the interned Japanese Americans, noting that "no collective evacuation of German and Italian aliens is contemplated at this time." Despite this assertion, Roosevelt did exhibit his personal fears about Italian and German Americans, and in his typical racist form he used an ethnic stereotype to make his point. Expressing about his position on German and Italian Americans during World War II, Roosevelt stated "I don't care so much about the Italians, they are a lot of opera singers, but the Germans are different. They may be dangerous."
Roosevelt also appointed two notorious segregationists to the United States Supreme Court. Roosevelt appointed South Carolina segregationist Democrat Jimmy Byrnes to the court. Roosevelt later made Byrnes a top advisor, where the segregationist earned the nickname "assistant president." Byrnes was Roosevelt's second choice behind Harry Truman for the VP nod in his 1944 reelection bid. Roosevelt also appointed segregationist Democrat Senator Hugo Black of Alabama to the court. Black was a former member of the Ku Klux Klan with a notorious record of racism himself.
Hugo Black: A former Democrat Senator from Alabama and liberal U.S. Supreme Court Justice appointed by FDR, Hugo Black had a lengthy history of hate group activism. Black was a member of the Ku Klux Klan in the 1920's and gained his legal fame defending Klansmen under prosecution for racial murders. In one prominent case, Black provided legal representation to Klansman Edwin Stephenson for the hate-induced murder of a Catholic priest in Birmingham. A jury composed of several Klan members acquited Stephenson of the murder, reportedly after Black expressed Klan gestures to the jury during the trial. In 1926 Black sought and won election as a Democrat to the United States Senate after campaigning heavily to Klan membership. He is said to have told one Klan audience "I desire to impress upon you as representatives of the real Anglo-Saxon sentiment that must and will control the destinies of the stars and stripes, that I want your counsel." In the Senate Black became a stauch supporter of the liberal New Deal initiatives of FDR and a solid opponent of civil rights legislation, including a filibuster of an anti-lynching measure. Black led the push for several New Deal programs and was a key participant in FDR's court packing scandal. Roosevelt appointed Black, a loyal ally, to the U.S. Supreme Court. During the Senate confirmation of Black's nomination, the issue of his strong Klan affiliations caused a public controversy over his appointment. Following the confirmation Roosevelt claimed ignorance of Black's Klan past, though this claim was dubious at best. Black's first Senate election, which occurred with Klan support, had been covered nationally a decade earlier in 1926. Black's Klan affiliations were a well known part of his political background and recieved heavy coverage in the newspapers at the time of his appointment. On the court, Black became a liberal stalwart. He also continued his career of supporting racism by authoring the opinion in favor of FDR's Japanese internment program in the infamous Korematsu ruling.
Senator Robert Byrd, D-WV: Byrd is a former member of the Ku Klux Klan and is currently the only national elected official with a history in the Klan, a well known hate group. Byrd was extremely active in the Klan and rose to the rank of "Kleagle," an official Klan membership recruiter. Byrd once stated that he joined the Klan because it was effective in "promoting traditional American values" (Source). Byrd's choice of words speak volumes about his bigotry considering the fact that the Klan is a notorious hate group, and the racist "values" it promotes are anything but American. One of the earliest criticisms of Byrd's Klan ties came in 1952 when he was running for Congress. Byrd responded by claiming that he had left the Klan in 1943 while noting that "(d)uring the nine years that have followed, I have never been interested in the Klan." Byrd was lying, however, as he engaged in correspondence with a Klan Imperial Wizard long after he claims to have ended his ties with the hate group.
In a letter to the Klan leadership (Source) dated 3 years after he purported to have ended his ties with them, Byrd wrote "I am a former kleagle of the Ku Klux Klan in Raleigh County and the adjoining counties of the state. The Klan is needed today as never before and I am anxious to see its rebirth here in West Virginia." Byrd continued his racist diatribe "It is necessary that the order be promoted immediately and in every state of the Union" and followed with a request for assistance from the hate group's leadership in "rebuilding the Klan in the realm" of West Virginia.
Byrd's racism extends far beyond his Klan membership. In a letter he wrote on the subject of desegregating the armed forces, Byrd escalated his racist rhetoric to an appalling level. In the letter, Byrd vowed that he would never fight in an integrated armed services noting "(r)ather I should die a thousand times, and see Old Glory trampled in the dirt never to rise again, than to see this beloved land of ours become degraded by race mongrels, a throwback to the blackest specimen from the wilds" (Source).
Byrd's racist opinions have shown their ugly face in his behavior in the Senate. Byrd led the filibuster of the Civil Rights Act of 1964 and, according to the United States Senate's own website, filibustered the legislation to the bitter end appearing as one of the last opponents to the act before a coalition of civil rights proponents led by Republican Minority Leader Everett Dirksen invoked cloture so that the Civil Rights Act of 1964 could pass. At the time, Byrd was in the the midst of a 14 hour and 13 minute filibuster diatribe against the key civil rights measure (Source). Throughout the 1960's, Byrd was was one of the staunchest opponents to civil rights in the U.S. Senate. Byrd's racist history drew attention recently when he went on national television and repeatedly used the n-word, one of the most vicious racial slurs in existence, in an appearance on national television. Byrd uttered the slur on Fox News Sunday with Tony Snow on March 5, 2001. Despite the appalling nature of the remark, it went largely ignored by the mainstream media and the self appointed "civil rights" leadership. Whereas a similar remark by anyone other than a leading Democrat Senator would assuredly prompt the likes of Jesse Jackson to assemble protest rallies demanding resignations, the Jackson crowd was eerily quiet following Byrd's remarks, issuing only low key suggestions that Byrd should avoid making such bigoted remarks.
In a sickening recognition of Byrd's appalling political career, the national Democrat party has done nothing but embrace the West Virginia senator with leadership roles and practically every honor imaginable. To this very day the Democrats call former Klansman turned U.S. Senator Robert Byrd the "conscience of the Senate." They have embraced him as their party's central pillar in all ways possible. Byrd has been reelected more times than any other Democrat senator, has served as a Democrat in Congress, a Democrat State Senator in West Virginia, and a Democrat State Delegate in West Virginia. Democrats have made repeatedly elected Byrd into their national party leadership and into the U.S. Senate leadership. He became secretary of the Senate Democrat Caucus in 1967, and Senate Democrat Whip in 1971. The Democrats elected former Klansman Byrd as their Senate Majority Leader from 1977-1980 and as their Senate Minority Leader from 1981-1986. Byrd was again elected Democrat Majority Leader from 1987-1988. Democrats made Byrd the chairman of the powerful Appropriations Committee and President Pro Tempore of the Senate from 1989 until the Republicans won control of the Senate in November 1994. Following the defection of Jim Jeffords in June 2001, the Democrats again made Byrd the chairman of the Appropriations Committee and elected him to the highest ranking office in the Senate: the President Pro Tempore, a position which also put this former Klansman 4th in line for the presidency. Byrd lost his position when Republicans retook the Senate in late 2002, but continues to serve as one of the highest ranking members of the Democrat Senate leadership today.
Senator Ernest Hollings, D-SC: Hollings is liberal Democrat Senator from South Carolina who is also notorious for his use of racial slurs. He rose out of the Democrat Party's segregationist wing in the 1960's as governor of South Carolina. While in office as governor, Hollings personally led the opposition to lunch counter integration in his state. The New York Times reported on March 17, 1960 that then-governor Hollings "warned today that South Carolina would not permit 'explosive' manifestations in connection with Negro demands for lunch-counter services." According to the article, Hollings gave a speech in which he "challenged President Eisenhower's contention that minorities had the right to engage in certain types of demonstrations" against segregation. In the speech Hollings described the Republican president as "confused" and asserted that Eisenhower had done "great damage to peace and good order" by supporting the rights of minorities to protest segregation at the lunch counters.
Governor Hollings' support for segregation continued throughout his term and included his attendance at a July 23, 1961 meeting of segregationist Democrats to organize their opposition to the civil rights movement. Hollings was one of four governors in attendence, all of them Democrats. The others included rabid segregationists Orval Faubus of Arkansas and Ross Barnett of Mississippi. The New York Times reported on the meeting, noting that among the strategies discussed were using the segregationist White Citizens Council organization to mobilize political opposition to desegregation.
In more recent years Hollings, a senior Democrat senator, has made disparaging racial remarks and slurs against minorities. Senator Hollings, who was a contender for his party's presidential nomination in 1984, blamed his defeat in the primaries by using a racial slur against Hispanics. After losing the Iowa Straw Poll, Hollings stated "You had wetbacks from California that came in here for Cranston," referring to one of his opponents, Alan Cranston. A few years later Hollings reportedly used the slur "darkies" to derogatorily refer to blacks. He also once disparagingly referred to the Rainbow PUSH Coalition as the "Blackbow Coalition," and called former Senator Howard Metzenbaum, who is Jewish, "the Senator from B'nai B'rith." Hollings gained international criticism for his remarks about the African Delegation to the 1993 Geneva GATT conference, where he crudely remarked "you'd find these potentates from down in Africa, you know, rather than eating each other, they'd just come up and get a good square meal in Geneva." Hollings was also the Governor of South Carolina who raised the confederate flag over the state capitol in the early 1960's in what was considered at the time to be an act of defiance to civil rights. The press ignored Hollings and his role in the flag issue at the same time the political correctness police were smearing George W. Bush during his campaign after Bush correctly remarked that the flag was a state issue to be decided upon by South Carolina and not the national government.
Jesse Jackson: Jackson was the featured prime time speaker at the 2000 Democrat Convention. Jackson has a history of using anti-Semitic slurs and derogatorily calling New York City "Hymietown." Jackson, a prominent self proclaimed "civil rights leader," is himself guilty of the same bigotry he dishonestly purports to oppose.
Dan Rather: Rather, the well known television anchor for CBS, is also a liberal Democrat who has spoken at fundraisers for the Democrat party in the past. The notoriously left wing reporter appeared on the Don Imus radio show on July 19, 2001 where he was interviewed about his long term refusal to cover the Gary Condit (D-CA) scandal involving an affair with a missing intern despite the scandal's national prominence. Rather noted on the air that CBS had basically forced him to cover the story that was on every other network and on the front page of all the major newspapers, all this after Rather avoided it for months. Rather stated on the air, refering to CBS, that "they got the Buckwheats" and made him cover the Condit scandal. The term "Buckwheat" is considered an offensive racial stereotype that stems from an easily frightened black character named "Buckwheat" on the Little Rascals comedies. It is widely regarded as a racial epithet and has long been condemned as an offensive stereotype by several civil rights organizations. In several past incidents (see here and here) the use of the epithet "Buckwheat" has recieved condemnation by the NAACP, Al Sharpton and other left wing organizations. These left wing organizations and personalities have demanded that other media personalities be fired over using the epithet, and even staged a protest at a school over the mere allegation that the racist stereotype had been used by a teacher. Yet these same liberal groups have, to date, remained completely silent now that one of their own, Dan Rather, is guilty of using the same offensive racial stereotype they have condemned elsewhere on a national radio show. It's just more proof of how the left wingers who cry the loudest with accusations of racism against others turn a blind eye when somebody of their own left wing ideology is the undeniable culprit of a blatantly racist act or statement!
Cragg Hines: Hines is one of the most rabidly partisan DC based Democrat editorial columnists to work for a major newspaper, and he makes no attempts to hide it. To Hines, pro-lifers are "neanderthals," as is often the case with those who differ in opinion with him. Ironically, Hines, a columnist who regularly touts himself as an enlightened progressive, is also known for racial remarks and religious intolerance. He attacked Senator Jesse Helms in an August 26, 2001 editorial with not only the usual liberal name calling, but also with a racial epithet. Hines used the racial slur "cracker" to attack Helms. He used the epithet not only within the article's text, but he even included it in the piece's title. In a sense of heavy irony, Hines' article accused Helms of bigotry for, among other things, opposing liberal policies like affirmative action. He didn't seem to object to himself for his own bigotted language in the same article. Hines has also drawn heavy criticism from Catholics including a letter to the editor from the former President of the U.S. Catholic Bishop's Conference for his seemingly agenda-driven criticisms of Catholicism and its religious leaders, often based on little or no historical evidence, which he has expressed in numerous editorial columns.
Al Sharpton: Sharpton, a perrenial Democrat candidate and one of the rumored candidates for the Democrat's 2004 presidential nomination, has a notorious racist past. Sharpton was a central figure who fanned the 1991 Crown Heights race riot, where a mob shouting anti-semetic slurs murdered an innocent Jewish man. Sharpton also incited a 1995 protest of a Jewish owned store in Harlem where protesters used several anti-semetic slurs. During the protests, a Sharpton lieutenant called the store's owner a "bloodsucker" and declared an intent to "loot the Jews." A member of the protest mob later set fire to the store, resulting in the death of seven (source).
Representative Dick Gephardt, D-MO: Gephardt, the former Democrat Minority Leader in the U.S. House of Representatives, gave several speeches to a St. Louis area hate group during his early years as a representative. According to the St. Louis Post-Dispatch, Gephardt spoke before the Metro South Citizens Council, a now defunct white supremacist organization, during his early years as a congressman. Newsmax.com further reported that Gephardt had openly asked the group for an endorsement of his candidacy during one of his many visits with the organization. Gephardt has long avoided questions about his past affiliation with this group.
Andrew Cuomo: Cuomo, Bill Clinton's former Housing Secretary and a prominent Democrat political player in New York, was tape recorded using racially inflamatory rhetoric to build opposition to a potential Democrat primary opponent while speaking to a Democrat group. Cuomo stated that voting for his rival for the New York Democrat gubernatorial nomination Carl McCall, who is black, would create a "racial contract" between Black and Hispanic Democrats "and that can't happen." Upon initial reports, Cuomo denied the statement but later a tape recording surfaced. Cuomo later dropped out of the race for governor (source).
Lee P. Brown: Brown, Bill Clinton's former drug czar and Democrat mayor of Houston, engaged in racist campaigning designed to suppress Hispanic voter turnout during his 2001 reelection bid. Brown faced challenger Orlando Sanchez, a Hispanic Republican who drew heavy support from the Hispanic community during the general election. Two weeks prior to the runoff, Brown's campaign printed racist signs designed to intimidate Hispanic voters. The signs featured a photograph of Sanchez and the words "Anti-Hispanic." The signs drew harsh criticism from Hispanic leaders as their message was designed to intimidate and confuse Hispanic voters. Around the same time the signs were being used, Brown supporter and city councilman Carol Alvarado made a series of racially charged attacks on Sanchez, implying a desire to see the supression of Hispanic voter turnout in the runoff. Brown staffers also went on record claiming that Sanchez was not a true Hispanic. The racist anti-Hispanic undertones of Brown's reelection bid were so great that liberal Democrat city councilman John Castillo, himself Hispanic, retracted his endorsement of Brown in disgust and became a Sanchez supporter in the final week of the campaign. Following the harsh condemnation of the racist signs and tactics, Brown purported that his campaign was removing them even though many still lingered around Houston up until the election. When election day came along, Brown placed more of the racist signs at polling places, despite his claim to have stopped using them. The large campaign billboard style election day signs featured, in Spanish, the word "Danger!" on them followed by Sanchez's name with a large red circle and slash through it. The signs identified the Brown campaign as their owner on the bottom. Brown's racially charged reelection effort barely squeeked by Sanchez on election day, winning 51% to 49% following a series of racially motivated advertisements in which the Brown campaign appealed to the fear of black voters by invoking images of the gruesome lynching death of James Byrd, Jr. and by attempting to pit them against Hispanics. While Brown had the audacity to declare himself a mayor for all people and all ethnicities at his victory party, many in Houston fear the racial wounds inflicted by his campaign will take years to heal.
Mary Frances Berry: Berry is the Democrat chair of the US Commission on Civil Rights (USCCR). She purports herself to be an "independent" in her political affiliation in order to hold her job on the civil rights commission where partisan membership may not exceed 4 for either party, but is in fact a dedicated liberal Democrat who openly supported Al Gore for president and has given a total of $20,000 in personal contributions to the Democrat Party, Al Gore for President, and other Democrat candidates over the last decade. Berry is an open racist who is affiliated with the far-left Pacifica radio network, a group with ties to black nationalist causes. Berry once stated "Civil rights laws were not passed to protect the rights of white men and do not apply to them," indicating that she believes the USCCR should only look out for civil rights violations against persons of certain select skin colors.
Billy McKinney: Former Democrat State Representative Billy McKinney of Georgia, who is also the father of former Democrat congresswoman Cynthia McKinney of the same state. During his daughter's failed 2002 reelection bid, McKinney appeared on television where he blamed his daughter's difficulties on a Jewish conspiracy. McKinney unleashed a string of anti-semitic sentiments, stating "This is all about the Jews" and spelling out "J-E-W-S." McKinney lost his own seat in a runoff a few weeks later.
The Democrat Party and the Ku Klux Klan: Aside from the multiple Klan members who have served in elected capacity within the high ranks of the Democrat Party, the political party itself has a lengthy but often overlooked history of involvement with the Ku Klux Klan. Though it has been all but forgotten by the media, the Democrat National Convention of 1924 was host to one of the largest Klan gatherings in American history. Dubbed the "Klanbake convention" at the time, the 1924 Democrat National Convention in New York was dominated by a platform dispute surrounding the Ku Klux Klan. A minority of the delegates to the convention attempted to condemn the hate group in the party's platform, but found their proposal shot down by Klan supporters within the party. As delegates inside the convention voted in the Klan's favor, the Klan itself mobilized a celebratory rally outside. On July 4, 1924 one of the largest Klan gatherings ever occurred outside the convention on a field in nearby New Jersey. The event was marked by speakers spewing racial hatred, celebrations of their platform victory in the Democrat Convention, and ended in a cross burning.
II. Democrat opposition to the Civil Rights Movement:
A little known fact of history involves the heavy opposition to the civil rights movement by several prominent Democrats. Similar historical neglect is given to the important role Republicans played in supporting the civil rights movement. A calculation of 26 major civil rights votes from 1933 through the 1960's civil rights era shows that Republicans favored civil rights in approximately 96% of the votes, whereas the Democrats opposed them in 80% of the votes! These facts are often intentionally overlooked by the left wing Democrats for obvious reasons. In some cases, the Democrats have told flat out lies about their shameful record during the civil rights movement.
Democrat Senators organized the record Senate filibuster of the Civil Rights Act of 1964. Included among the organizers were several prominent and well known liberal Democrat standard bearers including:
- Robert Byrd, current senator from West Virginia
- J. William Fulbright, Arkansas senator and political mentor of Bill Clinton
- Albert Gore Sr., Tennessee senator, father and political mentor of Al Gore. Gore Jr. has been known to lie about his father's opposition to the Civil Rights Act.
- Sam Ervin, North Carolina senator of Watergate hearings fame
- Richard Russell, famed Georgia senator and later President Pro Tempore
The complete list of the 21 Democrats who opposed the Civil Rights Act of 1964 includes Senators:
- Hill and Sparkman of Alabama
- Fulbright and McClellan of Arkansas
- Holland and Smathers of Florida
- Russell and Talmadge of Georgia
- Ellender and Long of Louisiana
- Eastland and Stennis of Mississippi
- Ervin and Jordan of North Carolina
- Johnston and Thurmond of South Carolina
- Gore Sr. and Walters of Tennessee
- H. Byrd and Robertson of Virginia
- R. Byrd of West Virginia
Democrat opposition to the Civil Rights Act was substantial enough to literally split the party in two. A whopping 40% of the House Democrats VOTED AGAINST the Civil Rights Act, while 80% of Republicans SUPPORTED it. Republican support in the Senate was even higher. Similar trends occurred with the Voting Rights Act of 1965, which was supported by 82% of House Republicans and 94% of Senate Republicans. The same Democrat standard bearers took their normal racists stances, this time with Senator Fulbright leading the opposition effort.
It took the hard work of Republican Senate Minority Leader Everett Dirksen and Republican Whip Thomas Kuchel to pass the Civil Rights Act (Dirksen was presented a civil rights accomplishment award for the year by the head of the NAACP in recognition of his efforts). Upon breaking the Democrat filibuster of the 1964 Civil Rights Act, Republican Dirksen took to the Senate floor and exclaimed "The time has come for equality of opportunity in sharing in government, in education, and in employment. It will not be stayed or denied. It is here!" (Full text of speech). Sadly, Democrats and revisionist historians have all but forgotten (and intentionally so) that it was Republican Dirksen, not the divided Democrats, who made the Civil Rights Act a reality. Dirksen also broke the Democrat filibuster of the 1957 Civil Rights Act that was signed by Republican President Eisenhower.
Outside of Congress, the three most notorious opponents of school integration were all Democrats:
- Orval Faubus, Democrat Governor of Arkansas and one of Bill Clinton's political heroes
- George Wallace, Democrat Governor of Alabama
- Lester Maddox, Democrat Governor of Georgia
The most famous of the school desegregation standoffs involved Governor Faubus. Democrat Faubus used police and state forces to block the integration of a high school in Little Rock, Arkansas. The standoff was settled and the school was integrated only after the intervention of Republican President Dwight D. Eisenhower.
Even the Democrat Party organization resisted integration and refused to allow minority participation for decades. Exclusion of minorities was the general rule of the Democrat Party of many states for decades, especially in Texas. This racist policy reached its peak under the New Deal in the southern and western states, often known as the New Deal Coalition region of FDR. The Supreme Court in Nixon v. Herndon declared the practice of "white primaries" unconstitutional in 1927 after states had passed laws barring Blacks from participating in Democrat primaries. But the Democrat Parties did not yield to the Court's order. After Nixon v. Herndon, Democrats simply made rules within the party's individual executive committees to bar minorities from participating, which were struck down in Nixon v. Condon in 1932. The Democrats, in typical racist fashion, responded by using state parties to pass rules barring blacks from participation. This decision was upheld in Grovey v. Townsend, which was not overturned until 1944 by Smith v. Allwright. The Texas Democrats responded with their usual ploys and turned to what was known as the "Jaybird system" which used private Democrat clubs to hold white-only votes on a slate of candidates, which were then transferred to the Democrat party itself and put on their primary ballot as the only choices. Terry v. Adams overturned the Jaybird system, prompting the Democrats to institute blocks of unit rule voting procedures as well as the infamous literacy tests and other Jim Crow regulations to specifically block minorities from participating in their primaries. In the end, it took 4 direct Supreme Court orders to end the Democrat's "white primary" system, and after that it took countless additional orders, several acts of Congress, and a constitutional amendment to tear down the Jim Crow codes that preserved the Democrat's white primary for decades beyond the final Supreme Court order ruling it officially unconstitutional.
Hispanics in South Texas were treated especially poorly by the Democrat Party, which relied heavily on a system of political bosses to coerce and intimidate Hispanics into voting for Democrat primary candidates of choice. Though coercion is illegal, this system, known as the Patron system, is still in use to this day by local Democrat parties in some heavy Hispanic communities of the southwest.
The next time Democrats take to the national airwaves to dishonestly accuse Republicans of racial hatred, remember who the historical record up until this very day points to as the real bigots: The Democrat Party. In all possible ways, the Democrat Party is built around the pillars of ultra leftists, many of whom are known participants in racism and/or affiliates of racist hate groups. Consider the Democrat Party of today's heroes and leaders:
- Franklin Delano Roosevelt, Democrat icon and orchestrator of Japanese Internment
- Ex-House Minority Leader Dick Gephardt, former affiliate of a St. Louis area racist group
- Ex-Senate President Pro Tempore Robert Byrd, former Ku Klux Klansman known for making bigoted slurs on national television
- Rev. Jesse Jackson, Democrat keynote speaker and race hustler known for making anti-Semitic slurs
- Rev. Al Sharpten, Democrat activist and perennial candidate and race hustler known inciting anti-Semitic violence in New York City
- Sen. Ernest Hollings, leading Democrat Senator known for use of racial slurs against several minority groups
- Lee P. Brown, former Clinton cabinet official and Democrat mayor of Houston who won reelection using racial intimidation against Hispanic voters
- Andrew Cuomo, former Clinton cabinet official and Democrat candidate for NY Governor who made racist statements about a black opponent.
- Dan Rather, Democrat CBS news anchor and editorialist known for using anti-black racial epithets on a national radio broadcast
- Donna Brazile, former Gore campaign manager known for making anti-white racial attacks. Brazile has also worked for Jackson, Gephardt, and Michael Dukakis
The simple truth is that the Democrat Party's history during this century is one closely aligned to bigotry in a record stemming largely out of the liberal New Deal era up until the modern day. Bigots are at the center of the Democrat party's current leadership and role models. And in a striking display of hypocrisy, many of the same Democrats who dishonestly shout accusations of "bigotry" at conservatives are practicing bigots of the most disgusting and disreputable kind themselves.
2001, The Capitalist Conservative Republican Homepage. All Rights Reserved.
Result number: 104
Posted by marie on 8/02/06 at 11:40
Yet another article on the Magnequench factory and it's move to China. The factory is responsible for producing 80 percent of the rare-earth permanent magnets used in the guidance systems of U.S. "smart bombs," according to lawmakers. World Net Daily has written an extensive piece on the issue and of the valiant efforts of Senator Bayh and Rep. Pete Visclosky to prevent this breech in National Security. I strongly urge every American to read this article carefully. Because the article is lengthy and complete I am only going to post a few snipets.
Citing national-security concerns, two Democratic lawmakers are engaged in a last-ditch effort to halt plans for the transfer of an Indiana factory that produces critical technology used in the guidance systems of U.S. "smart bombs" to the People's Republic of China.
Result number: 105
Posted by scott r - moderator on 7/28/06 at 07:43
No, it's not dr Ed. Try a search on
jr%3C%2Fb%3E>bill, jr
jref=http://heelspurs.com/cgi-bin/_search.cgi?a=yes&n=new&keyword=%3Cb%3Ecannot+say+who%3C%2Fb%3E>cannot say who
mr. mysterio
cannot say
and others....vince
Result number: 106
Posted by marie on 7/13/06 at 09:22
I saw this on another forum & thought a nice way to get aquainted with each other would be to learn who each others HERO is. Out of respect for each other I hope posters will refrain from judging others because of their hero.
My hero is St. Francis
When I was born my heart valves didn't work. I was baptized and given my last rights by a Franciscan monk who prayed with my father through the night. My recovery was complete.
Another one of my heros also likes St. Francis
"My hero is St. Francis of Assisi because he understood the connection between spirituality and the environment. He understood the way God communicates to us most forcefully is through the fishes and the birds and the trees and that it is a sin to destroy those things." Robert F. Kennedy, Jr.
Result number: 107
Posted by marie on 7/11/06 at 20:48
Oh they are still around! People describe Bayh as Trumanesque. The problem as I see it is that both parties have been invaded by the far left and the far right. I like many Republicans......not Bush but many. Not necesarily because I agree with them but because they are decent people who look for solutions instead of a fight. I love Dick Lugar, Arlen Spector, Kay Bailey Hutchison and Lindsey Grahm. On the left i like Evan Bayh, Barack Obama, Ben Nelson and Dick Durbin. I am pulling for Harold Ford Jr. in TN.
As far as 2008.....it's a bit far off but on the Republican side I have always liked McCain........may have voted for him in 2000 & Giulioni isn't to bad. On the Dem side I like Bayh....as you know and Warner. I would support Clinton over Bill Frist( aka the cat killer)in a heart beat. If Hillary gets the nod then it would depend on who her running mate is and who Republicans are running.
Result number: 108
Posted by Suzanne D. on 6/20/06 at 10:51
I agree with your intent, Autumn. For more than four years I have basically ignored hostile comments when they came; that is my style and what I am comfortable with doing. And I agree that responding can unnecessarily feed those wanting attention. So, since I am the one who responded initially after Kathy in KY's post that she was leaving, I apologize to the readers for giving the opportunity for more hostility here.
However, to quote Martin Luther King, Jr., "Our lives begin to end the day we become silent about things that matter." And it mattered to me that Kathy in KY was upset that her innocent question brought on hostility here. And I hated to see her leave without letting her know that.
And in that regard, I must say that I am sorry that what I wrote prompted Julie to respond and in return be hurt by ensuing remarks. She, of all people, who has helped so many on these boards for many years, did not deserve that. And I cannot live with myself if I don't make that point, too.
Now, I am finished with the subject. But I needed to respond to your post. It was never my intent to stir up anything, and I know and appreciate the reason for this site.
Result number: 109
Posted by Dr. Z on 4/06/06 at 09:55
Come on it was the last episode of Soprano's . Great show. Tony Soprano. Jr is his Uncle. Do you watch TV
Result number: 110
Posted by Dr. Zuckerman on 3/24/06 at 17:05
Dr. Wander,
It was Lowell Scott JR my good friend and colleague who was one of the first to use ESWT in the USA.
The Weil Institue has contributed tremendously to the publication of randonized, double blind studies for FDA evaluation.
Result number: 111
Posted by Jenny J. on 3/02/06 at 11:26
Yes, both Weil Sr. and Jr. were the podiatrist for the Chicago White Sox. They are good. I did not go to them for my EPF surgery though. I went to someone from Evanston Northwestern.
Result number: 112
Posted by Ralph on 1/31/06 at 12:56
Teddy Kennedy can finally stop posturing, shut up for a little while and pop his jugular veins back into his fat neck.
Alito Is Sworn in as Associate Justice
AP - 7 minutes ago
WASHINGTON - Samuel Anthony Alito Jr. was sworn in as the nation's 110th Supreme Court justice on Tuesday after being confirmed by the Senate in one of the most partisan victories in modern history.
Result number: 113
Posted by john h on 1/28/06 at 14:54
From all reports it is very probable that John Kennedy Jr. died from vertigo or spatial disorientation as it is also known. He was not a qualified instrument pilot and it takes very little to get in an uncontrollable situation flying at night with little horrizon to keep your self oriented with the earth. He really should never have taken off with his qualifications. Happens over and over to people who just do not understand or have experienced vertigo. Military pilots go though training on a regular basis where you can bring on vertigo by being placed in a spinning chair with you head down, eyes closed, and head cocked to the side. This gets the fluid in you ear canals flowing in such a direction that when the chair is suddenly stopped and you sit upright you have the very very real sensation that you are tumbling head over heals even though you can see clearly. You have to be buckled in this chair as you would be likely to jump out or dive out of the chair. Some pilots have to be restrained. When the early F-84 fighters were introduced there were a significant number of unexplained crashes in weather. After much study it was found out that the pilot had to turn his head to the right and down slightly to see his radio and change frequencies. This particular type of movement was perfect for inducing vertigo on occasion and when the radios were moved to a better position the crashed stopped.
Result number: 114
Posted by Suzanne D. on 1/19/06 at 19:52
You are very kind, Jan. Thank you!
I do know what you mean: sometimes it would be nice just to not have to think about feet, sensible shoes, and so forth! Sometimes it gets so tiring, and I long for my legs and feet to feel like I am young again.
And then I look at the little boy in my first-grade class who is confined to a wheelchair, paralyzed from the waist down, and facing surgery in March in which a steel rod will be inserted to try to hold up his back so that his organs will not be so restricted. And I feel badly for complaining - even if it is just to myself.
He is so cheery and happy, and never seems to feel sorry for himself. We had a lesson on Martin Luther King, Jr. last Friday, and the children wrote in little clouds what their dreams are. His is to go to high school. I thought I would cry.
Thanks for listening - I didn't mean to go on and on. Good luck with finding shoes that your feet will like!
Suzanne :)
Result number: 115
Posted by Dr. David S. Wander on 1/03/06 at 18:02
The article I had published in Journal of Foot & Ankle Surgery was titled "Surgical Management of a Ruptured Peroneus Longus Tendon with a Fractured Multi-Partite Os Peroneum". I did have an article published in the American Journal of Roentgenology (AJR) the "official" journal of the American College of Radiologists that was titled "MR Imaging of Plantar Fasciitis, Edema, Tears, and Occult Marrow Abnormalities Correlated with Outcomes". If you want, call me at the office and I'll fax the articles over to you, or walk over to my house and I'll hand them to you!
Result number: 116
Posted by John H on 12/15/05 at 10:36
Fun adult Christmas. 1968 Nakon Phanom, Thailand. Temperature around 97 degrees, hot and dusty. We were having a Xmas party around noon outside. Big pig roasting on an open fire. I was flying Santa in a helicopter and had a helicopter full of some sort of white substance that would simulate snow. We lowered Santa on a hoist. Then dispensed the so called snow. Unfortunately the snow all blew back into the helicopter due to the rotor wash and I could barely see. All the troops were half way drunk and cheered wildly. Till the day I left when I flew that helicopter the snow would be flying around in the cockpit. For 4 years when flying out of N.J. to Europe I always had to fly on Xmas as I was a junior officer. Xmas night was always spent out over the middle of the North Atlantic as a DC-6 would take about 10 hours to fly to Europe and we always departed so as to arrive in Europe mid morning. This may sound sad but sitting up front in the cockpit you had a panaromic view of the ocean and stars. Outside temperatures 20-30 below zero, a clear night with a big moon shining on an endless ocean was inspiring. Sometimes the northern lights would dazzle you and there would be a ring of fire around the tips of the propeller blades. The hum of 4 Pratt & Whitney 2500hp engines were music to your ears. All the passengers would be asleep and you were in your own little world untouched by anything but what you could see.
As I type this it reminds me of a poem familiar to most pilots:
High Flight
Oh! I have slipped the surly bonds of Earth
And danced the skies on laughter-silvered wings;
Sunward I've climbed, and joined the tumbling mirth
Of sun-split clouds, — and done a hundred things
You have not dreamed of — wheeled and soared and swung
High in the sunlit silence. Hov'ring there,
I've chased the shouting wind along, and flung
My eager craft through footless halls of air. . . .
Up, up the long, delirious burning blue
I've topped the wind-swept heights with easy grace
Where never lark, or ever eagle flew —
And, while with silent, lifting mind I've trod
The high untrespassed sanctity of space,
Put out my hand, and touched the face of God.
— John Gillespie Magee, Jr
Result number: 117
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Result number: 118
Posted by Ed Davis, DPM on 12/08/05 at 15:02
You hit the nail on the head. ;)
By the way, with one very active 9 year old and two six year old twin girls, I basiclly am on 24 hour home repair call. I still have not figured out how one of my twin girls, Elizabeth tackled Eddie Jr. against a closed bathroom door, completely ripping the door frame from the wall. I got home two nights ago only to hear a horrendous crash and immediately ran uptstains to see what happened. Eddie Jr. mistook a wall mounted cabinet in the bathroom for a jungle gym and the cabinet and part of the wall came crashing down with the only miracle being my son not getting hurt. Guess what my project for Sunday will be? The bright side, as I see it is a second career in construction after I retire from podiatry. Unfortunately, they did not teach me anything about drywall repair in school.
Result number: 119
Posted by a fellow sufferer on 12/07/05 at 22:04
Dr. Z or Dr. Goldstein: I have seen Dr. Weil Jr. in the past. Does he or his father on anyone in that large practice do the cryosurgery? I am assuming this is the the same Dr. Weil in IL. thanks for all this great info and for your time!!!
Result number: 120
Posted by Jan D. Rompe on 12/02/05 at 06:45
Read the official "Commentary & Persepctive" on this trial
Commentary & Perspective on
"Treatment for Osteonecrosis of the Femoral Head: Comparison of Extracorporeal Shock Waves with Core Decompression and Bone-Grafting"
by Ching-Jen Wang, MD, et al.
Commentary & Perspective by
Jan D. Rompe, MD, and Nicola Maffulli, MD, MS, PhD, FRCS(Orth)*,
OrthoTrauma Clinic, Gruenstadt, Germany (J.D.R.), and Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke-on-Trent, Staffordshire, United Kingdom (N.M.)
Dr. Wang and colleagues have reported a randomized-controlled trial in forty-eight adult patients with stage-I, II, or III osteonecrosis of the hip, comparing noninvasive single-treatment high-energy shock-wave application (a total of 6000 impulses; energy flux density equivalent to 0.62 mJ/mm2) to core decompression and nonvascularized fibular grafting. At a minimum of two years of follow-up, the pain and Harris hip scores were significantly better in the shock-wave group than in the surgical group. Total hip replacement was required in 10% of the shock-wave group, and in 32% of the surgery group.
We compliment the authors for a carefully prepared pilot study that provides new, and most importantly, scientifically tested information about the potential role of shock-wave application in the treatment of early stage osteonecrosis of the adult hip.
There are relatively few reports on shock-wave treatment for osteonecrosis of the hip, and certainly this management modality will remain controversial. Even in experienced hands, reproducible application of high-energy shock-wave treatment to the femoral head is not simple, and the results from subsequent reports might not always be as favorable as this report from Wang and colleagues was. We would also caution that because of the critical neurovascular structures that lie in direct anatomical proximity to the femoral head, it is important that the application of high-energy shock-wave treatment be carried out by experienced physicians in this technique.
The authors correctly state that surgical treatment is usually indicated even for early stage osteonecrosis of the hip. However, the prognosis varies considerably depending on the extent of involvement. ARCO (Association Research Circulation Osseous) involvement is potentially reversible, but the point of no return for almost all patients is when stage-II or greater involvement occurs. The prognosis for further progression for stage I or II depends primarily on the extent and location of the lesion. Only the rare, small-to-medium-sized lesions in the medial or central location may have a good prognosis over the course of five years or more. The much more common large-sized and laterally located lesions will have a probability of about 80% of progressing to femoral collapse within two years1.
The efficacy of the treatment might have been easier to discern if the authors had concentrated on one subgroup with a sufficient number of patients. The reader cannot deduce whether all of the treated patients were symptomatic (although one presumes so), nor can the reader know the exact localization (medial, central, lateral) and extent of the lesions (mild [<15% of head affected], moderate [15% to 30%], severe [>30%]) regarding the ARCO stages. This is particularly regrettable when the authors report regression of five of thirteen ARCO stage-I or stage-II lesions after shock-wave treatment. It will be necessary for future trials to have more information on this specific subgroup of successfully treated patients.
According to Table V, the size of the lesion was evaluated on plain radiographs and magnetic resonance images before and after treatment. In patients showing a regression from ARCO stage-II lesions (abnormal radiograph and abnormal magnetic resonance image) and ARCO stage-I lesions (normal radiograph, abnormal magnetic resonance image), it is not clear whether the sizes were measured uniformly by magnetic resonance imaging at all follow-ups or whether a mixture of radiographic and magnetic resonance imaging measurements were used.
The authors state that the radiologist involved in the evaluation of the ARCO stages of patients of both groups was blinded to the nature of treatment. This will have been the case before treatment, but as one of the study arms involved core decompression, the "blinded" radiologist might have been subjected to bias during the postoperative evaluation. This may be an additional potential source for bias in this study, as clinical assessment was not reported to have been performed independent of the treating physician.
It is not entirely clear how the authors approached the treatment of patients with bilateral disease in either group. Because core decompression and nonvascularized fibular graft required up to six months of protected weight-bearing after the operation, compared with only four to six weeks after high-energy shock-wave treatment, it might have been necessary to delay surgery on the contralateral hip for quite some time, thereby allowing the condition to progress and adversely affect the outcome.
A weakness of the study is whether the optimal dose of shock waves was delivered to these patients. Recently, the authors had reported an optimal treatment of 500 impulses of shock waves at a low-energy flux density of 0.16 mJ/mm2 to stimulate complete bone-healing without complications in both in vivo and in vitro experiments in animals2-5. But, without any preliminary clinical investigation described in the article, the rationale for the choice of the particular regimen in human application—6000 impulses of a high-energy flux density—is dubious.
Nevertheless, the take-home message from this pilot study is that there may be a promising way to avoid performing major surgery on patients with osteonecrosis, and thus also avoid the potential concomitant morbidity and complications, such as infection, perforation of the articular cartilage of the femoral head, or graft migration. The authors are to be congratulated for providing the data needed to calculate sample size and power for future randomized controlled trials. These data will be indispensable in assessing the efficacy of high-energy shock-wave application as a novel management for osteonecrosis of the femoral head.
*The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
1. Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha A, Urbaniak JR. Osteonecrosis of the hip: management in the 21st century. J Bone Joint Surg Am. 2002;84:834-53.
2. Chen YJ, Kuo YR, Yang KD, Wang CJ, Huang HC, Wang FS. Shock wave application enhances pertussis toxin protein-sensitive bone formation of segmental femoral defect in rats. J Bone Miner Res. 2003;18:2169-79.
3. Chen YJ, Kuo YR, Yang KD, Wang CJ, Sheen Chen SM, Huang HC, Yang YJ, Yi-Chih S, Wang FS. Activation of extracellular signal-regulated kinase (ERK) and p38 kinase in shock wave-promoted bone formation of segmental defect in rats. Bone. 2004;34:466-77.
4. Wang CJ, Wang FS, Yang KD, Weng LH, Sun YC, Yang YJ. The effect of shock wave treatment at the tendon-bone interface—an histomorphological and biomechanical study in rabbits. J Orthop Res. 2005;23:274-80.
5. Wang FS, Wang CJ, Chen YJ, Chang PR, Huang YT, Sun YC, Huang HC, Yang YJ, Yang KD. Ras induction of superoxide activates ERK-dependent angiogenic transcription factor HIF-1alpha and VEGF-A expression in shock wave-stimulated osteoblasts. J Biol Chem. 2004;279:10331-7.
Copyright © 2005 by the The Journal of Bone and Joint Surgery, Inc.
Result number: 121
Posted by Kathy on 11/29/05 at 15:07
Thanks, Kate in Cali - so sweet of you to respond :) The hardest thing I find to do is to relax - I have an office job, so my off time is activity time. I know better than to run right now, but staying off any activity is a huge challenge and you can only do upper body so much and I need that cardio fix! So I'm trying to do the elliptical, bike, and stepmill but trying to take it somewhat easy. It bothers it some, but just minor aches, nothing really severe. I know what you mean about focusing on healing instead of running - as a 46 yr old that has run since Jr High school - yikes, its horrendous. Thanks for the Foot Yoga link - I printed this off and will try these exercises! Great while watching TV - LOL. Funny thing is - I'm not really tight in the morning and try to stretch my foot in bed before that first step. My main problem is that bruise feeling at the heelbone - ouch! Thanks again so much, and happy feet to you, too!
Result number: 122
Posted by Buck T on 11/10/05 at 14:17
Hi: Maybe it was the same person who shot JR.
Buck T
Result number: 123
Posted by d fuller on 10/30/05 at 01:19
This is a list of citations begining in 1965 to date that deal with this "rare" adverse event. I present this not as an argumentative rebuttal but as proofs regarding my previous post. One would think if indeed this was a rare occurence we would not read medical journal articles concerning it each and every year for forty years. Nor does this list inlcude all such citations, only those readily available to the average person. Of special interest is the statements made at the 62 Meeting of the Anti-Infective Drugs Advisory Committee (circa 1994)where quinolone induced joint destruction (requiring complete joint replacement) is discussed as well as irreversible tendon and ligament damage. You will find that towards the end of this response. We find the same documentation when it comes to peripherial neuropathy as well which was first reported in association with Nalidixic Acid in the mid sixties.
Ned Tijdschr Geneeskd. 1965 Jan 2;109:59-60. Dutch. No abstract available.
PMID: 14284979 [PubMed - OLDMEDLINE for Pre1966]
Minerva Ortop. 1965 Jan-Feb;16:21-9. Italian. No abstract available.
PMID: 14303636 [PubMed - OLDMEDLINE for Pre1966]
Helv Chir Acta. 1965 Jan;32:253-6. German. No abstract available.
PMID: 14290218 [PubMed - OLDMEDLINE for Pre1966]
1. Rosolleck H.
[Subcutaneous achilles tendon rupture]
Monatsschr Unfallheilkd Versicher Versorg Verkehrsmed. 1969 Dec;72(12):544-7.
German. No abstract available.
PMID: 4248859 [PubMed - indexed for MEDLINE]
1. Auquier L, Siaud JR.
[Nodular tendinitis of the Achilles tendon]
Rev Rhum Mal Osteoartic. 1971 May;38(5):373-81. French. No abstract available.
PMID: 5092370 [PubMed - indexed for MEDLINE]
2. Krahl H, Langhoff J.
[Degenerative tendon changes following local application of corticoids]
Z Orthop Ihre Grenzgeb. 1971 Jul;109(3):501-11. German. No abstract available.
PMID: 4254811 [PubMed - indexed for MEDLINE]
1. Nalidixic Acid arthralgia
Bailey et al (CMA Journal 1972; 107 601-605)
2. Dupuis PR, Uhthoff HK.
In vivo study of the effects of a synthetic steroid, betamethasone (16B methyl-9X fluoroprednisolone) on the calcaneal tendon in rabbits Union Med Can. 1972 Sep;101(9):1763-7. French. No abstract available.
PMID: 5075006 [PubMed - indexed for MEDLINE]
1. Jouirland JP Les ruptures tendineusues. Le tendon normal et patholoqique
Seminar de Monte Carlo 13-14 February 1976
1. Mason JO, Meagher DJ, Sheehan B, O'Doherty CK.
The management of supraspinatus tendinitis in general practice.
Ir Med J. 1980 Jan;73(1):23-40. No abstract available.
PMID: 7380640 [PubMed - indexed for MEDLINE]
1. Jensen KE.
[Bilateral rupture of the Achilles tendon]
Ugeskr Laeger. 1981 Jul 6;143(28):1768. Danish. No abstract available.
PMID: 7292758 [PubMed - indexed for MEDLINE]
1. Fink RJ, Corn RC.
Fracture of an ossified Achilles tendon.
Clin Orthop. 1982 Sep;(169):148-50. No abstract available.
PMID: 6809391 [PubMed - indexed for MEDLINE]
2. Cetti R, Christensen SE.
[Rupture of the Achilles tendon after local steroid injection]
Ugeskr Laeger. 1982 May 10;144(19):1392. Danish. No abstract available.
PMID: 7135524 [PubMed - indexed for MEDLINE]
3. Chechick A, Amit Y, Israeli A, Horoszowski H.
Recurrent rupture of the achilles tendon induced by corticosteroid injection.
Br J Sports Med. 1982 Jun;16(2):89-90. No abstract available.
PMID: 7104562 [PubMed - indexed for MEDLINE]
4. Newmark H 3rd, Olken SM, Mellon WS Jr, Malhotra AK, Halls J
A new finding in the radiographic diagnosis of achilles tendon rupture.
Skeletal Radiol. 1982;8(3):223-4. No abstract available.
PMID: 7112151 [PubMed - indexed for MEDLINE]
1. Norfloxacin induced rheumatic disease
Bailey et al (NZ Med J 1983; 96; 590)
2. Kleinman M, Gross AE.
Achilles tendon rupture following steroid injection. Report of three cases.
J Bone Joint Surg Am. 1983 Dec;65(9):1345-7. No abstract available.
PMID: 6197416 [PubMed - indexed for MEDLINE]
1. Chamot AM, Gobelet C.
[Achilles tendinitis: a pathology of confines]
Rev Med Suisse Romande. 1984 Oct;104(10):783-7. French. No abstract available.
PMID: 6515224 [PubMed - indexed for MEDLINE]
1. Between 1985 and July 1992 100 cases of tendon disorders had been identified in France
Kessler et al (HRG Publication 1399, August 1. 1996)
2. Jones JG.
Achilles tendon rupture following steroid injection.
J Bone Joint Surg Am. 1985 Jan;67(1):170. No abstract available.
PMID: 3968099 [PubMed - indexed for MEDLINE]
3. 100 reported tendinopathies 1985-1992 France
In France, between 1985 and 1992, 100 patients who were being managed with fluoroquinolones had tendon disorders, which included thirty-one ruptures (Royer, R. J.; Pierfitte, C.; and Netter, P.: Features of tendon disorders with fluoroquinolones. Therapie, 49: 75-76, 1994.)
1. Ciprofloxacin an update on clinical experience
Areieri et al (Am J of Med 1987 82 381-386)
2. 93 ruptures, 103 tendinopathies, 20 tenasynovitis, 1987-1997
Source: http://www.sma.org/smj1999/junesmj99/harrell.pdf
1. McEwan SR, Davey PG. Ciprofloxacin and tenosynovitis. Lancet 1988; 2: 900.
2. Adverse effects of fluoroquinolones
Halkin et al (Rev Infect Dis 1988 10 258-261)
3. Ciprofloxacin and tenosynovitis
McEwan et al ( Lancet 1988 15 900)
4. Tendon disorders attributed to fluoroquinolones; a study on 42 spontaneous reports in the period 1988-1998
Van Der Linden et al (American College of Rheumatology; Arthritis Care and Research 45; 2001 pages
1. Adverse reactions during clinical trials and post marketing surveillance
Janknegt et al (Pharm Weekbl Sci 1989 11(4) 124-127)
2. Arthritis induced by norfloxacin
Jeandel et al (J Rheumatol 1989 16 560-561)
3. Schumacher HR Jr, Michaels R.
Recurrent tendinitis and achilles tendon nodule with positively birefringent crystals in a patient with hyperlipoproteinemia.
J Rheumatol. 1989 Oct;16(10):1387-9.
PMID: 2810266 [PubMed - indexed for MEDLINE]
1. Histologic and Histochemical Changes in Articular Cartilages of Immature Beagle Dogs Dosed with Difloxacin, a Fluoroquinolone
J.E. Kurkhardt et al (Vet Pathol 27;162-170, 1990)
1. Rheumatolgical side effects of quinolones
Ribard et al (Baillere's Clin Rheumatol 1991 5 175-191)
2. Perrot S, Ziza JM, De Bourran-Cauet G, Desplaces N, Lachand AT.
[A new complication related to quinolones: rupture of Achilles tendon]
Presse Med. 1991 Jul 6-13;20(26):1234. French. No abstract available.
PMID: 1831902 [PubMed - indexed for MEDLINE]
1. Seven Achilles tendinitis including three complicated by rupture during fluoroquinolone therapy
Ribard et al (J Rheumatol 1992; 19; 1479-1481)
2. 704 achilles tendinitis, 38 ruptures 1992-1998 Netherlands
Fluoroquinolone use and the change in incidence of tendon rupture in the Netherlands
Van der Linden et al (Pharmacy World and Science vol 23 no 3 2001 pg 89-92)
The cohort included 46 776 users of fluoroquinolones between 1 July 1992 and 30 June 30 1998, of whom 704 had Achilles tendinitis and 38 had Achilles tendon rupture
source: http://bmj.com/cgi/content/full/324/7349/1306
3. 100 reported tendinopathies 1985-1992 France
In France, between 1985 and 1992, 100 patients who were being managed with fluoroquinolones had tendon disorders, which included thirty-one ruptures (Royer, R. J.; Pierfitte, C.; and Netter, P.: Features of tendon disorders with fluoroquinolones. Therapie, 49: 75-76, 1994.)
4. Ribard P, Audisio F, Kahn MF, De Bandt M, Jorgensen C, Hayem G, Meyer O, Palazzo E.
Seven Achilles tendinitis including 3 complicated by rupture during fluoroquinolone therapy.
J Rheumatol. 1992 Sep;19(9):1479-81.
PMID: 1433021 [PubMed - indexed for MEDLINE]
5. Perrot S, Kaplan G, Ziza JM.
[3 cases of Achilles tendinitis caused by pefloxacin, 2 of them with tendon rupture]
Rev Rhum Mal Osteoartic. 1992 Feb;59(2):162. French. No abstract available.
PMID: 1604233 [PubMed - indexed for MEDLINE]
6. Lee WT, Collins JF.
Ciprofloxacin associated bilateral achilles tendon rupture.
Aust N Z J Med. 1992 Oct;22(5):500. No abstract available.
PMID: 1445042 [PubMed - indexed for MEDLINE]
7. Blanche P, Sereni D, Sicard D, Christoforov B.
[Achilles tendinitis induced by pefloxacin. Apropos of 2 cases]
Ann Med Interne (Paris). 1992;143(5):348. French. No abstract available.
PMID: 1482040 [PubMed - indexed for MEDLINE]
8. Olivieri I, Padula A, Lisanti ME, Braccini G.
Longstanding HLA-B27 associated Achilles tendinitis.
Ann Rheum Dis. 1992 Nov;51(11):1265. No abstract available.
PMID: 1466609 [PubMed - indexed for MEDLINE]
1. Spontaneous bilateral rupture of the Achille's tendon in a renal transplant recipient
Mainard et al (Nephron 1993;65- 491-492)
2. Boulay I, Farge D, Haddad A, Bourrier P, Chanu B, Rouffy J
[Tendinopathy caused by ciprofloxacin with possible partial rupture of Achilles tendon]
Ann Med Interne (Paris). 1993;144(7):493-4. French. No abstract available.
PMID: 8141519 [PubMed - indexed for MEDLINE]
1. Royer RJ, Pierfitte C, Netter P.
Features of tendon disorders with fluoroquinolones.
Therapie. 1994 Jan-Feb;49(1):75-6. No abstract available.
PMID: 8091374 [PubMed - indexed for MEDLINE]
2. Armengol S, Moreno JA, Xirgu J, Torrabadella P, Tomas R.
[Ciprofloxacin as a cause of a behavior disorder in a patient admitted into intensive care]
Enferm Infecc Microbiol Clin. 1994 May;12(5):271-2. Spanish. No abstract available.
PMID: 8049295 [PubMed - indexed for MEDLINE]
3. Donck JB, Segaert MF, Vanrenterghem YF.
Fluoroquinolones and Achilles tendinopathy in renal transplant recipients.
Transplantation. 1994 Sep 27;58(6):736-7. No abstract available.
PMID: 7940700 [PubMed - indexed for MEDLINE]
4. Onieal ME.
Achilles injuries.
J Am Acad Nurse Pract. 1994 Mar;6(3):125-6. No abstract available.
PMID: 8003362 [PubMed - indexed for MEDLINE]
5. Scioli MW.
Achilles tendinitis.
Orthop Clin North Am. 1994 Jan;25(1):177-82. Review.
PMID: 8290227 [PubMed - indexed for MEDLINE]
6. Hernandez MV, Peris P, Sierra J, Collado A, Munoz-Gomez J.
[Tendinitis due to fluoroquinolones. Description of 2 cases]
Med Clin (Barc). 1994 Sep 10;103(7):264-6. Review. Spanish.
PMID: 7934295 [PubMed - indexed for MEDLINE]
7. Achilles tenditinis and tendon rupture due to fluoroquinolone therapy
Huston et al (New England Journal of Medicene 1994 331 748)
8. Royer, R. J.; Pierfitte, C.; and Netter, P.: Features of tendon disorders with fluoroquinolones. Therapie, 49: 75-76, 1994.)
9. Dekens-Konter JA, Knol A, Olsson S, Meyboom RH, de Koning GH.
[Tendinitis of the Achilles tendon caused by pefloxacin and other
fluoroquinolone derivatives]
Ned Tijdschr Geneeskd. 1994 Mar 5;138(10):528-31. Dutch.
PMID: 8139714 [PubMed - indexed for MEDLINE]
10. Prantera C, Kohn A, Zannoni F, Spimpolo N, Bonfa M.
Metronidazole plus ciprofloxacin in the treatment of active, refractory Crohn's disease: results of an open study.
J Clin Gastroenterol. 1994 Jul;19(1):79-80. No abstract available.
PMID: 7930441 [PubMed - indexed for MEDLINE]
11. Van Linthoudt D, D'Oro A, Ott H.
[What is your diagnosis? Bilateral Achilles tendinitis associated with
quinolone treatment]
Schweiz Rundsch Med Prax. 1994 Feb 22;83(8):201-2. German. No abstract available.
PMID: 8134743 [PubMed - indexed for MEDLINE]
12. Kawada A, Hiruma M, Morimoto K, Ishibashi A, Banba H.
Fixed drug eruption induced by ciprofloxacin followed by ofloxacin.
Contact Dermatitis. 1994 Sep;31(3):182-3. No abstract available.
PMID: 7821014 [PubMed - indexed for MEDLINE]
13. Guharoy SR.
Serum sickness secondary to ciprofloxacin use.
Vet Hum Toxicol. 1994 Dec;36(6):540-1.
PMID: 7900274 [PubMed - indexed for MEDLINE]
1. Hernandez Rodriguez I, Allegue F.
Achilles and suprapatellar tendinitis due to isotretinoin.
J Rheumatol. 1995 Oct;22(10):2009-10. No abstract available.
PMID: 8992016 [PubMed - indexed for MEDLINE]
2. Szarfman A, Chen M, Blum MD. More on fluoroquinolone antibiotics and tendon rupture. N Engl J Med 1995; 332: 193[Free Full Text].
3. Magnesium Deficiency Induces Joint Cartilage Lesions in Juvenile Rats which are Identical to Quinolone Induced Arthropathy
Stahlmann et al (Antimicrobial Agents and Chemotherapy, Sept., 1995 pg 2013-2018)
4. Crowder SW, Jaffey LH.
Sarcoidosis presenting as Achilles tendinitis.
J R Soc Med. 1995 Jun;88(6):335-6.
PMID: 7629765 [PubMed - indexed for MEDLINE]
5. Pierfitte C, Gillet P, Royer RJ
More on fluoroquinolone antibiotics and tendon rupture.
N Engl J Med. 1995 Jan 19;332(3):193. No abstract available.
PMID: 7800022 [PubMed - indexed for MEDLINE]
6. Szarfman A, Chen M, Blum MD.
More on fluoroquinolone antibiotics and tendon rupture.
N Engl J Med. 1995 Jan 19;332(3):193. No abstract available.
PMID: 7800023 [PubMed - indexed for MEDLINE]
7. Norfloxacin induced arthalgia
Terry et al ( J Rheumatol 1995 22 793-794)
8. Fluoroquinolone Induced Tenosynovitis of the Wrist mimicking de Quervain's Disease
Gillet et al (British Journal of Rheumatology vol 34 no 6 pg 583-584, Feb 1995)
9. Mirovsky Y, Pollack L, Arlazoroff A, Halperin N.
[Ciprofloxacin-associated bilateral acute achilles tendinitis]
Harefuah. 1995 Dec 1;129(11):470-2, 535. Hebrew.
PMID: 8846955 [PubMed - indexed for MEDLINE]
1. McGarvey WC, Singh D, Trevino SG. Partial Achilles tendon ruptures associated with fluoroquinolone antibiotics: a case report and literature review. Foot Ankle Int 1996; 17: 496-498[ISI][Medline].
2. Pierfitte C, Royer RJ.
Tendon disorders with fluoroquinolones.
Therapie. 1996 Jul-Aug;51(4):419-20. No abstract available.
PMID: 8953821 [PubMed - indexed for MEDLINE]
3. Hugo-Persson M.
[Rupture of the Achilles tendon after ciproxine therapy]
Lakartidningen. 1996 Apr 17;93(16):1520. Swedish. No abstract available.
PMID: 8667750 [PubMed - indexed for MEDLINE]
4. Therapie 1996; 51: 419-420 Tendon disorders with fluoroquinolones 421 cases have been collected by the Centre de Pharmacovigilance, 340 of tendinitis and 81 cases of tendon rupture.
5. McGarvey WC, Singh D, Trevino SG.
Partial Achilles tendon ruptures associated with fluoroquinolone antibiotics: a
case report and literature review.
Foot Ankle Int. 1996 Aug;17(8):496-8. Review.
PMID: 8863030 [PubMed - indexed for MEDLINE]
6. Skovgaard D, Feldt-Rasmussen BF, Nimb L, Hede A, Kjaer M.
[Bilateral Achilles tendon rupture in individuals with renal transplantation]
Ugeskr Laeger. 1996 Dec 30;159(1):57-8. Danish.
PMID: 9012076 [PubMed - indexed for MEDLINE]
7. Jagose JT, McGregor DR, Nind GR, Bailey RR.
Achilles tendon rupture due to ciprofloxacin.
N Z Med J. 1996 Dec 13;109(1035):471-2. No abstract available.
PMID: 9006634 [PubMed - indexed for MEDLINE]
8, Ottosson L.
[An unexpected verdict by the HSAN in a case of Achilles tendon rupture]
Lakartidningen. 1996 Dec 18;93(51-52):4712, 4715. Swedish. No abstract available.
PMID: 9011717 [PubMed - indexed for MEDLINE]
9. Castagnola C, Suhler A.
[Tendinopathy and fluoroquinolones]
Ann Urol (Paris). 1996;30(3):129-30. French.
PMID: 8766149 [PubMed - indexed for MEDLINE]
10. Foot Ankle Int. 1996 Aug;17(8):496-8.
Partial Achilles tendon ruptures associated with fluoroquinolone antibiotics: a case report and literature review.
11. Fluoroquinolone induced arthralgia and Magnetic Resonance Imaging
Loeuille et al (The Journal of Rheumatology volume 23 no 7 , July 1996)
12. Fluoroquinolone Induced Tendinopathy; Report of Six Cases
Zabraniedkl et al (The Journal of Rhuematology 1996; 23; 3)
13. Quinolone induced cartilage lesions are not reversible in rats
Forster et al (Arch Toxicol (1996) 70; 474-481)
14. Maki T, Heinasmaki T, Riutta J, Tikkanen T, Laasonen L, Eklund K.
[Bilateral Achilles tendon rupture caused by oral fluoroquinolones]
Duodecim. 1996;112(19):1818-20. Finnish. No abstract available.
PMID: 10596182 [PubMed - indexed for MEDLINE
130 reported tendon inflammation or rupture (England, France and Belgium, 1996)
The group cited 130 reports of tendon inflammation or rupture in people who used the prescription drug in England, France and Belgium. The FDA has received at least 52 reports of patients in the U.S. who have suffered tendon damage
(from public citizens 1996 petition)
Szarfman et al. recommended that the labeling on packaging for fluoroquinolone be up-dated to include a warning about the possibility of tendon rupture. In its recommendations on the use of
this class of antibiotics, the British National Formulary
suggested that "at the first sign of pain or inflammation, patients should discontinue the treatment and rest the affected limb until the tendon symptoms have resolved."
British National Formulary. No. 32, p. 259. London, British Medical Association, Royal Pharmaceutical Society of Great Britain, 1996.
{Notice how this labeling change has not be altered since 1996 and appears to have been copied word for word in every monograph.}
921 reported tendon disorders France
340 reported tendonitis, 81 tendon ruptures 1996, WHO
Adverse drug reactions with fluoroquinolones The French system of drug surveillance has analyzed the reports of adverse drug reactions (ADRs) to fluoroquinolones since they were launched. The frequency of reactions ranges from 1/15000 to 1/208000 case per days of treatment. Cutaneous disorders and tendon disorders dominate in France, whereas cutaneous effects and neuropsychiatric disorders are predominant in the UK; tendon disorders take up only the 5th position. Among the most unexpected ADRs are the following: 1- Shock 2- Acure renal failure Tendon ruptures represent 81 cases for 921 reports of tendon disorders which are related in decreasing order to pefloxacin 1/23130 case per days of treatment, ofloxin, norfloxacin and ciprofloxacin 1/779600 case per days of treatment. Age and corticosteroids increase the risk of tendon rupture. Therapie 1996; 51; 419-420 Tendon disorders with fluoroquinolones 421 cases have been collected by the Centre de Pharmacovigilance: 340 of tendinitis and 81 of tendon rupture. These cases were attributed to Peflacine, Oflocet, Noroxine, Ciflox. Tendinitis was characterized by a bilateral malleolar oedema associated with a sudden pain. Sometimes this oedema evoked phlebitis. The tendon rupture was generally preceded by a tendinitis but in half of the cases it occurred without warning.
Source: http://www.who-umc.org/newsletter/newsltr97_1.html (sic)
1. Australia. The Adverse Drug Reactions Advisory Committee first reported tendinitis in association with fluoroquinolone antibiotics in 1997. The Committee has continued to monitor this adverse reaction, and has now received 60 reports of tendinitis, tensosynovitis and/or tendon rupture in association with these drugs. Ciprofloxacin was most frequently cited (55 reports), as well as norfloxacin (4) and enoxacin (1).
Forty-five reports described tendinitis alone, one report described tensosynovitis, and 14 reports documented tendon tear or rupture. Fifty-five of the 60 reports specified the Achilles tendon, including 20 which described bilateral Achilles tendon damage. All 14 reports of tendon rupture involved the Achilles tendon. The 58 patients ranged in age from 38 to 91 years (median: 69), with no significant difference between those with tendinitis and those with tendon rupture.
The daily doses of ciprofloxacin ranged from 500 mg to 2250 mg, with 46% of patients taking 1500 mg and 46% of patients taking 1000 mg daily. For those who developed tendon rupture, 57% were taking 1500 mg daily. Time to onset varied from within 24 hours after the drug was commenced to 3 months after starting, but the majority of cases of tendinitis occurred within the first week. Time to rupture was longer with a median time of 2-3 weeks. Known risk factors for these reactions include old age, renal dysfunction and concomitant corticosteroid therapy. In the cases reported to the ADRAC, 29 reports documented concomitant corticosteroid use, and in 21 of the other 31 reports the patients were aged 69 years or older. In the reports of tendon rupture, 12 of the 14 described either concomitant steroid use (9) or old age (9).
Prescribers are reminded to be alert for this reaction and to withdraw the fluoroquinolone immediately when symptoms of tendinitis appear in order to reduce the risk of tendon rupture.
[See also Pharmaceuticals Newsletter Nos. 7&8, July&August 1997.]
Tendinitis associated with Fluoroquinolone therapy
(Pharmaceuticals Newsletters Nos 7&8 July & August 1997)
2. 93 ruptures, 103 tendinopathies, 20 tenasynovitis, 1987-1997
Source: http://www.sma.org/smj1999/junesmj99/harrell.pdf
3. Danesh-Meyer MJ.
Complicated management of a patient with rapidly progressive periodontitis: a case report.
J N Z Soc Periodontol. 1997;(82):25-9. No abstract available.
PMID: 10483437 [PubMed - indexed for MEDLINE]
4. Poon CC, Sundaram NA.
Spontaneous bilateral Achilles tendon rupture associated with ciprofloxacin.
Med J Aust. 1997 Jun 16;166(12):665. No abstract available.
PMID: 9216589 [PubMed - indexed for MEDLINE]
5. Shinohara YT, Tasker SA, Wallace MR, Couch KE, Olson PE.
What is the risk of Achilles tendon rupture with ciprofloxacin?
J Rheumatol. 1997 Jan;24(1):238-9. No abstract available.
PMID: 9002057 [PubMed - indexed for MEDLINE]
6. Movin T, Gad A, Guntner P, Foldhazy Z, Rolf C.
Pathology of the Achilles tendon in association with ciprofloxacin treatment.
Foot Ankle Int. 1997 May;18(5):297-9.
PMID: 9167931 [PubMed - indexed for MEDLINE]
7. Tendons and Fluoroquinolones; Unresolved issues
Kahn et al (Rev Rhum [Engl. Ed.] 1997 64(7-9) 437-439)
(Rev Rhum [Ed. Fr.] 1997 64(7-9) 511-513
8. Fluoroquinolones tendinitis update Australia
Tendinitis associated with Fluoroquinolone therapy
(Pharmaceuticals Newsletters Nos 7&8 July & August 1997)
9. Toxic effects of quinolone antibacterial agents on the musculoskeletal system in juvenile rats
Yoko Kashida et al (Toxicologic Pathology vol 25 number 6 pages 635-643 1997)
10. Tendinitis and tendon rupture with fluoroquinolones
ADRAC (The Achilles heel of fluoroquinolones Aust Adv Drug React Bull 1997;16;7, Szarfman et al)
11. Effects of Ciprofloxacin and Ofloxacin on adult human cartilage in vitro
(Antimicrob Agents Chemother 1997, Vol 41; issue 11; pages 2562-2565)
12. Repeated rupture of the extensor tendons of the hand due to fluoroquinolones, Apropos of a case
Levadoux et al (Ann Chir Main Memb Super 1997, vol 16, issue 2, pgs 130-133)
13. Benizeau I, Cambon-Michot C, Daragon A, Voisin L, Mejjad O, Thomine JM, Le Loet X.
Tendinitis of the tibialis anterior with histologic documentation in a patient under fluoroquinolone therapy.
Rev Rhum Engl Ed. 1997 Jun;64(6):432-3. No abstract available.
PMID: 9513620 [PubMed - indexed for MEDLINE]
1. Khan KM, Cook JL, Bonar SF, Harcourt PR.
Subcutaneous rupture of the Achilles tendon.
Br J Sports Med. 1998 Jun;32(2):184-5. No abstract available.
PMID: 9631234 [PubMed - indexed for MEDLINE]
2. Stafford L, Bertouch J.
Reactive arthritis and ruptured Achilles tendon.
Ann Rheum Dis. 1998 Jan;57(1):61. No abstract available.
PMID: 9536827 [PubMed - indexed for MEDLINE]
3. Kahn MF.
Achilles tendinitis and ruptures.
Br J Sports Med. 1998 Sep;32(3):266. No abstract available.
PMID: 9773187 [PubMed - indexed for MEDLINE]
4. van der Linden PD, van Puijenbroek EP, Feenstra J, Veld BA, Sturkenboom MC, Herings RM, Leufkens HG, Stricker BH.
Tendon disorders attributed to fluoroquinolones: a study on 42 spontaneous reports in the period 1988 to 1998. Arthritis Rheum. 2001 Jun;45(3):235-9.
PMID: 11409663 [PubMed - indexed for MEDLINE]
5. Blanco Andres C, Bravo Toledo R.
[Bilateral tendinitis caused by ciprofloxacin]
Aten Primaria. 1998 Feb 28;21(3):184-5. Spanish. No abstract available.
PMID: 9607242 [PubMed - indexed for MEDLINE]
6. Tendon disorders attributed to fluoroquinolones; a study on 42 spontaneous reports in the period 1988-1998
Van Der Linden et al (American College of Rheumatology; Arthritis Care and Research 45; 2001 pages 235-239)
7. Petersen W, Laprell H
[Insidious rupture of the Achilles tendon after ciprofloxacin-induced tendopathy. A case report]
Unfallchirurg. 1998 Sep;101(9):731-4. German.
PMID: 9816984 [PubMed - indexed for MEDLINE]
8. Voorn R.
Case report: can sacroiliac joint dysfunction cause chronic Achilles
J Orthop Sports Phys Ther. 1998 Jun;27(6):436-43.
PMID: 9617730 [PubMed - indexed for MEDLINE]
9. West MB, Gow P.
Ciprofloxacin, bilateral Achilles tendonitis and unilateral tendon rupture--a case report.
N Z Med J. 1998 Jan 23;111(1058):18-9. No abstract available.
PMID: 9484431 [PubMed - indexed for MEDLINE]
10. Gabutti L, Stoller R, Marti HP.
[Fluoroquinolones as etiology of tendinopathy]
Ther Umsch. 1998 Sep;55(9):558-61. German.
PMID: 9789471 [PubMed - indexed for MEDLINE]
704 achilles tendinitis, 38 ruptures 1992-1998 Netherlands
Fluoroquinolone use and the change in incidence of tendon rupture in the Netherlands
Van der Linden et al (Pharmacy World and Science vol 23 no 3 2001 pg 89-92)
The cohort included 46 776 users of fluoroquinolones between 1 July 1992 and 30 June 30 1998, of whom 704 had Achilles tendinitis and 38 had Achilles tendon rupture
source: http://bmj.com/cgi/content/full/324/7349/1306
12. 42 spontaneous reports 1988-1998
Tendon disorders attributed to fluoroquinolones; a study on 42 spontaneous reports in the period 1988-1998
Van Der Linden et al (American College of Rheumatology; Arthritis Care and Research 45; 2001 pages 235-239) June 2001
1. Eriksson E.
In vivo microdialysis of painful achilles tendinosis.
Knee Surg Sports Traumatol Arthrosc. 1999;7(6):339. No abstract available.
PMID: 10639649 [PubMed - indexed for MEDLINE]
2. Mousa A, Jones S, Toft A, Perros P.
Spontaneous rupture of Achilles tendon: missed presentation of Cushing's syndrome.
BMJ. 1999 Aug 28;319(7209):560-1. No abstract available.
PMID: 10463901 [PubMed - indexed for MEDLINE]
3. Harrell RM.
Fluoroquinolone-induced tendinopathy: what do we know?
South Med J. 1999 Jun;92(6):622-5. Review.
PMID: 10372859 [PubMed - indexed for MEDLINE]
4. Gibbon WW, Cooper JR, Radcliffe GS.
Sonographic incidence of tendon microtears in athletes with chronic Achilles tendinosis.
Br J Sports Med. 1999 Apr;33(2):129-30.
PMID: 10205697 [PubMed - indexed for MEDLINE]
5. Lewis JR, Gums JG, Dickensheets DL.
Levofloxacin-induced bilateral Achilles tendonitis.
Ann Pharmacother. 1999 Jul-Aug;33(7-8):792-5.
PMID: 10466906 [PubMed - indexed for MEDLINE]
6. Zambanini A, Padley S, Cox A, Feher M.
Achilles tendonitis: an unusual complication of amlodipine therapy.
J Hum Hypertens. 1999 Aug;13(8):565-6. No abstract available.
PMID: 10455480 [PubMed - indexed for MEDLINE]
7. van der Linden PD, van de Lei J, Nab HW, Knol A, Stricker BH.
Achilles tendinitis associated with fluoroquinolones.
Br J Clin Pharmacol. 1999 Sep;48(3):433-7.
PMID: 10510157 [PubMed - indexed for MEDLINE]
8. Van der Linden PD, van de Lei J, Nab HW, Knol A, Stricker BHCh. Achilles tendinitis associated with fluoroquinolones. Br J Clin Pharmacol 1999; 48: 433-437[CrossRef][ISI][Medline].
9. 60 reported tendonitis August 1999
Fluoroquinolones tendinitis update Australia
Tendinitis associated with Fluoroquinolone therapy
(Pharmaceuticals Newsletters Nos 7&8 July & August 1997)
ADRAC Bulletin, vol 18, No 3, August 1999
Tendinitis and tendon rupture with
The Adverse Drug Reactions Advisory Committee (ADRAC) first reported tendinitis in association with the fluoroquinolone antibiotics in 1997. The Committee has continued to monitor this adverse
reaction, and has now received 60 reports of tendinitis, tenosynovitis and/or tendon rupture in association with these drugs. Most involved was ciprofloxacin (55), but there were also reports with norfloxacin (4) and enoxacin (1). Fortyfive reports described tendinitis alone, one report described tenosynovitis, and 14 reports documented tendon tear or rupture. Fifty five of the 60 reports specified the Achilles tendon, including 20 which described bilateral
Achilles tendon damage. All 14 reports of tendon rupture
involved the Achilles tendon.
Source: http://www.who.int/medicines/library/pnewslet/pndec99.html
10. 421 reported tendon disorders and 81 tendon ruptures 1999
Therapie 1996; 51: 419-420 Tendon disorders with fluoroquinolones 421 cases have been collected by the Centre de Pharmacovigilance, 340 of tendinitis and 81 cases of tendon rupture.
11. Rev Rhum Engl Ed. 1999 Jul-Sep;66(7-9):419-21.
Suspected role of ofloxacin in a case of arthalgia, myalgia, and multiple tendinopathy.
12. Levofloxacin-induced bilateral Achilles tendonitis
Lewis JR, JG Gums, and DL Dickensheets 1999
13. Inhibition of fibroblast metabolism by a fluoroquinolone antibiotic
Williams et al (American Academy of Orthopedic Surgeons, 1999 Annual meeting, paper number 118, Geb 5, 1999)
14. Levofloxacin induced bilateral achilles tendinitis
Lewis et al (The Annals of Pharmacotherapy 1999 July/August, volume 33 pages 792-795)
15. Fluoroquinolone induced tendinopathy; what do we know?
Harrell et al (South Med J 92(6) 622-625 1999)
16. Ann Pharmacother. 1999 Jul-Aug;33(7-8):792-5.
Levofloxacin-induced bilateral Achilles tendonitis.
17. Schwald N, Debray-Meignan S.
Suspected role of ofloxacin in a case of arthalgia, myalgia, and multiple tendinopathy.
Rev Rhum Engl Ed. 1999 Jul-Sep;66(7-9):419-21.
PMID: 10526383 [PubMed - indexed for MEDLINE]
1. Fluoroquinolone induced tendinopathy; also occurring with levofloxacin
Fleisch et al (Infection 28 2000 no 4 pages 256-257)
2. Infection. 2000 Jul-Aug;28(4):256-7.
Fluoroquinolone-induced tendinopathy: also occurring with levofloxacin.
3. Quinolone and Tendon Ruptures
Casperian et al (Southern Medical Journal May 2000 vol 93 no 5 pages 488-491)
4. Evaluation of toxicokinetic variables and arthropathic changes in juvenile rabbits after oral administration of an ivestigational fluoroquinolone, pd 117596
Johnson et al (AJVR vol 61 no 11, pages, 1396-1402, November 2000)
5. Rupture of the patellar ligament one month after treatment with fluoroquinolone
Rev Chir Orthop Reparatrice Appar Mot. 2000 Sep;86(5):495-7.
42 reported tendinopathies 2000
Register of adverse drug reactions in 2000
7. The majority of ADR reports received among antibacterials concerned levofloxacin, which is a fluoroquinolone antibiotic. Fourteen of the reports were on tendinitis or rupture of the Achilles tendon. Tendinitis caused by fluoroquinolones was discussed in TABU for the first time in 1996. Since then the ADR register has received a total of 42 reports on tendinopathies caused by
fluoroquinolones, over a third of which were ruptures of the tendon.
The use of fluoroquinolones has in-creased by about 75% since 1996. Levofloxacin is responsible for the major part of this increase. It has been marketed in Finland since mid 1998.
source: www.nam.fi/uploads/english/Publications/Tabu/tabu22001_eng.pdf
8. Casado Burgos E, Vinas Ponce G, Lauzurica Valdemoros R, Olive Marques A.
[Levofloxacin-induced tendinitis]
Med Clin (Barc). 2000 Mar 4;114(8):319. Spanish. No abstract available.
PMID: 10774524 [PubMed - indexed for MEDLINE]
9. Casparian JM, Luchi M, Moffat RE, Hinthorn D.
Quinolones and tendon ruptures.
South Med J. 2000 May;93(5):488-91. Review.
PMID: 10832946 [PubMed - indexed for MEDLINE]
10. Gravlee JR, Hatch RL, Galea AM.
Achilles tendon rupture: a challenging diagnosis.
J Am Board Fam Pract. 2000 Sep-Oct;13(5):371-3. No abstract available.
PMID: 11001009 [PubMed - indexed for MEDLINE]
11. Kouvalchouk JF, Hassan E
[Achilles tendon disorders]
Tunis Med. 2000 Jun-Jul;78(6-7):462-7. Review. French. No abstract available.
PMID: 11043038 [PubMed - indexed for MEDLINE]
12. Ortiz V, Holgado S, Olive A, Fite E.
Ach illes tendinitis as the presentation form of Lofgren's syndrome.
Clin Rheumatol. 2000;19(2):169-70.
PMID: 10791635 [PubMed - indexed for MEDLINE]
13. Vavra-Hadziahmetovic N, Hadziahmetovic Z, Smajlovic F.
Phy sical therapy in conservative (functional) treatment of acute achilles tendon rupture.
Med Arh. 2000;54(2):121-2.
PMID: 10934845 [PubMed - indexed for MEDLINE]
14. Martinelli B.
Rupture of the Achilles tendon.
J Bone Joint Surg Am. 2000 Dec;82-A(12):1804. No abstract available.
PMID: 11130653 [PubMed - indexed for MEDLINE]
1. Rev Clin Esp. 2001 Sep;201(9):539-40.
Achilles pain and functional impotence in a patient with chronic obstructive pulmonary disease with pneumonia. Tendon rupture caused by levofloxacin
2. Pharm World Sci. 2001 Jun;23(3):89-92.
Fluoroquinolone use and the change in incidence of tendon ruptures in the Netherlands.
van der Linden PD, Nab HW, Simonian S, Stricker BH, Leufkens HG, Herings RM.
3. Mennecier D, Thiolet C, Bredin C, Potier V, Vergeau B, Farret O.
[Acute pancreatitis after treatment by levofloxacin and methylprednisolone]
Gastroenterol Clin Biol. 2001 Oct;25(10):921-2. French. No abstract available.
PMID: 11852403 [PubMed - indexed for MEDLINE]
4. Csizy M, Hintermann B.
[Rupture of the Achilles tendon after local steroid injection. Case reports and consequences for treatment]
Swiss Surg. 2001;7(4):184-9. German.
PMID: 11515194 [PubMed - indexed for MEDLINE]
5. Adverse reactions to fluoroquinolones an overview on mechanistic aspects
De Sarro et al (Current Medicinal Chemistry 2001, 8, 371-384)
6. Fluoroquinolone use and the change in incidence of tendon rupture in the Netherlands
Van der Linden et al (Pharmacy World and Science vol 23 no 3 2001 pg 89-92)
7. Tendon disorders attributed to fluoroquinolones; a study on 42 spontaneous reports in the period 1988-1998
Van Der Linden et al (American College of Rheumatology; Arthritis Care and Research 45; 2001 pages 235-239)
8. 1847 reported tendinopathies December 2001
Tabelle 7
Pharmacovigilance: Meldungen von Tendinopathien im Vergleich zu allen gemeldeten unerwünschten Arzneimittelwirkungen (UAW), Stand 17. Dezember 2001.
9. Meldungen Schweiz (IKS-Datenbank) Welt (WHO-Datenbank)
Tendinopathie alle UAW Tendinopathie alle UAW
Ciprofloxacin 8 (5%) 155 649(2,2%) 29 090
Fleroxacin 9 (1,2 %) 754
Norfloxacin 1 (1%) 91 163 (2,1%) 7536
Ofloxacin 2 (6%) 34 432 (1,8%) 23 990
Levofloxacin 32 (41%) 79 576 (7,8%) 7432
Moxifloxacin 18 (4,5 %) 4030
Source: http://www.saez.ch/pdf/2003/2003-02/2003-02-694.PDF
Spontaneous Ruptures of the Achilles Tendon, US Armed Forces, 1998-2001
Methods. The Defense Medical Surveillance System was searched to identify all incident ambulatory visits of active duty servicemembers with a primary diagnosis of non-traumatic rupture of the achilles tendon (ICD-9- CM code 727.67) and other tendon ruptures (ICD-9- CM codes 727.60-727.66, 727.68-727.69) between January 1998 and May 2001.
The most striking finding of this analysis is the sudden and significant increase in rates of achilles tendon ruptures beginning in calendar year 2000. The increase was manifested across all Services and in most demographic subgroups (table 1). Rates
of non-traumatic ruptures of several other tendons also increased during the period; and increases in ruptures of the rotator cuff were comparable to those of the achilles tendon.
Source: http://amsa.army.mil/1Msmr/2002/v08_n01.pdf
11. Nuno Mateo FJ, Noval Menendez J, Suarez M, Guinea O.
[Achilles pain and functional impotence in a patient with chronic obstructive pulmonary disease with pneumonia. Tendon rupture caused by levofloxacin]
Rev Clin Esp. 2001 Sep;201(9):539-40. Spanish. No abstract available.
PMID: 11692412 [PubMed - indexed for MEDLINE]
12. Malaguti M, Triolo L, Biagini M.
Ciprofloxacin-associated Achilles tendon rupture in a hemodialysis patient.
J Nephrol. 2001 Sep-Oct;14(5):431-2. No abstract available.
PMID: 11730281 [PubMed - indexed for MEDLINE]
13. Butler MW, Griffin JF, Quinlan WR, McDonnell TJ.
Quinolone-associated tendonitis: a potential problem in COPD?
Ir J Med Sci. 2001 Jul-Sep;170(3):198-9.
PMID: 12120977 [PubMed - indexed for MEDLINE]
14. Bharani A, Kumar H.
Drug points: Diabetes inspidus induced by ofloxacin.
BMJ. 2001 Sep 8;323(7312):547. No abstract available.
PMID: 11546701 [PubMed - indexed for MEDLINE]
15. Toverud EL, Landaas S, Hellebostad M.
Repeated achilles tendinitis after high dose methotrexate.
Med Pediatr Oncol. 2001 Aug;37(2):156. No abstract available.
PMID: 11496361 [PubMed - indexed for MEDLINE]
16. Oatridge A, Herlihy AH, Thomas RW, Wallace AL, Curati WL, Hajnal JV, Bydder GM.
Magnetic resonance: magic angle imaging of the Achilles tendon.
Lancet. 2001 Nov 10;358(9293):1610-1.
PMID: 11716890 [PubMed - indexed for MEDLINE]
17. Fletcher MD, Warren PJ.
Sural nerve injury associated with neglected tendo Achilles ruptures.
Br J Sports Med. 2001 Apr;35(2):131-2.
PMID: 11273977 [PubMed - indexed for MEDLINE]
18. Humble RN, Nugent LL.
Achilles' tendonitis. An overview and reconditioning model.
Clin Podiatr Med Surg. 2001 Apr;18(2):233-54. Review.
PMID: 11417153 [PubMed - indexed for MEDLINE]
19. Eriksson E.
Achilles tendon surgery and wound healing.
Knee Surg Sports Traumatol Arthrosc. 2001 Jul;9(4):193. No abstract available.
PMID: 11522072 [PubMed - indexed for MEDLINE]
20. Speed CA.
Fortnightly review: Corticosteroid injections in tendon lesions.
BMJ. 2001 Aug 18;323(7309):382-6. No abstract available.
PMID: 11509432 [PubMed - indexed for MEDLINE]
21. Van der Linden et al (Pharmacy World and Science vol 23 no 3 2001 pg 89-92)
The cohort included 46 776 users of fluoroquinolones between 1 July 1992 and 30 June 30 1998, of whom 704 had Achilles tendinitis and 38 had Achilles tendon rupture
source: http://bmj.com/cgi/content/full/324/7349/1306
1. Ulreich N, Kainberger F, Huber W, Nehrer S.
[Achilles tendon and sports]
Radiologe. 2002 Oct;42(10):811-7. German.
PMID: 12402109 [PubMed - indexed for MEDLINE]
2. Doral MN, Tetik O, Atay OA, Leblebicioglu G, Oznur A.
[Achilles tendon diseases and its management]
Acta Orthop Traumatol Turc. 2002;36 Suppl 1:42-6. Review. Turkish. No abstract available.
PMID: 12510123 [PubMed - indexed for MEDLINE]
3. Hersh BL, Heath NS.
Achilles tendon rupture as a result of oral steroid therapy.
J Am Podiatr Med Assoc. 2002 Jun;92(6):355-8.
PMID: 12070236 [PubMed - indexed for MEDLINE]
4. [No authors listed]
Side effects of levofloxacin.
Prescrire Int. 2002 Aug;11(60):116-7. No abstract available.
PMID: 12199267 [PubMed - indexed for MEDLINE]
5. Hatori M, Matsuda M, Kokubun S.
Ossification of Achilles tendon--report of three cases.
Arch Orthop Trauma Surg. 2002 Sep;122(7):414-7. Epub 2002 May 03.
PMID: 12228804 [PubMed - indexed for MEDLINE]
6. Pouzaud F, Rat P, Cambourieu C, Nourry H, Warnet JM.
[Tenotoxic potential of fluoroquinolones in the choice of surgical antibiotic prophylaxis in ophthalmology]
J Fr Ophtalmol. 2002 Nov;25(9):921-6. French.
PMID: 12515937 [PubMed - indexed for MEDLINE]
7. Sobel E, Giorgini R, Hilfer J, Rostkowski T.
Ossification of a ruptured achilles tendon: a case report in a diabetic patient.
J Foot Ankle Surg. 2002 Sep-Oct;41(5):330-4.
PMID: 12400718 [PubMed - indexed for MEDLINE]
8. Lohrer H, Scholl J, Arentz S.
[Achilles tendinopathy and patellar tendinopathy. Results of radial shockwave therapy in patients with unsuccessfully treated tendinoses] Sportverletz Sportschaden. 2002 Sep;16(3):108-14. German. No abstract available.
PMID: 12382183 [PubMed - indexed for MEDLINE]
9. Eriksen HA, Pajala A, Leppilahti J, Risteli J.
Increased content of type III collagen at the rupture site of human Achilles tendon.
J Orthop Res. 2002 Nov;20(6):1352-7.
PMID: 12472252 [PubMed - indexed for MEDLINE]
10. Kannus P, Paavola M, Paakkala T, Parkkari J, Jarvinen T, Jarvinen M.
[Pathophysiology of overuse tendon injury]
Radiologe. 2002 Oct;42(10):766-70. German.
PMID: 12402104 [PubMed - indexed for MEDLINE]
11. Summers JB.
Importance of an accurate diagnosis for Achilles rupture.
Am Fam Physician. 2002 Nov 15;66(10):1836. No abstract available.
PMID: 12469956 [PubMed - indexed for MEDLINE]
12. Ulreich N, Huber W, Nehrer S, Kainberger F.
[High resolution magnetic resonance tomography and ultrasound imaging of the Achilles tendon]
Wien Med Wochenschr Suppl. 2002;(113):39-40. German.
PMID: 12621837 [PubMed - indexed for MEDLINE]
13. Dwornik L, Lomasney LM, Demos TC, Lavery LA.
Radiologic case study. Acute Achilles tendon rupture.
Orthopedics. 2002 Nov;25(11):1239, 1318-20. No abstract available.
PMID: 12452339 [PubMed - indexed for MEDLINE]
14. Wood ML, Schlessinger S.
Levaquin induced acute tubulointerstitial nephritis--two case reports.
J Miss State Med Assoc. 2002 Apr;43(4):116-7. No abstract available.
PMID: 11989200 [PubMed - indexed for MEDLINE]
15. McClelland D, Maffulli N.
Percutaneous repair of ruptured Achilles tendon.
J R Coll Surg Edinb. 2002 Aug;47(4):613-8. Review.
PMID: 12363186 [PubMed - indexed for MEDLINE]
16. Eriksson E.
Tendinosis of the patellar and achilles tendon.
Knee Surg Sports Traumatol Arthrosc. 2002 Jan;10(1):1. Epub 2001 Dec 18. No abstract available.
PMID: 11819012 [PubMed - indexed for MEDLINE]
17. Bleakney RR, Tallon C, Wong JK, Lim KP, Maffulli N.
Long-term ultrasonographic features of the Achilles tendon after rupture.
Clin J Sport Med. 2002 Sep;12(5):273-8.
PMID: 12394198 [PubMed - indexed for MEDLINE]
18. Majewski M, Widmer KH, Steinbruck K.
[Achilles tendon ruptures: 25 year's experience in sport-orthopedic treatment]
Sportverletz Sportschaden. 2002 Dec;16(4):167-73. German.
PMID: 12563559 [PubMed - indexed for MEDLINE]
19. Cook JL, Khan KM, Purdam C.
Achilles tendinopathy.
Man Ther. 2002 Aug;7(3):121-30. Review.
PMID: 12372309 [PubMed - indexed for MEDLINE]
20. Shukla DD.
Bilateral spontaneous rupture of achilles tendon secondary to limb ischemia: a case report.
J Foot Ankle Surg. 2002 Sep-Oct;41(5):328-9.
PMID: 12400717 [PubMed - indexed for MEDLINE]
21. Grechenig W, Clement H, Bratschitsch G, Fankhauser F, Peicha G.
[Ultrasound diagnosis of the Achilles tendon]
Orthopade. 2002 Mar;31(3):319-25. German.
PMID: 12017866 [PubMed - indexed for MEDLINE]
22. Mazzone MF, McCue T.
Common conditions of the achilles tendon.
Am Fam Physician. 2002 May 1;65(9):1805-10. Review.
PMID: 12018803 [PubMed - indexed for MEDLINE]
23. Schepsis AA, Jones H, Haas AL.
Achilles tendon disorders in athletes.
Am J Sports Med. 2002 Mar-Apr;30(2):287-305. Review.
PMID: 11912103 [PubMed - indexed for MEDLINE]
24. Fluoroquinolones and risk of Achilles tendon disorders: case-control study BMJ 2002;324:1306-1307 ( 1 June ) P D van der Linden, researcher a, M C J M Sturkenboom, assistant professor a, R M C Herings, associate professor b, H G M Leufkens, professor b, B H Ch Stricker, professor a.
a Pharmaco-epidemiology Unit, Department of Epidemiology & Biostatistics and Internal Medicine, Erasmus Medical Centre Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands, b Department of Pharmaco-epidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
25. Pai VS, Patel N.
Atypical coronal or sagittal Z ruptures of the achilles tendon: a report of four cases.
J Foot Ankle Surg. 2002 May-Jun;41(3):183-5.
PMID: 12075907 [PubMed - indexed for MEDLINE]
26. van der Linden PD, Sturkenboom MC, Herings RM, Leufkens HG, Stricker BH.
Fluoroquinolones and risk of Achilles tendon disorders: case-control study.
BMJ. 2002 Jun 1;324(7349):1306-7. No abstract available.
PMID: 12039823 [PubMed - indexed for MEDLINE]
27. Tiling T.
[Is an Achilles tendon rupture without degeneration possible?]
Dtsch Med Wochenschr. 2002 Jun 21;127(25-26):1401. German. No abstract available.
PMID: 12075502 [PubMed - indexed for MEDLINE]
28. Med Clin (Barc). 2003 Jan 25;120(2):78-9.
Comment on: Med Clin (Barc). 2002 Jun 8;119(1):38-9.
Levofloxacin and bilateral spontaneous Achilles tendon rupture
29. 4 cases of levaquin induced tendintis (orign spansih)
Mica magazine of Chile Issn0034-9887 versi printed
Rev. m. Chilev.130n.11Santiagonov.2002
Rev Méd Chile 2002; 130: 1277-1281
Associated aquiliana Tendinitis to the levofloxacino use:
communication of four cases
Claudius Hoops And, Claudius Flowers W, Sergio Mezzano A.
Levofloxacin associated Achilles
29. Pedros A, Emilio Gomez J, Angel Navarro L, Tomas A.
[Levofloxacin and acute confusional syndrome]
Med Clin (Barc). 2002 Jun 8;119(1):38-9. Spanish. No abstract available.
PMID: 12062009 [PubMed - indexed for MEDLINE]
30. Maffulli N, Kader D.
Tendinopathy of tendo achillis.
J Bone Joint Surg Br. 2002 Jan;84(1):1-8. Review. No abstract available.
PMID: 11837811 [PubMed - indexed for MEDLINE]
31. Sidorenko SV, Krivitskaia NS
[Use of ciprofloxacin in sequential antibiotic therapy]
Antibiot Khimioter. 2002;47(7):25-30. Review. Russian. No abstract available.
PMID: 12516193 [PubMed - indexed for MEDLINE]
32. Paavola M, Kannus P, Jarvinen TA, Khan K, Jozsa L, Jarvinen M.
Achilles tendinopathy.
J Bone Joint Surg Am. 2002 Nov;84-A(11):2062-76. Review. No abstract available.
PMID: 12429771 [PubMed - indexed for MEDLINE]
33. Roberts C, Deliss L.:
Acute rupture of tendo Achillis.
J Bone Joint Surg Br. 2002 May;84(4):620; author reply 620. No abstract available.
PMID: 12043793 [PubMed - indexed for MEDLINE]
34. Tumia N, Kader D, Arena B, Maffulli N
Achilles tendinopathy during pregnancy.
Clin J Sport Med. 2002 Jan;12(1):43-5. No abstract available.
PMID: 11854590 [PubMed - indexed for MEDLINE]
35. Paffey MD, Faraj AA.
Acute rupture of tendo Achillis.
J Bone Joint Surg Br. 2002 May;84(4):620-1; author reply 621. No abstract available.
PMID: 12043792 [PubMed - indexed for MEDLINE]
36. Chhajed PN, Plit ML, Hopkins PM, Malouf MA, Glanville AR.
Achilles tendon disease in lung transplant recipients: association with ciprofloxacin.
Eur Respir J. 2002 Mar;19(3):469-71.
PMID: 11936524 [PubMed - indexed for MEDLINE]
37. Greene BL.Physical therapist management of fluoroquinolone-induced Achilles tendinopathy.
Phys Ther. 2002 Dec;82(12):1224-31.
PMID: 12444881 [PubMed - indexed for MEDLINE]
38. Breck RW.
"Ciprofloxacin: a warning for clinicians".
Conn Med. 2002 Oct;66(10):635. No abstract available.
PMID: 12448217 [PubMed - indexed for MEDLINE]
39. Hufner T, Wohifarth K, Fink M, Thermann H, Rollnik JD.
EMG monitoring during functional non-surgical therapy of Achilles tendon rupture.
Foot Ankle Int. 2002 Jul;23(7):614-8.
PMID: 12146771 [PubMed - indexed for MEDLINE]
40. Khurana R, Torzillo PJ, Horsley M, Mahoney J.
Spontaneous bilateral rupture of the Achilles tendon in a patient with chronic obstructive pulmonary disease.
Respirology. 2002 Jun;7(2):161-3.
PMID: 11985741 [PubMed - indexed for MEDLINE]
41. Mert G.
Rupture of the Achilles tendon in athletes: do synthetic grass fields play a part?
J Bone Joint Surg Am. 2002 Feb;84-A(2):320-1. No abstract available.
PMID: 11861742 [PubMed - indexed for MEDLINE]
42. Lynch RM
Management of Achilles tendon ruptures.
Am J Sports Med. 2002 Nov-Dec;30(6):917; author reply 917-8. No abstract
PMID: 12435663 [PubMed - indexed for MEDLINE]
43. Amendola N.
Surgical treatment of acute rupture of the tendo Achillis led to fewer
reruptures and better patient-generated ratings than did nonsurgical treatment.
J Bone Joint Surg Am. 2002 Feb;84-A(2):324. No abstract available.
PMID: 11861747 [PubMed - indexed for MEDLINE]
44. Zwar RB.
Utility of musculoskeletal ultrasound.
Aust Fam Physician. 2002 Jun;31(6):559, 561.
PMID: 12154604 [PubMed - indexed for MEDLINE]
45. Cottrell WC, Pearsall AW 4th, Hollis MJ.
Simultaneous tears of the Achilles tendon and medial head of the gastrocnemius muscle.
Orthopedics. 2002 Jun;25(6):685-7. No abstract available.
PMID: 12083581 [PubMed - indexed for MEDLINE]
1. Journal of Antimicrobial Chemotherapy (2003) 51, 747–748
DOI: 10.1093/jac/dkg081
Advance Access publication 28 January 2003
Spontaneous Achilles tendon rupture in patients
treated with levofloxacin
L. J. Haddow, M. Chandra Sekhar, V. Hajela and
G. Gopal Rao
2. Manoj Kumar RV, Rajasekaran S.
Spontaneous tendon ruptures in alkaptonuria.
J Bone Joint Surg Br. 2003 Aug;85(6):883-6.
PMID: 12931812 [PubMed - indexed for MEDLINE]
3. Harris RD, Nindl G, Balcavage WX, Weiner W, Johnson MT.
Use of proteomics methodology to evaluate inflammatory protein expression in tendinitis.
Biomed Sci Instrum. 2003;39:493-9.
PMID: 12724941 [PubMed - indexed for MEDLINE]
4. Milgrom C, Finestone A, Zin D, Mandel D, Novack V.
Cold weather training: a risk factor for Achilles paratendinitis among
Foot Ankle Int. 2003 May;24(5):398-401.
PMID: 12801195 [PubMed - indexed for MEDLINE]
5. Schwalm JD, Lee CH.
Acute hepatitis associated with oral levofloxacin therapy in a hemodialysis patient.
CMAJ. 2003 Apr 1;168(7):847-8.
PMID: 12668542 [PubMed - indexed for MEDLINE]
6. Oh YR, Carr-Lopez SM, Probasco JM, Crawley PG.
Levofloxacin-induced autoimmune hemolytic anemia.
Ann Pharmacother. 2003 Jul-Aug;37(7-8):1010-3.
PMID: 12841809 [PubMed - indexed for MEDLINE]
7. Bardin L.
Comments on 'Achilles tendinopathy'.
Man Ther. 2003 Aug;8(3):189; author reply 190-1. No abstract available.
PMID: 12909446 [PubMed - indexed for MEDLINE]
8. Ackermann PW, Li J, Lundeberg T, Kreicbergs A.
Neuronal plasticity in relation to nociception and healing of rat achilles tendon.
J Orthop Res. 2003 May;21(3):432-41.
PMID: 12706015 [PubMed - indexed for MEDLINE]
9. Gotoh M, Higuchi F, Suzuki R, Yamanaka K.
Progression from calcifying tendinitis to rotator cuff tear.
Skeletal Radiol. 2003 Feb;32(2):86-9. Epub 2002 Apr 05.
PMID: 12589487 [PubMed - indexed for MEDLINE]
10. Dalal RB, Zenios M.
The flexor hallucis longus tendon transfer for chronic tendo-achilles ruptures revisited. Ann R Coll Surg Engl. 2003 Jul;85(4):283. No abstract available.
PMID: 12908473 [PubMed - indexed for MEDLINE]
11. Joseph TA, Defranco MJ, Weiker GG.
Delayed repair of a pectoralis major tendon rupture with allograft: A case report.
J Shoulder Elbow Surg. 2003 Jan-Feb;12(1):101-4. No abstract available.
PMID: 12610495 [PubMed - indexed for MEDLINE]
12. [No authors listed]
Tendon abnormalities and hypersensitivity of levofloxacin.
Prescrire Int. 2003 Feb;12(63):20. No abstract available.
PMID: 12602391 [PubMed - indexed for MEDLINE]
13. Magnusson SP, Beyer N, Abrahamsen H, Aagaard P, Neergaard K, Kjaer M.
Increased cross-sectional area and reduced tensile stress of the Achilles tendon in elderly compared with young women.
J Gerontol A Biol Sci Med Sci. 2003 Feb;58(2):123-7.
PMID: 12586849 [PubMed - indexed for MEDLINE]
14. Khan KM, Forster BB, Robinson J, Cheong Y, Louis L, Maclean L, Taunton JE.
Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study.
Br J Sports Med. 2003 Apr;37(2):149-53.
PMID: 12663358 [PubMed - indexed for MEDLINE]
15. DY, Song JC, Wang CC.
Anaphylactoid reaction to ciprofloxacin.
Ann Pharmacother. 2003 Jul-Aug;37(7-8):1018-23.
PMID: 12841811 [PubMed - indexed for MEDLINE]
16. Ying M, Yeung E, Li B, Li W, Lui M, Tsoi CW.
Sonographic evaluation of the size of Achilles tendon: the effect of exercise and dominance of the ankle.
Ultrasound Med Biol. 2003 May;29(5):637-42.
PMID: 12754062 [PubMed - indexed for MEDLINE]
17. Cook J, Khan K.
The treatment of resistant, painful tendinopathies results in frustration for athletes and health professionals alike.
Am J Sports Med. 2003 Mar-Apr;31(2):327-8; author reply 328. No abstract available.
PMID: 12642274 [PubMed - indexed for MEDLINE]
18. [No authors listed]
Fluoroquinolones in ambulatory ENT and respiratory tract infections: rarely appropriate.
Prescrire Int. 2003 Feb;12(63):26-7.
PMID: 12602405 [PubMed - indexed for MEDLINE]
19. Matsumoto F, Trudel G, Uhthoff HK, Backman DS.
Mechanical effects of immobilization on the Achilles' tendon.
Arch Phys Med Rehabil. 2003 May;84(5):662-7.
PMID: 12736878 [PubMed - indexed for MEDLINE]
20. Maffulli N, Kenward MG, Testa V, Capasso G, Regine R, King JB.
Clinical diagnosis of Achilles tendinopathy with tendinosis.
Clin J Sport Med. 2003 Jan;13(1):11-5.
PMID: 12544158 [PubMed - indexed for MEDLINE]
21. Forslund C.
BMP treatment for improving tendon repair. Studies on rat and rabbit Achilles tendons.
Acta Orthop Scand Suppl. 2003 Feb;74(308):I, 1-30. No abstract available.
PMID: 12640969 [PubMed - indexed for MEDLINE]
22. Cetti R, Junge J, Vyberg M.
Spontaneous rupture of the Achilles tendon is preceded by widespread and bilateral tendon damage and ipsilateral inflammation: a clinical and histopathologic study of 60 patients.
Acta Orthop Scand. 2003 Feb;74(1):78-84.
PMID: 12635798 [PubMed - indexed for MEDLINE]
23. Mulvaney S.
Calf muscle therapy for Achilles tendinosis.
Am Fam Physician. 2003 Mar 1;67(5):939; author reply 939-40. No abstract available.
PMID: 12643353 [PubMed - indexed for MEDLINE]
24. Khaliq Y, Zhanel GG.
Fluoroquinolone-associated tendinopathy: a critical review of the literature.
Clin Infect Dis. 2003 Jun 1;36(11):1404-10. Epub 2003 May 20. Review.
PMID: 12766835 [PubMed - indexed for MEDLINE]
25. Prasad S, Lee A, Clarnette R, Faull R.
Spontaneous, bilateral patellar tendon rupture in a woman with previous Achilles tendon rupture and systemic lupus erythematosus.
Rheumatology (Oxford). 2003 Jul;42(7):905-6. No abstract available.
PMID: 12826711 [PubMed - indexed for MEDLINE]
26. Gold L, Igra H.
Levofloxacin-induced tendon rupture: a case report and review of the literature.
J Am Board Fam Pract. 2003 Sep-Oct;16(5):458-60. Review. No abstract available.
PMID: 14645337 [PubMed - indexed for MEDLINE]
27. Schindler C, Pittrow D, Kirch W.
Reoccurrence of levofloxacin-induced tendinitis by phenoxymethylpenicillin therapy after 6 months: a rare complication of fluoroquinolone therapy?
Chemotherapy. 2003 May;49(1-2):90-1. No abstract available.
PMID: 12756981 [PubMed - indexed for MEDLINE]
28. de La Red G, Mejia JC, Cervera R, Llado A, Mensa J, Font J.
Bilateral Achilles tendinitis with spontaneous rupture induced by levofloxacin in a patient with systemic sclerosis.
Clin Rheumatol. 2003 Oct;22(4-5):367-8. No abstract available.
PMID: 14579169 [PubMed - indexed for MEDLINE]
29. Tomas ME, Perez Carreras M, Morillasa JD, Castellano G, Solis JA.
[Rupture of the Achilles' tendon secondary to levofloxacin]
Gastroenterol Hepatol. 2003 Jan;26(1):53-4. Spanish. No abstract available.
PMID: 12525331 [PubMed - indexed for MEDLINE]
30. Mathis AS, Chan V, Gryszkiewicz M, Adamson RT, Friedman GS.
Levofloxacin-associated Achilles tendon rupture.
Ann Pharmacother. 2003 Jul-Aug;37(7-8):1014-7.
PMID: 12841810 [PubMed - indexed for MEDLINE]
31. Aros C, Flores C, Mezzano S.[Achilles tendinitis associated to levofloxacin: report of 4 cases]
Rev Med Chil. 2002 Nov;130(11):1277-81. Spanish.
PMID: 12587511 [PubMed - indexed for MEDLINE]
32. Shah P.[Do tendon lesions occur during quinolone administration?]
Dtsch Med Wochenschr. 2003 Oct 17;128(42):2214. German. No abstract available.
PMID: 14562223 [PubMed - indexed for MEDLINE]
33. Melhus A, Apelqvist J, Larsson J, Eneroth M.
Levofloxacin-associated Achilles tendon rupture and tendinopathy.
Scand J Infect Dis. 2003;35(10):768-70.
PMID: 14606622 [PubMed - indexed for MEDLINE]
34. Cebrian P, Manjon P, Caba P.
Ultrasonography of non-traumatic rupture of the Achilles tendon secondary to
Foot Ankle Int. 2003 Feb;24(2):122-4.
PMID: 12627618 [PubMed - indexed for MEDLINE]
35. Bernacer L, Artigues A, Serrano A.
[Levofloxacin and bilateral spontaneous Achilles tendon rupture]
Med Clin (Barc). 2003 Jan 25;120(2):78-9. Spanish. No abstract available.
PMID: 12570920 [PubMed - indexed for MEDLINE]
36. Haddow LJ, Chandra Sekhar M, Hajela V, Gopal Rao G.
Spontaneous Achilles tendon rupture in patients treated with levofloxacin.
J Antimicrob Chemother. 2003 Mar;51(3):747-8. No abstract available.
PMID: 12615887 [PubMed - indexed for MEDLINE]
37. Othmani S, Battikh R, Ben Abdallah N.
[The myo-tendinopathy caused by levofloxacin]
Therapie. 2003 Sep-Oct;58(5):463-5. French. No abstract available.
PMID: 14682197 [PubMed - indexed for MEDLINE]
38. Gutierrez E, Morales E, Garcia Rubiales MA, Valentin MO.
[Levofloxacin and Achilles tendon involvement in hemodialysis patients]
Nefrologia. 2003 Nov-Dec;23(6):558-9. Spanish. No abstract available.
PMID: 15002793 [PubMed - indexed for MEDLINE]
40. Spontaneous Achilles tendon rupture in patients treated with levofloxacin
L. J. Haddow, M. Chandra Sekhar, V. Hajela and G. Gopal Rao*
Department of Microbiology, University Hospital Lewisham, Lewisham High Street, London SE13 6LH, UK 2003 The British Society for Antimicrobial Chemotherapy
41. Clinical Infectious Diseases 2003;36:1404-1410
2003 by the Infectious Diseases Society of America. All rights reserved.
Fluoroquinolone-Associated Tendinopathy: A Critical Review of the Literature
Yasmin Khaliq1 and George G. Zhanel2
42. J Am Podiatr Med Assoc. 2003 Jul-Aug;93(4):333-5.
Fluoroquinolone therapy and Achilles tendon rupture.
Vanek D, Saxena A, Boggs JM.
43. Clin Rheumatol. 2003 Dec;22(6):500-1. Epub 2003 Oct 18.
Ciprofloxacin and Achilles' tendon rupture: a causal relationship.
44. Aten Primaria. 2003 Sep 15;32(4):256
Bilateral Achilles tendinitis as adverse reaction to levofloxacine.
45. Therapie. 2003 Sep-Oct;58(5):463-5.
The myo-tendinopathy caused by levofloxacin
46. Reumatismo. 2003 Oct-Dec;55(4):267-9.
Levofloxacin-induced bilateral rupture of the Achilles tendon: clinical and sonographic findings
47. Gastroenterol Hepatol. 2003 Jan;26(1):53-4.
Rupture of the Achilles' tendon secondary to levofloxacin
48. J Antimicrob Chemother. 2003 Mar;51(3):747-8.
Spontaneous Achilles tendon rupture in patients treated with levofloxacin.
49. Foot Ankle Int. 2003 Feb;24(2):122-4.
Ultrasonography of non-traumatic rupture of the Achilles tendon secondary to levofloxacin.
50. Chemotherapy. 2003 May;49(1-2):90-1.
Reoccurrence of levofloxacin-induced tendinitis by phenoxymethylpenicillin therapy after 6 months: a rare complication of fluoroquinolone therapy?
51. rupture of the Achilles tendon: clinical and sonographic findings]
Reumatismo. 2003 Oct-Dec;55(4):267-9. Italian.
PMID: 14872227 [PubMed - indexed for MEDLINE]
52. Ann Pharmacother. 2003 Jul-Aug;37(7-8):1014-7.
Levofloxacin-associated Achilles tendon rupture.
53. Clin Rheumatol. 2003 Oct;22(4-5):367-8.
Bilateral Achilles tendinitis with spontaneous rupture induced by levofloxacin in a patient with systemic sclerosis.
54. Scand J Infect Dis. 2003;35(10):768-70.
Levofloxacin-associated Achilles tendon rupture and tendinopathy.
55. Levofloxacin-associated Achilles tendon rupture and tendinopathy. Scand J Infect Dis 2003;35(10):768-70 (ISSN: 0036-5548) Melhus A; Apelqvist J; Larsson J; Eneroth M Department of Medical Microbiology, Malmo University Hospital, Malmo, Sweden. asa.melhus at mikrobiol.mas.lu.se.
56. Levofloxacin and trovafloxacin inhibition of experimental fracture-healing. Clin Orthop 2003 Sep;(414):95-100 (ISSN: 0009-921X) Perry AC; Prpa B; Rouse MS; Piper KE; Hanssen AD; Steckelberg JM; Patel R Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
57. Levofloxacin-associated Achilles tendon rupture. Ann Pharmacother 2003 Jul-Aug;37(7-8):1014-7 (ISSN: 1060-0280) Mathis AS; Chan V; Gryszkiewicz M; Adamson RT; Friedman GS Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA. smathis at sbhcs.com.
58. Richardson LC, Reitman R, Wilson M.
Achilles tendon ruptures: functional outcome of surgical repair with a "pull-out" wire.
Foot Ankle Int. 2003 May;24(5):439-43.
PMID: 12801203 [PubMed - indexed for MEDLINE]
59. Ultrasonography of non-traumatic rupture of the Achilles tendon secondary to levofloxacin. Foot Ankle Int 2003 Feb;24(2):122-4 (ISSN: 1071-1007) Cebrian P; Manjon P; Caba P Departamento de Radiodiagnostico, Hospital Universitario 12 de Octubre, Madrid, Spain. pcvbb at yahoo.es.
60. J Am Board Fam Pract. 2003 Sep-Oct;16(5):458-60.
Levofloxacin-induced tendon rupture: a case report and review of the literature.
1. Mehra A, Maheshwari R, Case R, Croucher C.
Bilateral simultaneous spontaneous rupture of the Achilles tendon.
Hosp Med. 2004 May;65(5):308-9. No abstract available.
PMID: 15176150 [PubMed - indexed for MEDLINE]
2. Vergara Fernandez I.
[Muscle and tendon problems as a side-effect of levofloxacine: review of a case]
Aten Primaria. 2004 Mar 15;33(4):214. Spanish. No abstract available.
PMID: 15023326 [PubMed - indexed for MEDLINE]
3. McKinley BT, Oglesby RJ.
A 57-year-old male retired colonel with acute ankle swelling.
Mil Med. 2004 Mar;169(3):254-6. No abstract available.
PMID: 15080249 [PubMed - indexed for MEDLINE]
4. Fama U, Irace S, Frati R, de Gado F, Scuderi N.
Is it a real risk to take ciprofloxacin?
Plast Reconstr Surg. 2004 Jul;114(1):267. No abstract available.
PMID: 15220615 [PubMed - indexed for MEDLINE]
5. Kahn F, Christensson B.
[A rapid development of Achilles tendon rupture following quinolone treatment]
Lakartidningen. 2004 Jan 15;101(3):190-1. Swedish. No abstract available.
PMID: 14763088 [PubMed - indexed for MEDLINE]
6. Long term outcome after Fluoroquinolones tendinopathies
C Guy (1); Y Murat (1); MN Beyens (1); M Ratrema (1); G Mounier (1); M Ollagnier (1); (1) Centre de Pharmacovigilance, Hôpital Bellevue - CHU St-Etienne, Sant-Etienne
7. Levofloxacin-induced bilateral Achilles tendon rupture: a case report and review of the literature. J Orthop Sci 2004;9(2):186-90 (ISSN: 0949-2658) Kowatari K; Nakashima K; Ono A; Yoshihara M; Amano M; Toh S Department of Orthopaedic Surgery, Aomori Rosai Hospital, 1 Minamigaoka, Shirogane-machi, Hachinohe 031-8551, Japan.
8. Pharmacol Exp Ther. 2004 Jan;308(1):394-402. Epub 2003 Oct 20. In vitro discrimination of fluoroquinolones toxicity on tendon cells: involvement of oxidative stress.
9. Hosp Med. 2004 May;65(5):308-9.
Bilateral simultaneous spontaneous rupture of the Achilles tendon.
Mehra A, Maheshwari R, Case R, Croucher C.
10. Therapie. 2004 Nov-Dec;59(6):653-5.
Ofloxacin-induced achilles tendinitis in the absence of a predisposition
11. An Med Interna. 2004 Mar;21(3):154.
Achilles bilateral tendonitis and levofloxacin
12. J Orthop Sci. 2004;9(2):186-90.
Levofloxacin-induced bilateral Achilles tendon rupture: a case report and review of the literature.
13. Scand J Infect Dis. 2004;36(4):315-6.
Recurrent tendinitis after treatment with two different fluoroquinolones.
14. Joint Bone Spine. 2004 Nov;71(6):586-7. Related Articles, Links
Rupture of multiple tendons after levofloxacin therapy.
Braun D, Petitpain N, Cosserat F, Loeuille D, Bitar S, Gillet P, Trechot P.
Pneumology Department, Maillot Hospital, 54150 Briey, France.
15. Aten Primaria. 2004 Mar 15;33(4):214.
Muscle and tendon problems as a side-effect of levofloxacine: review of a case
16. Kowatari K, Nakashima K, Ono A, Yoshihara M, Amano M, Toh S.
Levofloxacin-induced bilateral Achilles tendon rupture: a case report and review of the literature.
J Orthop Sci. 2004;9(2):186-90. Review.
PMID: 15045551 [PubMed - indexed for MEDLINE]
17. Gomez Rodriguez N, Ibanez Ruan J, Gonzalez Perez M.
[Achilles bilateral tendonitis and levofloxacin]
An Med Interna. 2004 Mar;21(3):154. Spanish. No abstract available.
PMID: 15043504 [PubMed - indexed for MEDLINE]
18. Filippucci E, Farina A, Bartolucci F, Spallacci C, Busilacchi P, Grassi W.[Levofloxacin-induced bilateral
19. Burkhardt O, Kohnlein T, Pap T, Welte T.
Recurrent tendinitis after treatment with two different fluoroquinolones.
Scand J Infect Dis. 2004;36(4):315-6.
PMID: 15198194 [PubMed - indexed for MEDLINE]
1. Toxicology. 2005 May 9
Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells.
Sendzik J, Shakibaei M, Schafer-Korting M, Stahlmann R.
2. Arch Orthop Trauma Surg. 2005 Mar;125(2):124-6. Epub 2005 Jan 12.
Missed Achilles tendon rupture due to oral levofloxacin: surgical treatment and result.
3. An Med Interna. 2005 Jan;22(1):28-30.
Partial bilateral rupture of the Achilles tendon associated to levofloxacin
4. Expert Opin Drug Saf. 2005 Mar;4(2):299-309.
Fluoroquinolones and tendon disorders.
Melhus A.
5. Toxicology. 2005 May 9
Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells.
Sendzik J, Shakibaei M, Schafer-Korting M, Stahlmann R.
Institute of Clinical Pharmacology and Toxicology, Department of Toxicology, Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin, Garystr. 5, 14195 Berlin, Germany; Institute of Anatomy, Department of Cell and Neurobiology, Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin, Konigin-Luise-Str. 15, 14195 Berlin, Germany; Musculoskeletal Research Group, Institute of Anatomy, Ludwig-Maximilian-Universitat Munich, Pettenkoferstr. 11, 80336 Munich, Germany.
Additional references:
One of the more unusual adverse reactions known to be associated with the fluoroquinolone antibiotics is the occurrence of tendinitis. This is a serious effect since it may progress to tendon rupture with many weeks of disability as a result. Over 200 cases have been reported in the literature with the majority from France. Most members of the class including ciprofloxacin, enoxacin, ofloxacin, and norfloxacin have been implicated. The Achilles tendon is most often involved.
In Australia, there have been 25 reports of tendinitis in association with fluoroquinolones. Most (22) have been with ciprofloxacin and the other three with norfloxacin. The majority of the patients involved were elderly, ranging in age from 46 to 91 (median 69) years and the sex distribution was equal. For ciprofloxacin, daily dosages ranged from 750 mg to 2250 mg although most (13) patients were taking 1000 mg daily. For norfloxacin, all three patients were taking the usual dose of 800 mg daily. Time to onset ranged from the same day that the drug was commenced (in two patients) to two months although in 13 of the 24 reports which provided the information, the reaction occurred within the first week. Almost all (23) of the reports specified the Achilles tendon as the site of the tendinitis. Tendinitis was described as bilateral in 11 cases. Only 8 patients had recovered at the time the report was submitted and the other patients were being treated with rest and/or physiotherapy. There have been no reports of tendon rupture in Australia although in one severe case, the patient required a plaster cast up to the mid thigh.
A number of risk factors have been identified with regard to this adverse reaction. These include old age, renal dysfunction, and concomitant corticosteroid therapy. Of the patients reported to ADRAC, 72% were older than 60 years. Nine of these patients were taking corticosteroids as were three of the younger patients.
Prescribers are reminded that tendinitis, especially involving the Achilles tendon, is a rare adverse effect of the fluoroquinolones. It is more likely to occur in association with the risk factors referred to above. The antibiotic should be withdrawn immediately to reduce the risk of tendon rupture.
Fluoroquinolones have been associated with tendon disorders, usually during the first month of treatment,1-5 but the epidemiological evidence is scanty. We did a nested case-control study among users of fluoroquinolones in a large UK general practice database to study the association with Achilles tendon disorders.
Participants, methods, and results
We obtained data from the IMS Health database (UK MediPlus), which contains data from general practice on consultations, morbidity, prescriptions, and other interventions in a source population of 1-2 million inhabitants. The base cohort consisted of all patients aged 18 years or over who had received a fluoroquinolone. We excluded people with a history of Achilles tendon disorders, cancer, AIDS, illicit drug use, or alcohol misuse. We identified potential cases by reviewing patient profiles and clinical data and excluded tendon disorders due to direct trauma. We randomly sampled a group of 10 000 control patients from the study cohort.
We defined four categories of exposure to fluoroquinolones: current use, recent use, past use, and no use. We defined current use as when the tendon disorder occurred in the period between the start of the fluoroquinolone treatment and the calculated end date plus 30 days, recent use as when the calculated end date was between 30 and 90 days before the occurrence of the disorder, and past use as when the calculated end date was more than 90 days before the occurrence of the disorder. We used unconditional logistic regression analysis to calculate adjusted relative risks and 95% confidence intervals for Achilles tendon disorders, using the no use group as the reference. We adjusted for age, sex, number of visits to the general practitioner, use of corticosteroid, calendar year, obesity, and history of musculoskeletal disorders.
The cohort included 46 776 users of fluoroquinolones between 1 July 1992 and 30 June 30 1998, of whom 704 had Achilles tendinitis and 38 had Achilles tendon rupture. Four hundred and fifty three (61%) of the cases were women, and the mean age was 56 years. Cases visited the general practitioner significantly more often than did controls (mean 20 v 17). Cases and controls were similar with respect to indications for use of fluoroquinolone. Age, number of visits to the general practitioner in the previous 18 months, gout, obesity, and use of corticosteroid were determinants of Achilles tendon disorders. The adjusted relative risk of Achilles tendon disorders with current use of fluoroquinolones was 1.9 (95% confidence interval 1.3 to 2.6). The risk for recent and past use was similar to that for no use. The relative risk with current use was 3.2 (2.1 to 4.9) among patients aged 60 and over and 0.9 (0.5 to 1.6) among patients aged under 60 (table). In patients aged 60 or over, concurrent use of corticosteroids and fluoroquinolones increased the risk to 6.2 (3.0 to 12.8).
Relative risk of Achilles tendon disorders associated with use of fluoroquinolones according to age
Current exposure to fluoroquinolones increases the risk of Achilles tendon disorders. This finding is in agreement with a smaller study, in which we found an association between tendinitis and fluoroquinolones.5 Our results indicate that this adverse effect is relatively rare, with an overall excess risk of 3.2 cases per 1000 patient years. The effect seems to be restricted to people aged 60 or over, and within this group concomitant use of corticosteroids increased the risk substantially. The proportion of Achilles tendon disorders among patients with both risk factors that is attributable to their interaction was 87%. Although the mechanism is unknown, the sudden onset of some tendinopathies, occasionally after a single dose of a fluoroquinolone, suggests a direct toxic effect on collagen fibres. Prescribers should be aware of this risk, especially in elderly people taking corticosteroids.
We acknowledge the cooperation of IMS Health United Kingdom.
Contributors: PDvdL, MCJMS, and BHChS formulated the design of the study. PDvdL carried out the analyses. PDvdL, MCJMS, and BHChS wrote the paper, and RMCH and HGML edited it. BHChS and HGML are guarantors for the paper.
Dutch Inspectorate for Health Care.
Competing interests:
MCJMS is a consultant for Lundbeck (France) and Beaufour (UK) and has previously been a consultant for Pfizer (USA), Roche (Switzerland), and Novartis Consumerhealth (Switzerland). MCJMS is responsible for research conducted with the integrated primary care information database in the Netherlands, which is supported by project specific grants from GlaxoSmithKline, AstraZeneca, Merck Sharp & Dohme, Pharmacia & Upjohn, Bristol-Myers Squibb, Eli Lilly, Wyeth, and Yamanouchi. MCJMS has conducted research projects on use of antibiotics for Merck & Co (USA) and Bayer (Italy).
This is far from being an all inclusive list of such medical journal entries and other such main stream documentation. Starting in 1965 and ending in 2005, almost forty years worth of such reports and the treating physician as well as the patient have no prior knowledge concerning such events. This defies logic but sadly enough this is the true state of affairs. In spite of the overwhelming evidence presented at that 62 Meeting of the Anti-Infective Drugs Advisory Committee that the fluoroquinolones cause irreversible joint damage in the pediatric population the FDA has recently added the use of Ciprofloxacin in the pediatric population, treating children as young as one years of age.
Numerous studies have indicated that such use in a pediatric patient runs the risk of crippling the child for life. Yet additional clinical trials continue aided and abetted by the FDA, for other drugs in this class other than Ciprofloxacin. A disaster that is detailed within the 62nd meeting of the Anti-Infective Drugs Advisory Committee where it was so eloquently stated:
"…when we talk about the issue of arthropathy that potentially includes a number of things, ranging from simple effusion, for instance, of a knee joint, which might rapidly resolve after the conclusion of therapy, to a more permanent disability. .." (sic)
"…in September of 1997 there is now a ciprofloxacin suspension which is available, and although it continues to have the same warning statements about arthropathy in juvenile animals and the potential concern in pediatric populations, obviously, the issue of off label use will extend over to pediatric populations in this formulation…."(sic)
"…An important safety question is, what adverse events should be monitored, and Doctor Goldberger alluded to this earlier. This is some of the examples I present. One is permanent lameness, reversible lameness, joint effusion, joint pain, and even latent articular disease or damage that may occur months or years following drug exposure, and there may be others…."(sic)
"…And, data submitted to the Agency, as well as data from the scientific literature, indicate that these lesions don't appear to be reversible…"(sic)
"…Doctor Stahlmann in Berlin is working on an idea that it may be an effect between the endocrines, the magnesium and the matrix and the quinolone. And that data is just coming out now. But as to the exact mechanism, I think you're right. I don't think we have a handle, as far as I know, on the exact mechanism. If there's anybody else that does, I'd sure like to hear it…"(sic)
"… Relating your personal experience, I was wondering about the potential for a delayed effect that in fact one might have a patient who had some histologic changes that would not be manifest clinically for many years. Is that a potential?" (sic)
"… I think it is a potential…"(sic)
"… In trying to assess toxicity with a very sensitive assay, obviously you've got tissue that you can look at in your animal models. There is some human data that were collected by Doctor Urs Schaad using MRI scanning in children and I'm wondering if you can correlate some of your histopathologic findings with MR in the animal model to give us an idea of how sensitive it would be sort of as a follow-up to Doctor Klein's question is the MR something that will be able to predict long-term outcomes, even if there are no clinical symptoms during therapy…."(sic)
"… That I don't know. I'll just be perfectly frank. I don't know. But on the slides I've seen from the animals from the chronic study, the repaired articular cartilage that is there is principally fibrocartilage yet it will provide the same joint margin and it has a calcified base and when we stain it with safrain O screen there's no proteoglycans there so it's going to make it an extremely chondromalaistic area and beyond the one year I can't tell you what the results will be…"(sic)
"…Anyway, it was by a group in Vienna where they looked at the articular cartilage of postmortem specimens of articular cartilage from kids with cystic fibrosis that had been on quinolones for a period of time and they found that there was damage in the chondrocytes…."(sic)
"…There were no deaths reported in U.S. pediatric zero to 18 year old cases where a flouroquinolone was reported as the suspect drug. However, there are eight deaths in the whole cohort of suspect and concomitant flouroquinolone drug reports in the system. Five of these deaths reported ciprofloxacin as a concomitant drug and not the suspect drug. These five were U.S. cases with ages ranging from seven months to six years. The remaining three deaths were all foreign, all 18 year old patients with either ofloxacin or norfloxacin reported as the suspect drug…."(sic)
"…There are 14 reports of arthropathy or arthralgia in the pediatric zero to 18 year old flouroquinolone reports. One report of a 14 year old girl had both ofloxacin and lomefloxacin as the suspect drug so there is an extra count because of the two flouroquinolones on this one report. This particular report indicates that a pediatric orthopedic surgeon diagnosed femoral anteversion as the cause for the girl's arthralgia, therefore you see it listed twice, and not the flouroquinolones. Most of the reports indicated that either an involved knee or elbow with or without other joints was involved…."(sic)
"…One interesting case which is not included on this slide for arthralgias was a 15 year old boy who received ofloxacin IV for an emergency appendectomy and had not grown more than his 70 inches in height over the last year. The 15th percentile for height for a 15 year old boy however is 66.5 inches and the expected growth rate is about two inches per year…"(sic)
"…Three patients had their seizure after the first dose of flouroquinolone, one on ciprofloxacin and the other two on ofloxacin, one of which had received ofloxacin several months earlier…"(sic)
"…The 15 psychiatric reports are a loose grouping of reports which include events ranging from euphoria to psychosis. The ages range from five to 18 years with the median at 15 years. There were two suicide attempts, one on ofloxacin and the other on norfloxacin, three reports of hallucination, one each on ciprofloxacin, ofloxacin and norfloxacin, and one report of aggressive behavior with confusion in a patient who had a psychiatric history and was on norfloxacin. The seven cases of photosensitivity were reported with lomefloxacin with one case on ciprofloxacin and two cases on ofloxacin. …"(sic)
"…I will mention that there were 152 U.S. cases aged zero to 18 years in the U.S. AERS system suspect flouroquinolones in the WHO line listing. The country with the most pediatric reports in the WHO foreign reports is the United Kingdom with 177 reports followed by Germany with 72 and France with 71. The rest of the countries had 20 or fewer reports…."(sic)
"…And with regards to muscular-skeletal events, 21 percent of the patients had an event in ciprofloxacin…"(sic)
"…We have focused our analysis on joint disorders and pefloxacin. 79 cases were reported and consist mainly of arthralgia. I don't know the pronunciation of hydrarthrosis -- 49 persons. It involved the knee in 52 cases, the wrist in 20 cases, the elbow in 20 cases, the shoulder in 6 cases, the ankle in 5 cases, and the hip once. It is associated with a functional discomfort in all cases, and when the duration of this discomfort is known, it can persist more than one month in 61 percent of these cases. But the outcome was favorable in 58 cases without discontinuation in two cases. …"(sic)
"…There have been sequelae in three cases with knee effusions persisting one year later in one case with discomfort following 8 months later in the second case. The third case is articular. It is a 17-year-old patient who experienced arthropathy and the drug was not suspected and the treatment was continued two following months. It leads to destructive arthropathy of the knees and the hip and prothesis was performed three years later. He was treated for a cerebral abscess. The outcome was unknown in 18 cases. In 9 cases, there was no follow-up. In the 9 last cases, we had a follow-up three months later and patients were not -- were still with disabilities and after we have no evolution…." (sic)
"… It is my understanding that one of the children had a joint replacement, is that correct?"
" Pardon me?"
" One of the children with the complications had an artificial joint replacement?"
"…If an irreversible cartilaginous lesion can occur, it is very likely that is going to cause problems down the line and we can't even anticipate what they are like…" (sic)
Again I state that this is for your reference & review and being made in support of my oppossing opinion that such occurences are not rare. I also take exception to the statement made that there is some kind of obligation to report such events. There is not. Such reports are done strictly on a voluntary basis and no law mandates that this be done by the treating physician. The medwatch program is voluntary and less that 3% of such events are ever reported to the FDA. A full 97% of such events never make it to the FDA. When reviewing the medwatch data base for the fluoroquinolones, joint, tendon and cartilage damage are all the top three events being reported, more so than any other adr.
In addition when a physician fails to recognize such an event it is doubtful that it would be reported. The NUMBER ONE complaint of those who have suffered such an event is the fact that the treating physician DENIES that it could possibly be the result of fluoroquinolone therapy. Any number of the tens of thousands of such victims I have discussed this issue with have reported that their physician REFUSED to make such a report, REFUSED to review the citations brought to them by their patients, and instructed their patients to stay off the internet. Even when such documentation was presented to the drug reps via pharmacafe those posting such information were ridiculed and harassed. This is not a situation I find condusive to accurate reporting of such events. It is a situation that results in false and misleading information being available to both the patient and the physician, while the true state of affairs is swept under the carpet.
Result number: 124
Posted by Dr. David S. Wander on 9/23/05 at 08:38
Almost all studies have shown that surgery success rates are significantly higher than 37%. Additionally, most studies have also come to the conclusion that the actual heel spur, regardless of size is rarely the cause of the discomfort. Although ESWT is costly, I would certainly have ESWT prior to considering surgery. There are very few if any complications with ESWT and there are more potential complications with surgical intervention. There is an EXCELLENT doctor in the Chicago area that has significant experience with ESWT and is also well versed in sports medicine (he is the team podiatrist for some of Chicago's professional sports teams). His name is Lowell Scott Weil. I would at least contact him (there is a Lowell Scott Weil Jr, and Sr, father and son that practice together). The practice is state of the art and very well respected nationally. They have also published papers on ESWT and heel surgery. Make an appointment with their office, I'm sure you'll be happy.
Result number: 125
Posted by Julie on 9/11/05 at 08:38
The Titanic Of Our Era
Bill Fletcher, Jr.
September 09, 2005
Bill Fletcher, Jr. is the President of TransAfrica Forum, a Washington, DC-based non-profit organizing and education center formed to raise awareness in the USA regarding issues facing the nations and peoples of Africa, the Caribbean and Latin America. He can be reached at email@example.com .
The complete failure of the Bush administration —and to a lesser extent state and local authorities on the Gulf Coast— to respond to the devastation of Hurricane Katrina has raised questions about the motives at play. The fact that the lives of hundreds of thousands of poor and black people were thrown up for grabs and that the Bush administration could not mobilize any significant response for five days has led many people to assume that this was an act of planned genocide. How else, one may wonder, could such a thing have been allowed to happen?
There is another way to think about the disaster: the steerage on the Titanic. To refresh your memory, that was the section of the ship that provided the cheapest accommodations and where the poorest were housed. It was also the lowest part of the ship, the least safe and the site of overwhelming death. One may remember, as portrayed in the film Titanic , that the passengers in steerage were literally locked in, trapped like rats such that they could not escape the rising water.
Does this somehow sound familiar?
Did the builders of the Titanic design it in such a way that they aimed to kill the occupants of steerage? Not at all. They did, however, design it so that if anyone was going to die, it would be those in steerage. Their deaths were acceptable for the builders of the Titanic. After all, those in steerage were considered a less-relevant population than the rich on the upper decks.
The capitalism of the contemporary era shares many of the same values informing the builders of the Titanic; the poor are not the responsibility of society at large. The construction of the Titanic was not simply a technological matter. There was a decision that the poor could be sacrificed in order that the rich survive. That is the essence of capitalism in general, but particularly neo-liberal capitalism—the capitalism of this era. There need not have been an intent to wipe out thousands of poor and black people in the Gulf. The assumptions about how money would be spent, what was necessary, etc., meant that in the face of disaster, the poor and the black would be sacrificed, and the rich would have their SUVs [read: life boats]
For decades, this nation's economic policies have created a widening gap in personal wealth, making it impossible for many Americans to achieve economic security no matter how hard they work. The (largely unionized) jobs that provided opportunities for workers to climb out of poverty have been disappearing. In their place are low-wage service jobs, part-time employment or nothing at all. This is what makes comments such as those offered recently by conservative critic Linda Chavez , so outrageous and insulting. Instead of finding the sources of Gulf Coast poverty in an economic system that casts off hundreds of thousands of people, Chavez and her allies place the blame on so-called family values. Chavez never grapples with the question of how to keep families together when their worlds collide with the shockwaves of the modern economy.
Through directing tax cuts to serve the rich and powerful; through the allocation of billions of dollars to pursue an illegal war and occupation of Iraq; through urban relocation programs that destroy entire communities, the steerage compartments of the good ship 'Gulf Coast' were created. All that was needed to create total devastation was a collision with an iceberg.
The infrastructure of New Orleans had been collapsing for years. Various scenarios within the last five years indicated the catastrophe that could unfold if a Category 5 storm hit New Orleans. There was recognition, now openly being admitted, that tens of thousands of the poor of that city might be left stranded in the face of a major hurricane while the rich could climb into their SUVs and escape.
There simply were not enough lifeboats, because those in steerage where just not that relevant.
After years of attacking the public sector and the rationale for essential government programs and taxes, the conservative right has reaped the results. They calculated that they could get by without investing the necessary resources into repairing the growing inequality in America. They calculated that they could ignore the plight of the Gulf Coast's poor. Each hurricane that missed the Gulf Coast was another source of relief and a confirmation that it was better to put resources into wars and tax cuts than into saving the lives of those at the bottom.
So, it did not have to be a conspiracy, because, in fact, the game of U.S. capitalism has been rigged from the beginning. We just happened to see the results in bloated bodies, crying and ill children, the devastation of a beautiful coastline, and the possibly permanent displacement of hundreds of thousands of people.
Result number: 126
Posted by Ed Davis, DPM on 9/09/05 at 22:16
The more "conservative" churches tend to be in the Pat Robertson camp. A friend of mine Darrel Darby, DPM, went on to start a company named Darco now run by his son, Darrel Darby, Jr. Darrel passed away a couple of years ago with esophageal cancer due to undertreated chronic esopahgeal
reflux disease (GERD) -- dedicated docs often neglect their own health while trying to help others, unfortunately. Darco manufactures surgical shoes and removable casts. Darrel was a friend of Pat Robertson and supported Pat Robertson's bid for the Presidency. Naturally, Pat Robertson, stood little chance of winning as people in the US tend to gravitate toward candidates that are percieved as centrists. I am not sure how close Pat Robertson is to the Christian Coalition as I frankly don't pay a lot of attention to those groups but the Christian Coalition is somewhat of an alliance of the religous right in the US. I am not a Christian so beyond my friendship with Darrel, I do not know much more than this. If you are intersted, you could do a Google search on the Christian Coalition to see which churches belong.
I think that people of religion-- all religions, agnostics and so on need to learn to get along. The same applies for so-called "Liberals" and "Conservatives." I view the main problems in the US today to revolve around corporate and government corruption. A corrupt politician really has no ideology but simply is there to obtain power, money and influence.
Corruption at the corporate level is at epidemic proportions as corrupt corporate practices are becoming the norm rather than the exception. That occurs even in healthcare. I cannot name names but should our paths ever cross I could tell you stories that are incredible, tragic. I have seen corprorate medicine do some very negative things to patients. There are some ethical corporations out there but they are becoming the exception rather than the rule.
Result number: 127
Posted by marie on 9/09/05 at 17:11
You'll have to go down to my post on Nope I'm serious and the story of Smudge the kitten to catch up with who these folks are. Annie and Buddy are both defense attornies in NOLA. Attorney and activist Annie Spell endured death threats and the loss of a Girl Scout troop on her way to becoming one of the country's few white NAACP branch presidents. For Annie Spell, attacks against her only inspire her further in her leadership with the NAACP. 'This collection of white separatists -- obviously they're ignorant people,' Spell says. 'They make me glad I'm president. This is what our organization has to fight.'...........these are some incredible people! Glad to be their friend.
OK Buddy called from Algiers Point. He was there with a Newsweek photographer that took him to the Airport to pickup Annie's vehicle which is 4 wheel drive.
I've never heard Buddy sound as down as I did today. He was not down for himself of course, he was very thankful that his home was still standing to some degree, he was bewildered by the out and out racism being shown in America by the powers that be.
He said if you are armed and you are white they won't even stop you but if you were black you'd most likely be shot dead.
A team of white vigilantes has been scouring the streets armed to the teeth. Confronting any black person they see.
5..6..7..8..9.. Special Forces guys just arrived and were going from house to house across the street. Buddy asks the Newsweek photographer to get some shots.
While waiting he implored people that are going to Covington simply to hang out and not do anything to stay home. This is not about protest, this about work.
A large activists meeting is occurring tomorrow somewhere but no one is sure who really called it.
So why was Buddy in New Orleans? Well they were trying to get to Abramson High School where it is rumored that anywhere from 200-1500 people are dead. OF course there turns out to be no way in unless they had a boat and 2 days and a lot of luck.
The local courts are trying to pull some fast legal maneuvers so he was heading over to Court to see what he can do.
The area he was standing in was one of the few black neighborhoods that had been spared damage until of course a barge ran into the levee. He wonders about this fact aloud.
Personal notes:
Annie is Picking Up Smudge, the world famous kitten, today. Garcia Jr. is doing well.
Some very special house guests are arriving tonight.
Result number: 128
Posted by Dr. Z on 8/06/05 at 11:05
This is just one of the abstracts that are ALREADY on heelspurs ESWT site
Weil used the Big O for this study He uses 83%.
J Foot Ankle Surg 2002 May-Jun;41(3):166-72
Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: indications, protocol, intermediate results, and a comparison of results to fasciotomy.
Weil LS Jr, Roukis TS, Weil LS, Borrelli AH.
Weil Foot & Ankle Institute, Des Plaines, IL 60016, USA.
A review of the history, mechanism of action, and application of extracorporeal shock wave therapy for chronic plantar fasciitis is presented. The results of 40 feet treated with this modality are reviewed after a mean follow-up time of 8.4 months. All procedures were performed under intravenous sedation and local infiltrative anesthesia. An electrohydraulic shock wave with a mean of 20.6 kV combined with a mean of 2,506 pulses was used. The results of a similar demographic class of patients having undergone a percutaneous plantar fasciotomy at our institution were compared to the results of this cohort of shock wave patients. Eighty-two percent of the patients treated with extracorporeal shock wave therapy were successfully treated as compared to 83% with a percutaneous plantar fasciotomy. The mean score on the 11-point visual analog scale for satisfied patients was 7.9 preoperatively and 2.95 within 7 days postoperatively. After 3 months, the mean visual analog score was 4.2 or 50% of the preoperative value after a mean of 8.4 months following treatment. Eighty-three percent of the patients treated stated that shock wave therapy improved their symptoms. There were no complications encountered in any patient in this study. Extracorporeal shock wave therapy is an effective treatment, which significantly reduces the symptoms associated with chronic plantar fasciitis and compares favorably to the results achieved with surgical intervention in the form of a percutaneous plantar fasciotomy.PMID: 12075904
Result number: 129
Posted by Suzanne D. on 7/31/05 at 19:03
Kathy, unfortunately, he will not have an assistant. I always thought that to be the case with certain handicapping conditions, but the principal as well as the special ed department are telling me no. I have reminded them that during his past two years at school (both years spent in kindergarten) he has had the benefit of a full-time assistant. (KY law stipulates that all kindergarten classrooms have full-time assistants. In first grade, we have one assistant shared among 4 classrooms.) So I am rather nervous about how this is going to work out. I have been given boxes of special gloves containing no latex for his diaper changes and a special desk which accomodates his wheel chair. Other than that, I seem to be on my own. I did sit in on interviews for our assistant and asked each how they would feel about diapering a child. I believe we chose a very competent person, so I am in hopes she will be helpful in my situation.
So your son has Norman Bridwell's autograph; I am jealous! :) It has been a joy to me to meet a few authors through the years, and I treasure the autograph of Bill Martin, Jr. who wrote Brown Bear, Brown Bear among others. (Alas, I have forgotten how to do the italics!)
Yes, rowdy little boys can be a challenge, but they can also be hilarious; you are right. I usually can get them to "like me" - not saying that is my primary goal - but it helps in controlling them and keeping their attention. Last year my biggest "challenge" in the rowdy department told his mom one night during the first month of school that he thought when he grew up he would marry me. He thought my husband who had visited the school was my father. :)
Thanks for your kind and encouraging words. And, oh yes, this afternoon I did find a red jacket for my first-day-at-school outfit!
Suzanne :)
Result number: 130
Posted by Dr. Z on 7/22/05 at 20:42
Foot and Ankle
The Safety and Efficacy of High Energy Extracorporeal Shock Wave Therapy in Active, Moderately Active, and Sedentary Patients
By John P. Furia, MD
July 2005
Extracorporeal shock wave therapy was investigated in patients with chronic plantar fasciitis. Fifty-three patients (60 heels) were treated with a single session of shock wave therapy. Sixteen patients (19 heels) were active, 21 (22 heels) were moderately active, and 16 (19 heels) were sedentary. Twelve weeks post-treatment, mean visual analog scores improved from 9.2 to 2.4 (P<.05), RAND-Physical Functioning score improved from 40.4 to 91.5 (P<.05), and RAND-Pain score improved from 33.3 to 90 (P<.05). Fifty heels (83.3%) were assigned an excellent or good result. Extracorporeal shock wave therapy is an effective treatment for chronic plantar fasciitis.
Plantar fasciitis is the most common cause of inferior heel pain. It is estimated that plantar fasciitis occurs in approximately two million Americans per year,1 and it is the most common foot condition seen by most foot and ankle surgeons.2 The disorder frequently occurs in athletes3-5 but also afflicts sedentary individuals, particularly middle-aged women.6-8 Men and women are affected equally.7,8 Symptoms are bilateral in .10% of cases.2 The exact etiology is unknown.
Plantar fasciitis is characterized by pain on the bottom of the heel, particularly with the first steps in the morning and when weight bearing is resumed after sitting.9-12 The pain usually persists and often becomes worse with activities of daily living. Physical examination almost always reveals tenderness over the fascia. Pain is aggravated by dorsiflexion of the toes.
Radiographs frequently reveal a heel spur on the inferior surface of the calcaneus.10,11 The heel spur may be an incidental finding as heel spurs also have been noted in 10% to 27% of asymptomatic individuals.2,13
Most physicians agree that acute plantar fasciitis often will respond to traditional nonoperative measures6,8,14-16; however, approximately 20%-30% of those patients treated with traditional measures progress to a chronic condition.17 Martin et al17 reviewed a large number of reports of nonoperative treatment of plantar fasciitis and showed a wide range of acceptable outcomes ranging from 44% to 82% of patients who obtained complete pain relief.
There is no consensus as to the best method of treatment.8,15,16,18 Traditional measures include relative rest, ice, massage, stretching of the plantar fascia and Achilles tendon, anti-inflammatory medications, taping, shoe modification, orthotics, and night splints.
Steroid injections into the painful fascia may be helpful but are not without risk. Steroid injections often are associated with recurrence of symptoms, and the effect usually is temporary.19,20 Steroid injections may cause infection, fat pad atrophy, and complete plantar fascia rupture.19,20
Surgical treatment of chronic plantar fasciitis with either open or endoscopic partial plantar fascia release is an option for those who fail to respond to nonoperative measures.8,21-23 Surgical intervention is invasive, has inherent morbidity, and can produce inconsistent results.8,22
Extracorporeal shock wave therapy is a byproduct of renal lithotripter technology. Extracorporeal shock wave therapy has been used in Europe since the 1980s to treat a litany of orthopedic conditions including lateral epicondylitis, shoulder calcific tendinitis, Achilles tendinitis, and nonunion of fractures of long bones.24-32
In 1996 Rompe et al10 reported on their favorable experience using shock wave therapy to treat chronic plantar fasciitis. Since that time many investigators have substantiated these results.5,11,33-42
Extracorporeal shock wave therapy is approved by the United States Food and Drug Administration (FDA) for the treatment of chronic plantar fasciitis and chronic lateral epicondylitis. A meta-analysis of the current published literature on the relationship between shock wave therapy and chronic plantar fasciitis revealed that the application of shock wave therapy to the enthesis of the plantar fascia is a safe and effective method to treat chronic plantar fasciitis.43 The authors suggested that shock wave therapy should be considered prior to surgical intervention.43 Several recent studies, however, have questioned the efficacy of shock wave therapy for the treatment of chronic tendinopathies.44-46
This study examined the effects of extracorporeal shock wave therapy on patients with chronic plantar fasciitis treated by the same investigator (J.P.F.) in a rural, community setting to determine if there was a difference in outcome between active, moderately active, and sedentary individuals. The hypothesis was that extracorporeal shock wave therapy would be an effective treatment for each patient.
Materials and Methods
From June 2002 to June 2003 all patients treated by the primary investigator for chronic plantar fasciitis were considered for evaluation. Inclusion criteria included patients with an established diagnosis of chronic plantar fasciitis for at least six months prior to treatment who had failed at least three forms of traditional nonoperative treatment. For this study, chronic fasciitis was defined as symptoms of moderate to severe heel pain in the involved foot at the origin of the proximal plantar fascia on the medial calcaneal tuberosity. Traditional nonoperative treatments consisted of rest, anti-inflammatory medications, heel cups, orthotics, stretching, night splints, physical therapy, and steroid injections.
Exclusion criteria included rheumatoid arthritis, generalized polyarthritis, Reiter's syndrome, local infection, pregnancy, patients with bleeding disorders, patients with tumors, patients aged <18 years, patients with severe endocrine disease, and patients with advanced peripheral vascular disease. Patients with a history of spontaneous or steroid-induced plantar fascia rupture and patients with a history of previous plantar fascial surgery also were excluded.
For the purposes of this study "active" lifestyle was defined as one in which the patient regularly participated in some form of aerobic fitness activity approximately three hours per week. Patients were assigned an "active" designation if their work required extensive physical activity such as manual labor or heavy factory work
A "moderately active" lifestyle was defined as one in which the patient exercised <3 hours per week. Patients also were assigned a "moderately active" designation if their work required regular, moderate physical activity such as nursing or restaurant work. A "sedentary" lifestyle was defined as one in which the patient did not exercise or worked in a sedentary profession.
All patients signed an informed consent form. The details of the procedure and potential risks were discussed fully before treatment. The procedures followed were in accordance with the Helsinki Declaration of 1975, as revised in 1983.
All treatments were performed on an outpatient basis. Patients were anesthetized in a pre-treatment holding room using a combined tibial and sural nerve block with 1% lidocaine. A blood pressure cuff was applied to their right arm. They were positioned in the lateral decubitus position with a pillow between their knees and with their affected foot resting on the target head. A coupling gel was applied to their heel, and the ultrasound was used to focus on the area of intended treatment. The patient's vital signs and local discomfort were monitored by a registered nurse throughout the procedure.
The extracorporeal shock wave therapy was applied using the Dornier Epos lithotripter (Dornier MedTech Inc, Kennesaw, Ga) by following the protocol used in the FDA clinical trials.33,45 The Dornier Epos uses an electromagnetic coil to generate shock waves47 and the shock waves are focused using a lens. Shock wave application was applied to the area of maximal tenderness as based on the physical examination, and guided using ultrasound.
A standard protocol was used for application of shock waves. Each patient received a single treatment using a total of 3800 shocks for a total energy flux density of 1300 mJ/mm2. Fifty shocks were given at each power level from one through six for a total of 300 shocks. The final 3500 shocks were given at power level seven (0.36 mJ/mm2), which makes this a high-energy treatment. Frequency of shock wave application was increased from 60 shocks/minute at power level one to 240 shocks/minute at power level seven.
Upon completion of the procedure the treated heel was assessed for hematoma, bruising, and swelling. The patients were discharged from the same day holding area with instructions to ice and stretch their heels. No patient received narcotics or other forms of prescription medications. No other co-interventions were used, but patients were told to continue using their orthotics if they had used them regularly prior to treatment.
The follow-up examinations were scheduled at 4 and 12 weeks post-treatment. All patients were contacted via a telephone survey. Outcome measures included visual analog scores, RAND-Physical Functioning scores, RAND-Pain scores, Roles and Maudsley scores, and a subjective assessment of overall satisfaction with the procedure.
Visual analog scores were collected pre-treatment, 4 weeks post-treatment, and 12 weeks post-treatment. On the visual analog scale 10 points indicated severe pain and zero points indicated no pain. The values of the scores pre-treatment and at 4 and 12 weeks post-treatment were compared statistically using a paired t test with a statistical significance at P<.05.
The RAND-36 -Item Health Survey scores (Physical Functioning and Pain) were collected pre-treatment, 4 weeks post-treatment, and 12 weeks post-treatment. The RAND-36-Item Health Survey score is a validated instrument for the assessment of health concepts.48 The RAND-Physical Functioning score ranges from 100, indicating perfect physical functioning, to zero, indicating severe loss of physical functioning.48 The RAND-Pain score ranges from 100, indicating absence of pain, to zero, indicating severe pain.48 The values of the scores pre-treatment and at 4 and 12 weeks post-treatment were compared statistically using a paired t test with a statistical significance at P<.05.
The Roles and Maudsley scale49 is a subjective four-point rating scale that has been used by many investigators when reporting results of shock wave therapy.5,11,36 On the scale, one point was defined as an excellent result with the patient having no symptoms. Two points was defined as a good result with the patient significantly improved from the pre-treatment condition and satisfied with their result. Three points was defined as a fair result with the patient somewhat improved from their pre-treatment condition and partially satisfied with their treatment outcome. Four points indicated a poor outcome with symptoms identical or worse than their pre-treatment condition and with dissatisfaction with the treatment result.
At 12 weeks post-treatment patients were asked if they were pleased with their overall result, and, if they had the condition again, would they elect to undergo the procedure. The results of both questions were recorded as yes or no.
Statistical analysis was performed using the paired student t test for comparison of the outcome variables. The significance level was <.05.
A total of 56 patients (65 heels) were treated during the study. All but three patients were assessed by the primary investigator after treatment, and all patients were contacted by telephone three months after treatment. One patient did not return for follow-up. The other two patients were unable to return for a follow-up evaluation. Both of these patients had a bilateral procedure. Thus, after three months, 53 (34 women and 19 men) patients representing 60 heels were available for analysis. The average patient age was 47.7 years (range: 31-71 years). Seven patients underwent bilateral treatments. The average duration of the condition was 22 months (range: 9-120 months) for the entire group.
Visual Analog Scale
The mean pre-treatment visual analog score for the entire group was 9.2±0.7. Four weeks after treatment the VAS score decreased to 3.4±1.9. This difference was statistically significant (P<.05) (Figure 1).
Figure 1: The difference in mean visual analog score pre-treatment and four weeks post-treatment was statistically significant (P<.05).
Twelve weeks after treatment the VAS score decreased to 2.4±1.8. The difference between pre-treatment and 12 week post-treatment VAS scores was statistically significant (P<.05) (Figure 2).
Figure 2: The difference in mean visual analog score pre-treatment and 12 weeks post-treatment was statistically significant (P<.05).
RAND Score-Physical Functioning
The mean pre-treatment RAND-Physical Functioning score for the entire group was 40.4±1.3. Four weeks after treatment the RAND-Physical Functioning score increased to 91.5±11.5. This difference was statistically significant (P<.05).
Twelve weeks after treatment the RAND-Physical Functioning score was 91.5±10.6. The difference between pre-treatment and 12 week post-treatment RAND-Physical Functioning scores also was statistically significant (P<.05).
RAND Score-Pain
The mean pre-treatment RAND-Pain score for the entire group was 33.3±11. Four weeks after treatment the RAND-Pain score increased to 88.6±16. This difference was statistically significant (P<.05).
Twelve weeks after treatment the RAND-Pain score increased to 90±11.6. The difference between pre-treatment and 12 week post-treatment RAND-Pain scores also was statistically significant (P<.05).
Roles and Maudsley Score
Pre-treatment all patients rated the condition of the affected heel as "4" (poor) in the subjective four point Roles and Maudsley scale. Four week post-treatment, 34 (56.7%) heels were rated as "1" (excellent), 15 (25%) heels were rated as "2" (good), and 7 (11.6 %) heels were rated as "3" (fair), and 4 (6.7%) heels rated as "4" (poor or unchanged).
Twelve week post-treatment 36 (60%) heels were rated as "1" (excellent), 14 (23.3%) heels were rated as "2" (good), and 6 (10%) heels were rated as "3" (fair). There were 4 (6.7%) heels rated as "4" (poor or unchanged) (Table 1). No patient reported a worsening of symptoms compared to pre-treatment.
Table 1
Patients With Excellent, Good, Fair, and Poor Results 4 and 12 Weeks Post-Treatment*
No. (%)
4 Weeks Post-Treatment 12 Weeks Post-Treatment
Excellent 34 (56.7) 36 (60)
Good 15 (25) 14 (23.3)
Fair 7 (11.6) 6 (10)
Poor 4 (6.7) 4 (6.7)
*Roles and Maudsley Scores, N=60 heels.
Patient Satisfaction
Four weeks post-treatment, 49 (82%) patients reported that they were satisfied with their procedure and all 49 patients reported that they would undergo the procedure again. Twelve weeks post-treatment the same 49 (82%) patients reported that they were satisfied with their procedure and all 49 patients reported that they would undergo the procedure again.
There were 16 patients who were designated as having an "active" lifestyle. Mean VAS, RAND-Physical Functioning, and RAND-Pain scores 12 weeks post-treatment were 2.7±1.6, 90±11.3, and 87.6±11.2 respectively (Table 2). There were 21 patients who were designated as having a "moderately active" lifestyle. Mean VAS, RAND-Physical Functioning, and RAND-Pain scores 12 weeks post-treatment were 2.3±1.8, 92.3±10.4, and 91±11 respectively (Table 2).
Table 1
Mean VAS, RAND-Physical Functioning, and RAND-Pain Scores 12 Weeks Post-treatment
Visual Analog RAND-Physical Activity RAND-Pain
Active 2.7±1.6 90.0±11.3 87.6±11.2
Moderately active 2.3±1.8 92.3±10.4 91.0±11.0
Sedentary 2.2±1.5 92.5±10.5 91.7±13.4
Total group 2.4±1.6 91.5±10.6 90.0±11.6
There were 16 patients who were designated as having a "sedentary" lifestyle. Mean VAS, RAND-Physical Functioning, and RAND-Pain scores 12 weeks post-treatment were 2.2±1.5, 92.5±10.5, and 91.7±13.4 respectively (Table 2). Although the values of the VAS, RAND-Physical Functioning, and RAND-Pain scores for "active," "moderately active," and "sedentary" patients were similar, there were not enough patients in each subgroup to make statistically significant comparisons between the three subgroups.
A few minor complications were noted, all of which were temporary and that resolved spontaneously with minimal treatment. Two patients had pain for approximately one week after the treatment. The pain subsequently resolved without the use of prescription medication. One patient had pain during treatment that prolonged the procedure by approximately 15 minutes. One patient developed mild bruising at the site of the local injection. The bruising resolved without treatment 48 hours after the procedure.
The plantar fascia is a broad, thick structure that originates from the medial calcaneal tuberosity and inserts on the plantar plates of the metatarsalphalangeal joints and proximal phalanges.50,51 The plantar fascia supports the medial longitudinal arch of the foot.50,51
Although the exact pathogenesis of plantar fasciitis remains unclear, it has been hypothesized that excessive stress on the plantar fascia can result in microtears at its origin.52 An inflammatory reaction is incited that then leads to a degenerative process.44,52 Biopsies of diseased plantar fascia reveal fibroblastic proliferation and chronic granulomatous tissue.52 The diseased fascia becomes thickened, from a normal 3.0-mm thickness to as much as 15.0-mm of thickness.52 Decreased vascularity, loss of normal elasticity, and alterations of nociceptor function may all contribute to the onset and persistence of this condition.3,4
Prior to 1996, failure of nonoperative treatment often led to surgical intervention. Some investigators have reported favorable results with plantar fasciitis surgery23; however, several recent studies have demonstrated that, despite improvement in symptoms, a prolonged recovery time and persistent pain were not uncommon.53-58 Davies et al53 reported that <50% of patients treated with chronic heel pain were completely satisfied with the results of surgery.
Several lithotripsy devices have been approved by the FDA for the treatment of various musculoskeletal conditions. Two of the devices, including the Dornier Epos used in this study, generate the shock waves using electromagnetic energy; one device uses electrohydraulic energy.12 Comparison studies of devices used for musculoskeletal lithotripsy have not been performed.
Extracorporeal shock wave therapy is an emerging technology and protocols vary from trial to trial. The different delivery modes of shock waves—single treatment versus multiple treatments, low energy shock waves (often defined as energy levels between 0.05-0.10 mJ/mm2) versus high energy shock waves, electrohydraulic versus electromagnetic methods of generating the shock waves—all can influence the outcome of therapy. For this reason, the results reported in a study are only valid for the parameters applied in that study.
In a prospective single-blinded pilot study, Rompe et al10 in 1996 reported a significant alleviation of pain and improved function in 30 patients treated with low-energy shock wave therapy for chronic plantar fasciitis. Follow-up was 24 weeks. Maier et al36 reported 75% good or excellent results in 48 heels 29 months after shock wave therapy. These investigators noted that clinical outcome was not influenced by length of follow-up.
Ogden et al39 used a very rigid success criteria to determine efficacy of shock wave therapy for patients with chronic plantar fasciitis. Patients were assigned a success or failure status according to four criteria: a minimum of 50% improvement in investigator assessment of pain, a minimum of 50% improvement in a patient's self-assessment of pain, an improvement of a patient's assessment of physical activity, and lack of use of pain medication between 10 and 12 weeks after treatment.39 Each patient had to meet all four outcome criteria to be considered a success. Twelve weeks after treatment 47% of treated patients met all four success criteria compared to only 30% of patients who received sham treatment.39 This difference was statistically significant. Approximately 76% of treated patients were satisfied with their outcome, even when pain relief was not complete.39
Buch et al33 reported the results of another multicenter prospective randomized double blind placebo controlled trial. These investigators followed the identical protocol used in the present study. After 12 weeks 61% of the treated patients met all success criteria compared to 40% of the placebo group.33
Chen et al16 reported on 80 patients treated with high-energy shock wave therapy for chronic plantar fasciitis. At 24 week follow-up, 86% were either symptomatic or significantly improved. Hammer et al35 reported on their experience using high-energy shock wave therapy to treat 47 patients (49 heels) with chronic plantar fasciitis. Approximately 80% of patients experienced complete or nearly complete pain relief at six months post-treatment.35
Wang et al41 demonstrated 80% satisfactory results in their cohort of patients with chronic plantar fasciitis treated with shock wave therapy. These investigators noted a positive cumulative effect from 6 to 12 weeks post-treatment.41 In a second study with longer follow-up, these same investigators noted that shockwave therapy for patients with chronic plantar fasciitis provided 94% complete or nearly complete resolution of pain.34
Rompe et al5 demonstrated similar findings. In their cohort of 45 running athletes with chronic plantar fasciitis treated with low-energy shock wave therapy, visual analog scores decreased from an average of 6.9 to 2.1 24 weeks after treatment and from 6.9 to 1.5 one year after treatment.
In another report with longer follow-up, Rompe et al11 noted that patients with chronic plantar fasciitis treated with shock wave therapy had progressive diminution of pain on manual pressure over a five-year period. The mean score for pain on manual pressure gradually decreased from 77 points (before treatment) to 19 points (at six months post-treatment) to 9 points (at five years post-treatment).11 In controls, the mean scores were 79 points before treatment, 77 points at six months, and 29 points at five years post-treatment.11
The results from this study add to the growing number of favorable reports that substantiate the efficacy of extracorporeal shock wave therapy as an effective treatment for chronic plantar fasciitis. Mean VAS, RAND-physical functioning, and RAND-pain scores were statistically improved at one and three months following treatment. The percentage of excellent or good results using the Roles and Maudsley score at 12 weeks post-treatment was 83.3%. There were no significant complications and no patient required additional shock wave treatment. Subjectively, patients were very satisfied with the procedure.
Two patient cohorts seem to have a particularly high incidence of plantar fasciitis: obese middle-aged women and young athletic men.8,36,39 This is the first report that examined the relationship between activity level and outcome after extracorporeal shock wave therapy. Although the outcome parameters among "active," "moderately active," and "sedentary" patients were similar, the relatively small number of patients prevented meaningful comparisons among the subgroups. Larger prospective studies are necessary to better define the role of extracorporeal shock wave therapy in these groups of patients.
Recent reports have shown that extracorporeal shock wave therapy was ineffective in the treatment of chronic plantar fasciitis. In a double-blind, randomized study from Australia, Buchbinder et al44 reported no statistically significant difference in the degree of improvement between the extracorporeal shock wave therapy treated group and a placebo group. In a German trial, Haake et al45 also reported no difference between the extracorporeal shock wave therapy treated group and a placebo group. Speed et al46 reported that a moderate dose of shock wave therapy (1500 impulses of 0.12 mJ/mm2, given monthly for three months) resulted in a 37% improvement in the extracorporeal shock wave therapy group and 24% improvement in the sham group with respect to pain.
There were some important differences between these negative studies and the present study. In the Buchbinder et al study,44 shock wave therapy was given in smaller doses, weekly, for three weeks.44 In the Haake et al study,45 shock wave therapy was applied every 2 weeks ±2 days (3 doses of 4000 impulses). In the Speed study,46 shock wave therapy was given each month for three months. In this study, shock wave therapy was given in a single, larger dose.
In the Buchbinder study,44 the total calculated dose of shock waves administered to each treated patient was different. In this study, each patient received the same dose.
In regards to inclusion criteria, patients were enrolled in the Buchbinder et al study if they were symptomatic for at least six weeks.44 Patients were enrolled in the Speed et al study46 if they were symptomatic for three months. In this study, patients were only treated with shock wave therapy if they were symptomatic for a minimum of six months. In this author's experience, those patients with less chronic symptoms (<6 months) are likely to improve whether or not they have extracorporeal shock wave therapy.
The treatment parameters in the Speed et al46 study (1500 pulses of 0.12 mJ/mm2, given in several doses over a period of several months) are very different from the treatment parameters used in this study. The protocol in the Speed et al study used a "moderate-energy" dose of shock waves whereas a "high-energy" dose was used in this study.
We believe that the results of extracorporeal shock wave therapy are only valid for the therapeutic parameters applied. Patient selection and treatment technique (adequate number of shocks, adequate total dose) are critical. Differences in results between different trials may be related to heterogeneity of treatment parameters (total dose, interval of time between doses, number of sessions, etc), study populations (rural versus university), and perhaps machine design. Further work is needed to clarify these issues.
This study is retrospective and as such has some inherent weaknesses. This series represents a relatively large number of patients considering that patients were derived from a rural, community setting. However, when considering the number of patients in each subgroup, the absolute numbers are relatively small. The length of follow-up was only three months, however, a positive effect was already evident at this time. Other larger studies have used a similar length of follow-up.39,41,44 Finally, this study did not use a control group.
Nonetheless, this series contributes valuable information. The data from this study demonstrates that extracorporeal shock wave therapy is a safe and effective procedure that can be used to treat patients with chronic plantar fasciitis. The procedure is reliable and enjoys a high rate of patient satisfaction.
The results of the current study revealed beneficial effects of extracorporeal shock wave therapy in patients with chronic plantar fasciitis. Unlike surgery for plantar fasciitis, which bears a higher risk of complications, recovery from shock wave therapy generally occurs without significant morbidity. Our results show that this procedure can be an excellent treatment option. Further prospective work is underway to better define this emerging technology.
Pfeffer G, Bacchetti P, Deland J, et al. Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int.1999; 20:214-221.
Lapidus PW, Guidotti FP. Painful heel: report of 323 patients with 364 painful heels. Clin Orthop.1965; 39:178-186.
Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg Am. 1978; 60:537-539.
Leach RE, DiIorio E, Harney RA. Pathologic hindfoot conditions in the athlete. Clin Orthop.1983; 177:116-121.
Rompe JD, Decking J, Schoellner C, Nafe B. Shock wave application for chronic plantar fasciitis in running athletes. A prospective, randomized, placebo-controlled trial. Am J Sports Med.2003; 31:268-275.
Davis PF, Severud E, Baxter DE. Painful heel syndrome: results of nonoperative treatment. Foot Ankle Int.1994; 15:531-535.
Williams PL. The painful heel. Br J Hosp Med.1987; 38:562-563.
Schepsis AA, Leach RE, Gorzyca J. Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. Clin Orthop.1991; 266:185-196.
Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone and Joint Surg Am.2003; 85:872-877.
Rompe JD, Hopf C, Nafe B, Burger R. Low energy extracorporeal shock wave therapy for painful heel: a prospective controlled single-blind study. Arch Orthop Trauma Surg.1996; 115:75-79.
Rompe JD, Schoellner C, Nafe B. Evaluation of low-energy extracorporeal shock-wave application for treatment of chronic plantar fasciitis. J Bone Joint Surg Am.2002; 84:335-341.
Alvarez R. Preliminary results on the safety and efficacy of the OssaTron for treatment of plantar fasciitis. Foot Ankle Int.2002; 23:197-203.
Rubin G, Witten M. Plantar calcaneal spurs. Am J Orthop.1963; 5:38-41.
Helbig K, Herbert C, Schostok T, Brown M, Thiele R. Correlations between the duration of pain and the success of shock wave therapy. Clin Orthop. 2001; 387:68-71.
DiGiovanni BF, Nawoczenski DA, Lintal ME, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am.2003; 85:1270-1277.
Chen HS, Chen LM, Huang TW. Treatment of painful heel syndrome with shock waves. Clin Orthop.2001; 387:41-46
Martin RL, Irrgang JJ, Conti SF. Outcome study of subjects with insertional plantar fasciitis. Foot Ankle Int.1998; 19:803-811.
Mitchell IR, Meyer C, Krueger WA. Deep fascia of the foot. Anatomical considerations. J Am Podiatr Med Assoc.1991; 81:373-378.
Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int.1998; 19:91-97.
Sellman JR. Plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int.1984; 15:376-381.
Barrett SL, Day SV. Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique--early clinical results. J Foot Surg.1991; 30:568-570.
Kinley S, Frascone S, Calderone D, Wertheimer SJ, Squire MA, Wiseman FA. Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study. J Foot Ankle Surg.1993;32:595-603.
Weil LS Jr, Roukis TS, Weil LS, Borrelli AH. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg.2002; 41:166-172.
Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeltal disorders. Clin Orthop.2001; 387:22-40.
Thiel M. Application of shock waves in medicine. Clin Orthop.2001; 387:18-21.
Ko JY, Chen HS, Chen LM. Treatment of lateral epicondylitis of the elbow with shock waves. Clin Orthop.2001; 387:60-67.
Wang CJ, Yang KD, Wang FS, et al. Shock wave therapy for calcific tendonitis of the shoulder: a prospective clinical study with two-year follow-up. Am J Sports Med.2003; 31:425-430.
Rompe JD, Hope C, Kullmer K, Heine J, Burger R. Analgesic effects of extracorporeal shock-wave therapy on chronic tennis elbow. J Bone Joint Surg Br.1996; 78:233-237.
Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop.1991; 15:181-184.
Haupt G. Use of extracorporeal shockwaves in the treatment of pseudoarthosis, tendinopathy and other orthopedic diseases. J Urol.1997; 158:4-11.
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Rompe JD, Kirkpatrick CJ, Kullmer K, Schwitalle M, Krischek O. Dose-related effects of shock waves on rabbit tendo Achilles. A sonographic and histological study. J Bone Joint Surg Br.1998; 80:546-552.
Buch M, Knorr U, Fleming L, et al. Extracorporeal shockwave therapy in symptomatic heel spurs. An overview [in German]. Orthopade.2002; 31:637-644.
Wang C, Chen HS, Huang TW. Shockwave therapy for patients with plantar fasciitis: a one-year follow-up study. Foot Ankle Int.2002; 23:204-207.
Hammer DS, Rupp S, Kreutz A, Pape D, Kohn D, Seil R. Extracorporeal shockwave therapy (ESWT) in patients with chronic proximal plantar fasciitis. Foot Ankle Int.2002; 23:309-313.
Maier M, Steinborn M, Schmitz C, et al. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: prediction of outcome by magnetic resonance imaging. J Rheumatol.2000; 27:2455-2462.
Krischek O, Rompe JD, Herbsthofer B, Nafe B. Symptomatic low-energy shockwave therapy in heel pain and radiologically detected plantar heel spur [in German]. Z Orthop lhre Grenzgeb.1998; 136:169-174.
Cosentino R, Falsetti P, Manca S, et al. Efficacy of extracorporeal shock wave treatment in calcaneal enthesophytosis. Ann Rheum Dis.2001; 60:1064-1067.
Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop.2001; 387:22-40.
Rompe JD, Kullmer K, Vogel J, et al. Extracorporeal shock-wave therapy. Experimental basis, clinical application. Orthopade.1997; 26:215-228.
Wang CJ, Chen HS, Chen WS, Chen LM. Treatment of painful heels using extracorporeal shock wave. J Formosa Med Assoc.1999; 200:580-583.
Rompe JD, Kullmer K, Riehle HM, et al. Effectiveness of low energy extracorporeal shock waves for chronic plantar fasciitis. Foot Ankle Surg.1996; 2:215-221.
Ogden JA, Alvarez RG, Marlow M. Shockwave therapy for chronic proximal plantar fasciitis: a meta-analysis. Foot Ankle.2002; 23:301-308.
Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracoroporeal shock wave therapy for plantar fasciitis: a randomized controlled trial. JAMA.2002; 288:1364-1372.
Haake M, Buch M, Schoellner C, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ.2003; 327:75-79.
Speed CA, Nichols D, Humphreys H, et al. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial. J Orthop Res.2003; 21:937-940.
Dornier MedTech Inc. Dornier Epos Ultra: Summary of Safety and Effectiveness Data.Kennesaw, Ga: Dornier MedTech Inc; 2002.
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Aquino A, Payne C. Function of the windlass mechanism in excessively pronated feet. Foot.2001; 91:245-250.
Mitchell IR, Meyer C, Krueger WA. Deep fascia of the foot. Anatomical and clinical considerations. Am Podiatr Med Assoc.1991; 81:373-378.
Milne L. Plantar fasciitis. Emedicine.2001; 429:1-10.
Davies MS, Weiss GA, Saxby TS. Plantar fasciitis: how successful is surgical intervention? Foot Ankle Int.1999; 20:803-807.
Watson TS, Anderson RB, Davis WH, Kiebzak GM. Distal tarsal tunnel release with partial plantar fasciotomy for chronic heel pain: an outcome analysis. Foot Ankle Int. 2002; 23:530-537.
Sammarco GJ, Helfrey RB. Surgical treatment of recalcitrant plantar fasciitis. Foot Ankle Int.1996; 17:520-526.
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Tomczak RL, Haverstock BD. A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg.1995; 34:305-311.
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Dr Furia is from SUN Orthopedics and Sports Medicine, Lewisburg, Pa.
Reprint requests: John P. Furia, MD, SUN Orthopedics and Sports Medicine, 900 Buffalo Rd, Lewisburg, PA 17837.
· Experts discuss what to expect after ankle surgery (Jul. 2005)
· Treatment of Foot Drop Using a Dynamic, Non-Rigid Dorsiflexion Foot Lifter (Jun. 2005)
· How top surgeons treat arthritis (May. 2005)
Result number: 131
Posted by Robert M. on 7/15/05 at 17:47
Hey man,
Same boat as you, just alot farther along, & I did it the WRONG way....Get orthotics custom made, now, if not sooner....Ice morning and night(10 min. per session)....a product called CT cream has helped me....an antinflamitory supplement such as boswellia is a good idea...Try to cut out processed carbs, and sugars if possible. BUT, most of all, CHILL OUT, NO Running, NO biking, & NO swimming, until you are pain free for at least 2 months....be careful stretching too much as well, that doesn't really help that much, and can aggrevate your condition....If you do not discontinue ALL workout activities for a while, I can PROMISE you, you WILL be sorry....tough to hear, but true....there it is...develop your sense of humor, you are gonna need it....You DON'T want to go down the road alot of us are going down, RELAX, & let it heal...Good Luck.
Result number: 132
Posted by Liboralis on 7/12/05 at 22:18
Yes peroneal splits or other injries are common but many times get missed. Sometimes a higher arch can cause one to bear more wt on the lateral border. Other times an injury or pain can cause you to invert or bear more wt on the outside to make it less painful. Problem is the foot cant take longterm load on the lat border so you can do a number of things to it.
What area are you in?
Result number: 133
Posted by Ed Davis, DPM on 7/01/05 at 14:30
Montefiore Medical Center
Division of Sports Medicine
Albert Einstein College of Medicine
New York
Ehrlich R.V., M.D. Naidoo R., M.D.
Extra-corporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis
A randomized, prospective,
double-blind, placebo controlled study
Inclusion Criteria
- Evidence of plantar fasciitis by history and physical exam
- Unsuccessful non-operative treatment for period of 6 months
Exclusion Criteria
1. Dysfunction of the knee or ankle
2. Local DJD
3. Generalized polyarthritis
4. Rheumatoid arthritis
5. Ankylosing spondylitis
6. Reiter's syndrome
7. Neurologic abnormalities
8. Nerve entrapment syndrome
9. Age under 18 years
10. Pregnancy
11. Infection
12. Malignancy
13. Involvement with a worker's compensation claim related to the foot
14. Implanted metal in the area (i.e. plates or screws)
Cohort Groups
- Randomized
- 2 treatment sessions
- Local anesthesia
- Ambulatory post-treatment
- Home program
- Pain and medication diary
- 6, 12, 24, 52 weeks
- SF-36 Ware J.E. Jr.; and Sherbourne C.D.: The MOS 36-item short
form health survey (SF-36). Medical Care, 30(6): 473-81, June
- Mayo Clinical Scoring System
Daley, P.J.; Kitaoka, H.B.; and Chao, E. Y.S. Foot Ankle, 13:
185-195, 1992
- Pain / medication diary
- Subjective assessment – questionnaire
Pain to Palpation
08 72
77 Placebo
% 40
02 11
01 2 4
6 weeks 3 months 6 months
Time Post Treatments
PT Pain Scale Improvement
08 74
p= 0.04
06 53
% 40
02 14
01 3
6 weeks 3 months 6 months
Time post Treatment
Improvement in Activity Level
80 71
05 43
5 4
0 -2
6 weeks 3 months 6 months
Time Post Treatment
Patient Satisfaction Score
80 73
% 40
03 22
02 14
6 weeks 3 months 6 months
Time Post Treatments
I would go to Medline to download the actual paper because this site does not allow us to cut and paste graphics but this study is impressive.
Result number: 134
Posted by Harry Waters Jr. on 6/20/05 at 10:15
Today, computer to be computer, nothing else. http://computer.nalchik.ru/
Result number: 135
Posted by Ali on 5/17/05 at 16:34
Ty for being helpful, I did talk with that Podiatrist about my finacial situation and he was lets just say I have never been treated that way by a Professional, His words were " I am not touchiong this unless you have Insurance" anyways I did have a L N I claim ( yes I am In WA- Seattle) but it was for an injry on the left foot, I think maybe all the added pressure and strain put on the right foot prob caused the Plantar on the right foot. I have filed a short term disability through my Employer have a new appt with a Dr this Fri who will be my new Primary care and see if he can help me be referred to a good Podiatrist and I got married recently and now am covered. Wish me luck and please yes refer me to someone good in Seattle . My employer is threatening to fire me too, so far I am having a most unpleasant time trying to help myself with this situation, how very riduculous on top of the pain to be harrassed, I am pretty frustrated/ and am also actively looking for another job that does not require that amount of time on my feet.
Result number: 136
Posted by elliott on 4/15/05 at 15:37
I just bought a new one for work, the Black & Decker Smartbrew,
after dropping the carafe of my old one and watching it smash to pieces. I actually have the 5-cup version, but the picture looks identical, just scaled up. I'm pretty happy with it. It makes a decent cup, and the layout works very well. The flavor seems to hold even after sitting on the hotplate for several minutes (and is then hotter than when first coming out). It is also self-cleaning, in that a coworker takes the filter holder and carafe to the restroom for me while I am on crutches recovering from surgery. :-)
Result number: 137
Posted by milley on 4/12/05 at 10:33
Member: MILDRED BESTON Patient: MILDRED BESTON Issue Date: 05/14/2004 Member SSN: 344-56-4905 Patient SSN: Group Name: THE GATES GROUP Address: HC 4 BOX 288 Relationship: Employee Claim #: 04125901826 DONIPHAN, MO 63935 Patient #: 20123 Rec'd Date: 05/04/2004 Provider: ZACKWRIE S PARR DPM
Member: MILDRED BESTON Patient: MILDRED BESTON Issue Date: 06/15/2004 Member SSN: 000-00-0000 Patient SSN: Group Name: THE GATES GROUP Address: HC X BOX xxx Relationship: Employee Claim #: 04156100412 DONIPHAN, MO 63935 Patient #: OP532 Rec'd Date: 06/04/2004 Provider: ADVANCED HEALTHCARE SURGICAL CENTER
Member: MILDRED BESTON Patient: MILDRED BESTON Issue Date: 09/15/2004 Member SSN: 000 00 0000Patient SSN: Group Name: THE GATES GROUP Address: Doniphan Mo Relationship: Employee Claim #: 04147401587 DONIPHAN, MO 63935 Patient #: 1538C1O Rec'd Date: 05/26/2004 Provider: DONALD G FOUST JR CRNA
Member: MILDRED BESTON Patient: MILDRED BESTON Issue Date: 06/15/2004 Member SSN: 000-00-0000 Patient SSN: Group Name: THE GATES GROUP Address: HC 0 BOX 00 Relationship: Employee Claim #: 04167903301 DONIPHAN, MO 63935 Patient #: 20123 Rec'd Date: 06/15/2004 Provider: ZACKWRIE S PARR DPM
Total = 2,745.96
These are a copy of my gfirst epf surgery. Note the first billing is for my first appointment to this Dr. on 04/21/04, all he did was give me a shot. Notice that on 04/29/2004 he did the surgery, this shows no conserative treatment other then a shot was done prior to the surgery,8 days prior.
Most Dr.s say the epf surgery cost's around 1300.00 Mine was 2,745.96 I believe that is double is it not? Please note however this is what the Insurance company paid, I paid a $650.23 co-pay on top of this making it
$3,396.19 and this was just surgery #1
Result number: 138
Posted by Dr. Z on 3/19/05 at 13:40
Login Logout Search HMPCME Health Pro Connect Health Job Connect Discussion Board Related Links Home Current Issue Archives Subscribe Industry News New Products News and Trends Events and Symposia Educational Tools Classifieds E-News Email Directory About Us Specifications for Advertisers
Welcome Zuckerman
Continuing Education:
What You Should Know About Shockwave Therapy
- By Lowell Scott Weil, Jr., DPM, MBA
In order to provide clarity to a controversial and confusing subject, this author discusses different forms of shockwave therapy and offers a closer look at recent literature on the subject.
Continuing Education Course #125 — November 2004
I am very pleased to introduce the latest article, "What You Should Know About Shockwave Therapy," in our CE series. This series, brought to you by the North American Center for Continuing Medical Education (NACCME), consists of regular CE activities that qualify for one continuing education contact hour (.1 CEU). Readers will not be required to pay a processing fee for this course.
Extracorporeal shockwave therapy (ESWT) has been a subject of controversy as various experts have debated its efficacy in treating chronic plantar fasciitis. With this in mind, Lowell Scott Weil Jr., DPM, explores the various types of shockwave therapy and provides a thorough analysis of the literature on ESWT.
At the end of this article, you'll find a nine-question exam. Please mark your responses on the enclosed postcard and return it to NACCME. This course will be posted on Podiatry Today's Web site (www.podiatrytoday.com) roughly one month after the publication date. I hope this CE series contributes to your clinical skills.
Jeff A. Hall
Podiatry Today
INSTRUCTIONS: Physicians may receive one continuing education contact hour (.1 CEU) by reading the article on pg. 61 and successfully answering the questions on pg. 66. Use the enclosed card provided to submit your answers or fax the form to the NACCME at (610) 560-0502.
ACCREDITATION: NACCME is approved by the Council on Podiatric Medical Education as a sponsor of continuing education in podiatric medicine.
DESIGNATION: This activity is approved for 1 continuing education contact hour or .1 CEU.
DISCLOSURE POLICY: All faculty participating in Continuing Education programs sponsored by the NACCME are expected to disclose to the audience any real or apparent conflicts of interest related to the content of their presentation.
DISCLOSURE STATEMENTS: Dr. Weil has disclosed that he has received grant and/or research support from Healthtronics, EMS DolorClast, UMS Wolf and Orthometrix.
This article contains discussion of published and/or investigational uses of agents that are not indicated by the FDA. Neither NACCME nor HMP Communications recommends the use of any agent or device outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.
GRADING: Answers to the CE exam will be graded by the NACCME. Within 60 days, you will be advised that you have passed or failed the exam. A score of 70 percent or above will comprise a passing grade.
TARGET AUDIENCE: Podiatrists.
RELEASE DATE: November 2004.
EXPIRATION DATE: November 30, 2005.
LEARNING OBJECTIVES: At the conclusion of this activity, participants should be able to:
• discuss the different types of technology used to create medical shockwave;
• cite the potential benefits of ESWT for patients with chronic plantar fasciitis; and
• discuss the recent literature on electrohydraulic, piezoelectric and radial shockwave therapy.
Sponsored by the North American Center for Continuing Medical Education.
Last year, I wrote "Extracorporeal shockwave therapy (ESWT) has a long way to go to prove it has overwhelming medical benefits that are claimed by the manufacturers, but it is still in the early stages of its evolution. With time, it will be necessary to prove these claims through prospective studies." (See "Extracorporeal Shockwave Therapy: Hope Or Hype?," page 46, November 2003 issue.)
While this article is not intended to prove beyond a statistical doubt that ESWT works, emerging research via prospective placebo-controlled, double-blind studies shows that ESWT is effective and should be considered a proven technology.
Employing ESWT for the treatment of musculoskeletal (MSK) disorders evolved in Europe in the early 1990s. ESWT is a derivative of lithotripsy, the mechanical breaking up of renal stones with sound waves. ESWT has been considered valuable in treating many different MSK disorders including plantar fasciitis, epicondylitis, tendinitis and non-unions of bone. In all situations, it is considered the non-invasive alternative to surgery.
Clinicians should only consider ESWT for treating a pathology after more common, accepted and proven non-invasive treatments have failed.
In the United States, ESWT received its first FDA-approved indication for the treatment of plantar fasciitis. Up to 15 percent of podiatric visits result from painful plantar fasciitis. Given the prevalence of plantar fasciitis in the U.S., with over 1 million people suffering from it annually, it has become the epicenter of debate about ESWT.
What One Randomized Study Revealed About Electrohydraulic Shockwave
Numerous studies have proven that 80 to 90 percent of people suffering with plantar fasciitis will be treated successfully with conservative treatment over a six-month period of time. There is little debate over the most effective conservative management options for plantar fasciitis although the only randomized, proven method is the use of night splints in the chronic cases.
However, continued controversy abounds regarding the proper method of treating the 10 to 20 percent of plantar fasciitis sufferers who do not respond to conservative care in a timely fashion.
Over the years, many different procedures have been described for treating chronic heel pain. These procedures include: large incisional sectioning of the plantar fascia with removal of bone spur; only sectioning the plantar fascia; decompressing a branch of the lateral calcaneal nerve with partial sectioning of the plantar fascia; minimally invasive techniques with or without an endoscope; in-step fasciotomies; and more recently, injections of different chemical agents, either Botox or alcohol. For the past four years, ESWT has been on the list of available treatments in the U.S.
Understanding The Different Shockwave Technolologies
Electrohydraulic, electromagnetic, piezoelectric and radial are four different technologies that are currently utilized to create medical shockwave.
The electrohydraulic system is also known as spark gap technology and was employed with the first generation of shockwave machines. A spark plug is used to generate heat and a sonic pulse, resulting in cavitation. Eisenmenger first described the electromagnetic principle in 1962. This involves the passing of an electrical current through a coil, which produces a strong magnetic field. The subsequent compression of the fluid creates a shockwave.
The piezoelectric principle employs a high voltage current, which is applied to a substantial number of piezo crystals mounted on the inside of a sphere. The piezoelectric effect causes deformation of the crystals, inducing a shockwave. The focal point or area of maximal therapeutics is at some fixed distance away from the shock wave generator in the electrohydraulic, electromagnetic and piezoelectric machines.
The radial principle has a focal point that differs from the other three technologies. The focal point of the radial principle is directly at the device-skin interface and is dispersed in a megaphone fashion from the head of the radial device.
There have been several proposed theories when it comes to the mechanism of action of shockwave. Research by Wang described the mechanism of MSK-ESWT as multiple microtraumas that promote neovascularization to the tissue that one is treating. Others have compared the process to that of tenderizing meat whereby repeated pounding on the meat will break up the interstitial fascia or scar tissue, and make the meat more pliable.
In a study of the Achilles tendons of mongrel dogs versus a placebo, Wang showed that shockwave not only promotes neovascularizaton but also facilitates the release of growth factors PCNA, VEGF and eNOS. Shockwave treatments have been employed for several different MSK applications including the treatment of tendonitis, calcifying tendonitis, periarticular shoulder calcification, plantar fasciitis, medial and lateral epicondylitis, osseous non-unions and avascular necrosis.
Currently, there is no consensus on the use of low-energy shockwaves, which do not require local anesthesia, and high-energy shockwaves, which require local or regional anesthesia for the treatment of chronic plantar fasciitis. There is no consensus for differentiating between low-energy and high-energy shockwaves as multiple physical parameters are involved.
While the clinical effect of both protocols appears to be comparable, there is clear evidence of increasing side effects as the energy level increases. Although these side effects do not appear to be significant from a macroscopic view, local tissue and nerve tissue may be affected. No local anesthesia is required for low-energy shockwaves so related side effects are lacking.
The only "disadvantage" of low-energy shockwaves is that one has to provide a repeat application. A comparison of the effectiveness of low-energy and high-energy shockwaves has not been studied.
Shockwave Therapy Or Surgery For Chronic Plantar Fasciitis?
Why have surgeons continued to change their procedure of choice over the years despite citing literature with good to excellent early results? It is probably the same reason why there are over 100 bunion operations. They are searching for the procedure that is predictable over the long term with the least amount of complications and disability for the patient.
What One Randomized Study Revealed About Piezoelectric Shockwave
We have certainly heard surgeons proclaim minimally invasive surgery as being 95 percent successful with immediate weightbearing and no complications. Certainly, those statistics are far from reality. Whenever one performs invasive surgery, there are risks. It is not uncommon to hear of the patient who underwent an endoscopic plantar fasciotomy (EPF) and wound up having severe nerve injury to branches of the plantar nerve.
We have also encountered the patient who had open sectioning of the plantar fascia and removal of the bone spur only to wind up in severe pain for months, unable to work or pursue normal activities over that time frame. While these scenarios may be unusual, they are certainly more common than we would like.
ESWT has emerged as a noninvasive, minimal risk procedure for chronic conditions such as plantar fasciitis. ESWT allows patients to return to activities of daily life within one or two days with immediate return to most jobs and normal daily shoegear. Complications of ESWT for plantar fasciitis have been virtually non-existent.
In 2002, we published a paper in JFAS showing 82 percent success with ESWT. This success rate was comparable to our success rate with the minimally invasive plantar fasciotomy (83 percent), which we published in JFAS in 1994. This pilot study was a retrospective study and we are certainly aware that only a randomized, prospective, placebo-controlled study can provide evidenced based medicine.
However, this is true of all the studies on surgical outcomes for plantar fasciitis as these studies are similarly designed as retrospective without the control of a placebo group. Therefore, our study shows that outcomes with ESWT are comparable to surgical outcomes without the risks, complications and disability inherent to surgery.
Without a doubt, the literature is controversial when it comes to the relative benefit of ESWT. Opponents of ESWT point to literature that shows its ineffectiveness when it is compared to placebo. One can selectively quote literature to support a stance on ESWT either way.
However, some of the oft-discussed papers against ESWT have been scientifically flawed. The paper most often cited by the opponents of ESWT is by Buchbinder out of Australia. This study included patients who had heel pain for as little as six weeks and ESWT energy levels were given to each patient's tolerance rather than having a uniform standard application throughout the study. Furthermore, the energy levels used were far less than those recommended in the U.S.
Additionally, the placebo group was administered a small dose of ESWT that could have theoretically been therapeutic. Lastly, the study was performed by a non-clinician who worked for the government of a national health care system. The motives of the study were skewed from the beginning.
Critics will also point out that ESWT is extremely expensive. However, the cost of new technologies is often high as it is with new pharmaceuticals. The benefits of ESWT in terms of social costs are immeasurable. Patients are able to return to activities of daily life and work immediately. There are no costs of lost work to either the patient or employer. There are virtually no risks or complications with ESWT whereas postoperative nerve injuries and infections can require intense medical care that can run into tens of thousands of dollars. These are just some of the examples of the overall cost benefit of ESWT over surgical options.
What Studies Say About Electrohydraulic, Piezoelectric And Radial Devices
Over the past two years, the Weil Foot and Ankle Institute has been fortunate to be involved with five different randomized, double-blind, placebo-controlled studies on the effectiveness of shockwave. Three of the studies were multicenter, pivotal studies for the purpose of securing a PMA from the FDA. The other two were single site studies.
Two of the multicenter FDA studies utilized sedation. One study involved the electrohydraulic device whereas the other study involved the piezoelectric device. Both studies had a rigorous exclusion criteria with qualified patients having pain for greater than six months and medical treatment for at least four months that included at least four of the following: arch support (custom or OTC), antiinflammatory medication for at least four weeks, cortisone injection, physical therapy, night splints, stretching exercises and/or shoe modifications.
Patients were given sedation and the appropriate heel was anesthetized with 6 to 10 cc of 0.5% Marcaine plain. Computer randomization then determined whether the patient would receive active treatment or a sham treatment (no treatment). These patients were then followed for three months by a podiatric physician, who was not aware of the treatment that was provided to these patients.
What One Randomized Study Revealed About Radial Shockwave
The electrohydraulic device showed that 60 percent of the active group improved by more than 50 percent while only 38 percent of the sham group improved by more than 50 percent. This compares favorably to the Ossatron FDA study results.
The piezoelectric study showed that 48 percent of the active group had an improvement of greater than 50 percent while 50 percent of the sham group had more than 50 percent improvement.
However, there was a greater improvement in the Roles and Maudsley criteria for the active treatment group than the sham treatment group, and the active failures had more improvement than the sham failures. Composite scores from all sites are still undergoing statistical analysis.
A third randomized, double-blind, placebo-controlled multicenter study used radial shockwave therapy. Although local anesthetic was available for patients who had severe pain during treatment, no one required the injections.
The study had a rigorous inclusion criteria similar to the aforementioned studies. Computer randomization determined whether patients were treated with an active handpiece or a sham handpiece every two weeks for three treatments. A blinded physician then followed these patients for three months.
For this study of 242 randomized patients, 125 received active treatment while 118 received the sham treatment. The active group improved their visual analog scale (VAS) of pain from a baseline of 7.1 to 3.6 three months after the treatment. The sham group improved from 6.7 to 5.9 at three months.
The active group significantly outperformed the sham group using the Roles and Maudsley criteria. Fifty-seven percent of the active group achieved successful alleviation of their morning pain while only 40 percent of the sham treatment group had this success. Fifty percent of the active group had success treating their activity pain while only 33 percent of the sham group succeeded with treatment of their activity pain.
Using ESWT To Treat Bilateral Heel Pain And Painful Morton's Neuroma
A single center study focused on the use of ESWT for treating bilateral heel pain. Patients were only eligible for the study if they had been unsuccessfully treated for bilateral heel pain for greater than six months, they had a visual analog pain scale > 6, and systemic causes of the heel pain had been ruled out. Researchers sedated the patients and both heels received 6 to 10 cc of 0.5% Marcaine plain. Computer randomization determined which foot was to be treated.
Researchers used an electrohydraulic ESWT device at a level of 19 Kv and applied 2,000 pulses on the treated foot. The sham foot received no treatment. The patients then followed up with a blinded physician for three months.
This study showed that 70 percent of the active treatment group improved and 52 percent of the sham treatment group improved. Sixty-five percent of the active group improved by more than 50 percent while only 47 percent of the sham treatment group improved by more than 50 percent. Sixty-five percent of the active treatment group achieved a VAS of less than 3 while only 39 percent of the sham treatment group had a VAS less than 3.
According to the study, 4 percent of participants had no improvement in either foot while 39 percent of the participants had improvement in both feet.
A single center study focused on the use of ESWT for treating painful Morton's neuroma. Patients were only included in the study if they had been unsuccessfully treated for Morton's neuroma pain for greater than six months, they had a visual analog pain scale > 6, and they had been offered surgical treatment as an option to EWST.
Researchers sedated the patients and injected the third interspace with 3 to 5 cc of 0.5% Marcaine plain. Computer randomization determined whether the patients received active treatment or sham treatment.
Researchers utilized an electrohydraulic ESWT device at a level of 21 Kv and applied 2,000 pulses to the treated foot. The sham foot received no treatment. The patients then followed up with a blinded physician for three months.
The study revealed that 83 percent of the active treatment group improved by more than 50 percent while only 25 percent of the sham treatment group improved by 50 percent. Seventy-five percent of the active treatment group had a VAS of less than 3 three months following the procedure while only 25 percent of the sham treatment group had the same findings. Eight percent of the active treatment group had no improvement while 50 percent of the sham treatment group had no improvement three months following the procedure.
No surgical procedure for heel pain, epicondylitis, calcific shoulder tendinitis, Achilles pathology or Morton's neuroma has ever been subject to the rigors of a prospective, placebo-controlled, double-blind study the way ESWT has.
Final Notes
At the Weil Foot and Ankle Institute, we treat plantar fasciitis for at least four months with a strict conservative protocol that has been detailed in multiple publications. A vast majority of patients will respond to that conservative approach in that time frame.
After thoroughly ruling out other etiologies, we present patients with the option of ESWT or surgery to relieve their chronic heel pain.
Financial concern is the only issue that keeps patients from choosing the surgery option. In some cases, we provide the treatment pro bono to those who would be best served but just cannot afford the treatment.
At this time, one should consider ESWT a proven treatment for plantar fasciitis and part of any care pathway for physicians who treat the foot. In the future, research may reveal it appropriate to move to ESWT earlier in the treatment pathway if certain diagnostic criteria are met and show that ESWT is more likely to help than other conservative options.
Additionally, it is possible that ESWT will actually reduce overall costs if less money is spent on non-productive conservative care and physician visits, and if there is less chance of lost productivity and days off work from pain, physician visits and surgical recovery. Employers and patients alike may be crying out for ESWT to be utilized and the health insurance companies will have to listen.
Dr. Weil is the Fellowship Director of the Weil Foot and Ankle Institute in Des Plaines, Ill. He is a Fellow of the American College of Foot and Ankle Surgeons.
CE Exam 125
Choose the single best response to each question listed below.
1. Numerous studies have proven that between ___ to ____ percent of people with plantar fasciitis will be treated successfully with conservative treatment over a six-month period of time.
a) 50 to 60
b) 90 to 100
c) 80 to 90
d) 60 to 70
e) 70 to 80
2. Which of the following musculoskeletal disorders has extracorporeal shockwave therapy (ESWT) been considered valuable in treatment?
a) epicondylitis
b) plantar fasciitis
c) osseous non-unions
d) tendonitis
e) all of the above
3. The electromagnetic principle of shockwave therapy …
a) is also known as spark gap technology.
b) was employed with the first generation of shockwave machines.
c) involves the passing of an electrical current through a coil, which produces a strong magnetic field.
d) employs a high voltage current which is applied to a substantial number of piezo crystals mounted on the inside of a sphere.
e) a and b
4. The piezoelectric principle of shockwave therapy …
a) is also known as spark gap technology.
b) was employed with the first generation of shockwave machines.
c) involves the passing of an electrical current through a coil, which produces a strong magnetic field.
d) employs a high voltage current which is applied to a substantial number of piezo crystals mounted on the inside of a sphere.
e) a and b
5. The focal point or area of maximum therapeutics is at some fixed distance away from the shock generator in all currently available shockwave devices except those with _______ technology.
a) radial
b) electrohydraulic
c) piezoelectric
d) electromagnetic
e) a and b
6. One multicenter FDA study that involved using an electrohydraulic shockwave device to treat chronic plantar fasciitis found that _____ percent of the active treatment group improved by more than 50 percent.
a) 50
b) 60
c) 70
d) 80
e) 90
7. Another multicenter FDA study that involved using a piezoelectric
shockwave device to treat chronic plantar fasciitis found that _____ percent of the active treatment group improved by more than 50 percent.
a) 38
b) 58
c) 78
d) 28
e) 48
8. A randomized, double-blind, placebo-controlled multicenter study of radial shockwave therapy for chronic plantar fasciitis found that _____ percent of the active treatment group had successful alleviation of their morning pain three months after treatment.
a) 57
b) 47
c) 67
d) 87
e) 77
9. Three months after treatment, a single center study of ESWT for bilateral heel pain revealed …
a) 70 percent improvement for the active treatment group.
b) 50 percent improvement for the active treatment group.
c) 40 percent improvement for the active treatment group.
d) 60 percent improvement for the active treatment group.
e) 80 percent improvement for the active treatment group.
Instructions for Submitting Exams
Fill out the enclosed card that appears on the following page or fax the form to the NACCME at (610) 560-0502. Within 60 days, you will be advised that you have passed or failed the exam. A score of 70 percent or above will comprise a passing grade. A certificate will be awarded to participants who successfully complete the exam. Responses will be accepted up to 12 months from the publication date.
1. Tomczak RL, Haverstock BD. A Retrospective Comparison of Endoscopic Plantar Fasciotomy to Open Plantar Fasciotomy with Heel Spur Resection for Chronic Plantar Fasciitis/Heel Spur Syndrome. J. Foot Ankle Surg. 34(3): 305-311, 1995.
2. Gill L, Kiebzak G. Outcome of Non-surgical Treatment for Plantar Fasciitis. Foot Ankle Int. 1996; 17: 527-532.
3. Weil LS, Golding PB, Nutbrown NJ. Heel Spur Syndrome. A Retrospective Study of 250 Patients Undergoing a Standardized Method of Treatment. J. Foot Ankle Surg. 4: 69-78, 1994.
4. Benton-Weil, Borelli AB, Weil Jr. LS, Weil Sr. LS. Percutaneous Plantar Fasciiotomy: A Minimally Invasive Procedure for Recalcitrant Plantar Fasciitis. J. Foot Ankle Surg. 37(4): 269-272, 1998.
5. Jerosch JU. Endoscopic Release of Plantar Fasciitis - A Benign Procedure? Foot Ankle, 21: 511-513, 2000.
6. Alvarez R. Preliminary Results on the Safety and Efficacy of the Ossatron for Treatment of Plantar Fasciitiis. Foot Ankle Int. 2002; 23: 197-203.
7. Weil Jr. LS, et al. Extracorporeal Shock Wave Therapy for the Treatment of Chronic Plantar Fasciitis: Indications, Protocol, Intermediate Results, and a Comparison of Results to Fasciotomy. JFAS 41(3), 2002.
8. Chen HS, et al. Shockwave Therapy for Patients with Plantar Fasciitis: A One-Year Follow-Up Study. Clinical Orthopedics and Related Research 387: 41-46, 2001.
9. Wang CJ, et al. Shockwave Therapy for Patients with Plantar Fasciitis: A One-Year Follow-up Study. Foot and Ankle International, 23(3), 2002.
10. Ogden JA, et al. Shockwave Therapy for Chronic Proximal Plantar Fasciitis: A Meta-Analysis. Foot and Ankle International 23(4), 2002.
11. Hammer DS, et al. Extracorporeal Shockwave Therapy (ESWT) in Patients with Chronic Proximal Plantar Fasciitis. Foot and Ankle International 23(4), 2002.
12. Buchbinder R, et. al. Ultrasound-Guided Extracorporeal Shock Wave Therapy for Plantar Fasciitis: A Randomized Controlled Trial. JAMA 288(11), 2002.
13. Rompe JD, et. al. Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes: A Prospective, Randomized, Placebo-Controlled Trial. The American Journal of Sports Medicine 31(2), 2003.
14. Dalay PJ, et al. Plantar Fasciotomy for Intractable Plantar Fasciitis: Clinical Results and Biomechanical Evaluation. Foot and Ankle, 13(41), 1992.
15. Vohra PK, et al. Long-term Follow-up of Heel Spur Surgery: A 10-Year Retrospective Study. JAPMA, 89(2), 1999.
16. Lundeen RO, et al. Endoscopic Plantar Fasciotomy: A Retrospective Analysis of Results in 53 Patients. JFAS, 39(4), 2000.
Podiatry Today - ISSN: 1045-7860 - Volume 17 - Issue 11 - November 2004 - Pages: 60 - 66
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Result number: 139
Posted by Brenda G from Al on 2/05/05 at 07:50
Thank you all for your responses! I am going to make a personal survey of my friends about shoe size increase between PF sufferers and non-Pf'ers. This MD, if I get the jest, said your feet shouldn't increase that much as an adult, if it does, then something is going on, like maybe PF development. Now I could be wrong, but this was from my sister. I, also, am making an appointment with him, even though I am having very little problems now, I believe I need new. He doesn't recommend casting while the foot is inflammed. So I am getting new ones made by him. Bren
Result number: 140
Posted by one man on 2/04/05 at 02:48
Another name of the Japanese history is Kojiki ( = the beggar, the homeless.).
That they are doing is only to steal with dancing with making noise, now.
Warning !
Mail of help Dear Head of the country
You can be God by Hacking to Server !
It's almost PARADISE !
Believe me ! or you must regret forever ! It's terrorism ! You are controlled by radio wave unconsciously sent by Japanese-hacker(Taka-tsukasa (Duke)).
Your consideration is a thing sent by radio wave at your skull, nerve network(= antenna). You can control the anybody's brain wave(= consideration. emotion. speech. action. secretion) by radio wave, even make girls go to rut.(real) The theory is like a crystal radio set, a string telephone.【a(loud)speaker = a microphone. an antenna = a radio wave sending instrument. Telephone Server and TV is listening to your speech and action by radio wave come out from TV when it is ON. Make noise and sound in it not to stop the autorecording. Switch it on and off by a timer during your absence. Telephone Server is listening to your voice when the line is not dead, and watching your position when the telephone is ON. Computer Server is watching and operating your computer. Password is not effective. Mailbox has no lock. Submarine cable and Artificial satellite can relay it to the hacker in other country. It maybe written by Java. Every PC-System is only a rule of word like a law.】
It makes two marionettes have a conversation, fight and run on a rail. So they are felt like being keep watched perfectly and cannot run away. All Japanese and the head of Korea Russia China USA are the same. Even Communist Party, too (If they had declared off the USSR, it might be found out in more early time. Everything is a drama to make the racist, economist, politician obey their aim "My Soft and Secret Paradise". The election is so, too. It's a fiction by PC.). Sadam, Sendelo were so, too. They obeyed to be killed. The race of the development of nuclear armament and the power struggle bought time of you. The future of your country and you are a slave, which eats the same tribe like a puppet government of a colony. Teach them this for you ! Certainly, it is probably difficult to retrieve their brain wave. But it gets worse and worse. It's only a few person. It occures big change. Hurry up ! Try it ! Or you must regret forever. Send them various frequency of radio wave, and check their reaction. Even if it is difficult to control their motion, you can put them to sleep at least. Please understand and realize ! for you and every mankind, if you can be unmanipulated.
We need a law ( = When the person who obstructs the other person, makes the person unfortunate by the law. For example, a murder and a damage case. Punish a criminal. Make it impossible to obstruct the other person. Even if someone obstructs, the victim to have obstructed make not unfortunately. To secure the life of the whole nation ( = guarantee a minimum income and marriage.). Like a social security system and an insurance system.)
They continue to order however they don't find whether or not they should do. They fear to lose the leadership. They, too, can not expect when they become a victim. There is No security for them, too.
And we need a absorbing matter of radio wave. Have a helmet(mask) of it and cover your house with it ! Cut the every network with them ! Crush the spider ! Control the Server ! Please kill them, now ! Or you be done ! Put the blame for it on others ! Then, everything is OK. Nobody blame you for it. Anybody will give support to you. Kill them ! Believe me ! or you must keep on smiling in the bed disturbed and in the bathroom watched by their camera named sensor(Look at Toride building in Japan = Their paradise.). Believe me ! I want to help you (and me). Please understand ! You are being stolen one after another. Your country will be stolen everything, can say nothing (money, woman, liberty). Why are you bringing up the Devil which eats up you, like a spider, thief, Damian?Don't listen to their voice. Don't look at their dance and face and TV and news. Think nothing ! Kill them ! They have nothing ! So they must dance to deceive you. They use a complicated language to conceal the fact that they have nothing. They do so, to deceive you !
Don't play money-game. They are A controlled trap. Don't be deceived ! It's a lie ! How stupid you are ! Wake up ! Break off business relations with them ! All their money and what they have is what was stolen from your country by them. They steal it saying "I don't want it.", and kill you saying "I help you.". Don't give them ! Because they think it for their power. They never thanks ! They repay kindness with evil ! Wake up ! Their figure is ugly because they are Devil which crush and curse each other. So they cannot do even sleeping in soft bed. Devil lives not in Mars but in the edge of the earth, Japan. (Why do you pay so much for CG?for thief?) Kill them ! Make a big inflation ! Then, they will lose the money, much income from interests, and many mistress. There is no wrong for laborer. Don't forget USSR killed by Japanese-hacker for joy. The half of Japanese is disappeared by radio wave in 50 years with smile, saying "Thanks, I won Korea, Russia, China, USA. We are the champion ! ", in hell of lash with writhe・・・It's falling together with your country. They are a descendant of a farm thief. So they could live just in Asia. Domestic animal is hard to rob. They have created nothing for 13 centuries. All they have done is disturbing, fraud, theft. Now, too ! Greedy Devil ! Only misery of others is their pleasure. They follow only a lash. They can understand only an instinctive feeling.
For example, it is a pain and a pleasure and so on. Bury them alive ! It's the best way to make a peace and make you happy. They will say thank you. Not Sadam, Not North Korea, But they are Devil ! Iraq is their TV-game. Don't look at it ! They live in Japan because safety and enjoyable. It's their PARADISE ! If you meet them, say "SINE" for you and them, keep on disturbing and complaining, while say them "MANE (=It's following your way.)". And if you can, kill them, now ! Every Japanese will say "Thank you for your help.", even if they vanish. You have the power for it, no time to hesitate !
Believe me ! Believe me ! Kill them ! Kill them ! NOW !
They will make a toy of you all year long. They are not God. They are the expert of computer only.
Believe me ! I do anything I can do and give you all I have For it. Believe me ! This is your future. I am your future. Believe me ! Save who hits you, but he will help you.
Please help you and me ! I am Marquis.
(Copy and distribute and Exhibit on your web for the fine balance of force, by free.)
Rising sun?No ! Look ! Falling Sun ! more and more・・・for pleasure・・・in hell・・・with you !
To Japanese, value of human is that of chicken scraped. Believe me !
TV, phone, PC → Server → Hacker → Server → your hed, mail, PC
Hednism !
You will not want to believe this. It's OK. I, too, was so for a long time. No one tries to ask me the name of the hacker. They don't know what to do if they know it.
≪≪≪The claim≫≫≫
The mail of the help
●●●●●let's believe ! ●●●●●
Let's distribute to all over the world !
This is Japan !
Japan is dominated by them.
① The eternal noble who depends on the interest rate.
As for the foreign currency deposit with stuck expensive interest rate, too, it is burdened with the tax of Japan.
( The tariff of the company is about 50 % )
The person who concerned the bank by the financial transactions pays the half of.
If moving it to another bank account by a little, the inheritance tax, too, is unnecessary.
② The hacker---Extraordinary in the steal by the unjust approaching to a server, the hacking.
The electric wave goes out of the TV.
speaker = mike TV = A cell phone
A cell phone = the present location, sending e-mail, a photograph, are seen by them.
It is possible to send an order. It is possible to hear.
It operates the PC in the Internet and it is extraordinary.
It corrects the record of the automatic recording.
Make the noise during ON.
TV, phone, PC make a triplet by the server in the phone company
貞 "sada" = The ring → OFF !
Change it to the auto printing type and it is possible to search single shot.
The brain is a wire circuit → electric wave ⇔ electric current.
③ To be troublesome, the fraud, the thieving, and the making take off and commiting a woman,
they do only them.
Always trying to show themself strongly and god.
As for the present situation, only they are free.
It is not to be free, is reckless.
All they do is the obstacle, the destruction, the undress !
Hedonists =The devil
The armor of the law is being broken by them.
Keep a law ! If it is not・・・
Tomoko who waits in Island (Matsushima Tomoko) She is bitten by the lion. It's you.
We all are defended by the law.
The income, the safety, the service and the status, all of the others
It leaves in 6 laws, 生国厚健労雇, which breaks 666. ・・・・・・・・・・・・・・・・・ Now, writing.
◆ The mass communication is increasing a starved man, by interfering with woman's dreaming of the marriage.
( Evidence: As for the actor in Japan, all faces are bad ).
→ Because it makes a profit because it is easy to make take off a woman, it is easy to commit her, it is profitable and they are glad.
It is the hoodlum who throws away the money that the country worked by the processing trade to the foreign country by mass consumption.
( The sponsor and they = The casino sales person who is only making noise. The destroyer. The child of the sponger. )
They are only making the atmosphere that they are strong and right !
Because they make a profit when they are in the many crime !
Because it is possible to be seen, that they who are saying the abuse of the criminal are right and then being strong.
At money, it is doing the liking and extraordinary thing.
The paradise !
By the law, it should regulate !
→ It should assume that the sex at the thing except the subscribed bawdy house and all exposure of the skin are a rape charge and an obscenity charge !
Moreover, to do them is enough at the divorce woman !
Let's make them an official !
Even if it becomes sick, let's make be guaranteed !
Islam which is supported all over the world.
( The man, too, Long skirt = the turban = can live on the desert if doing attentively ).
It is to make it not be possible to have crowds of lemen !
It is to decrease the criminal and the hacker as glad that it obstructs a man because it has crowds of lemen by obstructs !
It is to make the whole nation equal !
Not to be taken by the foreigner, is the only excusing of them !
Now isn't important how the person thinks, already !
・・・ because all isn't moving in his will.
・・・ because the tripper seeks a temporary partner.
The man with the much marriage number of times is should impose a heavy tax !
Only that the mass communication, too, continues to pursue its pleasure is in the head.
They are ・・・ while pretending to do a good man.
First, they makes take off a woman at the model fee of 5,000,000 yen, and next they threatens her using it, and makes her appear on the sex video by 500,000 yen.
Next, it is ・・・ by 50,000 yen.
This is a famous trick.
The profit of the creating supplier continues forever.
The successful pornography actress is the successful man who was made to deceive a lot of ignorant girls and their parents.
The victim has no choice but to be laughing.
Because it is afraid of ・・・ to seem to be the person who doesn't have luck.
In other words the person who was abandoned in the hacker.
They put a camera to the compartment at the lavatory.
They are ・・・ saying it is a sensor while deceiving people.
The general public can not do in the distinction of the sensor and the camera and so on.
The ones such as the sensor are unnecessary completely.
If being not to make use a restroom, it should not make restroom itself.
It is the excusing to put a camera, to be false.
The facility supplier in the civilian tells a lie willingly for a little profits and pleasure.
The administrator in the public facilities is thinking only of trying to make there only his paradise.
Only the person who has power is happy.
It is a paradise for them.
◆ The one to seem a camera like the sensor at the locker room and the restroom and to make feel anxiety should think as the flagrante delicto of the crimes of threatening !
→ At all, let's do a complaint and an arraignment to the Public Prosecutor's Office ! ( by the letter is OK )
Or, let's file a suit to the court !
Let's do the report every day from the public telephone !
Because it has understood who is the owner when using a cell phone.
The power of the majority vote = the association and the general meeting
There is not authority which judges it in the police !
To do it becomes an official authority misappropriation sin !
The Criminal Procedure Code.
Let's publish their address and name to the style that it isn't possible to do a selfish thing !
Only the person who want to become a policeman in such condition, let's admit to become a policeman !
Consequential !
The official is the public server of the people chosen people task ! It is an entrusting contract on the civil law.
⇒ It is free originally !
The difference between the government service and the people overflows !
◆もともと女性は、男性ホルモンが・・・・・・・・・・・・・・・・Now, writing.
To grumble is said as frivolous.
It is because the hearing person is troublesome.
It is because he wants to do to be easy.
It is running about trying to escape from the thing where the immediateness is troublesome for all.
It tries to move around to the side which seems as strong as possible, the side which it seems that is as easy as possible.
It is ・・・ while thinking only of stealing existing one.
Victims are killed by devil being called a god and smile.
If continuing to strike the person who is in from the outside at the jail with the lash, the person do bloodshed each other in it.
It is because the person who is in seeks morphine.
It seeks the relative superiority complex which can be easily gotten by the immediate victim.
They are telling for all men to die silently.
It is thinking only of all immediate pleasures.
Only the person who could get status by good fortune can get high pay and is happy.
They are dropping an immediate person on the hell for a little pleasure.
The person of the blood type of A has such a tendency specifically.
They die while they are glad about the misfortune of the person.
They can forget even in their misfortune by the misfortune of a stranger.
In other words, the group commits suicide.
In the Europe, the thing that the developed time of the law, the welfare and the ethnology ( the Bible ) was early will be one of the reasons.
Because the consideration circuit is simple, the O person is thinking only of wining in the atmosphere.
All of they die while they make them cool.
It is just like to the style of the hell's angel and the soldier.
Therefore, no one wakens to the present situation.
It likes for the person of AB to be riding a wind in the singleness.
The person of B is very disadvantageous status.
It is because the instinctive greed is strong and an animal they like-ly, and moreover they have an imagination and they are an equalitarianism.
The Buddhism is the trap which India floated down.
It is a revenge on the rice ( the U.S. ) thief.
To make them do bloodshed.
It loses life if knowing an enemy and knowing you.
There is not a father.
In the Buddhism, no father lets me know.
Because it is killed when saying what it is.
Nothing is written in the scripture, too.
It uses a character like the cryptography and only the appearance is excellent.
Even what it is saying is unclear.
Rather, it is saying that you die silently.
The father brandishes a stick.
It beats a head ( the wooden drum ) and it intimidates neighborhood.
In Shorin-ji, the father does a fight and is doing a person by the beating to death.
It shaves a hair off by itself and it becomes an appearance like the skeleton, it recommends a fast and it is devil itself.
All is dreaming a dream.
It is a foolish crowd !
To escape from the pain, it is immersed to the pleasure of morphine.
All has an ugly face.
The body to crush each other !
They are the devil who left livestock in exchange for the bean.
All is being upset.
They call the criminal ( the hacker ) who kills us a god.
In Japan the sales person in the department and the supermarket think that it is permitted to put a poison in the food if he sells at the half price.
Though it is illegal that they do the one package sale which put a condition, they do it because it is glad because the superiority complex can be noticed.
Policeman do nothing because they want to be easy. Because it is easier to support to the strong side.
Rather, they seem to glad about the misfortune of the person.
It's a novel, you hope.
日本人は皆、恩をアダで返す、ハイエナ ! 本当だよ ! 猿そのもの!
≪≪≪ 救いのメール ≫≫≫
●●●●●貴方の為に ! 信じましょう ! ●●●●●
聖書の様に世界中に配りましょう !
貴方が助かる為です !
現実を知りましょう !
①永遠の金利貴族(外貨ダテ預金の高金利も半分日本の税負担(企業銀行の税率は50%程+銀行への支援)・半分周り(株等の金融取引で関わった人)負担 ! 別口座に少しづつ移せば相続税も不要 ! )10億円で2%なら年収2,000万円 ! 寝てるだけでどんどん貯金が増える ! しかも国が加工貿易で稼いだ金を大量消費で外国へドンドン捨てている悪人 ! (日本のものは全部輸入 ! ) 国なんてどうでも良い(イスラム教国の銀行同様に金利を0にしよう。当然。預かって貰ってるんだから)
③邪魔破壊脱がすの快楽主義者(悪魔)達 = 極悪犯罪者
◆国中北海道の北朝鮮や、タコ魔氏がどうの? 年間自殺者3万人=10年で30万人 ! (大量虐殺 ! )や常時3万人近いホームレスを産んでいる事の方が遥かに悪い
◆≪法・教科書・事実=左脳・理性・人間≫ ! ⇔≪思い付き・噂・雰囲気=右脳・感情・本能・野生動物≫で、判断してはいけない !
◆民族主義=キリスト教=シンデレラ(sweetパンプキン、ガラスの靴、過ぎたら・ずれたらダメ)・白雪姫(リンゴに毒つかせ寝かす。キスで目覚める)=卍(回転。神社のマークはリ(利・理)の無い刑)=仏教に成るぞ ! 猿が常任理事国だ。俺たちもヒトラ ! ヒゲ(キスの香り。リンゴ)=チャップリン(ユダヤ人:ダブダブ英国人、英連邦)・・・⇒救い⇒平等人権≠男は奴隷・女は快楽の道具=切捨てご免
◆悪魔=ジャック(家畜を手放させ、豆で狂わし昇天)=仏教(何も教えない、経典も解読不能。結局『黙って死ね』髪を剃り『風邪ひいて死ね』と言ってる。雰囲気だけ。狂ってるだけ。神父が棒振回し頭(木魚)を叩き威嚇し人を殴り殺す。少林寺)=呉の損文と同じ、(米)泥棒を殺し合わす為インドが流した罠⇒醜い顔の麻薬中毒・狂人集団。羊(草⇒乳、毛⇒服・ベッド、肉)が居たから地球の裏まで移住できた マサイ族や子牛が牛乳だけで生きている程高栄養、それ程重要なものを手放した狂人集団
◆どんな美人でもブスでも、カッコ良くてもブ男でも、ノッポでもチビでも、筋肉マンでも、収入・結婚は平等にすべき ! 当然 ! それをしないから潰し合いに成る。給食のクロワッサンを取り合って殴り合っている子供の様に。
◆知識・情報の差⇒力の差 義務教育・教科書同様に全て公表し平等にすべき
◆(タダ高額授業料が出せただけの)医者が患者を食い物にし、オッパイもみまくり、産婦人科医が膣に指を入れ撮影しまくって患者をレイプし、(運良く成れた高卒)警官が強い側に付き弱者を脅し、消防士が牛歩、(自惚れ)教師が邪魔して生徒を辞めさせ(それを防ぐ為に義務教育がある)、嫌なら辞めれば?と社長が袖の下を強要し、盗撮脅迫し、親が子を犠牲にする・・・それを君は認めている⇒めんどくさい・何もしない・逃げる事・盗む事・快楽しか考えていない⇒自ら人権を否定している。ムチで打たれれば誰にでも従います ! と宣言している。 被害者・ホームレスを保護する事は、可哀想だから(感情思考)ではなく、平等人権を保つ為 ! =給食
◆無(だから無限に続く宇宙)→光・星(有だから有限に成った無の障害者)→有機物(だから有期に成った無機物の障害者)→動物(葉緑体を失ったから動き回り他を食わなくては成らない植物の障害者)→人間(立つのに1年もかかり、毛も生えていない、木にも登れない、木の実も食えない、猿の障害者)=究極の障害者 ! 頭がデカイ(=変わっている)だけ(食われない、殺されない、安眠できる、生きられるのは法で守られてるから ! ≠頑張ってる・優秀だから)。法を壊せば・・・明白 ! 大洪水で陸が無くなれば鯨やイルカの方が進化していた事に成るだろう。猿の惑星。
◆オバQ⇒子供みたいに夢(漫画)見ていると、次 R 。大食いで、逃げ回りながら、ただ騒いで消えるお化け or 小さくなって『バケラッタ』意味不明言語(勝手に解釈されるお化け) 学校でウンコできない子供 ドラえもん(王ヤマのぶ呼=米国王は呼ばない) 2重国籍 リング 電電虫後者→NTT=~(T_T)
◆武富士=皆ダンサー(ただ脱いで踊ってるだけ⇒皆借金が膨らんでいく) 盗聴は犯罪(有線電気通信法、電波法、電気の窃盗罪、不法侵入(正当な理由ではないから)、職権乱用、名誉毀損) 楽をする為に逃げているだけで、放置すれば暴走する ! 悪化するだけ ! 当然 ! 際限の無い欲(≠法)による支配 !
◆どんどん増殖するマフィア・パチンコ屋の人形政治家。 見かけだけの偽医者・偽警官・偽裁判官・偽教師・偽消防士・・・・・。 金が目当ての泥棒医者・泥棒弁護士・泥棒〒職員・・・・・。 快楽主義のサービス歯科(抜き放題眠らせ放題)外科(切り放題取り放題)産科(指入れ中出しし放題眠らせ腹ませ放題)医・混入し放題安売りザマー食品売り場・・・・・。 奉仕させ公務員・保護しない司 ⇒ 居ない方が良い。 じっとしてろ !
◆鞭で打ち続ければ、誰だって何かする。 それを盗み、良い事は自分のおかげ、悪い事は本人(他人)のせい、にしているだけ。 理由など無い。
☆こういう主張は負け犬の様に見える?→面倒・不安→誰も言わない→アホ・空っぽカッコマン・嘘つきが増える→うぬぼれたバカだらけ、麻薬中毒患者=素直に人の話が聞けない=人を馬鹿に出来た所(≠真理)で思考が止まる(感情思考=快楽主義、だから)→『偉そうに ! カッコ付けやがって ! 利巧ぶりやがって ! 』と、坊主が耳を切られる、何の感謝もしない、教わろうともしない、皆恩をアダで返す暴走族=生きられない(授業中騒ぎ、政治家や教師の邪魔をし金庫を荒らし娘をレイプしている様なもの)=神父・板垣が殺される→悪化(=戦時下の心中)=教科書通りの繰り返し !
これの悪口を言う人はただ、読むのが面倒なだけ 考えたくないだけ なら、読むなよ 別にいいよ
☆(受験産業=マスコミ=バカロレア=無意味。なんとなく男を殺しながら腐り、心中している女進学者。何となくクリスタル(殺したる)) 大学受験関係知識も豊富。何でも聞いて下さい。家庭教師・進路カウンセラー経験有。予備校知識詳。女性は先に結婚するのが幸せになる一番の方法 ! その後で好きなだけ勉強・就労すれば良い。ババーに成ってから後悔する(皆笑ってるから分らない。笑うしかないから)、パートばばーに成る(高給は若いから)。離婚時に財産半分払うという契約して玉の輿 ! ?
独り言 日本人はどんどん悪魔に殺されている ! 醜い顔をした悪魔に 笑顔で
;名古屋 2003.11
年金の基礎知識(厚生年金 国民年金 共済年金)
:服部 営造編
;東京 2003.9
;東京 2004.5
:尾藤 広喜 松崎 喜良 吉永 純編著
;京都 2004.4
生活保護手帳 平成7年度版
:東京: 全国社会福祉協議会
:1995年6月 460p, 22cm, ¥2600
:注記等 監修:厚生省社会・援護局保護課 監査指導課
ただ時間を失わせる為にタブーと思わせてるだけ ! (ハッカーがこれで判断してたらどうする?だから秘密にしてるのかもね)
≪≪≪≪≪≪ ≪≪≪≪≪≪ 藤原氏(系図公表されてる). 人間はほぼ完全に父系遺伝 ! 顔体を見れば分る 『偽者は私刑で断たれ.コピーを伝なければ君は消る。黙っていても』 ≫≫≫≫≫≫ ≫≫≫≫≫≫
≪≪≪≪≪≪ ≪≪≪≪≪≪呉:〃≫≫≫≫≫≫ ≫≫≫≫≫≫
宇宙=無が(無だから、方角も距離も変化も時間も無い)無限に広がっている(Never ending storyより)⇒無のネット上にHPが拡がって行く様に有限の星が拡がって行く(星の価値≒HPの価値≒百万件の落書き帖)⇒有限の物は無の障害者⇒有期物は無期物の〃⇒食わなければ成らない動物は植物の〃⇒不毛無抵抗な人間は究極の障害者=法と道具で守られてるだけの地位だけお
血の否定⇔オカマで性別否定,目隠し;姓辞典は公の為目隠し多。姓は授かった称号(あざ名≒あだ名)名は体,呪い天罰で勝手に変えられなかった,自分は無いから関係ない?ここは君の国,区別≠差別(取替っ子する?)、「アメリカ遊学から永住権までQ&A100」亜紀書房,辻・山本著,「海外で働く」アルク,「日本脱出マニュアル」ハル&アーク,図書館注文 ! 米国で産だ子は米国人,2重国籍簡単(日本に日本だけと言う,米国は2重3重国籍認めてる,何も悪くないよ,米国国内化,重婚可,ネットで日本の放送受信可能。会社設立で永住権取れる→数年で市民権(国籍)),英語を話せ(世界一易⇒産業革命,高校参書で充分。植民地支配・世界言語化の為に簡略化し,誤魔化し・感情思考をし難くした(PC=2個単語),腕立・反射・言葉遊び・意味多重化は時間を失い生死さえ不明にし自滅する ! 有る無い教は周り・目先空想利益に縛られ心中する ! (貴族同士の決め事が元)。現実に1歩ずつ歩くんだ,自力で戸を開け実を取れ ! 全て言葉映像のサギ麻薬(詐欺師ほど立派な服を着る=騙す為),目を覚せ ! 皆服従=皆抵抗(犠牲の数),皆電波の操り人形・まゆ毛犬(動物,昆虫も)。個体≒遺伝子の同じ細胞(ホモ=人)★宇多田ヒカル(呉そのもの。外国育ちは伸び伸び) ! 萩原舞(中臣末裔)=鎌足そのまま良く見ろ ! (自分の顔も判らないのか?いくら貰ったか調べてみろ ! 悪魔の実態を知れ ! 笑ってるしかない。女は孤独でも平気だからそれ程・・・かも知れないけど。一人の男が不幸に成った事は事実⇒それを周りが背負う。16才で全員結婚させ離婚してからにすべき ! 何の問題も無い ! 大量愛人と大量犠牲女が欲しい快楽主義者以外、誰も困らない ! 外人男に取られない為=言い訳、誤魔化し ! 今も20代女の半分が未婚 ! 強制結婚でも半分離婚しない ! 例えしても同じ ! 具の小さい細目の言葉も通じない女をワザワザ妻にする?旅行者は一時の相手を求めてるだけ)(蘇我のそんなのイルカ(『か』を下に置き強調した反語。鞍作り=作った鞍)、どこの馬の骨の子、倉山田石川麻呂=他国史の寄せ集め、韓人・蝦夷=悪,と思える様にもしとこ、でも君には稲目ない、赤兄(赤の他人の兄、血のキスの香り)、則天武后)、大食漢(あ許,子,未来を犠牲にし,食い垂れ流し続けた,2度と爆発しない不二(六原。フン詰り))、芳や姫(竹節=時代のエポック(節)、月=中国,雲上人、不死山、ゆるい)、民族は女の容姿で保たれる、Uは母(U)系重視。日本人はシンデレラ、白雪姫さえ理解できない子供,豚に真珠(噛みついて来る。聖書より)★斜めに飛んで行く日本のロケット(宇宙は真上にある。金の行き先を良く調べろ ! 銀行に税金を使うな ! =盗聴ハッカーによる3億円事件。14億円 ! )★時間=空想概念(うるう秒・年,決め事)⇒周りにつられ絶対化=タイムマシン,狂歌,M・Foxの罠,キツネ狩り(消える,バカto the future,パ~of love,スケボー(足掛ける),待ーてー,毒,出ろリアン,30去れGo journey go ! 小さい,パー金損病。ファミリータイズ)。光より速く飛び追越せば過去が見える=逆方向に飛べば未来が見える?超遠視の未来人 ! ビデオはタイムマシン⇒仮想世界。ボイジャー?どこまで飛んでく?ジャンプして太陽からドンドン離れて行くカメラ,地球からも、地球も動く?月になぜカメラが無い?衛星の噴火=超巨大爆発 ! アレは恒星か?×の亀裂は有り得ない(線の左右は別世界) クローン?シープッ(名前ドリー無,脳移植で生き続れば?X線よけて(コーヒーコーンポテト,高山原産))らせんの罠、ハったリ君(フリーズで死ぬ忍耐の者)。Queen(太陽の女神、天照、FM、悔い、We are the Championで死ぬ、AIDS合図,抵抗不能、ボヘミアン(チェンコ)rhapsody狂詩曲。ヒゲ=チャップリンに似たヒトらー、夏目漱石(分裂病(電波技術の進歩と共に拡がった)、日本の最高学府も英国ではアホはったり、でも『吾輩は猫だ。坊ちゃんだ。子供の先生だ。』と誤魔化す。ゴ魔化し、ゴ負かし。食の基本が呉ドンとソバ(濁った水で実の量を誤魔化し放題の上に、大量の薪が必要⇒仏教=地獄))の様。父親全然違う人(写真)マリヤ・後鳥羽上皇の名が欲しかっただけ。カッコマンのアホ(菅原文太)に・・・。乗っ取る?違うよ乗っ取られてる ! どんどん殺されてる ! 人の不幸で・・・。AVで自慰しながら死んでいる)Say you say me(踊る人,無数の電波(光),頭くるくる,ヒゲ=民族チャップリンHL紳士☆Naturally半人)。Take on me『夢⇔現実』を行ったり来たり→捨てられて目が覚める女~~~幻想が遠ざかって行く・・・皆マネキン人形。The Sun always・・・TV。スリら(皆踊るゾンビ)白人に成る。卵子で単為発生?=クローン、男は女から発生する=うんこからカレーを作れる凄い奥さんに成れるよ ! 2010年は言いわけ ! 2001年に成るぞ !
もうすぐ 空から天使が降りて来る !
アメリカで子を産め !
※※※ アポロは月に行っている。ボイジャーも飛んで行った。蘇我入鹿はいた。・・・法定教科書に、そう書いてあるから。そう決めたから。あの信号が赤である事は不変。俺は青だから ! こういう考えだから(=リーゼント(頭が変)・たばこ(自傷)のヒネクレ暴走族・モルヒネ中毒・快楽主義)⇒無意味な事故・衝突=心中 !
『 告発します 』
トイレの大量盗撮です !
脅迫罪の現行犯です ! 毎日逮捕するべき !
みんなで、検察に手紙(書式自由)で告訴しよう !
裁判所に提訴しよう !
公衆電話から(携帯は使用者分る)毎日110番しよう !
不快・不安を感じない人はいないと思います。それが原因になって、仕事上の失敗やリストラ失業、事故や別の犯罪、病気に成る人も増えるはずです。男性にとっても普通に結婚したくても出来ない上にこんな拷問とも言える嫌がらせをされては性犯罪や連れ去り事件が増えるのは当然です ! 犯人が可哀想にすら思えます。彼らこそが犯罪を増やしているのです。税金を多く払っていれば(盗撮とは無関係ですが、本当に儲かっているのなら行政が買い取ったらどうでしょうか?黙っていたら悪化する一方です。大量消費者は金を外国に捨てる悪人なのです ! どんどんハッカーやマスコミに盗まれているのです ! 目を覚まして下さい ! )、やってれば、やってると言えば何をしても良いのでしょうか。犯罪は犯罪です(盗撮、迷惑防止条例、脅迫罪(行為でも成立)「使ったら盗撮するぞ」と脅迫しているのですから)。犯罪者は皆、口が上手くやってると言います(本当です)。口先だけなら何とでも言えるのです。行政指導などの公的な力で止めさせて下さい(経費水増しの脱税容疑・その為の文書不実記載など幾らでも出てくるはずです。容疑が有れば逮捕は出来るのです。)。明らかに公衆の場なのです ! 或いは、検察に直接手紙で告訴告発すべきです(特に公務員は公共の利益を守る為に告発しなくてはいけないのです)。書式などは特に決まっていません。証拠も用意出来ない場合は無くても良い様です。センサーの写真を撮ればそれが動かぬ証拠です。匿名でも多くくれば検察も調べざるを得ないはずです。警察は刑事訴訟法(六法全書に載っています)すら知らない人もいて、面倒だから告訴出来ない等と嘘を言う人もいます(公務員職権濫用罪、背任罪、証拠隠滅罪)。
彼らはただ人の不幸を喜んでいるだけなのです ! 人の不幸で自分の不幸さえ忘れる異常者なのです ! 快楽に溺れる子供なのです !
【執行猶予期間は判決確定日(14日後)から換算するので、上告したらその分先に伸びる?期間終了後は何も無かった事に成るので無罪と同じ。(六法全書) あと、一般人の事実は名誉毀損に成る事が有りますが、公務員の事実は名誉毀損に成りません。落書きは器物損壊に成る事も有るので辞めた方がいいかも。でも、自然治癒するものは損壊ではない ! ?】
金や力が有れば盗撮、ネガで脅迫、嫌がらせ、仕放題です !
現に盗撮映像で脅迫されている女性やその恋人等が居るかも知れません。彼らは誰にも相談出来ない筈です。脅されて何かを強要されているかも知れません。外も歩けない状態かも知れません !
真似をする人がどんどん増えるでしょう。真の地獄です !
手足を縛られ、苦痛に悶え、悲鳴を上げながら、互いの不幸を喜び、笑顔で生きて行かざるを得なく成るのです !
我慢しては損です ! 好き放題な事をしましょう ! (現に犯罪が増えています)
アホだらけです ! 互いの不幸を笑いながら、殴られて殺されている知恵遅れ集団そのものです !
皆、狂っているのと、頭が良い事との違いすら判らないのです !
(センサーが付く前、この駅ビル内は数人の低所得者やホームレスの溜まり場に成っていたのです。市役所、福祉課がめんどくさがって法を守らないから、民間に押し付けるから、こう成るのです。自分の目先の快楽の為に、国民を犠牲にしているのです。嫌なら辞めろ ! 詐欺師だ ! )
Result number: 141
Posted by John H on 1/18/05 at 09:20
Dorothy it sounds like you have a good handle on sports history to me. The Cardinals are the oldest NFL franchise in existence. Over 100 years old now. It has been in the Bidwill family since the 30's. When Bill Bidwill Sr died which was probably in the early 60's his wife took over operations of the franchise. She died not many years later and his son Bill Bidwill Jr. has owned and operated it since. They also have a daughter who is VP of something. As owners go in the NFL they derrive most of their money from the franchise so they have always been slow to spend any money on FA's and quality players. Their business practices with players has been out of touch . Consequentially we have always had a lousy team. They left St Louis because of a conflict with the baseball Cardinals as when the Cardinals would get into post season play the football Cards could not play their regular schedule games at Bush stadium. They then foolishly went to AZ with no guarantee of a new stadium and had to play their games at Sun Devil stadium where temps can reach 130 degrees on the field and the fans burn up in the stadium on Sunday afternoon. Thus they have the lowest attendance in the NFL by far. They averaged 38,000 last year. Compare that to the Redskins who averaged over 90,000 and have an owner who is a zillionaire and is willing to spend it just like George Steinbrenner. Phoenix finally passed a bond issue to fund a new domed stadium and it will be open in 2006. It will be state of the art and a super bowl is already scheduled there. We still have this long histroy as a loser which is hard to overcome. Unfortunately i stick with my teams lose or win so I continue to ride it out.
Result number: 142
Posted by marie on 12/29/04 at 19:59
Pick the one that you are comfortable with.
https://www.strategicprofitsinc.com/hosted/...cross/index.php -
Red Cross http://redcross.org - American Red Cross
http://www.redcross.org.uk - British Red Cross
http://www.redcross.org.au -
Australian Red Cross http://www.jrc.or.jp - Japan Red Cross
http://www.worldvision.org - Christian Charity and if you don't like to
donate online: American Red Cross 800-help-now :-)
Result number: 143
Posted by marie on 12/10/04 at 17:23
I just can't believe the cold hearted people who had Pale Male and Lola's nest of more than 10 years removed from their Manhatten Apartments. For those of you who don't know who Pale Male is....I'll explain. He is the ONLY red tailed hawk to take a home in a urben setting. He came to new York City in the early 90's and claimed Central Park for his hunting ground. He has had several mates and has raised 2 dozen chicks to the delight of thousands of new Yorkers who had never seen a red tailed hawk. Pale Male survived 9/11 and is even a famous movie star, as PBS did a documentry on him a few years ago. He has been an inspirational symbol of survival to all of new York. My heart is broken about this.
Here is a link to one of Pale Male's favorite supporters who passed away earlier this year. We can all relate to his quote on Carpal Tunnel.
Today I made this print about my emotions on this incident.
best wishes marie
Result number: 144
Posted by marie on 11/17/04 at 16:23
Hope these will brighten your day. It's all dreary and rainy here.
Result number: 145
Posted by Bill, jr on 9/14/04 at 22:01
Please keep your personal feelings about Dr. Z. off this board. It is distracting to read your attacks that are clearly aimed at Dr. Z. He is a podiatrist who contributes his time for free to help people on this board.
Please correct me if I am wrong but you are not a medical professional so please let the professionals give us their advice. After all, they have first hand experience treating patients with plantar fasciitis.
Result number: 146
Posted by Bill, jr on 9/03/04 at 23:39
Please read the article. It was careully reviewed by the editors at JAMA. I'm sure that you will find that it was conducted properly and was consistent in its statements.
Your quote says that high energy ESWT had better CMS improvements than low energy ESWT at 6 months and 3 months and 12 months. High energy ESWT also had better results than low energy ESWT when looking at self-rated pain and radiographic changes at 3, 6 and 12 months.
To put it another way, high energy ESWT had better CMS improvements, lower self-rated pain and more significant radiographic changes than low energy ESWT at 3, 6 and 12 months.
As I said before, the article is significant because it is a double blind, placebo controlled study. When measuring pain it is important to conduct double blind placebo controlled studies in order to eliminate the treatment effecgt.
I want to repeat my previous point because I think it is important! This article shows that ESWT works for chronic calcifying tendonitis of the rotator cuff and there is a measurable difference between high energy ESWT and low energy ESWT and high energy ESWT performed better!
Result number: 147
Posted by Dr. Z on 9/03/04 at 19:08
Your quote concludes what Bill Jr. just stated , not the opposite. Please explain what you mean that they conclude one thing and they say other. They conclude that high energy is better in this study and then then they state this. It was better at 3 months, 6 months , 12 months.
Another interesting point in this article is that both the high and low energy treatments were done under IV sedation.
Result number: 148
Posted by Bill, jr on 9/03/04 at 18:00
Dr Davis,
I was looking at a JAMA article where Rompe was one of the authors. The title of the article is "Extracorporeal Shock Wave Therapy for the Treatment of Chronic Clacifying Tendonitis of the Rotator Cuff" It appeared in the November 19, 2003 issues of the JAMA. The authors concluded, and I quote, "high energy ESWT appeared to be superior to low-energy ESWT".
It looks like we are finally seeing double blind, placebo controlled studies comparing high energy, low energy, and placebo. It is interesting that this study found a larger treatment effect for high energy ESWT compared to low energy ESWT and that it was conducted by doctors that have studied low energy ESWT.
Dr. Davis, since you believe that ESWT performs the same for all regions of the body, does this study pursuade you the high energy ESWT performs better than low energy for plantar fasciitis?
I think that Dr. Z's explanation of the cavitation effect may explain the results observed in this study.
Result number: 149
Posted by Bill, jr on 9/02/04 at 09:12
Dr Ed,
If Medicare is covering at the rate previously posted then I would expect area hospitals to contract with local equipment providers and start offering the service. Hospitals will offer services that are in demand when there is reasonable insurance coverage and physician interest. The current lack of ESWT in a hospital setting is probably the result of the lack of insurance coverage and physician interest.
Result number: 150
Posted by Bill, jr on 9/02/04 at 09:06
The Dornier EPOS is used in surgery centers and in podiatrist's offices so you cannot conclude that Dottie's friends were treated on an Ossatron. They may have been treated on an Epos Ultra.
Dottie should ask her friends if they saw the machine before they were put under. If so, what did the machine look like? Alternatively, where were they treated since people on this site might know which machine their surgery center/hospital is using.
Result number: 151
Posted by Pauline on 8/17/04 at 10:26
1. Insurance companies are not being forced to pay. Those that are paying for ESWT have agreed to pay any provider that provides this service within their network. If you don't want them to pay tell them and see what response you get. My guess is that they will tell you it's an agreement that they made with their providers and part of your coverage.
You always have the choice of finding another provider if this particular issue brings soooo much discord into your life. On the other hand, if there was no United and they didn't pay you'd also be angry because you'd think they should be covering this treatment cost. In other words, you want it both ways. "Don't pay when I don't want you to pay and pay when I want you to pay". Unfortunately in this day and age the consumer doesn't have that much flexibility or authority with insurance coverage.
I personally think the best place to take your complaint is "public".
Write a letter to your insurance company and carbon copy every newspaper in town. Who knows maybe they will stop paying United and you will have achieved your goal.
2. Unless you see the books you or I have no idea how much income is being generated by their unique marketing technique. They ain't going broke yet on the backs of their freebees.
I can understand the issue you argue and it's a legitimate observation, but who are you or I or anyone for that matter to tell a company how they can run their business, who they pass for free, and who they charge.
We don't run the world at lest that is the way it was when I work up this morning:* I understand what you're saying, I just can't fix it for you.
Result number: 152
Posted by Julie on 8/17/04 at 02:41
Darlene, based on Dr Ed's information, that sounds like good thinking to me. I guess you need to consider another sitting position for meditation. Any of the classic meditation postures will turn the feet "in and over", though a simple crossed-leg pose does it to not quite the same degree. Vajrasana, the kneeling posture, shouldn't be held for more than ten minutes (especially if one has varicose veins) because it cuts off the circulation in the lower extremities. And it's hard on the ankles too, albeit differently hard. A meditation stool, which allows space between the bottom and the heels, is a good alternative.
Have you tried sitting in a chair (the "Egyptian" position)? Its drawback is that you aren't in such good contact with the ground, but the most important thing about any seated posture is that the spine is held upright and lengthened, and that can be done in a chair (preferably a straight-backed one).
Anyway, I would certainly give half lotus a miss for now, and see if that makes any difference.
Result number: 153
Posted by Bill, jr on 8/16/04 at 23:17
I don't believe that any podiatrist receives $5,000 for the procedure, but I think that United has some contracts where they collect something close to that number just for the use of the machine!
I don't see how they will win their fight. I hope they do because it will result in universal coverage. However, they are fighting for high energy ESWT. Will you be disappointed if their result only apples to high energy?
Result number: 154
Posted by Bill, jr on 8/16/04 at 23:13
I really have two issues with your response.
First, I don't understand how providing service for free results in income to United. Companies market in order to get paying customers, not to give away services.
Second, and you really never addressed this issue, why should insurance companies continue to pay when United will offer the service for free?
I would appreciate your comments on these issues.
Thank you.
Result number: 155
Posted by Bill, jr on 8/16/04 at 23:02
Dear Pauline,
The same people are at the helm at United. Look at their web site and compare the names to the names in the FTC court action.
United does not treat medicare patients. I believe they are concern about federal anti-kickback statutes and their investor model. Their web site states that they will not even treat self pay medicare patients.
Result number: 156
Posted by Ed Davis, DPM on 8/16/04 at 22:10
I did not get the whole story on Mark. I did not find his posts that problematic but if Scott noted that he was using alias' and knew more than we see here, he may or may not give us more information. I don't know if Bill Jr. is the Bill of about 1 1/2 years ago but he is going in the opposite direction criticizing a company that is fighting for ESWT coverage. He has avoided criticizing any individuals on the board but made some remarks about a reputable company that go over the line as far as I am concerned -- I would watch the thread closely on the ESWT Board to see where it goes. The territorial issue is touchy so my approach is to provide the public with as much information as possible so they can make an informed choice. It is a bit difficult to spoon feed information to so many visitors who want a quick answer and not review the material on the site. After a few years, the amount of material here is large and could fill a book or two -- something I contemplated but did not have the time. Interested in a project?
Result number: 157
Posted by Ed Davis, DPM on 8/16/04 at 19:19
I agree with you completely. The ESWT market is potentially huge and there are those in the industry fretting over market share when market penetration of ESWT as a modality is tiny. There is not a chance that one company can corner the market. United's competitors need to realize that the end effect of United's "fight" for coverage is to open up the market and all (United, its competitors, patients) will eventually benefit. United's actions are not permanent; it is a temporary move to get the treatment out to those in need establishing a "critical mass" of cured patients that will drive the market forward. They are really taking a risk of losing in some cases, winning in others but have sufficient confidence that they will win the majority of the time. Every insurer that is "opened" is a victory for every company that provides ESWT and more cured patients. "Competitors" are focusing on the short term and not seeing the big picture.
Result number: 158
Posted by Pauline on 8/16/04 at 15:41
I believe United is graveling with the circumstances that they as a provider are faced with today. They are in an ESWT market that is providing very little insurance coverage at the moment.
What are their choices? Well, they can continue to provide service only to those people with insurance coverage which will be few and be satisfied with less profit, or they can plan a marketing program which not only includes those that are insured, but also offers treatments at a reduced rate to include people who's companies will not cover it and increase their over all earnings.
Common sense tells them why exclude when you can include and make money.
The basis for your arguement fails because they, United, has no control over which companies will pay and which will not. They just want income.
What is really bothering you, is that fact that you feel cheated and that you feel that United is gouging your insurance company, but in the U.S., United is able to provide their service any way they wish inside the law and if your insurance company happens to be one that is willing to pay then
that is the agreement they have made with their insured and United.
If they agreed to pay, why should United be required to tell them please don't pay us? Your insurance company can stop coverage as quickly as it started it. You can even recommend this to them.
Most people don't think they pay for anything once they have insurance.
Their "insurance" pays for it. It's sounds better to them and they come to believe the service is somehow free. They don't associate their insurance payments with actually paying for their treatment and in some ways they are correct because if it were not for the collective profit that insurance companies make from investments on those collected funds of their insured they would never be able to pay out the large somes of money to cover the medical bills that some of their insured require or the damages that occur from catastrophic conditions hit their neighborhoods like we see in Florida today. Although policy holders may pay the same premiums not all of them have the same type of claims throughout their lifetime. Their illness are not equal. Thats just life.
Personally what I think United is doing is the only thing they can right now. I think they hope to force the issue of insurance coverage for ESWT front and center, but until this happens they are willing to cut costs for patients.
How much of the market they gather really remains to be seen, but I doubt that we have to fear a single service provider for ESWT. United already provides ESWL and was hauled into court once, my guess is they learned from that experience.
Result number: 159
Posted by Bill, jr on 8/16/04 at 14:56
It is my understanding that United refuses to allow Orthopods to invest in its company so they have no Orthopod owners/investors. It seems that the site mostly refers to investors in United.
United cannot use physicians to describe podiatrists because in many states, podiatrists are not legally considered physicians.
Result number: 160
Posted by Bill, jr on 8/16/04 at 14:52
As far as I am concerned, there is no low energy market until low energy ESWT is FDA approved for plantar fasciitis. Until then, the success of low energy remains uncertain based on published articles in peer reviewed journals.
In terms of cases performed in a surgery center or podiatrist's office, United has performed the highest number of cases. United is rapidly expanding and has the ability, through their podiatrist investor model and preditory pricing, to monopolize the market.
United is driving others from the market by offering to treat patients for free. When United performs cases without the expectation of payment, they are performing the cases below cost. United can perform cases below cost because they have paying insurance companies in other parts of the country. This is a classic method for creating a monopoly.
I really think that United's willingness to give service away is not in the interests of getting universal insurance coverage for ESWT.
Maybe you could help us, what does United charge to your patients when they have insurance coverage that pays for ESWT?
Result number: 161
Posted by Bill, jr on 8/16/04 at 14:10
I am very concered about over $8000 for combined surgery fees. ESWT should be covered by all insurance companies and everyone involved should make a fair profit. I believe that the total price for the procedure should be less than $2,500. However, United is willing to treat patients from insurance companies who clearly state that ESWT will not be paid. If you treat a patient knowing that the insurance company will not pay then that is giving away the service.
What is United's success rate at getting paid from Aetna?
Result number: 162
Posted by Bill, jr on 8/16/04 at 14:03
I have no problem with your logic if United charged $500 to all payors. Their strategy is not to see reimbursements at $500, ask them. United charges significantly more to insurance companies that pay. My point is that why should my insurance company pay United's high prices when United is giving away the service. Please tell me what you think about this concern.
I really don't care about podiatrists who expect $5000 for the procedure. I don't see the honesty in giving away the service to some and gouging others. Furthermore, this is exactly how monopolies are created. Once the market is clear of competitors, United will be free to raise the price.
Result number: 163
Posted by Ed Davis, DPM on 8/16/04 at 10:11
No provider (rarely) gets the asking price for a procedure; it is generally set by the insurance company.
United is not willing to give the service away -- they are willing to fight for payment for a legitimate service.
Hmm. You are concerned about $2500 for ESWT (just an asking price) but not concerned about over $8000 in combined surgery fees, hospital fees, surgeon fees, rehab fees, anesthesia fees for plantar fascial release surgery. What gives?
Bill, Jr. -- Are you a patient or do you work for an entity involved in the health care industry?
Result number: 164
Posted by Bill, jr on 8/15/04 at 15:35
Dr Ed,
I'm not sure that United is a good guy here. I don't see the honor in soaking insurance companies that currently cover ESWT in order to offer ESWT for free in areas that don't have insurance coverage. How about setting a uniform, low price for the service? Do you think that insurance companies should pay United over $2,500 when they are willing to give the service away.
Alternatively, I don't want my insurance rates to increase because my insurance company pays United for ESWT when Aetna patients can get the service for free. It's not right or fair and cannot be sustained.
Result number: 165
Posted by Bill, jr on 8/15/04 at 15:28
It really isn't that simple. By offering services below cost, United is working to create a monopoly. Once the other ESWT providers fold, United will be free to charge insurance companies whatever they want. It simply doesn't help consumers to have one national ESWT provider that is run by people who have already demonstated their monopolistic tendencies. You need to think long term.
Result number: 166
Posted by Bill, jr on 8/13/04 at 21:34
Is Mark L, Mark Rubenstein? Just a thought. After all, Mark Rubenstein owns and controls the company that is referred to in the posting.
Just some interesting speculation.
Result number: 167
Posted by Bill, jr on 7/16/04 at 19:54
Dear Dr. Ed,
United is not operating within an Anti kickback safe harbor. I believe that this is one of the reasons that they will not treat Medicare patients. Likewise, United is also likely in violation of the Stark laws since ESWT is not exempt from Stark ( ESWL is exempt).
As far as I remember, there is no safe harbor related to the number of investors in a private company. There is a safe harbor related to the amount of ownership of a publically held company and to investing in companies with millions of dollars in assets, but nothing related to investing with 50 other referers in a medical device.
If such a safe harbor existed then 50 doctors could band together and buy MRI machines and refer patients. Remember the goal of the anti kickback statute is to remove financial incentives for refering patients covered by programs paid for by the federal government.
The financial incentive to refer is not diminished by the number of investors unless the return on investment is diminished. United's goal is create a nationwide closed system whereby their investors exclusively use their system and refuse to use competitors systems. This is why United's investors are practicing podiatrists and their investors must sell back their investment if they stop practicing medicine.
Result number: 168
Posted by Lori S. on 7/05/04 at 01:15
and I survived. My daugher did well. WE had our open show 7/3(not 4-H, but we also belong to northern nevada Jr. holstein association) It was a long hard week on my feet. And today the 4th of July was our yearly community service Petting zoo at the park. I never thought I would be buying a cow...... but we have. Its been a great thing for the whole family to be involved in. Thanks to all of you well wishers...... sometimes everything gets to you..... today is a better day....
Smiles and thanks,
Result number: 169
Posted by Bill, Jr on 6/28/04 at 14:42
Dr Ed,
ESWL machines are class 2 with special controls because they have been used in the US almost 20 years and their effects are fully understood. I am sure that ESWT devices will be reclassified in good time.
The problem I see is that insurance companies continue to believe that ESWT doesn't work. They cite Buchbinder and other articles to support their case. As far as I can tell, it really doesn't matter how ESWT machines are classified since insurance companies continue to deny coverage.
Let's work on the insurance companies. Once they are on-board, we can work on the FDA.
Result number: 170
Posted by Bill jr on 6/11/04 at 07:18
I know that you have read and analysed ESWT journal articles and that you take the view that some of the positive results are not convincing. I have to agree that there is not a grand conspircy to prevent insurance coverage of ESWT. Assuming that the studies are lacking something, is there a simple study that could be completed whose results would be compelling?
For example, a double blind, placebo controlled study that looked at the VAS score for the first few minutes of walking in a group of 200 participants over four months. Inclusion in the study would be 6 months PF, 4 failed conservative treatments, etc... If the results were positive, would that study be compelling? If not, is there a simple study that would work.
Finally, a study like this would have to have the support of an equipment manufacturer. Would the supplying of a technician and the limited use of the machine corrupt the results? If so, how do you see this study getting done? APMA funding?
It would be great if everyone would objectively discuss this question. I think that if we can get a good description of the "ideal" study we might be able to make it a reality.
Result number: 171
Posted by Bill jr on 6/08/04 at 08:16
I would like to see the personal attacks and political statements stopped. The best way for Mark to respond to a personal attack is to remain silent.
Mark talked about "govt hack", "down the toilet", "crooked political hacks", etc... I find these characterizations inappropriate for this forum. My post represents my feelings about Mark's post and its generalizations.
Over the past few weeks this forum has seen many personal attacks. The attacks are distractng and take away for the value of this forum. Maybe you could give us some guidance about the proper topics for this forum.
This forum would be valuable to me if it had more information about ESWT. I would like to know (1) what insurance companies are covering ESWT, (2) others experiences with the procedure, (3) rumors about machines close to FDA approval and whether to wait for a new machine, (4) rumers about results from other FDA studies, and (5) anything else that can help me evaluate ESWT.
Result number: 172
Posted by scott r on 6/08/04 at 07:26
Bill Jr, I believe Mark was responding to Elliott's personal attacks, so it's not right to address him in that manner. Complaints about posts should be sent to email@example.com instead of making similar posts in response.
Result number: 173
Posted by Bill jr on 6/08/04 at 07:18
Please stop the personal attacks. Your generalizations are inappropriate and offending and have nothing to do with this message board. At far as I can see, no one is advocating inadequate payments for effective treatments. People are questioning the effectiveness of ESWT. It is their right to question the effectiveness. If you strongly believe in your position and want to convince others then the best way to do that would be to conduct a careful study. Proclaiming ESWT's effectiveness does not pursuade. I've heard many claims in the past. I come to believe the ones that are proven to my satisfaction by people I trust and respect.
Result number: 174
Posted by Bill jr on 6/07/04 at 13:17
Dr Davis,
Thank you for posting the links and this abstract. Do you know if the results from the abstract you posted have been written up in a paper? If so, is it available.
Result number: 175
Posted by Bill jr on 6/07/04 at 11:56
It does not bother me that Dr. Ed has not responded. I respect his right not to respond!
I believe that the inaccuracies should be corrected when possible. However, everyone on the board establishes their own creditability. People who post inaccuracies eventually lose creditability.
Take a look at your posts for the past few days, do you think that you are gaining or losing creditability? If you truly believe in your position, I recommend that you refrain from personal attacks and stick to the facts.
Result number: 176
Posted by Bill jr on 6/07/04 at 11:44
Sorry about the accuracy in my quoting of your posts. I will quote you literally in the future to avoid any confusion and give the exact references.
I can't comment on what you were led to believe. The article speaks for itself. However, I object to your 25% number since it has not been published and is misleading. Your analysis has not been reviewed or accepted by the medical community. I invite you to writeup your analysis and submit it to a journal for proper review.
In terms of appropriateness of insurance coverage, again, the issue is more political than medical. Depending on which site of the fence you are on, depends on which articles you accept and which you reject. I trust the orthopedic reviewers who are part of Foot & Ankle International. This helps me have confidence in the published results. I think that ESWT works.
Result number: 177
Posted by Bill jr on 6/07/04 at 10:28
General discussions about medical abuses, fradulent billing, and politics do not belong on this board. This board is about ESWT.
At a poster to this board, Dr. Ed is not required to comment on all messages posted to this board. He is not required to correct all inaccuracies. I think that your demand for his response is unreasonable. He donates his time to this board and he is free to comment as he sees fit.
Let's move this discussion back to ESWT and away from these personal attacks.
Result number: 178
Posted by Bill jr on 6/07/04 at 09:41
You are right about the acknowledgement but it is my understanding that the "grant" from Dornier was the temporary use of the machine and conference support, hardly enough money for a professor to compromise his ethics. Dornier did not reward the investigators with a machine after the study. Furthermore, this type of arrangement is standard in academic research.
Do you really expect a college professor to buy a ESWT machine and conduct a trial without pay or recompense? Come on.
Finally, I'm trying to quote you accurately. Your position seems clear. You do not believe that the results are impressive and that parts of the article are not well written.
I think that the results are impressive. I agree that negative results contribute to science. This paper is not the publication of a negative result. The results in this paper were compelling to the reviewers who recommended publication in its current form. The reviewers were satisfied with the writing and the analysis of the results. If there were valid questions about the results in the article then the reviewers would have stopped the publication. Unlike the JAMA article, this article was reviewed by orthopedic surgeons.
I'm sorry that the article did not live up to your expectations but it satisfied the reviewers. You might try writing to the journal with your concerns.
Result number: 179
Posted by Bill jr on 6/07/04 at 07:51
You keep saying that the Theodore article was not well written. This article was written by George Theodore, an Orthopedic surgeon who is Chief of Foot and Ankle at Massachusetts General Hospital, part of Harvard Medical School.
Dr. Theodore does not have a financial stake in the acceptance of ESWT. He is an educator and researcher at one of this country's leading medical schools. He heads the department of Foot and Ankle and is a leading authority on Foot and Ankle surgery who teaches at Harvard.
In terms of the article, it was peer reviewed by orthopedic surgeons before being accepted for publications. The journal is in the orthopedic community, not the podiatric community. The science and statistics were carefully reviewed and the paper was determined to made a contribution to science.
The fact that this article was reviewed and accepted for publication by orthopedic surgeons says a lot about the results and presentation in the paper, after all, surgeons prefer surgery over non-surgical techniques.
Result number: 180
Posted by Bill jr on 6/07/04 at 07:24
I understand your argument about the 25%. I disagree with your reasoning. We will have to agree to disagree. However, from what I see, your reasoning can be applied to all PF treatments making treating PF a losing proposition. I don't know of any PF treatment that has a value greater than 50% since there is a high placebo effect.
Are you advocating doing nothing unless the treatment is paid for by insurance? If so, why should the insurance companies pay for something that you would not pay for yourself?
In terms of your runner friend, would he have paid for ESWT if it had a 67% chance of reducing the duration of his severe PF from four years to one year? Or more interestingly, why did he live with severe PF for four years when he could have had surgery?
Result number: 181
Posted by Bill jr on 6/05/04 at 07:27
I understand your concern about the control group being unblinded at 3 months . However it is not reasonable to expect study participants to remain blinded for one year. Remember study participants were restricted from all conservative therapies for the length of the study. This means that all of the study's participants where prohibited from taking pain medicine, orthotics, message, etc... until the study ended. I doubt that anyone would live with PF pain for one year, untreated, for the sake of science. Call me crazy, but I just don't see it happening.
Result number: 182
Posted by Bill jr on 6/05/04 at 07:21
I don't agree with your logic. People can have PF for many years. It is not possible at the time of failed treatment to know whether your PF will resolve in one year or whether you are chronic. Your logic implies that there is a 25% chance of success when the truth is that there is greater than 67% chance. If you don't have the treatment then the chance of being better is much lower due to the natural course of PF, of placebo effect. Are you willing to wait an additional year to learn whether you are one of the unlikely who would respond to ESWT?
Additionally, your reasoning could equally be applied to surgery showing that the success of surgery if also low.
It is really a timing issue. You decide when PF is chronic 6 months, 1 year, 5 years, and then test ESWT or surgery and judge success.
Result number: 183
Posted by Dr. Z on 6/04/04 at 13:23
I took the 92% from memory. It was a number from a graph that Dornier gave to Dr. Z in the beginning. It refers to the average reduction in pain ( 92% ) . VAS is so subjective that it really has no meaning to Dr. Z. R/M in my opinion is what counts. Bill Jr. pointed out that lack of pain is what counts and the R/M is the closest measurement of lack of pain
Result number: 184
Posted by Bill jr on 6/04/04 at 12:24
Sorry about the mistake, but why do you care about the RM score. It seems to me that talking about the number of patients who are pain free is a more reasonable measure of the success of ESWT.
I don't work for Dornier.
Result number: 185
Posted by Dr. Z on 6/04/04 at 12:06
Hi Bill jr.
In the abstract section the authors talk about 94% as success rate ( R/M) scoring.. The 92% is the average reduction in pain after 12 months. ( VAS)
Result number: 186
Posted by Bill jr on 6/04/04 at 11:51
The 92% (not 94%) referred to in the article was the reduction in pain of the treated group, not to a success rate. If you look at the article, 76 patients were in the treated group. The average pain level for the group before treatment was 7.7 on a scale of 0-10. The article surveyed the treated group at one year, 50 patients responded. The average pain score for those 50 patients was 0.6 on a scale of 0-10, essentially pain free.
Based on your point-of-view, the treatment provided complete pain relief at one year for 65.8% of the patients treated (65.8% = 50/76). We do not know the results for the remaining 26 patients because they were lost to follow-up.
The results are very good and demonstrate the ESWT is an effective, long term alternative to surgery. Based on this study, patients treated by ESWT can expect a 65.7% chance of being painfree at one year, post treatment.
I hope that we see future studies with a larger number of patients.
Result number: 187
Posted by Ed Davis, DPM on 6/02/04 at 17:03
This is from Barry Block's Podiatry Management:
I just got done stating that I did not spend much time with such magazines but this is a good letter from a fairly objective source:
Sent: Fri, 28 May 2004 10:44:02 -0500
Subject: Achilles treatment info
More info off the Barry Block page on Achilles.
RE: Osteotripsy for Posterior Calcaneal Spur and Achilles (Howard
Stone, DPM)
From: Lowell Weil, Jr., DPM, MBA
At the Weil Foot & Ankle Institute, we have performed over 150 ESWT
procedures on Achilles tendonopathy. This includes both insertional
Achilles/retro calcaneal spur pain and fusiform thickening of the
Achilles tendon. Our retrospective results have been promising. I
recently reported our results at the IFAC Meeting in New Orleans the
last weekend of April.
Our results show 87% of patients who have the procedure are pleased
with the results, with an average reduction of their VAS from 7.9 to
3.4. No one has been made worse with the procedure. We are
currently beginning a prospective, randomized, placebo controlled
double blind study to show the efficacy of ESWT for Achilles
I believe it is an excellent choice for this difficult problem. Many
of these patients are obese and/or not willing or able to go through
the immobilization or the recovery associated with surgery. I use
high energy for this treatment with no post procedure
immobilization. I ask patients not to perform high impact
activities like running or jumping for approximately two weeks
following the treatment. I have treated many professional athletes
with this modality including NBA players, NFL layers, professional
baseball players, PGA golfers and two sprinters who hope to compete
in the upcoming Olympics in Athens.
Lowell Weil, Jr., DPM, MBA
Result number: 188
Posted by Ed Davis, DPM on 5/27/04 at 21:16
Previous Volume 350:2159-2166 May 20, 2004 Number 21
Plantar Fasciitis
Rachelle Buchbinder, M.B., B.S., F.R.A.C.P.
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A 55-year-old overweight woman presents with a three-month history of pain in her right inferior heel. The pain is worse on taking her first steps in the morning. The physical examination is normal except for nonspecific tenderness in the region of the medial calcaneal tubercle. How should the patient be evaluated and treated?
The Clinical Problem
Epidemiologic Features
Plantar fasciitis, reportedly the most common cause of pain in the inferior heel, is estimated to account for 11 to 15 percent of all foot symptoms requiring professional care among adults.1,2 Reliable population-based incidence data are lacking, although plantar fasciitis has been reported to account for about 10 percent of injuries that occur in connection with running3,4,5 and is common among military personnel.6 The incidence reportedly peaks in people between the ages of 40 and 60 years in the general population and in younger people among runners.7,8,9 The predominance of the condition according to sex varies from one study to another.5,8,10 The condition is bilateral in up to a third of cases.6,7,8,10
Pathological Features
The site of abnormality is typically near the site of origin of the plantar fascia at the medial tuberosity of the calcaneus (Figure 1). Histologic examination of biopsy specimens from patients undergoing plantar fascia–release surgery for chronic symptoms has shown degenerative changes in the plantar fascia, with or without fibroblastic proliferation, and chronic inflammatory changes.11,12,13
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Figure 1. Plantar and Medial Views of the Foot Demonstrating the Origin and Insertion of the Plantar Fascia and the Location of Nerves in Proximity to the Heel.
The windlass mechanism, or bowstring effect, of the plantar fascia refers to its function in raising the arch of the foot during the push-off phase of walking.
Risk Factors
The cause of plantar fasciitis is poorly understood and is probably multifactorial. Limited data from case–control studies have identified such risk factors as obesity, occupations that require prolonged standing, pes planus (excessive pronation of the foot), reduced ankle dorsiflexion, and inferior calcaneal exostoses (or heel spurs).6,9,14,15,16,17,18
Because of its high incidence among runners, plantar fasciitis is commonly assumed to be caused by repetitive microtrauma.3 Proposed risk factors include running excessively (or suddenly increasing the distance run), wearing faulty running shoes, running on unyielding surfaces, and having a cavus (high-arched) foot or a shortened Achilles tendon, but evidence for most of these factors is limited or absent.19
Clinical Course
On the basis of long-term follow-up data in large case series that predominantly involved patients seen in orthopedic practices, the clinical course for most patients with plantar fasciitis is favorable, with resolution of symptoms in more than 80 percent of patients within 12 months.8,20,21,22 Up to 5 percent of patients in reported case series are treated surgically,3,7,8,22 although reliable data on surgical rates in unselected patients are lacking.
Strategies and Evidence
Clinical Diagnosis
The diagnosis of plantar fasciitis can be made with reasonable certainty on the basis of clinical assessment alone. Patients typically report a gradual onset of pain in the inferior heel that is usually worse with their first steps in the morning or after a period of inactivity. Patients may describe limping with the heel off the ground. The pain tends to lessen with gradually increased activity but worsens toward the end of the day with increased duration of weight-bearing activity. Associated paresthesias are uncommon. Patients may report that before the onset of their symptoms, they increased the amount or intensity of their regular walking or running regimen, changed footwear, or exercised on a different surface. There is often a localized area of maximal tenderness over the anteromedial aspect of the inferior heel. Limitation of ankle dorsiflexion due to tightness of the Achilles tendon may be present. Other causes of pain in the inferior heel are usually distinguishable on the basis of history and physical examination (Table 1).23,24
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Table 1. Differential Diagnosis of Pain in the Inferior Heel.
Imaging plays a limited role in routine clinical practice, although it may be useful in selected cases to rule out other causes of heel pain or to establish the diagnosis of plantar fasciitis when it is in doubt. Occasionally, it may be difficult to differentiate plantar fasciitis from calcaneal stress fracture on clinical grounds. Plain radiographs may rule out calcaneal stress fracture and other rare bony lesions. Although the detection of heel spurs is of no value in either confirming the diagnosis of plantar fasciitis or ruling it out, a "fluffy periostitis" with ill-defined borders may suggest an underlying spondyloarthropathy.
When plain radiographs are normal, bone scans are useful for distinguishing plantar fasciitis from calcaneal stress fracture. Positive findings on bone scanning for plantar fasciitis have been reported in 60 to 98 percent of cases,25 although the false positive rate is unknown. Typical findings in the early images include increased blood flow and blood pooling; in the delayed images, findings often include a focal increase in activity at the plantar fascial insertion site in the calcaneus. By contrast, a linear fracture line or more diffuse calcaneal uptake on delayed images is consistent with calcaneal stress fractures.
Ultrasonography may be diagnostically useful, although, like other imaging techniques, it is not routinely used. The plantar fascia can be easily distinguished from the hyperechoic superficial heel pad of fat and the underlying calcaneus and is normally 2 to 4 mm thick.26 Many studies have found a marked increase in the thickness of the plantar fascia in plantar fasciitis (to a total of approximately 5 to 7 mm) and have variably demonstrated local or diffuse hypoechogenicity at the calcaneal insertion of the plantar fascia, loss of definition at the interface between the plantar fascia and the surrounding tissue, and peri-insertion edema.25,26
Magnetic resonance imaging can also be used to visualize the plantar fascia, with sagittal and coronal images.27 Normally, the plantar fascia is characterized by homogeneous low signal intensity on all pulse sequences. In plantar fasciitis, a marked increase in plantar fascial thickness can be detected, together with variable features of moderately increased signal density in the substance of the fascia on T2-weighted and short tau inversion-recovery pulse sequences (consistent with edema and intrasubstance microtears) and abnormally increased signal intensity in adjacent subcutaneous tissue and in the calcaneus at the plantar fascial insertion site. Markedly increased signal intensity in the calcaneus may be suggestive of plantar fasciitis associated with an underlying spondyloarthropathy.28
A variety of therapies are used for plantar fasciitis; however, there are few data from high-quality, randomized, controlled trials that support the efficacy of these therapies.29 Initiation of conservative treatment within six weeks after the onset of symptoms is commonly believed to hasten recovery from plantar fasciitis,23,24 but this is also unproved. The role of various management strategies should be considered in the light of the self-limiting nature of the condition.
Physical Therapy
Many types of physical therapy have been proposed as treatments for plantar fasciitis.24 Support for the use of ice, heat, and massage and for strengthening of the intrinsic muscles of the foot comes predominantly from anecdotal data. Stretching of the calf muscles and plantar fascia and taping or strapping of the foot are commonly recommended, but these therapies have generally been assessed in combination with other interventions, making it difficult to interpret the results of any individual intervention. A recent trial involving 101 participants showed that heel pain was either eliminated or much improved at eight weeks in 24 of 46 patients (52 percent) who were treated with an exercise program to stretch the plantar fascia, as compared with 8 of 36 patients (22 percent) who reported such results after participating in a program to stretch the Achilles tendon.30 However, the study was not blinded, there was a large difference in the dropout rate between the groups (28 percent in the group in which patients stretched the Achilles tendon and 10 percent in the group in which patients stretched the plantar fascia), and only those who completed the trial were included in the analysis. Two randomized, placebo-controlled trials31,32 did not demonstrate a benefit of using magnetic insoles, and small randomized, placebo-controlled trials29 found no significant benefit of ultrasonography, laser treatment, iontophoresis, or exposure to an electron-generating device.
Orthotic Devices
A wide variety of prefabricated and custom-made orthoses, including heel pads and cups that are variously designed to elevate and cushion the heel, provide medial arch support, or both, are used to treat plantar fasciitis. There are no data on the efficacy of these devices as compared with placebo or no treatment, and the available data on their efficacy in comparison with that of other interventions are conflicting or limited. One study, involving 103 patients, compared mechanical treatment (taping and orthoses) with the use of a heel cup or antiinflammatory treatment (three corticosteroid injections administered at weekly intervals, plus nonsteroidal therapy). Among the 77 patients who completed the trial, mechanical treatment was more effective in achieving an outcome rated as "excellent" or "fair" at three months (reported for 19 of 27 patients, or 70 percent) than was use of the heel cup (7 of 23 patients, or 30 percent) or antiinflammatory treatment (9 of 27 patients, or 33 percent).33 In a trial involving 236 participants, prefabricated shoe inserts (a silicone cone, felt pad, or rubber heel cup) were found to be superior both to using custom-made orthotic devices and to stretching alone. (The percentages of patients whose condition had improved at eight weeks were 95 percent for a silicone-cone insert, 88 percent for a felt pad, 81 percent for a rubber heel cup, 68 percent for custom-made orthotic devices, and 72 percent for stretching alone.2 )
Splinting and Walking Casts
The use of night splints, designed to keep the ankle in a neutral position with or without dorsiflexion of the metatarsophalangeal joints during sleep, has been evaluated in two randomized, controlled trials, with conflicting results.34,35 One trial involving 116 participants showed no benefit of a night splint worn for three months as compared with no treatment.35 In contrast, a crossover trial involving 37 participants suggested a benefit of a night splint worn for one month as compared with no treatment.34 However, a crossover design may not be a valid method for studying interventions for treatment of a self-limiting condition. A third trial involving 255 participants showed no benefit of a posterior tension splint used at night as compared with either custom-made orthoses or over-the-counter arch supports.36 There are no published data from controlled trials of immobilization with casts or other devices. A retrospective review reported a recurrence of pain, usually within a month after cessation of the use of a plaster cast, in 11 of 24 patients (46 percent) for whom follow-up data were available.37
Antiinflammatory Agents
Nonsteroidal antiinflammatory drugs are often used in practice, but randomized trials have not been conducted to assess their benefit. The injection of corticosteroids, usually mixed with local anesthetic and injected with the use of a medial approach, is another common treatment for heel pain.29 Limited data suggest that this treatment provides only short-term pain relief. One trial, involving 91 participants, showed that 1 ml of prednisolone acetate (25 mg) with 1 ml of local anesthetic, injected with the use of a medial approach, resulted in significantly greater improvement in pain at one month than did injection of local anesthetic alone; the mean (±SD) changes in the pain score, measured on a 10-cm visual-analogue scale, were 2.0±2.9 and 0.06±3.0, respectively.29 At three and six months, there were no differences between the groups in pain measures, but a high rate of loss to follow-up precluded the drawing of conclusions. A tibial-nerve block given before injection did not appear to reduce the discomfort of the injection. One concern is that corticosteroid injections may be associated with an increased risk of rupture of the plantar fascia,38,39 although data to support this association are limited and inconclusive.13,38
Extracorporeal Shock-Wave Therapy
Extracorporeal shock-wave therapy has been proposed as an alternative approach on the grounds that it may stimulate healing of soft tissue and inhibit pain receptors.40 However, the available data do not provide substantive support for its use. Of six randomized, double-blind, placebo-controlled trials assessing the efficacy of extracorporeal shock-wave therapy,40,41,42,43,44,45 three studies (involving 166, 272, and 88 participants) showed no benefit,40,43,44 and two studies (involving 150 and 302 participants) reported small benefits that were of questionable clinical importance.41,42 A sixth trial, involving 45 runners, showed that extracorporeal shock-wave therapy, as compared with placebo, resulted in a significant reduction in the score for pain on first walking in the morning (a mean reduction of 2.6 on a 10-cm visual-analogue scale) at six months.45
Surgery may be considered for a small subgroup of carefully selected patients who have persistent, severe symptoms despite nonsurgical intervention for at least 6 to 12 months. The surgical procedures used for plantar fasciitis include variations of open or closed partial or complete plantar fascia release with or without calcaneal spur resection, excision of abnormal tissue, and nerve decompression.46,47 In case series, favorable outcomes were reported in more than 75 percent of patients who underwent surgery, although the recovery times varied and were sometimes months,48 and persistent pain occurred in up to a quarter of patients who were followed for an average of two or more years.48,49 Potential complications include transient swelling of the heel pad, calcaneal fracture, injury of the posterior tibial nerve or its branches, and flattening of the longitudinal arch with resultant midtarsal pain. As compared with open release surgery, closed procedures may allow for more rapid recovery and resumption of usual activities,47,50 although the risk of nerve injury may be higher with endoscopic release and other closed procedures than with other approaches.51 Controlled trials are required to verify these findings.
The efficacy of preventive strategies such as stretching exercises and control of the intensity of running (e.g., limiting distance, frequency, and duration) is not known.52 A randomized trial that involved 390 male infantry recruits showed that improved shock absorption, obtained with the use of basketball shoes rather than standard infantry boots, during 14 weeks of training resulted in a significantly lower incidence of foot-overuse injuries (including heel pain, arch pain, and metatarsalgia but not metatarsal stress fracture). Overuse injuries occurred in 15.5 percent of the men who wore basketball shoes, as compared with 29.1 percent of those who wore standard infantry boots (relative risk, 0.53; 95 percent confidence interval, 0.36 to 0.80).53
Areas of Uncertainty
The cause or causes of plantar fasciitis remain uncertain. The potential role, if any, of imaging studies in guiding treatment, monitoring the course of the disorder, or both has yet to be clarified; currently, imaging techniques have little role in routine clinical practice. One study showed that ultrasound-guided corticosteroid injections had the same outcome as injections administered without such guidance.54 Randomized clinical trials are needed to assess whether the commonly used treatments are beneficial in modifying the natural history of plantar fasciitis.
The American College of Foot and Ankle Surgeons issued a practice guideline in 2001 that is based on expert opinion.55 The recommendations generally reflect current clinical practice, but most of them are of unproven benefit. Initial treatment options include administering nonsteroidal antiinflammatory drugs, padding and strapping the foot, injecting corticosteroids, regularly stretching the calf muscles, avoiding the use of flat shoes and walking barefoot, applying ice to the affected area, using over-the-counter arch supports and heel cushions, and limiting activities. Second-line options for those patients who have not had any improvement after six weeks include the use of custom orthotic devices, night splints, and immobilization of the foot with casts and other devices during activity for four to six weeks. Plantar fasciotomy is reserved for patients in whom conservative measures have failed; removal of the plantar spur is not believed to add to the success of surgery.
A position statement regarding endoscopic and open heel surgery that was issued by the American Orthopaedic Foot and Ankle Society recommends that endoscopic plantar fascia release not be performed if there is nerve compression.51 This recommendation is based on suggestions that the risk of nerve injury may be higher with endoscopic procedures than with open procedures.
Conclusions and Recommendations
Patients, such as the woman in the introductory vignette, who have symptoms and signs consistent with plantar fasciitis — including heel pain that worsens on first walking in the morning and tenderness over the anteromedial aspect of the inferior heel — should be informed that the condition is self-limiting and that in more than 80 percent of patients, the symptoms will resolve within a year, regardless of therapy. Since there is limited evidence about the value of treatments for plantar fasciitis, a reasonable approach to intervention is to start with patient-directed, low-risk, minimal-cost interventions, such as regularly stretching the calf muscles and the plantar fascia, avoiding flat shoes and walking barefoot, using over-the-counter arch supports and heel cushions, and limiting extended physical activities. A trial of nonsteroidal antiinflammatory drugs may be reasonable. Corticosteroid injections may provide a short-term benefit.
More costly treatments — such as the use of custom-made orthotic devices, night splints, and immobilization with casts or other devices — may be options for patients in whom the condition does not improve, although the value of these treatments is currently uncertain. Surgery should be reserved for those patients whom conservative therapy has not helped after 6 to 12 months. In the absence of data to guide the surgical approach, referral to a surgeon with expertise in treating patients with plantar fasciitis is recommended.
I am indebted to Daniel Riddle, Stephen Hall, and Peter Lowthian for their insightful comments.
Source Information
From the Department of Clinical Epidemiology, Cabrini Hospital; and the Department of Epidemiology and Preventive Medicine, Monash University — both in Melbourne, Vic., Australia.
Address reprint requests to Dr. Buchbinder at Cabrini Medical Centre, Suite 41, 183 Wattletree Rd., Malvern, VIC 3144, Australia, or at email@example.com.
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Result number: 189
Posted by John Martello Jr on 5/09/04 at 17:47
Dr z,
I have posted on here and have battling FHL and FDL tenosynovitis with minimal nerve irritation based on MRI and NCV. Tried almost everything. My question to you is would a diagnostic ultrasound be more beneficial to view the tendon pathology than the MRI? Also would ESWT be worth a try for my condition? Also is there any exercises using light weights that you can think of to strenghten this area? Thank you for your time.
Result number: 190
Posted by John Martello Jr on 5/07/04 at 18:23
I am 33 and have had this for 7 months, with an MRI showing tenosynovitis of the Tarsal Tunnel TEndons and as i mentioned before the NCV test showed minimal post tib nerve irritation. My ortho FOOt& ankle wants to operate, while the nerologist i saw said not to have the operation. The success rate given to me was 50%. Those odds suck!!!
This is what I've tried for relief yet no success:
1. ICE-feels okay while massaging, but pain returns
2. HEAT- Same as ice , but seems to aggravasate it more
3. Strertching-pulling foot/toes towrd me with a towel hold for 10 sec.
4. Ankle rotations 30- 60 daily
5. 2 cortisone injections minimal if any relief , but lasted a week
6. Accupuncture- 4 treatments no relief.
7. TEns unit- feels okay , but short lived
8. Lexapro- Currently on ythis for associted depression for this condition.
Helps stay calm, but offers little pain relief.
9. Chiropractor-3 weeks of trigger point therapy on calf muscles, no help
10. Immobilization in hard cast from toes to knee.- Probaly helped the most as far as pain relief, but no fun to walk on cast for 1 month.
11. Physical Therapy- Ionto, phonophoresis,massge not much relief
12. Prayer- not helped so far but keep hope and faith.
13. orthotics- 3 pairs tried rigid, and currently have soft firm which are a liitle help.
14. Shoes-Asics,nike, if the problem is in the ankle area changing shoes is not addressing the problem.
15. Vioxx, for 2 weeks with some relief, but do not know how long to stayt on them( baad stomach)
Any other suggestions would be appreciated as to what therapy i might have neglected, besides the surgery which i do not want to rush into, even thoigh i feel like it's the answer, but based on outcomes on this site i'm skeptical.
Thanks for listening
Result number: 191
Posted by John Martello Jr on 5/07/04 at 18:23
I am 33 and have had this for 7 months, with an MRI showing tenosynovitis of the Tarsal Tunnel TEndons and as i mentioned before the NCV test showed minimal post tib nerve irritation. My ortho FOOt& ankle wants to operate, while the nerologist i saw said not to have the operation. The success rate given to me was 50%. Those odds suck!!!
This is what I've tried for relief yet no success:
1. ICE-feels okay while massaging, but pain returns
2. HEAT- Same as ice , but seems to aggravasate it more
3. Strertching-pulling foot/toes towrd me with a towel hold for 10 sec.
4. Ankle rotations 30- 60 daily
5. 2 cortisone injections minimal if any relief , but lasted a week
6. Accupuncture- 4 treatments no relief.
7. TEns unit- feels okay , but short lived
8. Lexapro- Currently on ythis for associted depression for this condition.
Helps stay calm, but offers little pain relief.
9. Chiropractor-3 weeks of trigger point therapy on calf muscles, no help
10. Immobilization in hard cast from toes to knee.- Probaly helped the most as far as pain relief, but no fun to walk on cast for 1 month.
11. Physical Therapy- Ionto, phonophoresis,massge not much relief
12. Prayer- not helped so far but keep hope and faith.
13. orthotics- 3 pairs tried rigid, and currently have soft firm which are a liitle help.
14. Shoes-Asics,nike, if the problem is in the ankle area changing shoes is not addressing the problem.
15. Vioxx, for 2 weeks with some relief, but do not know how long to stayt on them( baad stomach)
Any other suggestions would be appreciated as to what therapy i might have neglected, besides the surgery which i do not want to rush into, even thoigh i feel like it's the answer, but based on outcomes on this site i'm skeptical.
Thanks for listening
Result number: 192
Posted by John Martello Jr on 5/07/04 at 17:58
So if i have Flexor hallucis longus tenosynovitis would ESWT be an ideal treatment plan after i have tried all conservative measures? Where in CanadA is this offered? Niagara Falls? Can
Result number: 193
Posted by John Martello Jr on 5/05/04 at 16:33
Can eswt be used for tarsal tunnel?
Result number: 194
Posted by John Martello Jr on 5/05/04 at 16:32
Can eswt be used for tarsal tunnel?
Result number: 195
Posted by John Martello Jr on 5/05/04 at 16:27
I have been diagnosed with a component of tarsal tunnel, and my ncv test showed minimal irritation to the posterorir tibial nerve, so my ortho thinks it is more tenosynovits based on my mri. However i feel the pain constant and even at rest. Wouldn'y tendonitis cause pain when the ankle joint is moved and not at rest? Also haow acccurate are these NCV tests? I had one done by an excellent neurologist who had tons of experience with this and he said DO NOT dot the tarsal tunnel release in my case. Now my foot and ankle ortho wants me to do it because i'v exhausted all my conservartive options. I am not on any medication except Lexapro to combat the depression assocaited with this debilatating problem. Any one advice that is going through this would be appreciated. I feel like ending it!!!
Result number: 196
Posted by John Martello Jr on 5/04/04 at 15:46
Can Tendonitis pain be present at rest as i have struggled with this for 6 months?
Result number: 197
Posted by pala on 3/09/04 at 20:33
poe was one of the first poets i stumbled upon whien i first discovered there was such a thing as poetry. i was in jr high. shelley was the other one. Poetry blew me away back then. such beauty and truth. i committed all i could to memory when i had a good memory. Shelley's ode to the west wind:"oh lift me as a wave, a leaf , a cloud. i fall upon the thorns of life, i bleed. a heavy weight of hours has chained and bowed one too like thee, tameless and swift and proud."
Result number: 198
Posted by marie on 3/05/04 at 17:20
Hey Phil...don't get me in trouble here....ok.
Thanks marie
Result number: 199
Posted by Phil C. on 3/04/04 at 00:34
You deserve to be treated as an equal with anyone here.
Phil C.
Result number: 200
Posted by Phil C. on 3/03/04 at 23:56
Go where you are needed and RESPECTED.
Phil C.
Result number: 201
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