The podiatrist I saw decades ago and my current podiatrist both ordered the custom orthotics from their preferred places and had me come in to pick them up.
this podiatrist is in the office of the OS that I saw and had a very bad experience with, and also the office where the dr I wanted to switch to works- but I was told that wasn't allowed (although that is untrue, it's allowed for those who matter- ppl with better insurance)
so I wasn't expecting much.
they are all so rushed at this practice... it's a true assembly line, get em in and get em out as fast as possible, on to the next one.
They are NEVER pleasant to you, ever! this is the same for everyone, so that's got nothing to do with my insurance.
so it was a stressful appt.
I refused the foot xrays because I'd just had my feet xrayed a month ago, because I just had foot xrays and my insurance won't cover more without good cause (there is none) I told them that my PT wanted an xray of my ankle, they said that was up to the Dr- that he'd need to see me first.
saw the Dr (podiatrist) He was very rushed. I'd brought a copy of the radiology report from just a month ago, he wasn't interested. Told him about my PT wanting my right ankle cleared as being "structurally sound"- he ignored that completely.
He immediately told me that my foot problems are all caused by my valgus right knee.
I knew this was going to happen, but fortunately he was the FIRST dr to actually LOOK at my body and we briefly discussed the pelvic fracture and the SI joint issue, the leg length difference and how the OS said getting TKR would make my leg even longer, when it being too long was already an issue
He inserted a comment that what I was told wasn't true, that they COULD make the right leg shorter (and this is indeed what the OS whom I despise told me- he could shorten that leg)
so I informed the podiatrist that I was getting conflicting opinions from different OS and that one said there was no way they could shorten my right leg because then the ligaments would be too loose and I'd have serious instability... He cut me off and wanted to know where I went, and who told me that, and I told him I'd seen many diff OSs and none of them agree.
However in the course of pushing the point that any thing is not going to be very effective, he pointed out what I was trying to figure out on my own (and kind of knew, but wasn't sure of)
He (very quickly) showed me how the valgus deformity is causing the SI joint pain to move higher up, as the leg moves further in the opposite direction, he also showed me how the valgus knee is pulling on the ligaments of my right ankle and how the pressure on the great toe is increased by all these abnormal angles. I kind of knew this all along but since physics is def not my subject, I needed to hear this very clear explanation.
I really wish he hadn't been so rushed- because he's one of the few drs who was willing to give me answers to some of my most pressing questions
he said that the valgus knee could be fixed with an osteotomy or (and?) TKR
I don't know what an osteotomy is- I looked it up of course but there are SO many different kinds and different reasons for them and it appears they are not often used in people over 60 and also that the recovery from those involves a period of non weight bearing, vs TKR where you need to be wt bearing
I am so depressed/defeated and feeling really hopeless now
He did give me an PX for off loading custom inserts and the names of several places to get them. I might be able to get them free, I need to call a place today and find out.
he suggested Hoka shoes as having more cushioned springy soles.
and he gave me a "prescription" for a wheelchair but will not do the paper work that the insurance would need to get it approved
He used several diagnostic codes for this visit: bilateral foot pain and callus of foot and lower limb difference and ACQUIRED VALGUS DEFORMITY KNEE, RIGHT
It may not make a difference to the OS who have wanted to do the TKR (or the first one who did not want to do it) but this makes a huge difference to me.
we can't even have a discussion about my chances of a good outcome without the surgeon acknowledging this simple fact- I don't have primary OA of the knees.
United States
