Hello everyone,

I have something that has been on my mind for a while. It is to do with Dr. opinions and diagnosis. Even though sometimes it is good to get a second or third opinion, what happens when these opinions do not match, who do you believe?

As I read about everyone stories online, including my own and the amount of opinions I have had. I have come to the conclusion that, is it worth getting so many opinions? Do we get confused along the way? As doctors have had training at various institutions and have learned to diagnose in several methods, and we the patients end up with the results, when do you know who you should believe along with all of your xrays, MRI's , blood test, etc.. etc..?

Just my thought for the day...

Have a great day all.

CJ....
BERMUDA

the decision of having any kind of surgery is very anxiety provoking. The only remedy for that is preparation, that is, knowing ALL (or as much as possible) the information, options, possibilities available. A visit to a single doctor chosen at random out of the phone book is just not sufficient. Thank goodness we have the internet now to dispel some of our ignorance, plus use other qualified people's recommendations. Otherwise it is just blind faith on a doctor whom you may have never met before who tells you what is best, and there are some very sketchy doctors/podiatrists, out there

If we are talking real medicine hear, not the alternative stuff, The Diagnosis at the second opinion should match that of the first. If it doesn't, go get a third. Medicine done correctly is not subjective, it is objective, and what one Doctor sees should be the same as the next doctor. As far as treatment is concerned, In foot sugery there are different methods to treat the same deformity. One particular method might work better for a particular dr., another Doctor might prefer a slightly different approach. They both should address the same problem. Dont be shy, ask the Dr. why he feels one approach is better then the other. If you still do not feel comfortable, get a third opinion.

Part of this issue is the orthopedist versus the podiatrist. I went with an orthopod, but made sure he specialized in foot surgery. I asked how many bunionectomies he's performed and how often. I didn't get a second opinion because I felt my guy was experienced and I immediately trusted him. He didn't encourage the surgery (didn't feel like he was out for the $$) and told me that most people opt for it when they just can't take the bunions any more. I felt ready to have it done, after many years of dealing with them. Thought about a second opinion but then found I was satisfied with my doc's experience in the area, his certifications and his overall medical training. I even checked out where he attended med school and did his residency. One caution about orthopedists though, be sure they have ample experience dealing with feet. It should be their specialty, not just something they do once in a while.

Good luck!

sailmaven - you have touching faith in the medical field; medicine IS both subjective and empirical, ie one approach will work for an individual patient and not for another depending on so many factors. Plus what is considered to be good in one period of time can get discounted in the next. QV the postmenopausal estrogen replacement backtrack just recently - 10 years ago hormones was pushed strongly, and now the new evidence is that is actually is bad for you! The doctors just went, OOPS!

marketing mom - curious what kind of exact surgery you had, to see if there is any difference in podiatrist and orthopod

My concern,

is that I have had two opinions that were the same diagnosis. I was told to seek a 3rd and the third is not sure and wants to recommend me to someone else. I just want to make sure that I am doing the right thing, as feet are important and We all need them to get around...

As the pain grows more, I think I will end up doing the surger....

thanks
CJ..

well it depends on your specifics - are we talking about bunion surgery? if so what kind of angles are we talking about, plus other issues like degenerative arthritis, hammertoes, tailor's bunion, etc. What specific surgical approach was described to you by your 2 concurring doctors? were these 2 podiatrists in the same practice group, or one that was referred by the other? Why is the 3rd not sure, and is he/she also a podiatrist or MD?
I had 3 opinions on mine (before I did research online unfortunately) and I just went w/the one who would do the surgery that sounded the most reasonable to me (the orthopedic surgeon wouldn't do it, and one podiatrist offered a bumpectomy only that didn't seem very good, and another post confirmed that it is not sufficient to really correct) But who knows really!

Hello Sweetficus,

I am talking about a Metatarsal Osteotomy. My first podiatrist diagnosed it as Capsulitis. The Orthodepist - agreed that is was Capsulitis. He did not offer me the surgery @ first because of my high level of activity (ballet, yoga, pilates). He was very skeptical and consulted his surgeon friends somewhere else. He then came back to me 6 weeks later and said that he can offer the surger to me, provided I slow down in the activity. HE feels that he can relieve the pain with the surgery and I will get 80% flexibilty back. I will have a permanent screw in my foot.

I am not a sixteen year old. I am a 35 year old active person. I do not depend on my activities to provide for me. At this point I am constantly in pain, tinglying all the time. Have to go home every evening and ice my foot. when it is bad, I take tylenol Pm to go to sleep. Even tried PT this week and it made things worse. I am even limited in how far I walk these days.. This is frustrating.. This problem has been progressing since May 2003...

Anyway... I am trying to get a 3 opinion. Of course I am scared of this surgery. He will have to cut into the Metatarsal bone and shorten it, because it does all the work for my foot.
Your feet take you every where you need to go and they are very important to me!!

Also, spoke to my good friend who is Internal Medicine, and she said that I should go with the surgeon and get the surgery. I do feel very confortable with him and he did not try to push the surgery on me. He was very open with me and I like his attitude.

thanks
CJ..






well it depends on your specifics - are we talking about bunion surgery? if so what kind of angles are we talking about, plus other issues like degenerative arthritis, hammertoes, tailor's bunion, etc. What specific surgical approach was described to you by your 2 concurring doctors? were these 2 podiatrists in the same practice group, or one that was referred by the other? Why is the 3rd not sure, and is he/she also a podiatrist or MD?
I had 3 opinions on mine (before I did research online unfortunately) and I just went w/the one who would do the surgery that sounded the most reasonable to me (the orthopedic surgeon wouldn't do it, and one podiatrist offered a bumpectomy only that didn't seem very good, and another post confirmed that it is not sufficient to really c
orrect) But who knows really!

Be careful and make sure whichever surgeon you use (be it Podiatric or Orthopedic) has done this procedure many times. It is not a mechanically difficult surgery, however the hard part is determining how much to shorten the metatarsal. If you shorten it too much (by just millimeters) the pain will recur in the next Metatarsal joint over. If you don't shorten it enough, you will not gain relief. Many of these surgeries are not successful because of this. Make sure your surgeon makes you aware of these risks, if he does not, then he is not giving you informed consent and go to someone else. It kind of worries me that your orthopedist had to go ask collegues, it's not a difficult diagnosis, or difficult to come to a treatment plan. He might not have seen many of them, and that is not who you want doing it. If a podiatrist does it, make sure they are board certified and did a surgical residency. That kind of guarantees that he has done/seen many before as they only do foot surgery. If you go to an orthopedist make sure that they are foot/ankle board certified and did some kind of fellowship devoted to feet.

Good Luck