@MolotoW:

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Great, spanishbudda, thx for this information ...

From your report it sounds pretty straight forward; however, would you think, something was
special and really worth the long trip to the Professor or could it be done elsewhere in the USA
to the same level ... ? What is really special about him ...?

Was his examination technique somewhat different then what you had expected yourself ... ?

Could you describe the scoring system with which he decides to treat or not to treat ?

spanishbuddha:

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Hello Di

About treating my foot: at the moment there is no indication that treatment is needed. There are no symptoms, and I can feel with my fingers the area that needs monitoring. Part of the plan, when you don't live local is that the Professor shows you how to palpate your hands and feet to detect changes so that you can follow up concerns via email. Of course I'm back in 3 months anyway, but I don't expect any changes so soon with my feet ( touching wood).

Second treatment today. Nothing to report. The machine whizzes, bangs and clicks, and you hope something is really going on :-)

Spent the day down town in Hamburg. It's a nice city, easy to get around using train and metro, but it'll be much better to this Spanish blooded person in spring.

Round 4 today of RT, nothing to report. I have had a second meeting with the Prof to confirm and receive his report of the diagnosis and treatment. Also an opportunity to discuss concerns, what to do, not do, and the second round in 3 months.

Hello Di

It's quite balmy today in Hamburg at +4C. I've managed to get about quite a bit downtown Hamburg, and today enjoyed the museum of arts and crafts which has a show of pianos some dating back o the 1600's (they weren't called pianos then). The only thing not possible is the outdoor pavement cafe, boat trips and lake beaches. Having said that a few hardy souls were eating wurst and drinking coffee outside. I've actually walked quite a bit and the feet are tired and a bit sore at the end of the day, but fine in the morning. You can hire cycles downtown from racks at specific parking places.

I found some Nike Free shoes downtown, but was not convinced enough to spend €100 Euros. Interesting sole design, but just not sure. As I've said elsewhere I spend quite a lot on shoes, getting nowhere, and what I really need is a place that rents shoes out to try, but of course the hygiene factor makes that impossible.

David26

The first thing to say is the Professor understands in detail the anatomy of the hand and feet. He took some time to explain the location of DD in the hand fascia, and also where it occurs in the feet. He starts the exam by stretching lightly the palm or soles so that you can see where nodules or cords in the fascia press against the skin displacing blood and creating white patches. Then comes the feeling or palpation. In the hand he feels for the nodules or cords and checks that they lift up if the skin is pinched and lifted. This is done in conjunction with a knowledge of the anatomy of the underlying tendons and sheaths to help with differentiation. He also checks for functional ability, the distance between thumb and fingertips, ands of course any contraction. In the sole it's similar, he finds the outline of the plantar and looks for nodules along or at the edges.

Edited to add that for deep or large nodules with LD in the foot, they use a MRI (I think he said it was an MRI, the terminology might not be quite right) to determine the extent but especially the depth which cannot be so easily determined by feel in the foot. I did not need this so apologies for the uncertainty.

For ourselves it's important to learn your own hand and foot anatomy so that you can detect changeover time.

Edited 02/24/11 19:40

Larry:

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What about sketches and photographs ? How is the documentation done ?

I absolutely LOVE Zappos!