Guest guest Posted September 23, 2010 Report Share Posted September 23, 2010 Half The Battle by Glenn B. Pfeffer, MD Last week a 42 year old man came to the Charcot-Marie Tooth Clinic at Cedars-Sinai. He had driven over 300 miles for the appointment. " I have come here, " he explained, " to understand what's wrong with me, and to see if there's anything I can do about it. " He had surgery on his ankle tendons a year earlier by a local surgeon, and was told that his recovery would be slow. When his ankle weakened further after the operation a neurologist ultimately diagnosed him with CMT. Unfortunately, his surgeon had not understood the extent of his problem, and had performed a procedure that was doomed to failure. " Don't worry, " I assured him, " I can help you. " " That's what the other doctor said, " he replied. I spoke with my patient for about an hour. I explained his condition to him, and what options he had for treatment. We discussed the possibilities of shoe modification, special braces and surgical correction. I encouraged him to participate in a specialized physical therapy program that focuses on the unique needs of a person with CMT. He asked me about current CMT research. When he left, I asked him what he was going to do. " I'm not sure, " he said, " but I understand my options, and that's half the battle. " CMT is one of the most commonly overlooked and misdiagnosed problems in medicine. Most patients experience symptoms that remain undiagnosed for years, if not decades. Isolation from one's peers and a distrust of the medical community often occur. Many people stop turning to doctors for help; and when they do, they are often sort changed, like my 42 year old patient. Perhaps the most important increased awareness for CMT needs to occur among physicians and other caregivers. Once patients with CMT understand their condition and what can be done for them, half the battle is won. At Cedars-Sinai we have a team of caregivers who are highly specialized in CMT. As an orthopaedic foot and ankle specialist I typically take care of patients who have failed conservative care, including bracing and our CMT physical therapy program. When needed, surgery can transform an unbalanced and deformed foot into one with a remarkable improvement in function. Even if a patient decides not to have surgery, he or she will leave our comprehensive care better prepared to deal with the second half of the battle that lies ahead. Glenn B. Pfeffer, MD can be reached at Pfefferg@... He is currently Director of the Foot and Ankle Center and Charcot-Marie-Tooth Clinic, at Cedars-Sinai Medical Center in Los Angeles. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 1, 2010 Report Share Posted October 1, 2010 I must say, I have been the see this doctor, and it is kind of weird, but he seems to think CMT stops at the belt line. He is not, at least in early 2008 when I saw him, interested in anything CMT that happens above the hips. If you have problems with CNS symptoms or hand problems, or problems with neck, mouth, chewing, and/or swallowing, Dr. Pfeffer isn't really interested, or so it seemed to me. This is just the feeling I walked away with, as I asked about hands and mouth and other symptoms, and he referred me to another doctor at another Cedars Sinai facility. It was really disconcerting. On Sep 23, 2010, at 8:07 AM, gfijig wrote: > Half The Battle by Glenn B. Pfeffer, MD > > Last week a 42 year old man came to the Charcot-Marie Tooth Clinic at Cedars-Sinai. He had driven over 300 miles for the appointment. " I have come here, " he explained, " to understand what's wrong with me, and to see if there's anything I can do about it. " He had surgery on his ankle tendons a year earlier by a local surgeon, and was told that his recovery would be slow. When his ankle weakened further after the operation a neurologist ultimately diagnosed him with CMT. > > Unfortunately, his surgeon had not understood the extent of his problem, and had performed a procedure that was doomed to failure. " Don't worry, " I assured him, " I can help you. " " That's what the other doctor said, " he replied. > > I spoke with my patient for about an hour. I explained his condition to him, and what options he had for treatment. We discussed the possibilities of shoe modification, special braces and surgical correction. I encouraged him to participate in a specialized physical therapy program that focuses on the unique needs of a person with CMT. He asked me about current CMT research. > > When he left, I asked him what he was going to do. " I'm not sure, " he said, " but I understand my options, and that's half the battle. " > > CMT is one of the most commonly overlooked and misdiagnosed problems in medicine. Most patients experience symptoms that remain undiagnosed for years, if not decades. Isolation from one's peers and a distrust of the medical community often occur. Many people stop turning to doctors for help; and when they do, they are often sort changed, like my 42 year old patient. > > Perhaps the most important increased awareness for CMT needs to occur among physicians and other caregivers. Once patients with CMT understand their condition and what can be done for them, half the battle is won. > > At Cedars-Sinai we have a team of caregivers who are highly specialized in CMT. As an orthopaedic foot and ankle specialist > I typically take care of patients who have failed conservative care, including bracing and our CMT physical therapy program. When needed, surgery can transform an unbalanced and deformed foot into one with a remarkable improvement in function. Even if a patient decides not to have surgery, he or she will leave our comprehensive care better prepared to deal with the second half of the battle that lies ahead. > > Glenn B. Pfeffer, MD can be reached at Pfefferg@... He is currently Director of the Foot and Ankle Center and Charcot-Marie-Tooth Clinic, at Cedars-Sinai Medical Center in Los Angeles. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 1, 2010 Report Share Posted October 1, 2010 , Not true at all. I have met with him many times and throughout the years, he has gained great knowledge and experience about what CMT is. But, remember he is first and foremost a specialist/surgeon in ankle/feet problems. That is his area of expertise. Of course it is common sense that if you have hand, neck, swallowing issues, that he would refer you to someone else. " At Cedars-Sinai we have a team who are highly specialized in CMT " . Gretchen > > > > Quote Link to comment Share on other sites More sharing options...
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