Complaint Review: Desert Foot and Ankle

In August 2008, I returned from Guatemala with my right ankle in a
cast. I had turned my weak ankle and chipped the ankle bone while working in a
Guatemalan village. My doctor at the time, Dr. Hummel, referred me to
specialist, Dr. Maling in Tempe.

I first visited Dr. Maling on September 5th.
During that visit, he was rather insistent that I have surgery on both ankles
to tighten the outside ligaments on both ankles. He explained this would make
my feet tilt inward, thus lessening the possibility of twisting outward when
walking on uneven land. He further explained each would be be operated on
separately, as the recovery time was six months each ankle, during which I
would be unable to even step on the recovering foot. 

I declined for two reasons:

1. My gut feeling was this was a rather drastic first line
of action. It seemed to me that there must be another, less invasive, option to
try first.

2. I run a foundation and did not have a year to sit in a
chair. By the end of the year, my muscles would have atrophied and I may never have
gotten back the aging physical capacity I now have. I have seen too many
elderly lose capacity and never regain it.

 

Dr. Maling reluctantly agreed to try orthotics and
recommended the Walkshop in Mesa.
He was going to send them the adjustment he wanted done after he saw the MRI
results.

 

I had the MRI done on September 15th; I believe,
and went to the Walkshop on October 9th. We were still waiting for
the required adjustments until October 15th. I made a phone call to Dr. Maling,
stating that if he was no longer interested in providing appropriate treatment,
to say so and I would find another doctor. He assured me he would follow
through and provide appropriate treatment. He sent the prescription that day.

 

Unfortunately, when he provided the measurements, I assumed
he knew what he was doing. I paid the $385 for the orthotics.

 

I wore the orthotics faithfully from late October on. My
May, I noticed I had rather severe pain when getting out of bed in the morning.
However, this pain did lessen after walking around a bit. I was getting ready
for the semi-annual trip for the foundation to Guatemala and did not think to ask
about it. I was, after all, following the doctor and being safe. While in Guatemala, I
wore the braces daily and didnt seem to have the morning pain.

 

On July 1st. during my trip back to the USA, I did not
use the braces, as I was walking on even ground in airports. However, between
flights, the pain was such that I could barely walk. Every time I sat down and
rested, the pain subsided, but was much worse when I got up, until I walked it
out.      

 

I made an appointment with Dr. Eulano for July 29th.
He took a look at the orthotics and was visibly upset. After taking
measurements of the damage to my plantar fascia, he was ready to explain.

 

The previous treatment had been destroying my plantar
fascia, which was now full of an extreme amount of scar tissue. I do not know
the measurement he was using, but he explained damage up to #3 was indication
of enough damage to require treatment. Mine was measuring slightly less than
#6. He further explained that every time I was off my feet, the body was trying
to heal the ripped tendon pieces and every time I got up and walked, I was
retearing them, causing the amount of scar tissue to increase.

 

I got a second opinion a month later and it was the same. I
had been destroying the plantar fascia.

 

When the plantar fascia is stretched to abnormal lengths,
damage is inevitable. It is not meant to be so abused.

 

I am dismayed and angry that Dr. Maling did not have this
knowledge when he prescribed stretching my plantar fascia. I will be eternally
grateful for following my gut feeling, rather than his strong pressure to have
the permanent surgery. I would be in a wheelchair by now had I done so.  

 

Dr. Malings uninformed diagnosis cost me months of pain
that I am still overcoming, not to mention the $385 for his damaging orthotics.
I hope some day I will be able to take a few steps without needing constant
supporting shoes. It is a nuisance when in the shower.

 

This doctor needs retraining and until then stopped. He is
surgery happy without having sufficient knowledge to treat at least ankles.

 

I sent this lett to the Arizona Medical Assoc, who forwarded
it to the Podiatrists Assoc. some 6 months ago. The no response tells me they
protect their own, not the public.

 

It has been over 2 1/2 years and I am still in pain on my
left heel. The recovering right foot gives me hope Malings damage to the left
can be overcome eventually.