Iontophoresis - adverse reaction?

[RolliePollie]

This is really interesting. Knotted - I'm so glad you asked all those questions. Now I am thinking even more that I should seek out a new PT and see what they think. Thank you so much for your replies!

My PT does have me do some stretching/strengthening exercises, but no hip exercises. He is not recommending insoles because he says he considers those a last resort. I am kind of suspicious that this particular PT finds my case quite boring. I've watched him with other patients and he seems more enthusiastic about their treatment. Being a brand new PT, I wonder if he's looking for exciting cases that give him a challenge. Well, I guess maybe I'm giving him a challenge now! Even though I live in a really small town, we do have at least one other PT clinic that I know about. I think next week I'll call the Dr., hopefully go in and get checked out, and then definitely pursue a new PT referral.

My mom is an R.N. and she really thinks I have nerve/blood vessel issues going on. For one thing, my foot is tending to be a different color than the good foot. She thinks the blood vessels are freaking out. I just hope that if this is damage from the ionto, that it's temporary and not permanent. No more ionto or any other electrical treatments for me!

[KnottedYet]

I've watched him with other patients and he seems more enthusiastic about their treatment.

Ummmm, how is it you can watch him with other patients while you're there? Is he treating more than one patient at a time? (that's illegal)

I like using Superfeet insoles, they are cheap ($35) and very easy to wedge to sort of customize the fit. As a person's muscles get stronger they often need less and less wedging, and I can peel the wedges off the Superfeet and trim them down. Sometimes by the end of PT the patient doesn't even need wedges anymore, but they keep using the Superfeet. The nice thing about sturdy neutral insoles is that they also help cue the muscles when to fire. (the bottom of the foot gets more positional info from touching the insoles than from touching a flat surface, for example.) Insoles are usually my first resort, rather than my last. (I have a very good orthotist I can send folks to who need custom orthotics. Those are expensive!)

I'm glad you've got your mom as a resource. Instead of Rudolf's Red Nose for Christmas, you've got the glowing red toes!

[VeloVT]

Hi Sara,
Of course Knot can offer much more valuable information than I can, since I've only experienced ionto as a patient and I have NO medical expertise. But I just wanted to reinforce that you are NOT having a normal reaction to it. I had ionto for about 4-6 weeks last year for peroneal tendinitis from running (tendon that runs behind the ankle and wraps under the foot). The ionto was mildly helpful for me, got rid of the acute "I can't walk for more than 100 yards without limping" pain but didn't return me to running (massage did though, amazingly well).

But, I never had anything more than mild tingling from the treatments. We did twice a week. I think the machine worked on some sort of watt/minute measurement (takes less time at higher wattage, more time at lower wattage) and they would always take 5 minutes adjusting the settings to my comfort. I think my skin must be thick, because they kept asking, ok, do you feel anything now? does it hurt now? and every time they were able to crank it up as high as it would go (they always seemed surprised). Afterwards the therapist would rub a little cream on the areas that the electrodes had contacted. But I never even had redness.

I did have weird systemic reactions that I attribute (perhaps erroneously) to the dexamethasone. On days I had treatments, I would be jittery after the treatment and couldn't sleep at all. I was also off/irritable and it seemed to aggravate acne... I attributed the mood/sleep symptoms (which were pronounced and completely limited to days I had treatments) to the dex because I've had similar experiences other times I've had to take medications with steroids -- but, according to the package inserts anyway, this kind of systemic reaction is supposed to be unusual with ionto (as opposed to steroids taken orally or through injection), so maybe it was coincidence .

Anyhoo you shouldn't be swelling. I hope you are able to find another treatment that works.

[RolliePollie]

Well, I'm all done with PT. But my foot is not completely better. I am a bit puzzled by the whole PT experience. If I ever need PT again, I'll ask for a referral to a different clinic. My PT's final hypothesis about what happened with my foot is that I have some disorder, like Reynaud's, that causes my nerves to react to ice. He now says he doesn't think it was the Ionto. I disagree. I think is was too much Ionto at too high of a level, and I think it messed up the nerves in my foot. Based on Liza's comments about the Dexamethasone, I think I may have been reacting to that as well. I was really grumpy but that could've also been because I was annoyed that my foot was hurting, plus the holidays kind of make me grumpy. So who knows about that. But my face broke out really bad during the couple of weeks I was getting Ionto, and I could've sworn that I just looked puffy in general. Now my skin is back to it's normal level of breaking out and I don't think I look puffy anymore.

I still haven't been back to the Dr. because it is getting progressively better. There is just minor pain that comes and goes, and the swelling is pretty minimal at this point. I'm going to give it one more week and see what happens. I'm planning to go skiing on Wednesday, so that should be a good test. Oh, and I bought Superfeet insoles yesterday, so I'll be trying those out as well.

Knotted, thanks again for your insight on the whole PT thing. I almost hope I need PT again sometime so I can go to someone else and see the difference!

[KnottedYet]

I'm sorry your PT experience wasn't the best.

If your foot doesn't get better, don't hesitate to contact your doc.

If you have any issues with your Superfeet, please contact me. If I can't help solve the problem, I have the name of a rep for the Superfeet company who might be able to help.