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Surgery Repost

Posted by Scott on 11/18/98 at 00:00 (002271)

Here's an interesting discussion posted previously. I'm posting it here because a search feature will be added so that old posts can be found.

It has been a while since I posted, and I
want to see if anyone has had this new
procedure my new podiatrist is thinking I will
have to have next summer.

I was pain free from the fourth through
sixth week after my EPF in July. After I
had been back to work two weeks (teacher),
the pain came back worse than ever. I had
one more cortisone shot, and I've been in a
cast boot (metal bars down the sides and
attaches with velcro) since the first week
of September. That has enabled me to work,
but it has done nothing for the sharp,
shooting pain I get later in the day and at
night. I wear the boot to bed so that I have
less pain at night. Now I'm having ankle pain
because of being in the boot so long. I'm now
going through two weeks of physical therapy.

For two months, I've been trying to get my podiatrist
(the one who did the EPF) to tell me what's wrong with
my foot, since the pain is much worse than before the
surgery. He has refused to tell me, and gets angry when
I ask. I finally went to a podiatrist yesterday who was
highly recommended by a colleague of mine. He determined
that my podiatrist who did the EPF trapped a nerve on the
bottom of my foot. No wonder my podiatrist was so reluctant
to tell me! I'm partially flat footed, and that greatly
narrowed the margin of error in doing the EPF. Now scar
tissue from the surgery, plus PF, plus walking all day is
pinching the nerve (Somehow it's called pinched nerve in
your back and nerve entrapment in your foot.). Anyway, the
recommendation is orthotics (already ordered by doc who did
the EPF), physical therapy, and a rather extensive surgery
next summer after school gets out.

This new surgery involves general anesthesia, and a three
to four inch incision shaped like an 'L' on the bottom of
the foot. It is done in the arch as opposed to the heel.
This podiatrist I saw yesterday said that it would relieve
the nerve entrapment and the EPF. It enables the surgeon
to see much clearer the structures and nerves inside the
foot. It also minimizes scar formation.This doctor
doesn't do the procedure and says that it's new. Anyone
ever heard of anything like this?


Diane R. (DIANE5)
10/28/98 10:12 PM
So sorry to hear the surgery was so unsuccessful for you - I have come to feel that is
the case for most people, actually, after reading so much on these heel spur sites. I
have yet to see anyone who is a year past surgery come on and say they had such and
such done, by so and so, and are now pain free. Instead most people appear to be in
more pain and are more disabled than with the orginal PF problem.

Also, I don't know anything about the new surgery you are contemplating but do have a
friend who (several years ago) got the full PF release type surgery (before endoscopy
was around) and it resulted in more pain, scar tissue etc. etc. She has had two later
surgeries to try and relieve this but nothing has worked. She told me not to get started
with surgeries and I believe her.

Now that you have had one surgery, I feel unqualified to really give any advice as to
what might help the pain - as I haven't had any experience with nerve entrapment/scar
tissue etc. What works for me may not work with these added nerve/scar tissue
problems. Have you tried birks? How about glucosamine with sulfate?? These work
well for PF and they help me but... maybe someone out there can tell you if it has
helped them with post surgery pain like you are having?? Or is there somethingelse that
works for them??

Another friend has had so many back surgeries (5 or 6) - each one being the one that
was to fix what the others had failed to do or to correct problems caused by previous
surgeries. His back is such a mess they can't do the anything more for him. He is on
morphine constantly and it does not help anymore. He went to see about that new nerve
implant device that they show on tv where it blocks the pain impluses to the brain etc.
They tried the procedure but his nerves are so misplaced/re-routed from his previous
surgeries that the electrodes generated impluses/spasms into the chest area and caused
potential heart problems - so they had to quit right in the middle of the procedure and tell
him he would not be a successful candidate for this pain relief method. They said if he
hadn't had so many surgeries they probably could have helped him. The only resort left
to him is some sort of permanent morphone drip that goes right into this spinal area.

I'm not trying to discourage you with all this info, but rather to warn you to be really
careful about who you let do what to your body. You have to live with the
consequences and then they (the dr.'s - like the one who is mad at you now) just get
angry and defensive when you aren't cured or complain of pain that doesn't go away.
They take it as a criticism of their 'God-like image of themselves'...and they sure do not
like that... but then they are not living with the pain the way you are.

So, please just do alot of checking... I would want to talk to some people who had
whatever procedure you may decide on, done by the same doctor and who he says are
cured by him, etc. If he doesn't have cured people he can let you talk to then what does
that say about his success rate??

You sure have some tough decisions to make - I'll keep you in my thoughts and prayers
that if you do go in for another surgery it works to help you this time.

Bead (BEAD)
3 of 6
10/28/98 11:16 PM

I think Diane gave you very good advice. The only thing I
would want to add is to be careful of podiatrists, their
training is much less that orthopedic people. I ccertainly
would try accupunture before any more surgury. Good Luck ,
(email removed) (BECKYB1)

10/28/98 11:37 PM

Please really reconsider when thinking of seeing as Podiatrist or getting the EPF. Both
failed for me.
I think for those of us who have tried everything (and no I haven't done accupuncute or
taped yet), hopefully the Ossatron will be the answer.
By the way for those of you who are wondering. I am still huring from the blind study I
got. I don't think I got the real thing. Am taking a lot of ibu as usual.

gcul (GCUL)

So sorry to hear of your surgery outcome. I don't know anything about the type of
surgery now recommended. But in my experience, podiatrists are much more likely to
want to do surgery than orthopedic surgeons. I would suggest you get a few second
opinions with one being from an orthopedic surgeon, especially one who specializes in
foot and ankle. I know they are difficult to get appointments with, but usually you can
can get in more quickly if you specifically say you need a second surgical opinion. Hope
things work out for you.




Top of Page
Message 555
6 of 6
11/3/98 4:53 PM
Reply to:

Oh, Melissa, I knew it must be you when I read the heading about the failed EPF. I had
hoped that you were doing better by now. This is cindy near Seattle, I had the EPF last
January by Dr. Barrett in Houston. I am still having just a terrible time with both feet. I,
and the drs., think the EPF worked to get rid of the PF, but now I have trapped nerves
in both feet. At first, they thought it was Tarsal tunnel, which is a trapped nerve under
the round ankle bone area. But 3 nerve conduction studies don't prove it, altho. the drs.
say those aren't a 100% perfect test. So, now I have seen 2 very good orthopedic
surgeons, one in North Carolina, recommended by Peggy Whitesides, our friend on this
board, and one in Seattle recommended by the Dr. in North Carolina. These drs. are
both ankle and foot specialists, and I really liked the dr. in North Carolina; the guy in
Seattle was pretty abrupt and forward. Anyway, they both agree that I have a trapped
nerve (the posterior tibial nerve), but its not trapped in the tarsal tunnel (which is a
specific space near the ankle bone), but below that, in muscle and fascia. The bad news
is that neither of them thinks the surgery will be very successful. The dr. in North
Carolina was more optimistic, saying 70% of the people operated on get 70% relief.
But, the dr. in Seattle was less enthused, and told me point blank that he would follow
me for 4 weeks post-op and then didn't want to be stuck with me as a chronic pain
patient! So, that tells you a lot what he thinks about the possible success of the surgery.

I don't know anything about the 'new' surgery your dr. described, but it must be similar
to what I would have. I would have the L shaped incision, and then the dr. would try to
pull the muscle back from the nerve, and then we pray. There is a good risk of scar
tissue, which will squeeze the nerve more. So, I have decided to try everything else I
can before I would try this surgery. I forgot to say, I also saw a group of 10 podiatrists
at a 'grand rounds' prsentattion of my case by my podiatrist. All 10 podiatrists also think
I have a trapped nerve, and that surgery won't be very helpful. Nobody had any ideas
of what else to do (I've done a lot already, that's why). The dr. in N. Carolina wrote a
prescription for new shoe inserts, which I got, and they haven't helped at all. $250
again! But, they are more comfy cuz they are a little softer.

I most recently saw a pain specialist in Laredo, TX; he is very nice, very competent,
and has very good credentials. He thought I might have RSD (now called the Complex
Regional Pain Syndrome instead of Reflex sympathetic dystrophy), but said I only have
some of the symptoms, not all of them. Anyway, I went down a second time and he did
a sympathetic nerve block in the hospital; then, he inserted a catheter in my back, and I
went to his office 3 days in a row for injections into the catheter to try to numb the
sympathetic nerves. Well, the upshot is, it didn't work. So, he says that pretty much
rules out that its the small, sympathetic nerves causing my pain, and it is the larger
nerves (posterior tibial). He said I could get an implant that would stimuate the nerve,
and it works on the larger nerves, not just the small ones that the nerve block work on.
He said a dr. in South Carolina is more expert than he is at that, and he would refer me.

But, I decided to hold off on any more procedures for a while. So, he put me on very
strong narcotic meds, which have helped a lot,but I still can't complete a trip to the
grocery store, or walk around the block (I tried to walk for 5 minutes on Sat., after 2.5
minutes, my feet were killing me, and this was with the drugs!). so, I think I will need a
stronger dose, and there are risks with that, of course. He says I can take the drugs for
life if needed and if they help. I don't know if I want to do that, but if I can get more
relief than I have now, I guess I would do it.

So, if you would like any more info. on the drs. I have seen, or ask any questions, please
e-mail me. It sounds like we have a very similar problem. I agree with the others that
you need to see an ortho. that specializes in foot and ankle. Maybe 2 or 3 of them, then
decide. I know how awful this is, believe me. My prayers are with you, and all of us!
Love, Cindy