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What I am wondering?

Posted by cindyp on 7/06/00 at 15:20 (022912)

Over this long term of my illness I have started to wonder. Was this originally pf and because of lack of treatment turned into a severe neuroma? Or is something else going on that is the underlying cause of this neuroma?

Re: What I am wondering?

Laurie R on 7/06/00 at 16:00 (022915)

Hi Cindy,
Were you first diagnosed with PF? Did a doctor tell you do not have PF? I am sure you can have both . Did you ever find out if you can move your appointment up with the pain clinic? I hope they will help you. I feel for you and I do understand the pain......

I have been doing so well for the last 3 weeks and I walked around the mall the other day and now my foot went from a 3 to about a 20+ so my husband made me call my Pod today and I am going in to get a shot to numb my foot today ,the shot will only last 8 to 12 hours but it is worth it to me because at this point I can't stand this pain. It really upsets me because I have been doing so well. But thats what this is all about and I know you all understand.

My very best to you Cindy.......Laurie R


Re: What I am wondering?

cindyp on 7/06/00 at 17:30 (022926)

Well seven years ago i got the pf diagnosis. Went through the physical therapy route and it worked but at the end i remember one small area of pain in my foot. I also remember at that time a click when I pressed on that area. So maybe I have had this all along and was misdiagnosed. Have to wait on the pain clinic as it is through v.a. and they pretty much make you wait.

Re: What I am wondering?

john h on 7/06/00 at 18:46 (022930)

laurie: have you ever had a cortisone shot for PF? i know that some people are dead set against them but i have found them helpful in my ongoing approach to recovery. i did not find them that painful (from side) . they are by nearly all doctors standards an accepted method of treatment and in some cases work wonders.

Re: What I am wondering?

cindyp on 7/06/00 at 19:28 (022934)

The reason I was wondering about this is because every doctor I have talked to has NEVER heard of a neuroma in my heel. It is on my lateral plantar nerve. None of them has ever heard of one being there. So I am just wondering is could this have been caused by some underlying problem yet to be discovered? I have searched my memory and do not remember any specific injury so ?

Re: What I am wondering?

Laurie R on 7/06/00 at 19:44 (022937)

Hi john,
When I first got the shots months back the first 2 were cortisone and they did not help me at all.I know alot of people are against them but I figured that I better try them just in case they were going to be the thing that was going to work,I was so sad when they didn't help than my therapist said some times it can take up to 2 weeks before the cortisone would help well 2 weeks went by and still nothing.

I just got back from my pod ,I had to go in to get a shot to nimb my foot and boy is it numb ,he gave to me different today because of all the pain I have been in,it was in the TTS area and also just on top of the TTS area.The bad pain is gone right now my foot is very numb and hot and it should last about 8 to 9 hours.

My best to you John......Laurie R


Re: What I am wondering?

Dr. Zuckerman on 7/06/00 at 19:49 (022938)

There is article in the APMA journal. It was written by a Dr. Murray Davidson. He is the inventor of the tuli cup if you have ever heard of this heel cup device, anyway he was a big believer in the heel neuroma. The diagnostic sign was called the heel cord sign. You rolled your fingers from side to side and in the area and it felt like a 'lamp cord'. I have never myself removed a neuroma from the heel in my over twenty years of practice or saw one removed. I was talking to a podiatric colleague the past few weeks and he told me he removed his first heel neuroma via the Davidson diagnosis. I guess if you don't look for the neuroma it won't be there and it you do you always look for the neuroma it is always there. If you can find a spot that is painful, then an injection with either a steriod or alchol sclerosing solution could either help or diagnosis the heel neuroma if the pain went away for any length of time. If the pain did get away and the area was very local I would then do an excision thru the plantar surface of the heel with a transverse incision and have the patient non-weight bearing with a cast.

Re: What I am wondering?

cindyp on 7/06/00 at 20:33 (022944)

'diagnosis the heel neuroma if the pain went away for any length of time. If the pain did get away and the area was very local' The pain has never went away, it's always been there. Can you pretty please find that article. All the doctors I have seen have said the same mantra no it could cause more scar tissue because it is between so many muscles. If we just sever the nerve it could leave a bigger neuroma that already there. It's almost a half an inch don't see how that can be bigger. They have assured me it won't grow. But cannot explain why the pain is steadily worsening or what has caused this. That is what is worrying me. Is something else going on I don't know about and should?

Re: To Dr. Zuckerman re: What I am wondering?

Walt on 7/07/00 at 08:15 (022958)

Dr. Zuckerman,
From former postings, I think Cindy has been told that her neuroma
is inoperatable. From what you are saying this option may be possible for her. Could you clarify that. What are her pro's and
cons. If her local Drs do not do this surgery, what do you think
of her contacting a large major medical center neurology dept.

Re: To Dr. Zuckerman re: What I am wondering?

Dr. Zuckerman on 7/07/00 at 11:15 (022981)

think that if the area can be localized and there is some relief from a steriod or alchol sclerotic solution then surgery is the option.
Risks.

Infection,
Scar.
Failure. The doc screws the foot up by cutting wrong nerve or cutting muscles and tendons. Or there is more damage to the nerve for example its the entire lateral plantar nerve and not just a branch. Then I wouldn't operative on the foot.



Re: To Dr. Zuckerman re: What I am wondering?

cindyp on 7/07/00 at 12:13 (022984)

Okay so setting here reading my records again I see that my diagnosis says 1.2cm hypointense mass along the lateral plantar nerve? I(could be wrong here) am taking it to mean that a bigger than usual portion of the nerve is involved. I looked at my mri slides. There are views of both the left and right foot(the right one is the one with the neuroma). The same kind of picture on both the left and right foot just don't look the same at all. The right one looks totally different than the left with lots of darkness and shadow. Course I am not a radiologist so? There was at one time discussion about shots of cortizone. I said no. The ortho said good because I cannot tell where to give the injection because this is between a lot of different muscles? That is what made me wonder about why this happened where it did and it seems to be uncommon? But the thing that bugs me most is that now I have to learn to live this way. There is a lot of swelling on the bottom of my foot in the heel area or just above it. Looks like grape sometimes and a softball at others. No mention of what to do about that. They want to leave me this way. Then if I go to the pain clinic and they start with needles how are they going to know where to put the shots?

Re: What I am wondering?

Laurie R on 7/06/00 at 16:00 (022915)

Hi Cindy,
Were you first diagnosed with PF? Did a doctor tell you do not have PF? I am sure you can have both . Did you ever find out if you can move your appointment up with the pain clinic? I hope they will help you. I feel for you and I do understand the pain......

I have been doing so well for the last 3 weeks and I walked around the mall the other day and now my foot went from a 3 to about a 20+ so my husband made me call my Pod today and I am going in to get a shot to numb my foot today ,the shot will only last 8 to 12 hours but it is worth it to me because at this point I can't stand this pain. It really upsets me because I have been doing so well. But thats what this is all about and I know you all understand.

My very best to you Cindy.......Laurie R


Re: What I am wondering?

cindyp on 7/06/00 at 17:30 (022926)

Well seven years ago i got the pf diagnosis. Went through the physical therapy route and it worked but at the end i remember one small area of pain in my foot. I also remember at that time a click when I pressed on that area. So maybe I have had this all along and was misdiagnosed. Have to wait on the pain clinic as it is through v.a. and they pretty much make you wait.

Re: What I am wondering?

john h on 7/06/00 at 18:46 (022930)

laurie: have you ever had a cortisone shot for PF? i know that some people are dead set against them but i have found them helpful in my ongoing approach to recovery. i did not find them that painful (from side) . they are by nearly all doctors standards an accepted method of treatment and in some cases work wonders.

Re: What I am wondering?

cindyp on 7/06/00 at 19:28 (022934)

The reason I was wondering about this is because every doctor I have talked to has NEVER heard of a neuroma in my heel. It is on my lateral plantar nerve. None of them has ever heard of one being there. So I am just wondering is could this have been caused by some underlying problem yet to be discovered? I have searched my memory and do not remember any specific injury so ?

Re: What I am wondering?

Laurie R on 7/06/00 at 19:44 (022937)

Hi john,
When I first got the shots months back the first 2 were cortisone and they did not help me at all.I know alot of people are against them but I figured that I better try them just in case they were going to be the thing that was going to work,I was so sad when they didn't help than my therapist said some times it can take up to 2 weeks before the cortisone would help well 2 weeks went by and still nothing.

I just got back from my pod ,I had to go in to get a shot to nimb my foot and boy is it numb ,he gave to me different today because of all the pain I have been in,it was in the TTS area and also just on top of the TTS area.The bad pain is gone right now my foot is very numb and hot and it should last about 8 to 9 hours.

My best to you John......Laurie R


Re: What I am wondering?

Dr. Zuckerman on 7/06/00 at 19:49 (022938)

There is article in the APMA journal. It was written by a Dr. Murray Davidson. He is the inventor of the tuli cup if you have ever heard of this heel cup device, anyway he was a big believer in the heel neuroma. The diagnostic sign was called the heel cord sign. You rolled your fingers from side to side and in the area and it felt like a 'lamp cord'. I have never myself removed a neuroma from the heel in my over twenty years of practice or saw one removed. I was talking to a podiatric colleague the past few weeks and he told me he removed his first heel neuroma via the Davidson diagnosis. I guess if you don't look for the neuroma it won't be there and it you do you always look for the neuroma it is always there. If you can find a spot that is painful, then an injection with either a steriod or alchol sclerosing solution could either help or diagnosis the heel neuroma if the pain went away for any length of time. If the pain did get away and the area was very local I would then do an excision thru the plantar surface of the heel with a transverse incision and have the patient non-weight bearing with a cast.

Re: What I am wondering?

cindyp on 7/06/00 at 20:33 (022944)

'diagnosis the heel neuroma if the pain went away for any length of time. If the pain did get away and the area was very local' The pain has never went away, it's always been there. Can you pretty please find that article. All the doctors I have seen have said the same mantra no it could cause more scar tissue because it is between so many muscles. If we just sever the nerve it could leave a bigger neuroma that already there. It's almost a half an inch don't see how that can be bigger. They have assured me it won't grow. But cannot explain why the pain is steadily worsening or what has caused this. That is what is worrying me. Is something else going on I don't know about and should?

Re: To Dr. Zuckerman re: What I am wondering?

Walt on 7/07/00 at 08:15 (022958)

Dr. Zuckerman,
From former postings, I think Cindy has been told that her neuroma
is inoperatable. From what you are saying this option may be possible for her. Could you clarify that. What are her pro's and
cons. If her local Drs do not do this surgery, what do you think
of her contacting a large major medical center neurology dept.

Re: To Dr. Zuckerman re: What I am wondering?

Dr. Zuckerman on 7/07/00 at 11:15 (022981)

think that if the area can be localized and there is some relief from a steriod or alchol sclerotic solution then surgery is the option.
Risks.

Infection,
Scar.
Failure. The doc screws the foot up by cutting wrong nerve or cutting muscles and tendons. Or there is more damage to the nerve for example its the entire lateral plantar nerve and not just a branch. Then I wouldn't operative on the foot.



Re: To Dr. Zuckerman re: What I am wondering?

cindyp on 7/07/00 at 12:13 (022984)

Okay so setting here reading my records again I see that my diagnosis says 1.2cm hypointense mass along the lateral plantar nerve? I(could be wrong here) am taking it to mean that a bigger than usual portion of the nerve is involved. I looked at my mri slides. There are views of both the left and right foot(the right one is the one with the neuroma). The same kind of picture on both the left and right foot just don't look the same at all. The right one looks totally different than the left with lots of darkness and shadow. Course I am not a radiologist so? There was at one time discussion about shots of cortizone. I said no. The ortho said good because I cannot tell where to give the injection because this is between a lot of different muscles? That is what made me wonder about why this happened where it did and it seems to be uncommon? But the thing that bugs me most is that now I have to learn to live this way. There is a lot of swelling on the bottom of my foot in the heel area or just above it. Looks like grape sometimes and a softball at others. No mention of what to do about that. They want to leave me this way. Then if I go to the pain clinic and they start with needles how are they going to know where to put the shots?