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Questions from a lurker

Posted by Jean S. on 8/27/00 at 11:14 (026335)

Hi all. I was up for hours last night reading a long backlog of postings on this board. I found some answers, but found myself with a number of unanswered questions, so... may I?

A brief summary of my history is that about two years ago, I developed pain in my right heel after initiating a walking program in which I progressed from half a mile to two miles over about six week. The pain was diagnosed as p.f. I was given the usual self help advice, and a pat on the back, told the pain would probably go away, but if it didn't, orthotics and/or surgery *might* or might not help... not too encouraging. The pain subsided to a bearable level, but never really went away. Meanwhile, I developed sciatic nerve pain radiating down my LEFT leg and into my foot, for which I received some physical therapy, consisting primarily of learning abdominal and back strengthening exercises. The physical therapist also taught me self massage techniques to help my p.f. The exercises brought a gradual return to sciatic pain-free living. However, I got way too busy in my life and stopped doing the exercises or the massage religiously (or at all) for several months, and of course, the sciatic pain came back and the p.f. got worse.

Then I did a really stupid thing: I had a couple of vacation days where I didn't need to leave my home, and so I never bothered to put my shoes on (Saucony Jazz 3000 running shoes with full length Spenco inserts, which had provided considerable pain relief from flare-ups in the past, and no doubt, worked daily to prevent recurrences.) My foot did not hurt during the two days I went barefoot, but I woke the morning of the third day and needed crutches! I had to sleep in my shoes for the next five days, because if I had to get up during the night, I couldn't walk the few paces to the bathroom without them (and was too groggy to put them on then). After a week or so, my p.f. pain had mostly subsided to the bearable level it had been at before the barefoot episode.

Then, after a normal day or two, in a store, I noticed some comfy looking Dr. Scholl gel inserts for the heel. I put them in my running shoes on top of the Spenco inserts. BAD MOVE! (And BTW, no, I don't actually run, or even do aerobic walking anymore). After an hour or two, I decided they were doing more harm than good and took them out. The next morning (yesterday) I woke with numbness along the side of my foot on the bottom on the baby toe side, including the baby toe itself. I still have my p.f. heel pain, but the sole of my foot is not painful. This numbness does not improve with lying down, and in fact, seemed worse this morning.

This morning, as I explored further, I realized that the line of numbness runs around the back of my heel, and up the outisde of my lower leg at least to the knee and then up to my lower back, following the general path of the sciatic nerve (this is not the side where I normally have sciatic nerve pain).

I am considerably overweight, 45 years old, and was just treated with radioactive iodine (four weeks ago) for an OVERACTIVE thyroid. I am hypertensive (on betablockers, which control it), and my blood sugar runs on the high side of normal, but I am not diabetic. I have some benign nerve tumors buried deep in the muscle tissue of my upper thighs (runs in my famiy), but they haven't caused trouble in the past and haven't shown any signs of increasing in size recently. Spinal stenosis (narrowing of the spinal canal) runs in my family. So you see, I have a lot of factors that could be causing/contributing to this recent numbness. For what it's worth (and it's a lot, I know!), I don't have foot drop, or signs of bowel or bladder weakness that might indicate that those nerves are affected.

I realize this is a lot to try to take in at once, but I would be grateful if some of you long-timers could read through this and tell me if it rings any bells. I don't know whether to take this numbness problem to a chiropracter, a back doctor, my podiatrist (whom I'm not nuts about), an orthopedic surgeon, or a neurologist. I have great insurance that will cover pretty much any or all of them: any thoughts?

I was surprised not to see more mention made of chiropractic in these posts. Does that mean you all have tried them and they don't help? Or is the general thinking that they aren't likely to do much good? If I do have a pinched nerve in my back, is it naive to think they would be able to resolve that? Has anyone found that chiropractic makes things worse, either in the short term (before a subsequent improvement), or in the long run? Have chiropracters used techniques other than spinal manipulations or adjustments, such as electro therapy, magnetic therapy, or ultrasound? With any success?

What about weight loss? I am surprised that I haven't read much on the subject.... surely I'm not the only one whose foot pain is complicated by carrying around too many pounds? How much weight does a person have to lose for there to be a noticeable improvement in foot pain or numbness? (I guess I'm hoping someone will tell me that they noticed improvement after only a 10 pound loss... when you have a lot to lose, it is discouraging to contemplate the whole problem at once!

Someone on this board spoke of a yeast diet that was primarily protein: that sounds a lot like Atkins. I find that I feel the best on Atkins, not hungry, more alert, more energy, etc... What have others found effective for weight loss and feeling good in the process? I know that whatever diet I use, most of my borderline health problems are certain to improve if I can manage to lose a significant amount of weight. But it is harder to lose weight if I can't walk, which has always been my preferred means of aerobic exercise. I'm not a swimmer. I've ordered one of those Chuck Norris Total Gym things--has anyone else tried that?

Thanks for your patience in reading through this...

Jean S.


Re: Questions from a lurker

Nancy S. on 8/27/00 at 11:43 (026338)

Hi Jean, welcome! That is a lot to take in, but no problem -- the more info. you give, the more helpful responses you should get.
I can't speak to your numbness, because I've not had that (I've had bad PF in left foot, and now am dealing with a few versions of tendonitis in both feet).
But: As it sounds like you learned, don't go barefoot. Your feet need support at all times. And if you're not crazy about your podiatrist, definitely move on. To me it sounds as though you could use the attention of both an orthopedic dr. and a neurologist, but I'll leave it to others to advise you better on this.
Re: weight: I am one who went on the yeast-killing diet (at the end of December), and it has made a huge difference to me, and I believe also to the PF. Before PF, I could've stood to lose 10-15 pounds; then I gained more due to inactivity. On the yeast-killing diet, I lost 30 pounds, and I know that helped my PF, which is much much better since (I also attribute the progress to rest, Birkenstocks, night splint). I did a strict version for somewhere between 2 and 3 months, and it was not hard for me, because I had so many goals besides weight loss -- my feet, my brain, my energy level, all needed help. So I was highly motivated. That diet is similar to Atkins, in that you restrict carbohydrates -- there are other factors too -- but the bottom line is that I no longer eat sugar or bread. And the weight has stayed off, and I feel a million times better in other ways. I would really encourage you to commit to something along these lines -- it WILL help your physical problems.
As for your numbness, and nerve problems, others here will no doubt jump in with advice and suggestions. Best of luck to you, Jean, and ask any questions you want. There are a lot of knowledgeable and helpful people on this board -- good spirits!
Nancy

Re: Questions from a lurker

john h on 8/27/00 at 11:53 (026341)

having a bad back myself, i would suggest you see a spine specialist especially with a history of spinal stenosis in your family.

Re: Questions from a lurker

Beverly on 8/27/00 at 13:49 (026355)

Jean,

I feel for you, because I know how frustrating it is to have multiple diagnosises and not know which is contributing to which.

When I don't know what type of specialist to go to, I go to my internist first. A specialist in internal medicine has extra training in diagnosising. That's what they do. I often use my internist to get a referral to a specialist when I don't know which direction to take.

I gave up on family practioners about two years ago. It's not that they are not good doctors, but I decided I'd had enough bad luck with my health that I wanted someone more trained as my first line of defense.
I asked my GYN for his top three favorite internists, and I went from there. The reason I asked my GYN is that I think very well of him, like him, trust him, know he is well reguarded in his field, and so I concluded he would give me a good referral.

Whatever you learn, that barefooted business is bad news. Sounds like you've already learned that. I keep shoes by my bed at night for going to the bathroom. After awhile, putting on those shoes before letting the tootsies hit the ground becomes second nature.

Weight loss is important for PF. With all the other problems you have,
I would suggest that you talk to your doctor about the diet that would be right for you. With hypertension, the Dr. Atkins or yeast-killing diet, could be harmful.
I am allergic to yeast and sugar and so I follow a yeast-free diet.
However, mine is a modified one. I eat fruit for instance. I could not always eat that, but I do now.

I have tried many diets, and Weight Watchers has seemed the most sensible. I liked it, lost weight, and you gets lots of support.
My suggestion is to ask your doctor about a diet that would be healthy for you. If he likes Weight Watchers, you get the added support benefit. If you don't like group meetings, there is a do-it-yourself version with online support/chat.

Good Luck,
Beverly


Re: Questions from a lurker

salina on 8/27/00 at 15:08 (026384)

Hi, I don't believe that being an overweight person is the cause of getting PF. But for me, i maintained the same weight pretty much throughout adulthood, until I had back to back pregnancies, and gained a whole lot of weight over a short amount of time. I think it was the quickness of the weight gain, and at the same time was unable to do much activity at all. Then I started a bigtime walking program, and within a week, couldn't walk hardly at all. that was nine months ago. At this point, I am really trying to lose weight also, so if you find something that works let me know. I am interested in starting one of the high protein diets also. I feel sluggish a lot of the time, and when I look at our meals we are really packing in the carbs way too much. I got gestational diabetes with my last two pregnancies, and the doc said to watch my weight afterwards, or I could end up with type 2 or B (get confused) diabetes. The kind you get in adulthood from gaining weight. So I am really considering looking into the new low carb diets. I am not seeing an actual chiropractor, but have had a few back and neck manipulations from some military doctor. I have developed neck and shoulder aches and pains along with this PF stuff, and have also had low back pain all my adult life. i used to never go to a doctor, just suffered through back pain. I wish now that I had taken better care of myself back then. I think I am payng the price now with more and more problems. At least you have good insurance. Just keep going to the docs and get answers to your questions.
If you get the total gym, post about it here on the board. i was checking it out too, because with PF it is hard to do anything to stay in shape or lose weight. The total gym seems to have quite a few exercises that may not aggrevate the PF problem.
Keep posting and reading. i hope you find what works for you.

Re: Questions from a lurker

Jean S. on 8/29/00 at 19:25 (026660)

Nancy,

Thanks for your reply. I agree with your comments on the low carb diet (especially wrt to breads and sugar). I feel 100% better when I avoid these... at least after the first three days of withdrawal subsides!

What on earth is a Birkenstock? And where do you get them? Do they have a website?

Thanks, Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:27 (026661)

Hi John,

I have been seeing a doctor at the Texas Back Institue for sciatic pain. Hopefully, he can point me in the right direction about the incipient stenosis. I will opt for surgery sooner rather than later for that, since I have seen the effects of having and not having it, and I think it is worth the risk.

Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:30 (026662)

Hi Beverly,

Thanks very much for your kind comments. One question, though... why would Atkins diet be bad for hypertension? Seems like if it was effective, the hypertension would tend to improve? I agree with you about internists, and I've been fortunate enough to find a pretty good one. There is a Weight Watchers clinic near me... I will check them out.

Thanks,
Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:33 (026663)

Hi Salina,

Thanks for your reply. My weight history and history of low back problems are similar to yours. Somehow, it is helpful just knowing I'm not alone with these frustrations! I will let you know about the Total Gym, but it hasn't arrived yet. They said it can take up to 4 weeks.

Jean S.


Re: Questions from a lurker

Nancy S. on 8/27/00 at 11:43 (026338)

Hi Jean, welcome! That is a lot to take in, but no problem -- the more info. you give, the more helpful responses you should get.
I can't speak to your numbness, because I've not had that (I've had bad PF in left foot, and now am dealing with a few versions of tendonitis in both feet).
But: As it sounds like you learned, don't go barefoot. Your feet need support at all times. And if you're not crazy about your podiatrist, definitely move on. To me it sounds as though you could use the attention of both an orthopedic dr. and a neurologist, but I'll leave it to others to advise you better on this.
Re: weight: I am one who went on the yeast-killing diet (at the end of December), and it has made a huge difference to me, and I believe also to the PF. Before PF, I could've stood to lose 10-15 pounds; then I gained more due to inactivity. On the yeast-killing diet, I lost 30 pounds, and I know that helped my PF, which is much much better since (I also attribute the progress to rest, Birkenstocks, night splint). I did a strict version for somewhere between 2 and 3 months, and it was not hard for me, because I had so many goals besides weight loss -- my feet, my brain, my energy level, all needed help. So I was highly motivated. That diet is similar to Atkins, in that you restrict carbohydrates -- there are other factors too -- but the bottom line is that I no longer eat sugar or bread. And the weight has stayed off, and I feel a million times better in other ways. I would really encourage you to commit to something along these lines -- it WILL help your physical problems.
As for your numbness, and nerve problems, others here will no doubt jump in with advice and suggestions. Best of luck to you, Jean, and ask any questions you want. There are a lot of knowledgeable and helpful people on this board -- good spirits!
Nancy

Re: Questions from a lurker

john h on 8/27/00 at 11:53 (026341)

having a bad back myself, i would suggest you see a spine specialist especially with a history of spinal stenosis in your family.

Re: Questions from a lurker

Beverly on 8/27/00 at 13:49 (026355)

Jean,

I feel for you, because I know how frustrating it is to have multiple diagnosises and not know which is contributing to which.

When I don't know what type of specialist to go to, I go to my internist first. A specialist in internal medicine has extra training in diagnosising. That's what they do. I often use my internist to get a referral to a specialist when I don't know which direction to take.

I gave up on family practioners about two years ago. It's not that they are not good doctors, but I decided I'd had enough bad luck with my health that I wanted someone more trained as my first line of defense.
I asked my GYN for his top three favorite internists, and I went from there. The reason I asked my GYN is that I think very well of him, like him, trust him, know he is well reguarded in his field, and so I concluded he would give me a good referral.

Whatever you learn, that barefooted business is bad news. Sounds like you've already learned that. I keep shoes by my bed at night for going to the bathroom. After awhile, putting on those shoes before letting the tootsies hit the ground becomes second nature.

Weight loss is important for PF. With all the other problems you have,
I would suggest that you talk to your doctor about the diet that would be right for you. With hypertension, the Dr. Atkins or yeast-killing diet, could be harmful.
I am allergic to yeast and sugar and so I follow a yeast-free diet.
However, mine is a modified one. I eat fruit for instance. I could not always eat that, but I do now.

I have tried many diets, and Weight Watchers has seemed the most sensible. I liked it, lost weight, and you gets lots of support.
My suggestion is to ask your doctor about a diet that would be healthy for you. If he likes Weight Watchers, you get the added support benefit. If you don't like group meetings, there is a do-it-yourself version with online support/chat.

Good Luck,
Beverly


Re: Questions from a lurker

salina on 8/27/00 at 15:08 (026384)

Hi, I don't believe that being an overweight person is the cause of getting PF. But for me, i maintained the same weight pretty much throughout adulthood, until I had back to back pregnancies, and gained a whole lot of weight over a short amount of time. I think it was the quickness of the weight gain, and at the same time was unable to do much activity at all. Then I started a bigtime walking program, and within a week, couldn't walk hardly at all. that was nine months ago. At this point, I am really trying to lose weight also, so if you find something that works let me know. I am interested in starting one of the high protein diets also. I feel sluggish a lot of the time, and when I look at our meals we are really packing in the carbs way too much. I got gestational diabetes with my last two pregnancies, and the doc said to watch my weight afterwards, or I could end up with type 2 or B (get confused) diabetes. The kind you get in adulthood from gaining weight. So I am really considering looking into the new low carb diets. I am not seeing an actual chiropractor, but have had a few back and neck manipulations from some military doctor. I have developed neck and shoulder aches and pains along with this PF stuff, and have also had low back pain all my adult life. i used to never go to a doctor, just suffered through back pain. I wish now that I had taken better care of myself back then. I think I am payng the price now with more and more problems. At least you have good insurance. Just keep going to the docs and get answers to your questions.
If you get the total gym, post about it here on the board. i was checking it out too, because with PF it is hard to do anything to stay in shape or lose weight. The total gym seems to have quite a few exercises that may not aggrevate the PF problem.
Keep posting and reading. i hope you find what works for you.

Re: Questions from a lurker

Jean S. on 8/29/00 at 19:25 (026660)

Nancy,

Thanks for your reply. I agree with your comments on the low carb diet (especially wrt to breads and sugar). I feel 100% better when I avoid these... at least after the first three days of withdrawal subsides!

What on earth is a Birkenstock? And where do you get them? Do they have a website?

Thanks, Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:27 (026661)

Hi John,

I have been seeing a doctor at the Texas Back Institue for sciatic pain. Hopefully, he can point me in the right direction about the incipient stenosis. I will opt for surgery sooner rather than later for that, since I have seen the effects of having and not having it, and I think it is worth the risk.

Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:30 (026662)

Hi Beverly,

Thanks very much for your kind comments. One question, though... why would Atkins diet be bad for hypertension? Seems like if it was effective, the hypertension would tend to improve? I agree with you about internists, and I've been fortunate enough to find a pretty good one. There is a Weight Watchers clinic near me... I will check them out.

Thanks,
Jean S.


Re: Questions from a lurker

Jean S. on 8/29/00 at 19:33 (026663)

Hi Salina,

Thanks for your reply. My weight history and history of low back problems are similar to yours. Somehow, it is helpful just knowing I'm not alone with these frustrations! I will let you know about the Total Gym, but it hasn't arrived yet. They said it can take up to 4 weeks.

Jean S.