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To Dr. Zuckerman from your future patient?

Posted by Judy G. on 5/15/01 at 14:24 (047822)

Dr. Zuckerman,
I spoke with you once before on the message board and I thank you for valuable time and your reply. I hope you will respond to me once again.

An MRI confirms that I have tenosynovitis of the flexor hallucis longus tendon. There is also increased signal intensity along the most medial aspect of the insertion of the plantar fascia adjacent to the calcaneus.

I originally was treated for plantar fasciatis. The stretching, cortizone, shot to the heel, deep tissue massage,& ultra sound are some of the treatments I have been through. Some of these treatments set me back quite severely.

Over the last two months I have had some discoration of the foot from the mid arch and out over the toes. Upon receiving your advice, I saw a pain specialist and a neurologist. A neve conduction test showed good response of the tree major nerve brances. Some of the smaller nerve branches which feed into the injury site were a little less responsive than normal. All in all, concern about possible reflex sympathetic dystrophy has been pretty much ruled out by way of novacaine shots into the major nerve branchs. ( The discoloration did not improve.) The foot is still dicolored when I first get up from reclining for a period of time and all the blood runs into it. After I've been sitting for a while it goes away almost completely. The color is completely normal when I first wake up in the morning. When it is discolored it also appears and feels puffy. Ice and elevation consistanly will return it to normal. RSD does'nt behave like that...I don't think. ?????

At this point my doctor and I believe that all the rest in the world is not going to change this condition. This condition has persisted for nine months. I've done very little walking for at least three of those nine months and I've been on crutches for the last two, with no sign of improvement. I do not walk at all because if I do there is severe burning. My doctor thinks we should try another cortisone shot ... this time directing it into the area of the injury. Do you think this could help or at this point could it make matters worse?

Also my doctor mentioned the possible need for surgery and suggested we try to find a docter who has treated conditon on a more regular basis. He said it wis a common dance injury. I was wondering if you have treated many cases of tenosynovitis similar to mine? If so, I would be more than willing to fly out for treatment. If you don't think you'd be the right docter for this particular problem, do you have any suggestions as to where I might go?

Also, what do you think about trying the cortisone again and what are your thoughts about the discoloration?

P.S.(Sorry for the long message, but I wanted you to have at least some of my history. I have no idea where to go from here and I'm just sitting on crutches with no light at the end of the tunnel.)

Most Respectfully,
Judy G. (your future patient?)

Re: To Dr. Zuckerman from your future patient?

Laurie R on 5/15/01 at 17:08 (047834)

Hi judy, I'm not a doctor and I know you were asking Dr.Z for his advice. But I wanted to let you know that I also have the same thing as you. I started out with PF and then it went into tenosynivitis in the FHLT .I had a tenogram to confrim this. I also had an MRI. My Pod like your wants me to see a specialist that deals with this more then he does. I have waited over four months for this appointment to get approved by my WC insurance company. My appointment is nest Monday the 21th of May.

I'm not a dancer and I have been told that dancers get this.

If you would like to talk please e-mail me anytime. angels1108@msn.com
My very best to you Judy.Laurie R

Re: To Dr. Zuckerman from your future patient?

wendyn on 5/15/01 at 17:52 (047837)

Judy - I'm not a doctor...but your foot discoloration sounds similar to what I sometimes get. Always fine in the morning...sometimes by night it's purple and puffy and hot.

My orthepedic surgeon told me in very non medical terms that those symptoms were consistent with a 'pissed off nerve'.

Actually - I haven't had this for some time now come to think of it, as my pain went down - so did the weird colors....

Re: To Dr. Zuckerman from your future patient?

Dr. Zuckerman on 5/15/01 at 17:57 (047839)

Hi,

Where do you live. Have they rules out a tear of the Flexor hallucis longus tendon?? E-mail at footcare@home.com so we can talk some more about your foot. If I can't help you I will find someone in your area that can

Re: To Dr. Zuckerman from your future patient?

Laurie R on 5/15/01 at 17:08 (047834)

Hi judy, I'm not a doctor and I know you were asking Dr.Z for his advice. But I wanted to let you know that I also have the same thing as you. I started out with PF and then it went into tenosynivitis in the FHLT .I had a tenogram to confrim this. I also had an MRI. My Pod like your wants me to see a specialist that deals with this more then he does. I have waited over four months for this appointment to get approved by my WC insurance company. My appointment is nest Monday the 21th of May.

I'm not a dancer and I have been told that dancers get this.

If you would like to talk please e-mail me anytime. angels1108@msn.com
My very best to you Judy.Laurie R

Re: To Dr. Zuckerman from your future patient?

wendyn on 5/15/01 at 17:52 (047837)

Judy - I'm not a doctor...but your foot discoloration sounds similar to what I sometimes get. Always fine in the morning...sometimes by night it's purple and puffy and hot.

My orthepedic surgeon told me in very non medical terms that those symptoms were consistent with a 'pissed off nerve'.

Actually - I haven't had this for some time now come to think of it, as my pain went down - so did the weird colors....

Re: To Dr. Zuckerman from your future patient?

Dr. Zuckerman on 5/15/01 at 17:57 (047839)

Hi,

Where do you live. Have they rules out a tear of the Flexor hallucis longus tendon?? E-mail at footcare@home.com so we can talk some more about your foot. If I can't help you I will find someone in your area that can