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having PF surgery, but I'm confused

Posted by cindy on 6/25/01 at hrmin (051451)

I have a heel spur. My first Doc I have been seeing since Nov., says I need surgery, I agree since other options are not working.
I have my own small business, that requires that I stand 9 hours a day. While I recover I can close for 5 or 6 days max. then work
6 hour days leaning on a stool for the following week. My first Doctor makes it sound like I will be back to work in a shorter period
of time, but I am scared he is being optimistic. Can you PLEASE tell me if you see anything about these two procedures that send up a caution flag. Neither doc is using the scope, and neither one want to remove the spur.
#1.First Doctor, In the hospital, with anesthesia about 10 minute procedure ,incision on the bottom of foot @ 3 stitches.
I need to be off my feet for 72 hours. Then just don't over do it. He may have more directions but it is hard to get info from him that is why I went to the second doctor.
#2. Second Doc. says in office procedure (he has a sterile room), no anesthesia, incision where the heel meets the inside, side of the foot, appears to be a bit longer incision,Very little walking for 2 days, I need to take in very easy for 10 to 12 days, and I cannot drive until the stitches are out (it's my right foot) about 2 weeks. In this doc. defense he was going to do the procedure in his office to save me the $1000.00 that the hospital will charge, (I don't have health insurance). If this is not the kind of thing that should be done in office or with me awake, I don't mind paying the extra money. It's just that this doc. says I need more serious recoup. time Help which makes the most sense. Thank You, Cindy

Re: to Cindy - think again

Julie on 6/25/01 at 03:05 (051453)

Hi Cindy

I'm not a doctor, but I'm in England, where it's morning, so I'm awake to see and respond,to your post. Welcome to heelspurs.com.

There are several things about your post that worry me. What kind of doctor have you been seeing, and what options have been tried? Perhaps you really have tried everything, but you don't say, so I'm assuming otherwise. There are many conservative treatments for plantar fasciitis, and surgery should be considered as a last resort. You'll find a great deal of information about them on this site, especially in the heel pain book - click on it right here or at the top of the page. When all other treatments have been tried and have failed, there is still ESWT (Electronic Shock Wave Treatment) to be considered before surgery - it's a non-invasive procedure that has been successful in a great many cases.

As for surgery and recovery, I think both your doctors are being extremely optimistic. If you read recent posts from people who have had surgery, you will find that recovery from most procedures, for most people, is a long process: months rather than weeks, and certainly not days. I seriously doubt that you would be able to return to your work in either of the time-scales that the two doctors have predicted for you. (I say this not from personal experience but from long acquaintance with these message boards.) And surgery, as I'm sure you're aware, is not without risk and complications.

If you do eventually decide to have surgery, you will need to make alternative arrangements for your work to be covered while you recover - training and paying someone to keep things going for as long as it takes. This is particularly important in your case, as it is your own business that is at stake. Don't assume that you will be able to carry on as normal after a three-day or ten-day post-surgery rest. If you try, you will only delay your recovery and possibly let yourself in for long-term problems.

So given your circumstances, and assuming that you haven't yet really tried all the conservative measures, I would advise you to think very carefully before agreeing to surgery. At this point, I would suggest you find a good podiatrist or sports medicine doctor who specializes in feet and ankles and who will work with you on a comprehensive treatment programme. Read the heel pain book, and read these message boards: you will get a lot of help and support here.

Rest is the first line of treatment for plantar fasciitis, so see if it is possible for you to cut down on the hours you have to stand at work (this has probably been a contributory cause of your pain). Taping, which supports the arch, helps many people; icing to reduce inflammation can be useful; appropriate stretching - but go carefully avoid anything that causes more pain. Wear good quality, supportive footwear always. Never go barefoot. You may need orthotics to correct any biomechanical faults.

I think you get the idea. There is lots you can to to help yourself before going for the knife, and whatever you decide, you'll find heelspurs.com a great help, as I and so many others have.

All the best

Julie

Re: re: think again

cindy on 6/25/01 at hrmin (051469)

I did not elaborate on what I had tried to be considerate of the Doctors' time that answer this board. I have $300.00 orthotics, Celebrex at $130.00 per 30 capsules, I ice for immediate relief (helps little for @ an hour an a half), Tape doesn't stop the little man with the knife that stabs me repeatedly when my foot is already throbbing. Cortisone shots help for @ 5 weeks at a time but it's not possible to get monthly injections and it's not a cure. Both docs. are podiatrist, and both agree that my heel will not get better without release surgery. I do not disagree with them. My pain started @ a year ago November it became disabling. Most have morning pain, I do too but that works out in @ 20-30 minutes. My pain is terrible after working for about 3 to 4 hours then it doesn't go away. It is worse that natural child birth (I have 4 kids). My business is not of a repetitive nature, so no-one can take my place, my husband can help me however. The 2nd Doc. is the only one in my city that is certified to use the Ossatron, but I do not want to be his first patient for this procedure
especially when it will cost me $3500.00. I am upset with my first Doc. because he NEVER told me how I could care for my condition,(ice, don't go barefoot,etc.) I learned these things on this web site. I did however get one of his nurses today on the phone and she told me the same thing about
after the surgery as the other Doctor. Now my only question is; can this procedure be done in office safely and effectively or should I have it done in the Hospital? That You, Cindy

Re: re: think again

Julie on 6/25/01 at 11:56 (051475)

I'm sorry, Cindy: I shouldn't have butted in. I'm sure you will get the answer to your question from the doctors.

Re: re: think again

Dr. Zuckerman on 6/25/01 at 13:32 (051485)

Even if you are having minimial incision foot surgery, the recovery time meaning no pain can be up to six months or more. Rest is very important after heel spur surgery. If you have the ability to rest and go into a cast then 10-14 days may be ok

Re: re: think again/forgive me but it is true cindy

Tammie on 6/25/01 at 15:19 (051492)

Cindy I just wanted to tell you I did have the minimal pf release and it was april 17 and lets see about 10 weeks ago, I am still off work,and there is still pain and I hate being home I want to be at work in the worst possible way,I cannot be at this point,Not that it is not going to heal ,it just seems like it takes forever!!!!! I just wanted to tell you from my point so as for you to get a big Shock as I did!!!! Feel free to ask questions and email if you like! The Dr. is trying to prepare you for long time healing possibilities!!!!If were doing this again I would as my ins. would not even consider ESWT but if it had I would have considered it first and surgery as very last!!!!!!!!!!!!!!!! Take care and good luck with decision!

Re: oops

Tammie on 6/25/01 at hrmin (051493)

Cindy what ever you decide keep us posted!!!!!!!!!!

Re: to Cindy - think again

Julie on 6/25/01 at 03:05 (051453)

Hi Cindy

I'm not a doctor, but I'm in England, where it's morning, so I'm awake to see and respond,to your post. Welcome to heelspurs.com.

There are several things about your post that worry me. What kind of doctor have you been seeing, and what options have been tried? Perhaps you really have tried everything, but you don't say, so I'm assuming otherwise. There are many conservative treatments for plantar fasciitis, and surgery should be considered as a last resort. You'll find a great deal of information about them on this site, especially in the heel pain book - click on it right here or at the top of the page. When all other treatments have been tried and have failed, there is still ESWT (Electronic Shock Wave Treatment) to be considered before surgery - it's a non-invasive procedure that has been successful in a great many cases.

As for surgery and recovery, I think both your doctors are being extremely optimistic. If you read recent posts from people who have had surgery, you will find that recovery from most procedures, for most people, is a long process: months rather than weeks, and certainly not days. I seriously doubt that you would be able to return to your work in either of the time-scales that the two doctors have predicted for you. (I say this not from personal experience but from long acquaintance with these message boards.) And surgery, as I'm sure you're aware, is not without risk and complications.

If you do eventually decide to have surgery, you will need to make alternative arrangements for your work to be covered while you recover - training and paying someone to keep things going for as long as it takes. This is particularly important in your case, as it is your own business that is at stake. Don't assume that you will be able to carry on as normal after a three-day or ten-day post-surgery rest. If you try, you will only delay your recovery and possibly let yourself in for long-term problems.

So given your circumstances, and assuming that you haven't yet really tried all the conservative measures, I would advise you to think very carefully before agreeing to surgery. At this point, I would suggest you find a good podiatrist or sports medicine doctor who specializes in feet and ankles and who will work with you on a comprehensive treatment programme. Read the heel pain book, and read these message boards: you will get a lot of help and support here.

Rest is the first line of treatment for plantar fasciitis, so see if it is possible for you to cut down on the hours you have to stand at work (this has probably been a contributory cause of your pain). Taping, which supports the arch, helps many people; icing to reduce inflammation can be useful; appropriate stretching - but go carefully avoid anything that causes more pain. Wear good quality, supportive footwear always. Never go barefoot. You may need orthotics to correct any biomechanical faults.

I think you get the idea. There is lots you can to to help yourself before going for the knife, and whatever you decide, you'll find heelspurs.com a great help, as I and so many others have.

All the best

Julie

Re: re: think again

cindy on 6/25/01 at hrmin (051469)

I did not elaborate on what I had tried to be considerate of the Doctors' time that answer this board. I have $300.00 orthotics, Celebrex at $130.00 per 30 capsules, I ice for immediate relief (helps little for @ an hour an a half), Tape doesn't stop the little man with the knife that stabs me repeatedly when my foot is already throbbing. Cortisone shots help for @ 5 weeks at a time but it's not possible to get monthly injections and it's not a cure. Both docs. are podiatrist, and both agree that my heel will not get better without release surgery. I do not disagree with them. My pain started @ a year ago November it became disabling. Most have morning pain, I do too but that works out in @ 20-30 minutes. My pain is terrible after working for about 3 to 4 hours then it doesn't go away. It is worse that natural child birth (I have 4 kids). My business is not of a repetitive nature, so no-one can take my place, my husband can help me however. The 2nd Doc. is the only one in my city that is certified to use the Ossatron, but I do not want to be his first patient for this procedure
especially when it will cost me $3500.00. I am upset with my first Doc. because he NEVER told me how I could care for my condition,(ice, don't go barefoot,etc.) I learned these things on this web site. I did however get one of his nurses today on the phone and she told me the same thing about
after the surgery as the other Doctor. Now my only question is; can this procedure be done in office safely and effectively or should I have it done in the Hospital? That You, Cindy

Re: re: think again

Julie on 6/25/01 at 11:56 (051475)

I'm sorry, Cindy: I shouldn't have butted in. I'm sure you will get the answer to your question from the doctors.

Re: re: think again

Dr. Zuckerman on 6/25/01 at 13:32 (051485)

Even if you are having minimial incision foot surgery, the recovery time meaning no pain can be up to six months or more. Rest is very important after heel spur surgery. If you have the ability to rest and go into a cast then 10-14 days may be ok

Re: re: think again/forgive me but it is true cindy

Tammie on 6/25/01 at 15:19 (051492)

Cindy I just wanted to tell you I did have the minimal pf release and it was april 17 and lets see about 10 weeks ago, I am still off work,and there is still pain and I hate being home I want to be at work in the worst possible way,I cannot be at this point,Not that it is not going to heal ,it just seems like it takes forever!!!!! I just wanted to tell you from my point so as for you to get a big Shock as I did!!!! Feel free to ask questions and email if you like! The Dr. is trying to prepare you for long time healing possibilities!!!!If were doing this again I would as my ins. would not even consider ESWT but if it had I would have considered it first and surgery as very last!!!!!!!!!!!!!!!! Take care and good luck with decision!

Re: oops

Tammie on 6/25/01 at hrmin (051493)

Cindy what ever you decide keep us posted!!!!!!!!!!