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I am wondering?

Posted by Carol C on 8/16/01 at 19:18 (056945)

Ok--after reading a lot of your post, I have some quesetions if you all could help to clear up some issues for me....I am in the process of being
diagnosed with TTS. I get the impression that most of you have had your
sypmtoms for much longer or it took much longer for your diagnosis to
evolve than did mine. I first noticed numbness in the toes and ball of my foot on Mid June--two months ago. I did have some tenderness in the ankle and arch of the foot, but mostly had the discomfort of numbness. It has
progressed to become more painful with a feeling of something being
'bunched up' underneath the ball of my foot near my toes....numbness in the big toe and the second and third toes, tenderness in the ankle and arch, and extreme tenderness to touch on the little toe and outside of my foot on the side of the little toe. I have seen my family practice doctor and a orthopedic surgeon. They both feel that I am positive for TTs, I have seen a Neurologist who based on symptoms feels it is TTS, but I have
a negative nerve conduction study. I do have a positive Tinels Sign. All
physicians involved feel that I am early enough in the TTS that it is not
showing on the nerve conduction study yet. I am currently on Topamax and
Vioxx and am showing no improvement. I am to return in three weeks for a
cortisone injection and if no improvement with that injection, surgery is to be scheduled. Given this information, do you guys feel that with EARLY
INTERVENTION, and going ahead with treatment before the symptoms are so
severe as most of yours, maybe I stand a better chance at a more complete and timely recovery than most of you seem to have experienced.
I am determined to come out a winner here and don't want to wait until it
is beyone repair to do something. Please SOMEONE, give me some words
of encouragement. I have full confidence in my Orthopaedic surgeon----
I think that will help in my recovery---but don't you guys think it is best to get ahead of this thing as early as I can?

Re: I am wondering?

Lisa Cook on 8/16/01 at hrmin (056949)

I personally don't think there is a cure tts.I've had it over a year now.I been on almost every type of inti-flamtory meds.I had surgery back in March.I also had 2 cortozone shots since the surgery.The shots help for 2 weeks at most and it's back to pain.Take someone with you when u have the shot because my whole foot was tottally numb and it's hard to drive with a numb foot.The doctor told me in the last visit if i don't improve going to send me back to have another nerve test.I now have tts in my other foot.Sometimes i wonder what i'm going to do.I'm 34 single women and have 2 kids.I have to work! I've tried finding a job where i'm not on my feet 8-10 hrs a day.Good luck! Lisa

Re: Conservative methods for TTS Re: I am wondering?

Donna SL on 8/16/01 at 22:05 (056953)

Carol,

Have you tried any conservative treatments other than medication? A large percentage of TTS cases even with a positive nerve conduction test can be cured with conservative methods especially in the early stages.

You can have TTS even if you don't have a positve nerve conduction test. A positive test just means there is some injury to the nerves (demyelination) enough to cause slowing on these test. The nerves will heal, once the inflammation is reduced. Most of the time the nerves in the foot are just irritated due to inflammed tissue pressing on the them, and if you can find a way to reduce that, then in most cases the TTS will disapear, without surgery.

I had a a confirmed case of TTS, complicated with PF. I had a positive nerve conduction test in both feet, mild in the left, and moderate in the right. I had symptoms for close to two year before I was finally diagnosed with this, yet I'm so much improved with just conservative methods. I've never even had a cortisone shot (which I was advised against). I'm sure my case was much more advanced than yours, so you should have an easier time than me. There is so much that can be done, and should be tried before you even consider surgery. The main thing is to reduce inflammation on the nerves. This can be done with acupuncture, icing, active release technique (ART), myofascial release technique, various forms of PT, orthotics if there is a biomechanic reason causing this, icing, casting if necessary, cortisone, etc. Just stay away from deep tissue massage of any kind.

You shouldn't even consider surgery unless you have exhausted all these methods. A lot of cases of TTS can be cured with conservative methods if you have the determination to go to these treatments.

Did you have an MRI to determine if there was any lesion, etc., causing pressure in the TT area? Usually that is the only time surgery should be considered.

If possible you should try to find a podiatrist associated with a sports medicine clinic who has seen a lot of these cases, and would be knowledgeable of conservative treatements. A good podiatrist, or orthoped will not rush you into surgery so fast. Also if possible try to find a physiatrist (physical med, and rehab md) to help you manage this. They are usually excellent for conservative methods, and will make sure nothing else in causing this.

I personally have had the most sucesss with ART performed by a chiropractor, acupuncture done by my physiatrist, and Vioxx, and just recently a small dose of neurontin. You need to give the Vioxx some time to work, but it is only one small part of a total conservative package.

The only other thing I can suggest is do a lot of searching on the web, and read as much as you can about conservative treatments for TTS. You may have to plug in Tarsal Tunnel, and wade your way through various articles.

Donna

Re: I am wondering?

chris on 8/17/01 at 07:43 (056972)

First....I am no doctor!

Brief history...diagnosed with Plantar facitis in Feb 2000. Treated with all conservative methods. Around August doctor did the nerve conduction test which was positive for tts. They stated I was an unusal case because I did not have the positive tingle sign but had a positve NCT. I was told that it is usually the other way around (which would be your case).

My podiatrist, upon dx of tts said that surgery was the next option. Now I know this is different than what everyone else on the board has posted, but at that time I had not found this board. After reading the boards I believe I had had all the conservative tx's done before surgery was scheduled.

I am quite interested in your statement about early treatment and success rates (not to offend anyone on the board) and have wondered the same thing. Is there any link between/correlation between how long one has suffered and when surgery is performed???

I had surgery in Nov '00 for PF and TTS and have had wonderful results. Every now and then I have some pain, but we are talking times when I totally overdid it (like walking the entire Vegas strip!)

Please note--the surgery is not a fun one and the recovery is long and should (in my opinion) involve PT. But, in at least my case well worth it!
chris

Re: I am wondering?

AJ on 8/17/01 at 09:23 (056975)

Hi, in my case I wish I had the TTS surgery done sooner. My doctor recommended surgery but I was determined to try the conservative approach. Well, the conservative approach didn't work for me. If I had listened to my doctor I would have saved myself alot of misery.

Perhaps there is a reason why your doctors want to fix the problem via surgery so soon. You should ask them why do I need surgery now instead of prolonging the conservative approach?

Based upon my experience, I favor more aggressive treatment e.g. surgery. I had alot to gain and not alot to lose.

.

Re: I am wondering?

carol c on 8/17/01 at 21:18 (057049)

So---basically you had a 10 month span from diagnosis to surgery. Looks like I am going to probably be about 3 to 3 1/2 months from onset of symptoms to surgery. I am beginning to believe that I may benefit from the more aggressive option of surgery rather than letting
the disease progress to a more serious stage before trying to tackle it.
I do have a history of having a complete reconstruction of the other ankle due to instability. (Reconstruction being a grafting of a ligament from the calf of my leg into my anlke) This was done almost 20 years ago and
with a full recovery and NO residual pain or stiffness. I have been most
pleased with the results of that procedure and it will be the same surgeon
who will perform the TTS surgery if I proceed with it. I feel comfortable
with him and I feel like being comfortable with your surgeon is a to win
a large part of the battle before you even begin. I think my greatest
fear in having to give in and have the cortisone injection in a few weeks.
The surgeon seems determined to try at least one injection to see if that
provides any relief---and I feel like I should trust his judgement on that, even if I fear the pain of it. That is scheduled for Sept 5th.
We will see how that goes, the if no relief....surgery will probably be
soon thereafter.....I really appreciate the words of support from you guys.

Re: I am wondering?

tony o. on 8/17/01 at 22:43 (057060)

i have reserched this condition very thoroughly for the last year ive had it. topamax and vioxx dont work. what you have to be careful about is the pain taking over your mind. it will become intense and you won't be able to do anything.. nothing! i have tried all the meds except heavy narcotics. and none of the docs will prescribe them for me anyways. they will test you, probe you, try lotions, patches, pills, anti-depessents, siesure med, epilepsy med,creams, shots, epurderals, physological testing and consulting, pain management is a joke. they have no idea how to treat this condition. at least from what i have experienced. i have read a lot of threads in here and no one. not one seems satisfied with any results. i have a Tens unit for shock theropy, and 32 different kinds of pills. i havent taken one pill in 4 months, nothing. it gets worst. and you cant get disability for this. if all i truthfully know is......there is no cure for this. some people who don't have it to bad do find some reliefs, but as of 8/4/2000.......i havent found any. good luck kid. hope your strength holds up. this will be your biggest test yet. good luck and i hope you don't have it to bad. T

Re: Tony - Advanced pain treatment site

Donna SL on 8/18/01 at 02:47 (057068)

Tony,

Have you ever tried any advanced pain therapies like neurostimulators, or pain pumps? This is just one one many sites that give some information on this type of treatment. They explain how people have been treated to control severe crippling chronic pain from nerve damage, rsd, cancer, etc. The company also has a section to help you find a doctor in your area.

http://www.medtronic.com/neuro/apt/

Donna

Re: order drugs off internet

Scott R on 8/18/01 at 08:26 (057075)

http://www.canadadrugs.com

http://www.libsol.net

But I would first try:
http://www.dmso.com

x

Re: Tony - Advanced pain treatment site

tony o on 8/18/01 at 11:24 (057086)

thanks for the info at APT site. but.......i don't seem to have any say in any of those treatments. when i suggestted the neurostimulator they said i wasn't a prime candidate for it. thats whats really bothering me. they all think im a baby and exagerating. what kind of a doctor doesnt want to listen to your cries. its very frustrating to get anyone to believe what is going on not only in your foot...but your mind. the pump they say the same. out of the question. im trying to survive right now trying to find some type of work to at least have a place to live and eat. all i really do is wait...wait...wait...and wait some more.i have requested a hearing with the WC insurer and that is on sept. 14 th... so im just looking to survive till then. ive never felt so alone in my life....AND IVE ALWAYS LIVED ALONE. i feel that depression may overtake me if this continues. im not depessed if i dont think about it, after all, the pain is so bad at times.......who can even think about depression. i feel i would at least like to try pain pills before any more surgeries. im just not confident or trusting of doctors right now. all heve done is take my money and told me NO to pain pills. i know there might be others out there with similar circumstances, but mine feel futile. i just want to make a decent living and do the things that make people happy. in this state of mind.........no one wants to be near me. i dont blame them for that. you do know what i mean. just to ride my harley again would be enough. ill sacrifice all the other stuff for that. just one last ride.........tony o

Re: nothing!

tont o on 8/18/01 at 11:50 (057088)

sorry theres nothing on here i can use. i checked everything on all 3 web sites. theres nothing there for severe pain. thanks for at least trying.

Re: Tony -

tammie on 8/18/01 at 11:57 (057089)

I am so sorry I dont even know what to say, or how to give you hope or faith,I feel like a loss for words , which I have always been blessed with talking! I am going to try and atempt to speak to you from my heart,Tony I do not know you but from your posts, I hear the pain and the lost sound in your post I hear the I have had enough I give up, I hear the total defeat, but yet I hear the glimmer of maybe a hope that someone might offer you the majic to cure your woes.I cannot do this or most of us cannot do it but we can give you something else, we can give you understanding we can give you encouragement to find a Dr. who will listen to u and care,can offer advice and how we all deal with things can direct you in any way we can. It tears my heart apart to hear your despair,it really does,I just dont know what I can do to make you feel that life is worth living and that tho there may not be a so called cure, there are other ways of adapting and living with the pain,I am hoping my good friends here will hear your pain and maybe direct you in areas that maybe will help you I am so sorry this is more then I can help with, maybe your perception is off if you are in so much pain maybe you cannot hear what is being said to u,often it is very hard,Please advise the Dr. here of the area you live maybe they can suggest a dr. more willing to listen to you, and hear you. If you want to you could post on the ask Dr. board to , dont give up please, find the help that you need and find the will to go on living life and find some happiness. There are different boards to post on there is a social on to which you will find very many people who are loving and caring who maybe able to give u a gentle hug with some intuitive words. Please stick around and remember there is always peace in prayer, you might not hear the answer but sometimes it is because we choose to not hear or see the gift he is given us. Dont think me as a goody 2 shoes lol cause I am far from it but I do believe in the power of friends and the power of love and the power of prayer. I am sorry that I can not offer you much I feel bad,but know that people here care and are here for u.

Re: Tony - speaking of prayer

DR. Zuckerman on 8/18/01 at 12:11 (057091)

I want to tell a story just last week about healing and prayer. If I hadn't seen it myself I would say no way.

This long time patient comes into my office. She is limping. She has pain in her left foot. She has no motion at the ankle joint. The foot is almost useless.

I did a range of motion, complete neurological testing , motor funciton testings. X-ray circulation.

I felt that she has herniated a disc and . I sent her for an mri and consultation with orthopedics

She was told she needed immediate surgery due to a herniation. Well she didn't want that. Ok so I see her a few days ago.

She is walking great like nothing every happened

She was in my office for me to see her son. I concentrate on her son and really don't ask at first what happen. I was kind of afraid because I really though that someone serious was wrong and now she is find. Boy do I look like a fool.

So not being able to keep my mouth shut I ask hey you are walking great.

So she begins to tell me about the power of prayer.

I wouldn't of believed it if I hadn't seen it

Re: Tony - Advanced pain treatment site

Donna SL on 8/18/01 at 12:27 (057096)

Tony,

I don't know if this is worth a shot or not, but there are some doctors listed in GA on the Medtronic site. (I think that's where you said you lived) If you give them a call, or email them, maybe they could help you out, or support your case. I would think they would be very emphathetic to your problems. Also they may know of some clinics to refer you to, further advice on where to get help, etc.. If you call ask to speak to the doctor directly.

I called many doctors in the US that were out of my area, and even some out of the country, when I was having problems, and didn't know what was wrong with my feet. They helped me more than my local doc here, and one actually diagnosed what was wrong just from listening to my symptoms on the phone, and several others offered treatment suggestions. I'm assuming your health care is controlled by some type of HMO through workman's comp, but you must try everything you can. I also can only assume there has been some type of nerve damage from the surgery, because of the info you have provided, and any doctor in their right mind would know this would cause unrelenting pain. I cannot understand why you are not getting the help you need, and hopefully you will find some way to fight this system that is controlling your health care, and well-being.

Don't give up, and keep fighting for what you deserve.

Donna

Re: dear dr. Z

tony o on 8/18/01 at 13:10 (057101)

the reality of it is, im not going to pray for something like this, however i will pray for relief. it seems that is all i can do. this Fentanyl you speek of. how do i get a doctor to give it to me. someone suggested cutto
ing my hair and gotee to (mask who i really am) just to get pain relievers. if i do that i'm bowing to the system that is innoing me. although it is not out of the question to cut the hair, i would be going against my principles. yes i was a hippie in the 60's - 70's but that was a long time ago and today verything is a lot different. i will try to get a pain management clinic to accept me for now but when they know i have no income or no ins. they wont do squat. is there some way you can give me a referal or a letter of intent about my situation or is that out of the question without an examination? i do and have all my med. records and could fax them to you if you wish. its pretty long but if you specify what you want i can sort threw them .. let me know. T

Re: I am wondering?

chris on 8/18/01 at 13:40 (057105)

Actually, it was 10 months from the dx of pf to surgery, as soon as tts was confirmed my pod scheduled surgery.

I hated the injections. The first I received from a Gp without any pain relief and it hurt beyond **** When I was referred to the pod specialist and she said she was going to give me another injection....I cried like a baby! But they numbed the area with some cold spray and it did not hurt as much....I ended up having about 3 or 4 injections before surgery.

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/19/01 at 23:43 (057220)

Hey Tony..
If I was you....I would look for another Orthopedic Doctor...
My Ortho here told me to sign up for disability...he states this is a qualifying disability..
I have been off of work since April...and have had a TT release and some other nerves had scar tissue removed...
My last surgery was 3 weeks ago....
I signed up last week for the disability insurance...we will see...
If you could get the right Doctor to listen to your complaints...then you could possibly qualify...
Please....don't give up hope...
If we all gave up....who will help change it for the people in the future...
I beleive if we speak out now...then people will listen to our cries of pain and take us seriously...
I guess I am lucky to have a very compationate Orthopedic Doctor...
I know I have a long road of pain ahead of me....but with this board and my Doctor....I know I will be able to endure it and offer my experiences as help to someone else in the future...
And I feel your Doctor was very wrong to take your appearance into consideration of how you have pain...
I am a nurse...and I know pain is something no one can see...it is only felt by the individual...and who are we as medical personel to judge weather someone is in pain or not...
Thanks for listening...
Cindy

Re: Tony...My Ortho states you can get disability for this...

BrianG on 8/20/01 at 19:40 (057340)

Hi Cindy,

When you applied for Social Security, what was the illness, or code that you used? Is TTS on the approved list of SSD ailments? I know PF isn't, can you believe that!! If it was, I would have already applied, I feel dicriminated against. My disability is just as bad and just as real is all of the codes on the approved list.

Please keep us updated
BCG

Re: Tony...My Ortho states you can get disability for this...

tony o on 8/20/01 at 20:22 (057346)

oh i got disability all right. i was released to go back to full duty climbing my telephone poles. no wat. workmans comp. docs gave me 6% disability. can you believe that. said it was 94% physcological. im ready to sue em all. this is not right. theres no way only6% thats outragious. im not going to take this lying down . im soooo pissed. i thought i was realistically at the least...60- 70%. what next????? i cant even think about how there screwing me. but thanx for the push. anyways......... T

Re: Forget the lawyers for now, plenty of time later

BrianG on 8/20/01 at 20:53 (057353)

Hi Tony,

Good to see you back tonight. So, have you thought any more about how your going to go about getting some good pain management? I don't think lawyers are the way to go right now. It sounds like the anger is getting the best of you. Put some of that energy to use in a more positive direction. Did you check out http://www.pain.com yet ? Do you have any questions? My ailments are different, but I'd be willing to bet my pain was just as severe. I was in tears many a night driving home from work, 2nd shift. I worked at it, and you can also. Good luck

BCG

Re: Tony...My Ortho states you can get disability for this...

Laurie R on 8/20/01 at 21:00 (057356)

Hi Tony,
From what you say here that the doctor said your were only 6% disable and 94% physcological ,that tells me this doctor did not know enough about PF. And believe me just because he or she is a doctor does not mean he or she knows all their is to know.You keep fighting you will win .... Don't give up ..I believe you can get disability for this too. It is up to your doctor though .Tony I wish you lived in CA I would tell you to go and see my Pod ,he would help you and he would also take your pain seriously . My Pod also has PF ,he knows all to well what the pain feels like.

I really feel for you ,not only are you in pain and you had to change your whole life around , but you have to deal with doctors that don't care. Tony find a good doctor that will give you the pain meds you need and deserve ,and that will listen to you and help you . I know it is hard.Just don't give up.

My very best to you ,Laurie R

Re: Forget the lawyers for now, plenty of time later

tony o on 8/21/01 at 06:23 (057402)

been having a lot of disdain. can't sleep with this and with the fact that my doctor just gave me his final repoer.
im shocked, stunned and totallt confused. he listed me as DISABLED! the problem is......only 6%. thats it. i can't believe he won't here my cries for relief. im so frustrated.im upset, i feel betrayed by the people i put my trust into letting them help me overcome this horrible nightmare. i do not want monitary rewards, nor do i seek drugs to get high off of.i can't stop looking at this with a look of puzzelment. i only want to get back to my work and earn my living without a lot of pain.nothing else.here is his report :::::we agree he has reached maximum medical improvementand can return to work without restricktions. he is not taking any medications. we would not recomend any surgical or evasive treatments. we would not recomend any narcotic treatments. he has a 6% permanent partial physical impairment to the whole body. i will see him again on a PRN basis.
thats it! he underwent a FCE but did not finish it and walked out on the rehab person. his major problem is psychological and not secondary to any work injury.
this is so shocking! this isn't the way it is.i did not walk out of the evaluation... i couldn't continue because of the pain. i was crawling on the floor it was so bad.psychological? absolutly! but not for that (exageration or faking) because of the non cooperation of my doctors to not listen to my pleas for relief. yes its all psychological. from them trying to steer me to what they wanted, not for what i needed. no one can maintain a degree of sanity with all that is happening to him because that person is trying to live with the constant pain that is trying to overtake him. it was and i fought it day and night without meds.they used 90% anti-depressants on me. when i told them im not depressed im in pain. BIG difference. the pain is pschologically altering my normal thinking process. i knew that idont deny it. but your treat the sorce not the mind. thats where i feel i was not being propw
erly cared for. i am a warrior and i took it. its been 13 months through this pain. and it has worstened steadily since the operation. at one point i begged him to take the leg off or cut the nerve or anything to ease the pain. no has listened. that is so frustrating. now their saying im imagining it. all i want is relief and get to work. i feel so alone. im stubborn. i will fight this war of bullshit. im tired of lying down and soaking my foot and plugging in that #$%^%$3 tens unit and the patches and the ointments and the advice from doctors who havent a clue and couldn't possible know what im feeling.
oops. sorry man. i got carried away. didnt mean to run like this. its my theropy to do this to vent my mind in another direction instaed of bowing to the pain masters. anyways....i just to know...what have your docs perscribed for your pain and how long have you been going threw this. whats your outlook? thanks. i feel a little better knowing someone might have a clue what im going through. tony o

Re: I am glad you vented

Tammie on 8/21/01 at 08:56 (057413)

Tony, glad to see u back and I think maybe some here maybe able to help you! Brian is great he really is give what he says some real thought, he has been thru allot as so many others have been! I know that it is not fair life is not fair but we have to get thru it some how. Keep talking and keep listening that and putting to work what is given information to u may begin to help. There are more then one set of docs out there.I am dealing with my employers right now, they did a check up call on me yesterday questioned my son and to where abouts I was, I was at pt. A co worker called in evening and informed me they are looking to replace me , as I have been off playing since april.They need help not me playing the game.The so called co worker told them I would not be back till jan probly with my dr. so they are loosing faith, I did not ever say anything about Jan, I to if I could would be there today,my job is a part of me the person and part of my life, yes it is on hold but so is everything else in my life that I enjoy, like you say the sleeping thru a night without pain the walking without pain the life is not fun but they see it from there eyes.I tell them what my dr. tells me , gave them his number to call, they have his report, he has got me off not me they have a inhouse dr. and a pod why dont they consult with them? I hear you my friend life is not fair and not all people are either, I will not forget it either, It is not over yet! See Tony we have to help ourselves and take care of us cause most dont care, they do not feel or see our pain, they do not understand that it is not something we can put a darn band aide on and return to life. There is no set time that our bodies will cooperate with us, we or unfortuantly the Dr.s cant give us promisis they can only estimate and work with us and sometimes they are lost to and some cannot admit to it or some may not be as well informed or trained in all areas. Some do not have a advanced compassion course (LOL) some are better there. I do not believe all are like your Dr. I have seen Dr.s here and listened to there advice and then heard there compassion along with the obvious restraint in there messages when they might have liked to say more. I think you have found a good place to re start your search. Keep talking ask all questions read learn and put it to work for u! Lots of info and help here! Some that we are selves do not want to hear at times and then we get some brave soul who tells it like it is ( then we dump on him for being brash lol) but it all comes together most are here to give help and hope! Hang in Tony , Good luck to u!

Re: Where are you from ?

BrianG on 8/21/01 at 09:52 (057415)

Hi Tony,

What is the nearest good sized city / state that is close to you? Maybe someone could give you a recommendation. At the bottom of the http://www.pain.com home page you can look up pain clinics according to each state. Just remember, all are not created equal, they may (or may not) have what you need, but there are ways of finding out before you spend money for an appointment.

BCG

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/21/01 at 12:17 (057430)

Hey BrianG...I'm not sure what code they used...I applied about 2 weeks ago...I'm still waiting to hear....
My Orthopedic Dr. and the Neurologist both said this would allow me to be on disability....
They are sending in the reports....
Talk to your Dr. about this...
I mean...if your profession includes walking like mine does...and it is extreme pain to walk...then you are considered disable in my books...
here is a good site I found while searching disabilities...
http://www.ssa.gov/disability/
There...you can find so much info on what would be covered....
hope this helps...
Cindy

Re: Tony...My Ortho states you can get disability for this...

BrianG on 8/21/01 at 12:36 (057432)

Thanks, I've checked this site out, but there is no code for PF. I think you'd have to group some other generalized things together, so it makes it more complicated.

BCG

Re: Tony...My Ortho states you can get disability for this...

Laurie R TO Brian on 8/21/01 at 20:32 (057484)

Hello Brian , YOu have already helped me out so much . I have another question for you if you don't mind. I went to the SS site and I checked all over it for the codes to see if RSD is one of the codes for disability ... I could not find the codes on the site. Can you please tell me where on the site are the codes.. Thank you as always for your help .... Laurie R

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/21/01 at 22:49 (057495)

Laurie....
I went to the ss site again...
You can go to the frequently asked questions...and there is a place to ask a question....by e-mail...and you will get a reply....
I applied 2 weeks ago for the disability at the insistence of my Orthopedic Dr.....and they said it could be 4-6 months before I even know if I qualify....but I do have more problems than the regular TTS...I had nerves trapped all over my foot from scar tissue...and I had 2 surgeries since April 2001....
I had my last surgery on July 26....and I still haven't been allowed to crutch walk...
Good luck...
CindyF
That could be why...
I don't know

Re: Tony...My Ortho states you can get disability for this...

Laurie R on 8/22/01 at 01:16 (057500)

Hi Cindy , Thank you so much . I will go back to the web site and send them an email and ask. This is very good to know . Do you also have RSD?? I would think any of the long foot probelms would be covered for SSI ,I can not see why . Thanks again ..My very best to you ,Laurie R

Re: I am wondering?

Lisa Cook on 8/16/01 at hrmin (056949)

I personally don't think there is a cure tts.I've had it over a year now.I been on almost every type of inti-flamtory meds.I had surgery back in March.I also had 2 cortozone shots since the surgery.The shots help for 2 weeks at most and it's back to pain.Take someone with you when u have the shot because my whole foot was tottally numb and it's hard to drive with a numb foot.The doctor told me in the last visit if i don't improve going to send me back to have another nerve test.I now have tts in my other foot.Sometimes i wonder what i'm going to do.I'm 34 single women and have 2 kids.I have to work! I've tried finding a job where i'm not on my feet 8-10 hrs a day.Good luck! Lisa

Re: Conservative methods for TTS Re: I am wondering?

Donna SL on 8/16/01 at 22:05 (056953)

Carol,

Have you tried any conservative treatments other than medication? A large percentage of TTS cases even with a positive nerve conduction test can be cured with conservative methods especially in the early stages.

You can have TTS even if you don't have a positve nerve conduction test. A positive test just means there is some injury to the nerves (demyelination) enough to cause slowing on these test. The nerves will heal, once the inflammation is reduced. Most of the time the nerves in the foot are just irritated due to inflammed tissue pressing on the them, and if you can find a way to reduce that, then in most cases the TTS will disapear, without surgery.

I had a a confirmed case of TTS, complicated with PF. I had a positive nerve conduction test in both feet, mild in the left, and moderate in the right. I had symptoms for close to two year before I was finally diagnosed with this, yet I'm so much improved with just conservative methods. I've never even had a cortisone shot (which I was advised against). I'm sure my case was much more advanced than yours, so you should have an easier time than me. There is so much that can be done, and should be tried before you even consider surgery. The main thing is to reduce inflammation on the nerves. This can be done with acupuncture, icing, active release technique (ART), myofascial release technique, various forms of PT, orthotics if there is a biomechanic reason causing this, icing, casting if necessary, cortisone, etc. Just stay away from deep tissue massage of any kind.

You shouldn't even consider surgery unless you have exhausted all these methods. A lot of cases of TTS can be cured with conservative methods if you have the determination to go to these treatments.

Did you have an MRI to determine if there was any lesion, etc., causing pressure in the TT area? Usually that is the only time surgery should be considered.

If possible you should try to find a podiatrist associated with a sports medicine clinic who has seen a lot of these cases, and would be knowledgeable of conservative treatements. A good podiatrist, or orthoped will not rush you into surgery so fast. Also if possible try to find a physiatrist (physical med, and rehab md) to help you manage this. They are usually excellent for conservative methods, and will make sure nothing else in causing this.

I personally have had the most sucesss with ART performed by a chiropractor, acupuncture done by my physiatrist, and Vioxx, and just recently a small dose of neurontin. You need to give the Vioxx some time to work, but it is only one small part of a total conservative package.

The only other thing I can suggest is do a lot of searching on the web, and read as much as you can about conservative treatments for TTS. You may have to plug in Tarsal Tunnel, and wade your way through various articles.

Donna

Re: I am wondering?

chris on 8/17/01 at 07:43 (056972)

First....I am no doctor!

Brief history...diagnosed with Plantar facitis in Feb 2000. Treated with all conservative methods. Around August doctor did the nerve conduction test which was positive for tts. They stated I was an unusal case because I did not have the positive tingle sign but had a positve NCT. I was told that it is usually the other way around (which would be your case).

My podiatrist, upon dx of tts said that surgery was the next option. Now I know this is different than what everyone else on the board has posted, but at that time I had not found this board. After reading the boards I believe I had had all the conservative tx's done before surgery was scheduled.

I am quite interested in your statement about early treatment and success rates (not to offend anyone on the board) and have wondered the same thing. Is there any link between/correlation between how long one has suffered and when surgery is performed???

I had surgery in Nov '00 for PF and TTS and have had wonderful results. Every now and then I have some pain, but we are talking times when I totally overdid it (like walking the entire Vegas strip!)

Please note--the surgery is not a fun one and the recovery is long and should (in my opinion) involve PT. But, in at least my case well worth it!
chris

Re: I am wondering?

AJ on 8/17/01 at 09:23 (056975)

Hi, in my case I wish I had the TTS surgery done sooner. My doctor recommended surgery but I was determined to try the conservative approach. Well, the conservative approach didn't work for me. If I had listened to my doctor I would have saved myself alot of misery.

Perhaps there is a reason why your doctors want to fix the problem via surgery so soon. You should ask them why do I need surgery now instead of prolonging the conservative approach?

Based upon my experience, I favor more aggressive treatment e.g. surgery. I had alot to gain and not alot to lose.

.

Re: I am wondering?

carol c on 8/17/01 at 21:18 (057049)

So---basically you had a 10 month span from diagnosis to surgery. Looks like I am going to probably be about 3 to 3 1/2 months from onset of symptoms to surgery. I am beginning to believe that I may benefit from the more aggressive option of surgery rather than letting
the disease progress to a more serious stage before trying to tackle it.
I do have a history of having a complete reconstruction of the other ankle due to instability. (Reconstruction being a grafting of a ligament from the calf of my leg into my anlke) This was done almost 20 years ago and
with a full recovery and NO residual pain or stiffness. I have been most
pleased with the results of that procedure and it will be the same surgeon
who will perform the TTS surgery if I proceed with it. I feel comfortable
with him and I feel like being comfortable with your surgeon is a to win
a large part of the battle before you even begin. I think my greatest
fear in having to give in and have the cortisone injection in a few weeks.
The surgeon seems determined to try at least one injection to see if that
provides any relief---and I feel like I should trust his judgement on that, even if I fear the pain of it. That is scheduled for Sept 5th.
We will see how that goes, the if no relief....surgery will probably be
soon thereafter.....I really appreciate the words of support from you guys.

Re: I am wondering?

tony o. on 8/17/01 at 22:43 (057060)

i have reserched this condition very thoroughly for the last year ive had it. topamax and vioxx dont work. what you have to be careful about is the pain taking over your mind. it will become intense and you won't be able to do anything.. nothing! i have tried all the meds except heavy narcotics. and none of the docs will prescribe them for me anyways. they will test you, probe you, try lotions, patches, pills, anti-depessents, siesure med, epilepsy med,creams, shots, epurderals, physological testing and consulting, pain management is a joke. they have no idea how to treat this condition. at least from what i have experienced. i have read a lot of threads in here and no one. not one seems satisfied with any results. i have a Tens unit for shock theropy, and 32 different kinds of pills. i havent taken one pill in 4 months, nothing. it gets worst. and you cant get disability for this. if all i truthfully know is......there is no cure for this. some people who don't have it to bad do find some reliefs, but as of 8/4/2000.......i havent found any. good luck kid. hope your strength holds up. this will be your biggest test yet. good luck and i hope you don't have it to bad. T

Re: Tony - Advanced pain treatment site

Donna SL on 8/18/01 at 02:47 (057068)

Tony,

Have you ever tried any advanced pain therapies like neurostimulators, or pain pumps? This is just one one many sites that give some information on this type of treatment. They explain how people have been treated to control severe crippling chronic pain from nerve damage, rsd, cancer, etc. The company also has a section to help you find a doctor in your area.

http://www.medtronic.com/neuro/apt/

Donna

Re: order drugs off internet

Scott R on 8/18/01 at 08:26 (057075)

http://www.canadadrugs.com

http://www.libsol.net

But I would first try:
http://www.dmso.com

x

Re: Tony - Advanced pain treatment site

tony o on 8/18/01 at 11:24 (057086)

thanks for the info at APT site. but.......i don't seem to have any say in any of those treatments. when i suggestted the neurostimulator they said i wasn't a prime candidate for it. thats whats really bothering me. they all think im a baby and exagerating. what kind of a doctor doesnt want to listen to your cries. its very frustrating to get anyone to believe what is going on not only in your foot...but your mind. the pump they say the same. out of the question. im trying to survive right now trying to find some type of work to at least have a place to live and eat. all i really do is wait...wait...wait...and wait some more.i have requested a hearing with the WC insurer and that is on sept. 14 th... so im just looking to survive till then. ive never felt so alone in my life....AND IVE ALWAYS LIVED ALONE. i feel that depression may overtake me if this continues. im not depessed if i dont think about it, after all, the pain is so bad at times.......who can even think about depression. i feel i would at least like to try pain pills before any more surgeries. im just not confident or trusting of doctors right now. all heve done is take my money and told me NO to pain pills. i know there might be others out there with similar circumstances, but mine feel futile. i just want to make a decent living and do the things that make people happy. in this state of mind.........no one wants to be near me. i dont blame them for that. you do know what i mean. just to ride my harley again would be enough. ill sacrifice all the other stuff for that. just one last ride.........tony o

Re: nothing!

tont o on 8/18/01 at 11:50 (057088)

sorry theres nothing on here i can use. i checked everything on all 3 web sites. theres nothing there for severe pain. thanks for at least trying.

Re: Tony -

tammie on 8/18/01 at 11:57 (057089)

I am so sorry I dont even know what to say, or how to give you hope or faith,I feel like a loss for words , which I have always been blessed with talking! I am going to try and atempt to speak to you from my heart,Tony I do not know you but from your posts, I hear the pain and the lost sound in your post I hear the I have had enough I give up, I hear the total defeat, but yet I hear the glimmer of maybe a hope that someone might offer you the majic to cure your woes.I cannot do this or most of us cannot do it but we can give you something else, we can give you understanding we can give you encouragement to find a Dr. who will listen to u and care,can offer advice and how we all deal with things can direct you in any way we can. It tears my heart apart to hear your despair,it really does,I just dont know what I can do to make you feel that life is worth living and that tho there may not be a so called cure, there are other ways of adapting and living with the pain,I am hoping my good friends here will hear your pain and maybe direct you in areas that maybe will help you I am so sorry this is more then I can help with, maybe your perception is off if you are in so much pain maybe you cannot hear what is being said to u,often it is very hard,Please advise the Dr. here of the area you live maybe they can suggest a dr. more willing to listen to you, and hear you. If you want to you could post on the ask Dr. board to , dont give up please, find the help that you need and find the will to go on living life and find some happiness. There are different boards to post on there is a social on to which you will find very many people who are loving and caring who maybe able to give u a gentle hug with some intuitive words. Please stick around and remember there is always peace in prayer, you might not hear the answer but sometimes it is because we choose to not hear or see the gift he is given us. Dont think me as a goody 2 shoes lol cause I am far from it but I do believe in the power of friends and the power of love and the power of prayer. I am sorry that I can not offer you much I feel bad,but know that people here care and are here for u.

Re: Tony - speaking of prayer

DR. Zuckerman on 8/18/01 at 12:11 (057091)

I want to tell a story just last week about healing and prayer. If I hadn't seen it myself I would say no way.

This long time patient comes into my office. She is limping. She has pain in her left foot. She has no motion at the ankle joint. The foot is almost useless.

I did a range of motion, complete neurological testing , motor funciton testings. X-ray circulation.

I felt that she has herniated a disc and . I sent her for an mri and consultation with orthopedics

She was told she needed immediate surgery due to a herniation. Well she didn't want that. Ok so I see her a few days ago.

She is walking great like nothing every happened

She was in my office for me to see her son. I concentrate on her son and really don't ask at first what happen. I was kind of afraid because I really though that someone serious was wrong and now she is find. Boy do I look like a fool.

So not being able to keep my mouth shut I ask hey you are walking great.

So she begins to tell me about the power of prayer.

I wouldn't of believed it if I hadn't seen it

Re: Tony - Advanced pain treatment site

Donna SL on 8/18/01 at 12:27 (057096)

Tony,

I don't know if this is worth a shot or not, but there are some doctors listed in GA on the Medtronic site. (I think that's where you said you lived) If you give them a call, or email them, maybe they could help you out, or support your case. I would think they would be very emphathetic to your problems. Also they may know of some clinics to refer you to, further advice on where to get help, etc.. If you call ask to speak to the doctor directly.

I called many doctors in the US that were out of my area, and even some out of the country, when I was having problems, and didn't know what was wrong with my feet. They helped me more than my local doc here, and one actually diagnosed what was wrong just from listening to my symptoms on the phone, and several others offered treatment suggestions. I'm assuming your health care is controlled by some type of HMO through workman's comp, but you must try everything you can. I also can only assume there has been some type of nerve damage from the surgery, because of the info you have provided, and any doctor in their right mind would know this would cause unrelenting pain. I cannot understand why you are not getting the help you need, and hopefully you will find some way to fight this system that is controlling your health care, and well-being.

Don't give up, and keep fighting for what you deserve.

Donna

Re: dear dr. Z

tony o on 8/18/01 at 13:10 (057101)

the reality of it is, im not going to pray for something like this, however i will pray for relief. it seems that is all i can do. this Fentanyl you speek of. how do i get a doctor to give it to me. someone suggested cutto
ing my hair and gotee to (mask who i really am) just to get pain relievers. if i do that i'm bowing to the system that is innoing me. although it is not out of the question to cut the hair, i would be going against my principles. yes i was a hippie in the 60's - 70's but that was a long time ago and today verything is a lot different. i will try to get a pain management clinic to accept me for now but when they know i have no income or no ins. they wont do squat. is there some way you can give me a referal or a letter of intent about my situation or is that out of the question without an examination? i do and have all my med. records and could fax them to you if you wish. its pretty long but if you specify what you want i can sort threw them .. let me know. T

Re: I am wondering?

chris on 8/18/01 at 13:40 (057105)

Actually, it was 10 months from the dx of pf to surgery, as soon as tts was confirmed my pod scheduled surgery.

I hated the injections. The first I received from a Gp without any pain relief and it hurt beyond **** When I was referred to the pod specialist and she said she was going to give me another injection....I cried like a baby! But they numbed the area with some cold spray and it did not hurt as much....I ended up having about 3 or 4 injections before surgery.

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/19/01 at 23:43 (057220)

Hey Tony..
If I was you....I would look for another Orthopedic Doctor...
My Ortho here told me to sign up for disability...he states this is a qualifying disability..
I have been off of work since April...and have had a TT release and some other nerves had scar tissue removed...
My last surgery was 3 weeks ago....
I signed up last week for the disability insurance...we will see...
If you could get the right Doctor to listen to your complaints...then you could possibly qualify...
Please....don't give up hope...
If we all gave up....who will help change it for the people in the future...
I beleive if we speak out now...then people will listen to our cries of pain and take us seriously...
I guess I am lucky to have a very compationate Orthopedic Doctor...
I know I have a long road of pain ahead of me....but with this board and my Doctor....I know I will be able to endure it and offer my experiences as help to someone else in the future...
And I feel your Doctor was very wrong to take your appearance into consideration of how you have pain...
I am a nurse...and I know pain is something no one can see...it is only felt by the individual...and who are we as medical personel to judge weather someone is in pain or not...
Thanks for listening...
Cindy

Re: Tony...My Ortho states you can get disability for this...

BrianG on 8/20/01 at 19:40 (057340)

Hi Cindy,

When you applied for Social Security, what was the illness, or code that you used? Is TTS on the approved list of SSD ailments? I know PF isn't, can you believe that!! If it was, I would have already applied, I feel dicriminated against. My disability is just as bad and just as real is all of the codes on the approved list.

Please keep us updated
BCG

Re: Tony...My Ortho states you can get disability for this...

tony o on 8/20/01 at 20:22 (057346)

oh i got disability all right. i was released to go back to full duty climbing my telephone poles. no wat. workmans comp. docs gave me 6% disability. can you believe that. said it was 94% physcological. im ready to sue em all. this is not right. theres no way only6% thats outragious. im not going to take this lying down . im soooo pissed. i thought i was realistically at the least...60- 70%. what next????? i cant even think about how there screwing me. but thanx for the push. anyways......... T

Re: Forget the lawyers for now, plenty of time later

BrianG on 8/20/01 at 20:53 (057353)

Hi Tony,

Good to see you back tonight. So, have you thought any more about how your going to go about getting some good pain management? I don't think lawyers are the way to go right now. It sounds like the anger is getting the best of you. Put some of that energy to use in a more positive direction. Did you check out http://www.pain.com yet ? Do you have any questions? My ailments are different, but I'd be willing to bet my pain was just as severe. I was in tears many a night driving home from work, 2nd shift. I worked at it, and you can also. Good luck

BCG

Re: Tony...My Ortho states you can get disability for this...

Laurie R on 8/20/01 at 21:00 (057356)

Hi Tony,
From what you say here that the doctor said your were only 6% disable and 94% physcological ,that tells me this doctor did not know enough about PF. And believe me just because he or she is a doctor does not mean he or she knows all their is to know.You keep fighting you will win .... Don't give up ..I believe you can get disability for this too. It is up to your doctor though .Tony I wish you lived in CA I would tell you to go and see my Pod ,he would help you and he would also take your pain seriously . My Pod also has PF ,he knows all to well what the pain feels like.

I really feel for you ,not only are you in pain and you had to change your whole life around , but you have to deal with doctors that don't care. Tony find a good doctor that will give you the pain meds you need and deserve ,and that will listen to you and help you . I know it is hard.Just don't give up.

My very best to you ,Laurie R

Re: Forget the lawyers for now, plenty of time later

tony o on 8/21/01 at 06:23 (057402)

been having a lot of disdain. can't sleep with this and with the fact that my doctor just gave me his final repoer.
im shocked, stunned and totallt confused. he listed me as DISABLED! the problem is......only 6%. thats it. i can't believe he won't here my cries for relief. im so frustrated.im upset, i feel betrayed by the people i put my trust into letting them help me overcome this horrible nightmare. i do not want monitary rewards, nor do i seek drugs to get high off of.i can't stop looking at this with a look of puzzelment. i only want to get back to my work and earn my living without a lot of pain.nothing else.here is his report :::::we agree he has reached maximum medical improvementand can return to work without restricktions. he is not taking any medications. we would not recomend any surgical or evasive treatments. we would not recomend any narcotic treatments. he has a 6% permanent partial physical impairment to the whole body. i will see him again on a PRN basis.
thats it! he underwent a FCE but did not finish it and walked out on the rehab person. his major problem is psychological and not secondary to any work injury.
this is so shocking! this isn't the way it is.i did not walk out of the evaluation... i couldn't continue because of the pain. i was crawling on the floor it was so bad.psychological? absolutly! but not for that (exageration or faking) because of the non cooperation of my doctors to not listen to my pleas for relief. yes its all psychological. from them trying to steer me to what they wanted, not for what i needed. no one can maintain a degree of sanity with all that is happening to him because that person is trying to live with the constant pain that is trying to overtake him. it was and i fought it day and night without meds.they used 90% anti-depressants on me. when i told them im not depressed im in pain. BIG difference. the pain is pschologically altering my normal thinking process. i knew that idont deny it. but your treat the sorce not the mind. thats where i feel i was not being propw
erly cared for. i am a warrior and i took it. its been 13 months through this pain. and it has worstened steadily since the operation. at one point i begged him to take the leg off or cut the nerve or anything to ease the pain. no has listened. that is so frustrating. now their saying im imagining it. all i want is relief and get to work. i feel so alone. im stubborn. i will fight this war of bullshit. im tired of lying down and soaking my foot and plugging in that #$%^%$3 tens unit and the patches and the ointments and the advice from doctors who havent a clue and couldn't possible know what im feeling.
oops. sorry man. i got carried away. didnt mean to run like this. its my theropy to do this to vent my mind in another direction instaed of bowing to the pain masters. anyways....i just to know...what have your docs perscribed for your pain and how long have you been going threw this. whats your outlook? thanks. i feel a little better knowing someone might have a clue what im going through. tony o

Re: I am glad you vented

Tammie on 8/21/01 at 08:56 (057413)

Tony, glad to see u back and I think maybe some here maybe able to help you! Brian is great he really is give what he says some real thought, he has been thru allot as so many others have been! I know that it is not fair life is not fair but we have to get thru it some how. Keep talking and keep listening that and putting to work what is given information to u may begin to help. There are more then one set of docs out there.I am dealing with my employers right now, they did a check up call on me yesterday questioned my son and to where abouts I was, I was at pt. A co worker called in evening and informed me they are looking to replace me , as I have been off playing since april.They need help not me playing the game.The so called co worker told them I would not be back till jan probly with my dr. so they are loosing faith, I did not ever say anything about Jan, I to if I could would be there today,my job is a part of me the person and part of my life, yes it is on hold but so is everything else in my life that I enjoy, like you say the sleeping thru a night without pain the walking without pain the life is not fun but they see it from there eyes.I tell them what my dr. tells me , gave them his number to call, they have his report, he has got me off not me they have a inhouse dr. and a pod why dont they consult with them? I hear you my friend life is not fair and not all people are either, I will not forget it either, It is not over yet! See Tony we have to help ourselves and take care of us cause most dont care, they do not feel or see our pain, they do not understand that it is not something we can put a darn band aide on and return to life. There is no set time that our bodies will cooperate with us, we or unfortuantly the Dr.s cant give us promisis they can only estimate and work with us and sometimes they are lost to and some cannot admit to it or some may not be as well informed or trained in all areas. Some do not have a advanced compassion course (LOL) some are better there. I do not believe all are like your Dr. I have seen Dr.s here and listened to there advice and then heard there compassion along with the obvious restraint in there messages when they might have liked to say more. I think you have found a good place to re start your search. Keep talking ask all questions read learn and put it to work for u! Lots of info and help here! Some that we are selves do not want to hear at times and then we get some brave soul who tells it like it is ( then we dump on him for being brash lol) but it all comes together most are here to give help and hope! Hang in Tony , Good luck to u!

Re: Where are you from ?

BrianG on 8/21/01 at 09:52 (057415)

Hi Tony,

What is the nearest good sized city / state that is close to you? Maybe someone could give you a recommendation. At the bottom of the http://www.pain.com home page you can look up pain clinics according to each state. Just remember, all are not created equal, they may (or may not) have what you need, but there are ways of finding out before you spend money for an appointment.

BCG

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/21/01 at 12:17 (057430)

Hey BrianG...I'm not sure what code they used...I applied about 2 weeks ago...I'm still waiting to hear....
My Orthopedic Dr. and the Neurologist both said this would allow me to be on disability....
They are sending in the reports....
Talk to your Dr. about this...
I mean...if your profession includes walking like mine does...and it is extreme pain to walk...then you are considered disable in my books...
here is a good site I found while searching disabilities...
http://www.ssa.gov/disability/
There...you can find so much info on what would be covered....
hope this helps...
Cindy

Re: Tony...My Ortho states you can get disability for this...

BrianG on 8/21/01 at 12:36 (057432)

Thanks, I've checked this site out, but there is no code for PF. I think you'd have to group some other generalized things together, so it makes it more complicated.

BCG

Re: Tony...My Ortho states you can get disability for this...

Laurie R TO Brian on 8/21/01 at 20:32 (057484)

Hello Brian , YOu have already helped me out so much . I have another question for you if you don't mind. I went to the SS site and I checked all over it for the codes to see if RSD is one of the codes for disability ... I could not find the codes on the site. Can you please tell me where on the site are the codes.. Thank you as always for your help .... Laurie R

Re: Tony...My Ortho states you can get disability for this...

CindyF on 8/21/01 at 22:49 (057495)

Laurie....
I went to the ss site again...
You can go to the frequently asked questions...and there is a place to ask a question....by e-mail...and you will get a reply....
I applied 2 weeks ago for the disability at the insistence of my Orthopedic Dr.....and they said it could be 4-6 months before I even know if I qualify....but I do have more problems than the regular TTS...I had nerves trapped all over my foot from scar tissue...and I had 2 surgeries since April 2001....
I had my last surgery on July 26....and I still haven't been allowed to crutch walk...
Good luck...
CindyF
That could be why...
I don't know

Re: Tony...My Ortho states you can get disability for this...

Laurie R on 8/22/01 at 01:16 (057500)

Hi Cindy , Thank you so much . I will go back to the web site and send them an email and ask. This is very good to know . Do you also have RSD?? I would think any of the long foot probelms would be covered for SSI ,I can not see why . Thanks again ..My very best to you ,Laurie R