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Dr Davis can you give your opinion?! PLEASE!

Posted by Joel on 9/17/01 at 19:13 (060792)

My wife had PF release on her right foot with a scope in Dec of 2000. It relieved the pain for about 4 mths and now she can hardly walk. The muscle is huge. The orthopedic doesn't know what to do. They have tried casting it, immobilizing it, night splints, injections, orthotics for special shoes YOU NAME IT. She can hardly take a step. Let alone stand. We are desperate for answers.

Any help you can give would be appreciated!

Re: Dr Davis can you give your opinion?! PLEASE!

Ed Davis, DPM on 9/17/01 at 19:27 (060798)

Joel:

Which muscle is huge?
The items you have listed--injections, night splints---were they tried before surgery of after surgery?

Is the pain in the same place as before the surgery or a different place?
Is she having problems with swelling? Are ther any temperature or color changes in her foot?
Ed

Re: Dr Davis can you give your opinion?! PLEASE!

Answers for Dr. Ed on 9/18/01 at 10:16 (060840)

Dr. Davis, the muscle in the 'belly' of the foot, running along the instep, to the point of protruding. This is on her right foot and the inside of the arch there is a obvious bulge. The thought it could be a tumor, so they did an MRI. Thankfully it wasn't a tumor. They say it is the muscle enlarged tremendously and thick.

She had injections a year ago, then it was put in a cast to immobilize it.
None of this worked and they finally resorted to the PF release surgery, done with a scope. She never had complete relief from it. Bear in mind, she had the same problem with PF in her other foot, 4 years ago, and after all trmt were exhausted, they did surgery, but NOT SCOPE, her orthopedist thought it was more successful than the scope. Although the recovery was lengthy, she is PAIN-FREE in that foot. Praise the Lord (and the doc). She has been consulting with this doctor, he is not able to practice right now b/c he contracted hepatitis from a patient :(
So, when this foot got unbearable she went to a podiatrist, ankle & foot surgeon locally. She had several injections.

She does have a lot of swelling, this noted in the MRI also. The doctor had her on Vioxx and last week took her off, b/c they said sometimes it causes swelling. She has also been on Lasix, trying to help the water problem. They have now changed from Lasix to a different diuretic.

There is no redness in the foot.

She is not able to work now. She can't even go to the grocery, b/c walking hurts her so bad, not to mention standing in line.
She went for a second opinion, they requested the MRI. After finding the bulge was a muscle and not a tumor or scar tissue, they told her they do not know what caused it. Possibly post surgical?! They then told her they would give her a RX for pain and they were sorry but they couldn't help her and did not know where to send her for help. They did make custom orthodic inserts for her, but they hurt her foot sooo bad she can't hardly wear them.

Her former doc, who is not working: Suggested that the muscle be biopsied and then if all was well, possibly going in and surgically removing part of the muscle. This makes sense. But we don't know if we need a podiatrist or an orthopedist.?!

I AM SORRY TO HAVE GIVEN YOU SUCH A LONG ANSWER< BUT I am just desperate to find her some help. We don't know where to turn next. She is in such pain, her life has gone downhill, being immobilized. We have four children who need their mom back.
Thanks so much for your time and opinion.
Joel V.

(One other note: She has a rare allergy to COLD, so ice is not an option: She swells and has a horrible reaction to ICE, even cold drinks sometimes. There is a name for it but I can't recall it)

Re: Dr Davis can you give your opinion?! PLEASE!

Pauline on 9/18/01 at 13:13 (060854)

Joel,
Check Gail's 'Searching for answers' post below. Your wife and she may have something in common. Good luck

Re: Dr Davis can you give your opinion?! PLEASE!

Ed Davis, DPM on 9/18/01 at 14:28 (060868)

Joel:

This is definitely a tough case--the type of case where a doctor needs to exam a patient and sit down with all the records and tests that evening in order to figure things out. Some of the things that need to be ruled out include: stress fracture of the heel bone, infection of the heel bone and reflex sympathetic dystrophy syndrome. A bone scan may be in order at this point. Discuss this with her podiatrist. Stick with him if you feel confident with him/her, otherwise, let me know where you live and I will see if I know any names in your area. I wanted to follow up with you on this despite the fact that I will not be participating in the message boards---please contact me at eddavisdpm@hotmail.com
Ed

Re: Dr Davis can you give your opinion?! PLEASE!

Ed Davis, DPM on 9/17/01 at 19:27 (060798)

Joel:

Which muscle is huge?
The items you have listed--injections, night splints---were they tried before surgery of after surgery?

Is the pain in the same place as before the surgery or a different place?
Is she having problems with swelling? Are ther any temperature or color changes in her foot?
Ed

Re: Dr Davis can you give your opinion?! PLEASE!

Answers for Dr. Ed on 9/18/01 at 10:16 (060840)

Dr. Davis, the muscle in the 'belly' of the foot, running along the instep, to the point of protruding. This is on her right foot and the inside of the arch there is a obvious bulge. The thought it could be a tumor, so they did an MRI. Thankfully it wasn't a tumor. They say it is the muscle enlarged tremendously and thick.

She had injections a year ago, then it was put in a cast to immobilize it.
None of this worked and they finally resorted to the PF release surgery, done with a scope. She never had complete relief from it. Bear in mind, she had the same problem with PF in her other foot, 4 years ago, and after all trmt were exhausted, they did surgery, but NOT SCOPE, her orthopedist thought it was more successful than the scope. Although the recovery was lengthy, she is PAIN-FREE in that foot. Praise the Lord (and the doc). She has been consulting with this doctor, he is not able to practice right now b/c he contracted hepatitis from a patient :(
So, when this foot got unbearable she went to a podiatrist, ankle & foot surgeon locally. She had several injections.

She does have a lot of swelling, this noted in the MRI also. The doctor had her on Vioxx and last week took her off, b/c they said sometimes it causes swelling. She has also been on Lasix, trying to help the water problem. They have now changed from Lasix to a different diuretic.

There is no redness in the foot.

She is not able to work now. She can't even go to the grocery, b/c walking hurts her so bad, not to mention standing in line.
She went for a second opinion, they requested the MRI. After finding the bulge was a muscle and not a tumor or scar tissue, they told her they do not know what caused it. Possibly post surgical?! They then told her they would give her a RX for pain and they were sorry but they couldn't help her and did not know where to send her for help. They did make custom orthodic inserts for her, but they hurt her foot sooo bad she can't hardly wear them.

Her former doc, who is not working: Suggested that the muscle be biopsied and then if all was well, possibly going in and surgically removing part of the muscle. This makes sense. But we don't know if we need a podiatrist or an orthopedist.?!

I AM SORRY TO HAVE GIVEN YOU SUCH A LONG ANSWER< BUT I am just desperate to find her some help. We don't know where to turn next. She is in such pain, her life has gone downhill, being immobilized. We have four children who need their mom back.
Thanks so much for your time and opinion.
Joel V.

(One other note: She has a rare allergy to COLD, so ice is not an option: She swells and has a horrible reaction to ICE, even cold drinks sometimes. There is a name for it but I can't recall it)

Re: Dr Davis can you give your opinion?! PLEASE!

Pauline on 9/18/01 at 13:13 (060854)

Joel,
Check Gail's 'Searching for answers' post below. Your wife and she may have something in common. Good luck

Re: Dr Davis can you give your opinion?! PLEASE!

Ed Davis, DPM on 9/18/01 at 14:28 (060868)

Joel:

This is definitely a tough case--the type of case where a doctor needs to exam a patient and sit down with all the records and tests that evening in order to figure things out. Some of the things that need to be ruled out include: stress fracture of the heel bone, infection of the heel bone and reflex sympathetic dystrophy syndrome. A bone scan may be in order at this point. Discuss this with her podiatrist. Stick with him if you feel confident with him/her, otherwise, let me know where you live and I will see if I know any names in your area. I wanted to follow up with you on this despite the fact that I will not be participating in the message boards---please contact me at eddavisdpm@hotmail.com
Ed