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could u explain please I need help

Posted by Tammie on 12/01/01 at 12:48 (065823)

I was wondering what this means as I really dont think I understand .It is on my Pt script, Tibialneuritis/pt tenosynovits the spelling may be off as very hard to read the script.And I was wondering if you could tell me about it and how it might relate to my past pf and heel spur surgery and then the tts surgery? I am getting extreamly confused again . My pod is saying I must listen as I am risking some longterm or lifetime problems if I dont think about possible job change and getting off this foot. Lots of swelling a lump under which is getting larger at times it seems .A great deal of pain.I walk on toe alot on this foot do to pain and then the whole foot is painful. He wants me to use my boot more if I insist on working . He suggests strongly that I only work no more then 4 hrs on feet may find sit down work tho. But there is not much of that in my field. He gave me ultram for pain but warned that is not a cure and that tho it may help with pain not to over do it cause it feels better. I have had so many shots in this foot I can not remember how many. He did tell me that when he puts cortisone it is very little to just try to take a bit of inflamation out more is a numbing or something to help with pain for a few days at most. He would like me to consult with a neuro dr. for possible other nerve damage?

I am sorry this is long as u know I tend to be long winded. I do apoligise ahead of time! I get so upset at his office I find it very difficult to really understand what he is trying to explain to me. I guess I tend to blot out things I wish not to hear. I am sorry for bringing it here but I know that you are very good and may be able to give me some advice, I do have a dr. appt. with another dr. in dec not a neuro but another for some added help or another side. I am not giving up on my pod but need to do this so everyone will get off my case . Could u please please with sugar on it give me some advice or a thought on what might be going on here? I feel very lost and extreamly frustrated and depressed over this whole foot business I feel as tho everything I love is being ripped away from me , and I do not mean to sound ungrateful for what I do have as I know I am luckier then some but I really need some help Please I think this is like begging? My whole life is in turmoil right now and this seems as tho it is the icing on the cake so to speak. I am wondering if really my working and such can really be hurting me as much as my pod says. He really frightened me with what he said. Enough to make me think and ask questions to those who have a great deal of expierance. Thank u for your kindness and generousity! Have a good day and please except a hug for your time and effort!

Re: could u explain please I need help

elliott on 12/01/01 at 18:58 (065856)

Neuritis is nerve dysfunction secondary to inflammation of the nerve tissue. I guess tibial neuritis means neuritis of the (posterior) tibial nerve, i.e. the main TTS nerve. You just had a TTS release, didn't you?

PT tenosynovitis is inflammation of the sheath encasing the posterior tibial tendon. That sheath helps the tendon glide properly when walking. If necessary, there is a surgery which sort of cleans out the inflammation (I had it as part of my TTS release in my right foot, but I think I regret it). It is possible it will resolve with rest, walking boot cast, proper shoes, NSAIDS, etc. The tenosynovitis may be an early indication of posterior tibial tendon dysfunction, which, left alone, could worsen to the point where you can't walk too well and more serious surgery (tendon transfer or bone fusion) is necessary. As a possibly relevant aside, tenosynovitis is one cause of TTS, apparently because the inflammation on the tendon takes up space and presses on the nerve.

Tammie, can you summarize (briefly :-)) what your symptoms were pre-surgery, what surgery you had and what was found at surgery, and what your symptoms are now post-surgery? Just these things. (You can leave out the hugs and kisses. :-))

Did you have an MRI? If yes, get a copy of the report and post its contents here. If you didn't, just get that MRI--you need it (you can't rely on a script for that), and then post its contents here. And don't hestitate or feel guilty about going to other doctors. Maybe an orthopedist who has experience with both TTS and posterior tib dysfunction would be a good idea.

Re: elliott

Tammie on 12/01/01 at 21:03 (065868)

Ok I will try. First I had the spur and pf release in april, symptoms then were heel pain could not put weight on at all walked totaly on toes. Arch pain and some electrical feelings that would go to big toe. First morning pain and after rest. Took several anti inflams, orthodics,iced ,pt ,cortisone shots, Taped new shoes.

Ok after that surgery things were some what better, could now put weight on heel and foot, some lateral pain I think outside of foot right.Still allot of the tingling feelings and some jolts that would progress down to my large toe, inside ankle area thru heel arch area. I get like a hot feeling in foot and a throbbing sensation in the arch to heel.(all this is to the inner ankle side and under.Night time is the worse for symptoms seems as the day progresses the tingling and the jolts along with the throbbing get extreamly worse . I try to go to sleep and the pain is real I cannot sleep and when I do fall asleep I often wake with a jolt that certainly makes me know it is there, then will throb untill I cannot stand it or sleep or anything till It settles down or I take something like ultram and it will let me sleep for a few hrs. It seems to be a all day type feeling but getting worse later in day. At times I feel as tho someone stuck me with a hot machetee and left it in.There is a numbness on the inner side of ankle about a inch or so below the ankle bone which goes under foot along that nerve area. It is not totaly numb tho it sometimes has the nervy feel.if u follow that line the lump comes and it is very painful and has progressed more so. This is what I am feeling since the tts surgery which was done aug 30 .

I am having allot of trouble walking that toe walk is back along with a terrible limp when I try to walk flat, I have always had flat feet no arch.Sometimes as I walk I feel as tho it is ripping inside it will stop me dead in tracks for a min to catch a breath if u know what I mean. That is when i am tired and have been going to long and that is when things get worse. I have not had a MRI, or nerve testing. I will ahve to be refered by the dr. for insurance, I do have a appt. in dec with another dr. Ok I tryed to keep this brief I thank u for the explanation thank u much.

I am sorry I forgot to say the tts surgery was not what people have described here the incision was small on the side of ankle about 2 inches I would guess, and a small incision on bottom of foot I believe camera inc? He told my husband and showed him pics he took where he said the nerve was compressed into a ligment with scar tissue around it he had to cut I believe I may have misunderstood now , but that he had to cut part of ligment to get it released? I am not to smart on this ok, I am sorry I get flustered and get lost quick . Simple is best for me.I get hung up on technical terms and miss the rest.So what do u think now , Am I totaly nuts or can this really be this painful? No one would ever understand but I usually am a very strong person with a high pain thresh hold this has wimped me out to a whiny snivling baby. I need help.

Re: Tammie, you've got to get that MRI

elliott on 12/01/01 at 22:40 (065878)

Don't worry about sounding like a wimp. You're in a lot of pain. TTS pain can make anyone with a high pain threshhold into a whiny sniveling wimp; don't feel guilty at all about that. I was there not too long ago myself, and it ain't fun.

After reading your post, I'm a little unclear about what, if any, change you had in your nervy symptoms pre- and post-TTS release. If you'd like to elaborate on that, fine. I presume the ligament you're talking about is the laciniate ligament--also called the flexor retinaculum--which is always cut during any initial TTS surgery to give the nerve room to move; nothing special about that. Not sure why your incision is so small; it should be more like 4'. Not sure what your doc did with all that camera stuff. I don't like the description of his surgery, but what do I know?

Your nervy symptoms sound like classic severe TTS symptoms. Couldn't be more obvious. That lump may be a mass pressing on the nerve and causing the symptoms. You have to know what that is. An MRI likely will say what that is and if anything else is going on. It is standard procedure to get an MRI before TTS surgery to see what possibly is causing the TTS (e.g. heel spur, tenosynovitis, etc.) so that they can be repaired as well at surgery and increase the odds of success. You need an MRI, and you need it now. You've got to get your primary or whoever to OK it pronto. Cry and scream at them, but get it. If ever it was warranted, this is sucha case.

I think you may need to see some big-name TTS people to straighten this out. Where do you live? There are a few big specialists in my city. If you need to fly here, maybe I can pick you up from the airport and take you there.

Sometimes things get worse post-surgery before they get better, so you don't want to rush into another surgery until you're sure. Maybe things will settle down. There are some topical drugs that can give you some partial relief, if you can get your hands on them.

Besides a nerve conduction test (which will probably just confirm what you're already complaining about, and anyway is a little less useful post-surgery), the first step is an MRI. Whatever doctors you eventually go to, they'll all need to see that same MRI and its written report, a copy of which you can get from the doc who requested it or from the MRI place a week or so after the test. If at all possible, get a copy from the MRI place of the actual films to take with you. They gave me mine on the spot.

GET THAT MRI NOW.

Real sorry for the pain you're suffering. Try and hang in there.

Re: Tammie, you've got to get that MRI

DR Zuckerman on 12/02/01 at 07:12 (065889)

Man ,

Can't be any more descriptive. Couldn't of answered this any better. Dr. Elliot you are now an honary heelspurs.com doctor. Keep up the great work

Re: wow! thanks!

elliott on 12/02/01 at 08:04 (065895)

I've been working hard for just such a title. Does honorary heelspurs.com doctor satisfy Richard C.Ped's requirements of need-to-know foot care professional? I just gots to know what's behind that shower curtain! :-)

Re: could u explain please I need help

Laurie R on 12/02/01 at 10:57 (065900)

Dear Tammie, Did your doctor tell you where you have tenosynivitis ? I sure know how painful it is . I have it in my FHL tendon .... They found out when I had the tenogram done . I have the films here and you can see it . My Pod told me it is like glue in the outer part of the tendon .. Elliott explained it really well.... It is the outer cover of the tendon . How does your doctor know you have tenosynivitis ??

I can't remember ,have you have a MRI yet ?? My tednosynivitis also showned up on my MRI ....

My heart really goes out to you . Tammie you have been through so much with your feet .. I wish I could say something to make you feel better. Just know I am also just a email away .. Also I know you love your job . That has to be so hard to hear you better think about doing something else.

I was told I can NEVER go back to bartending ever . It took me a long time to realize I can't . I thought for a long time I would be able to someday , but now I know I can't .. My focus now is to just get somewhat better ... It has been a long road for me with some pretty big bumps along the way , but I try so hard to stay positive , but you know I have my times where I feel like it is never going to get better.....

Keep the faith and I know you have a lot on your mind , I am praying for you ...

Much love to you Tammie , Laurie R

Re: Tammie, you've got to get that MRI

Tammie on 12/02/01 at 12:24 (065907)

Thank u very much for the help I really mean it ! I want to tell more about the surgery, he had told me that the outer incision was much smaller then the inner one in fact he stressed that to me as I had said once about how much pain for such a small incision. He told me with the modern ways of operating they dont always need to make a large incision on the outside . Now I dont know what u make about this . As for pre op and post op changes, I feel that some of thease symtoms were there from the very begining back when I first had the pf and spur done, he kept saying that he thought the first surgery would help the secondary stuff which he had called tarsal tunnel. He really did not want to do any surgery on the nerve area unless absoulutely needed he stated at that time. So thus we did his way, which all thru healing of first and continuing the nervy stuff kept up and getting more painful.

Now I did not know if it was because I was not getting rest as I had so much pain I was not getting much sleep, or if it was really getting worse. It boiled and finally he said time to think about the surgery for the tts. Ok done it and now I would say if honest with myself, That things got worse when I returned to work. I hate to admit this I really do, but working anywheres from 9 to 10 hrs a day and well I am one who does not sit unless my body just wont allow me to move. I am being serious about this. Now I feel as tho I am back to square one and maybe a bit worse . He asks me % from before surgery, I kinda I know this is bad but I tell him better then is really the case, I told him about 50%, not true. But I know if I tell him really he will not let me work at all and he will tell me I will have to find another dr. cause I wont listen .

I am sorry I am getting myself into a mess and am so darn frustrated and tired of pain, but I also need to work I have bills to! Plus how do I pay for dr. if I am not working? My husband has his own high medical bills also.I feel as tho life is closing in on me and I am feeling a bit desperate and very frightened at what I might really be doing to myself.I was really thinking I am crazy that this cannot really be this painful that people are right when they tell me I am being a big baby. I am ready to try and find some help.I see a dr. on the 20 of dec I can maybe get a referral for a mri what are they and what should I expect? I am not frightened of pain as what at this point is a little more? But I would like to know in advance what I should expect. Thank u again please dont tell me I am a fool I already know this , I am ready to listen.

Re: Tammie, you've got to get that MRI

Julie on 12/02/01 at 15:59 (065914)

Tammie, no-one should tell you you're being a big baby, and if they do, you shouldn't listen! You're in pain, and the pain is real. We all believe you, so please believe it yourself, and get whatever help and take whatever steps you can to deal with it.

Everyone's prayers are with you. You've had a terrible time!

Re: Tammie, you've got to get that MRI

Tammie on 12/02/01 at 16:36 (065919)

Thank u , but it is the old saying if u are told something often enough it soon gives u doubts about yourself. So u understand why it feels that way. I do Thank all of you for being so very special in my life and understanding , This is sure been a really long road and I am glad I have you all with me ! I would have gotton really lost without you all.I am only sorry that you all have to feel the pain also! Thank you again for the kind words! I have been glad to see you back again Julie!

Re: Tammie, you've got to get that MRI

elliott on 12/03/01 at 00:45 (065958)

Not sure what your doc is talking about with that smaller outer incison. TTS release, dealing with teensy-weensy nerves, is so delicate that it does not really lend itself to a smaller incision on the outside; they have to cut the entire laciniate ligament (whose roof starts well above the ankle) as well as follow the course of the nerve and its immediate branches, at least one being lower down past the ankle, to see if they're clear. They gotta see all that with their eyes. I know some big TTS names, and all do that bigger incision. I may recall having seen some article talking about what you describe, but in any case, you already had the surgery, so let's not dwell on that.

MRI (magnetic resonance imaging) takes pictures of the tissue inside you (unlike xrays or bone scans, which are limited primarily to bone). It is expensive, but it can be crucial. Hopefully your insurance will cover it. There is a foot-type MRI where just your foot is enclosed and you sit outside and read a magazine (but you have to make extra sure you don't mistakenly leave your credit cards in your pocket when entering its range, as they can de-magnetize). More typical is an all-purpose MRI, where you lie down and they slide you into something looking like a half-cylinder (cut the long way, so when standing at the front of it, you see a semicircle on the outside--sort of looks like the matter-anti-matter pod that Scotty of Star Trek would have to climb into). You will be in the MRI room alone (no reason for the technician to get constantly radiated), and the tech talks to you by microphone. For an MRI of your foot, your head till about your waist will remain outside the device (unlike for an MRI of your back, where you're slid totally in). Your foot has to remain still while they take the pictures. The machine clangs very loudly, and when the tech says just a few more minutes and we're done, it's a lie that means around another 45 minutes to go. :-) Overall, this test does not hurt at all. Keeping your foot still or up against the surface may be a tad uncomfortable depending on your foot problems, but for most is no big deal. Now if one is claustrophobic and wants to panic, well... On a pain scale of 1 to 10, I give it a 0. So don't worry about it.

Tammie, where do you live?

Re: Tammie, you've got to get that MRI

Janet C on 12/03/01 at 02:12 (065961)

Dear Tammie,

You have been given some excellent advice so far, but I wanted to add my two cent's worth...

I was dx'ed with heel spurs a little over ten years ago. How I wish I had the support and knowledge from this Web site back then!!! I also had a plantar fasciotomy, both heel spurs removed, and a tarsal tunnel release on both feet, so I think I can REALLY relate to the pain that you are feeling!

Unfortunately, I also found it extremely difficult to stay down; as a mother of three, I constantly pushed myself. And like Laurie, I also worked as a bartender, at not just one but two jobs, seven days a week, to help support our family. Because my husband became sick with a terminal illness, I didn't think I had much choice.

I now have RSD as a result of the nerve damage, and it has spread from my feet, up my legs, into my hips and lower back, and now is affecting my arms. I am now 100% permanently disabled, and have to use a wheelchair. The pain is far worse than it ever was, and I continue to slowly lose my independence. For instance - just last year, I was driving a half hour trip twice a week, although it was quite painful. Now I need to take a taxi cab to my Dr's appts. 15 min. away.

Through the years we have had to rely on free Med Ins available from the state for families with lower incomes. We also had to declare bankruptcy just last year, after living off of our credit cards for as long as possible. I still have a WC case pending, although it has been over five years since I was able to work, and my husband and I are still fighting for our SSDI benefits. Although it has been a long and difficult struggle, I have confidence that we will win, some day.

I am writing you and telling you all these personal details because I want you to know that you are at a point now, when you still can make choices to help reverse the damage. I wish that I could prevent just one person from making the same mistakes that I did. At the time, I had no idea of the severe consequences of my actions. PLEASE try to understand that the nerve damage can and will get MUCH WORSE, if you continue to work on your feet all day long! If you must work, please try to find some sort of desk job. Even if you have to accept a decrease in pay, consider the alternative that I have described.

My very best wishes to you, always ~ Janet

Re: Tammie, please listen to Elliott and Janet

Julie on 12/03/01 at 05:39 (065964)

Dear Tammie

I understand what you say: that if you're told something often enough you begin to doubt yourself and even the reality of your pain. I was trying to put some weight on the other side of that see-saw. The voices you hear and the hurtful, disbelieving things that are said in 'real life' are louder and seem realer than the ones you 'hear' on your computer screen, but we're real too, and really and truly, we all believe you. We know you're in great pain. And we know you're not a wimp, and you're not a baby. You're still the strong person you once thought you were, and that strength will see you through.

Now you need to use that strength to make some decisions about the future. Some of them, the ones to do with the professional help you need, are easier to make than others: get an MRI, and get at least one more specialist view. Elliott has given you clear explanations and excellent advice, and has even offered to take you to a top TTS specialist - a kind offer you could surely take him up on: I'm sure he means it.

Janet has given you good advice too, from her experience and from her heart. It was brave and kind of her. It's difficult for you to hear, because it's about your work which you love so much, but it may be the most important decision you'll ever have to make. I feel sure that Janet is right in telling you the same thing that your pod has told you. I know how painful it is for you to hear that you are likely to get worse and do permanent nerve damage if you continue to do work that keeps you on your feet. But you really have to think about it now, because working on your feet is hurting you.

It's a pretty clear-cut question of putting two and two together and accepting the answer. Having followed your story for almost a year, I really don't like to think that in another year you'll be in a worse state of damage and pain than you are now because you couldn't accept the facts now.

You're already one of the most compassionate people I know, and it's hard to see how you could be more so, but you know as well as I that the pain you go through makes you even more sensitive to the pain others go through. So I've absolutely no doubt that this long, painful experience will bear fruit later on in your work and in your life, in ways you cannot foresee. Please be hopeful and look forward to all the help you're going to be able to give others, even though you don't know right now how that's going to happen.

My thoughts and prayers are with you - and in your next posts I would like to hear what steps you've decided to take towards healing.

Love and blessings

Julie

Re: RSD

elliott on 12/03/01 at 10:03 (065975)

Sorry for your condition. Could you (and Laurie R, if you're reading this) explain what symptoms you feel as part of RSD, why it goes into the arms, how RSD is diagnosed, what can be done for it? Thanks.

--------

Re: It's time to shi*, or get off the pot !!

BrianG on 12/03/01 at 10:59 (065976)

Hi Tammy,

Ellott is correct about getting the MRI. It's absolutely painless, but on the other hand it's quite expensive. I think you have a decision to make here. First, I think that you should read Janet's post 5 or 6 times before deciding anything. It is one of the the most compelling posts I have ever read about why we should all take care of our feet before it's too late.

If you decide that you just can't stop working, no matter what the consequences, I woldn't even bother with the MRI's, Neurologists, 2nds opinions, none of it. Why waste your money if you don't want to help yourself. Please find a competent, compassionate pain management specialist who will give you enough pain meds to continue on with your job until you are crippled.

I'm sorry for sounding so harsh, but just remember, I continue to pray for you everyday.

BCG

Re: It's time to shi*, or get off the pot !!

Tammie on 12/03/01 at 15:59 (066002)

Brian , Yes you are right . Thank you for showing your friendship I do appreciate it always. I guess I dont deserve to be here this is not for me I am sorry . I just can't accept this as a final ending . Take care and I wish you the best of luck . Dont waste your prayers on me as as you have said I am just not ready to give into this life.Please send your prayers for those more in need and those willing to change there life for there feet. Thanks and take care and my prayers go out to you and all.

Re: Tammie, you've got to get that MRI

Tammie on 12/03/01 at 16:04 (066003)

I live in a very small northeastern area of Ohio. But I think maybe someone is right I just dont think I am ready to give in to this final dx and give up my life for my feet. So maybe it is a waste of the dr.s time and effort. You are a very smart man and i do appreciate all of your knowledge I really do. My hope is that u continue to help those here that are open to lisitening and wanting to change there lives. I want to heel but I want life also and I am not willing to give up what I love . If I have to drag myself around i will.I thought I was making the best choice by contacting another dr. for a look but maybe I will be wasting there time also. Life just is not worth living for me if I can not do any thing that I love so I guess that is my answer. Thank u and I do hope for your recovery thru all of this. Keep up the good work here on the board!

Re: Tammie, you've got to get that MRI

Tammie on 12/03/01 at 16:07 (066004)

Thank u for sharing . Unfortuantly I just have a very hard time believing this could be my potential problem but if it is I guess I deserve what ever happens. Thank u for taking the time to offer your thoughts and advice. I am sorry for the pain you have I truly am and my hopes and prayers for you are with u always. May God shine upon your heart always!

Re: Tammie, please listen to Elliott and Janet

Tammie on 12/03/01 at 16:11 (066005)

Thank u Julie, No u do not want to hear what steps are planned ! But thank u for the care and effort. I guess there are some of us who well just cannot change. I will not bother anymore as I finally realize I just do not belong here. Maybe i will never belong anywhere. I am just not ready to accept all of this.I feel as tho I have been given a type of death sentence, and not sure how to handle it. I am having trouble coping with all of this . I dont think I want to anymore. Take care and good to see you back there allot of people here who have missed u !

Re: Tammie, we care

Carole C on 12/03/01 at 16:29 (066007)

Tammie, life is worth living.

It's just necessary sometimes to take care of yourself for a limited period of time, so that you can continue living your life as you want to for many many years to follow.

Hang in there! And do try to get all the help you can find, and try to help yourself as much as you feel able to do, too. Try to be your own best friend, and tell yourself what you might tell your best friend if she was faced with this. I am so sorry that you are in all this pain, and I know how rugged it is to try to deal with things when you are hurting like this! I sincerely hope that things get better for you soon.

Carole C.

Re: bartending

Carole C on 12/03/01 at 16:41 (066008)

I have never been a bartender, and actually I have hardly ever been in a bar, but isn't that the type of thing that Tammie might be able to do in a wheelchair for a short time while her feet heel? Could she reach high enough to do this?

If not, how about going on disability temporarily? She needs to earn a living and I can certainly relate to that. There is no Santa Claus.

I'm no more a lawyer than a bartender. Some of you probably know all about this stuff and could tell us if this is something she could pursue.

Carole C

Re: oh

Carole C on 12/03/01 at 16:45 (066009)

Oh... re-reading all these posts, I'm not sure if Tammie is a bartender or what. I hope her job is something that could be done from a wheelchair though.

Re: Tammie, think again

Julie on 12/03/01 at 16:49 (066011)

Tammie, I don't believe you. Not for a moment. You're in pain, unhappy and angry and that's why you're saying this. But try to think of it this way. If you go on working now, the time is going to come when you're going to have to give up the work you love, probably forever. You will be too disabled to do it. If you back off now, and focus your considerable energies and determination on healing, there is a good chance that you will be able to work as you want to work again. Maybe even without pain.

Wouldn't it be worth a try?

Oh - and you can change. Everyone can, and what's more, everyone does, whether they like it or not. The only question is how. And it's up to you to decide that. Please make an intelligent decision!

And yes, I do want to hear about it. And about your progress towards full healing.

Re: Sorry for being harsh

BrianG on 12/03/01 at 16:53 (066012)

Tammie, none of my prayers for you were waisted, no matter what you may think today. You always told me how strong you were, and now your ready to throw in the towel? Doesn't sound like the Tammie I know. I urge you to continue to look for help, where ever that might be. It's obvious, I am no expert, for I am like Janet. We both worked well beyond when we should have. I just don't want to see you go down the same path. Please do whatever it takes.

BCG

Re: Tammie, see if we care

elliott on 12/03/01 at 17:18 (066014)

Trying to use some reverse psychology. :-)

Hard to tell if you're hinting at suicide or just chucking all the advice and saying goodbye. Giving up doesn't sound like what you're about. I for one didn't say you have to stop what you're doing for life, although sometimes that can happen (let's hope not). Those saying so are just offering advice and warnings in case that need be. It's one thing to declare that you're just going to go on as if nothing's stopping you, but you might find very shortly down the road that you just can't do so, maybe can't walk at all, or that you can't bear the pain. At the least, you need short-term rest.

Give it a chance to rest and get better, get prescription drugs--both oral and topical--to help you get through (I can tell you more about these if you'll listen). But go see a big doc anyway. You can always delay a decision, but being informed is a good thing. A second surgery, if and when you feel it has come to that, might give you a second chance. That's all I'm saying, and the decision would be yours and yours alone to make, as there are risks.

Ohio? Lucky lucky lucky lucky lucky lucky break! There are some leading TTS docs in Ohio. Stephen Conti, a foot/ankle orthopedist, I believe has been bouncing around between Cincinnati and Cleveland the last several years, I think now in Cleveland. He is a WORLD giant, especially in posterior tibial tendon dysfunction, but also has extensive TTS surgical exposure. Another is GJ Sammarco, Sr., also a bona fide giant in TTS, and a colleague of the famous Baxter (ask his office when calling to make sure he's the one). Forget the schlock doctors. Go to one of these two. (I know there are loads of high-quality TTS pods in Ohio as well; some Oriental guy with a one-syllable short name that escapes me, as well as others; I'm sure the pods here know of them.) But get that MRI first, then go see one of these docs, even if you have to wait months for an appointment. Just do it! With a little luck, the rest of your life, you'll just do it!

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Re: Elliott Talk

Tammie on 12/03/01 at 21:17 (066032)

I am listening to your advice, I am trying very hard to begin somewhere. I have a appt. on the 20 of dec for a start. I am not going to do anything stupid. Reverse psychology huh well dont even try it I am ok just some bad days. Now i am ready to hear u . No promises tho .

Re: oh

wendyn on 12/03/01 at 21:24 (066033)

Laurie was the bartender. Tammie works as a nurse (or nurses aide?).

I don't think you could ever bartend sitting down.

Re: OK, here goes

elliott on 12/03/01 at 22:56 (066043)

First of all, if your foot hurts more and more by just standing on it or working, you've got to temporarily stop or slow down enough, as you might do permanent damage that could have been avoided with temporary rest. We don't all heal at the same rate post-surgery. How would you feel if you could've returned in a few months but did yourself in permanently because you didn't give it a little rest? We're not talking about forever at this point.

I don't know whom you're seeing on the 20th, but if there is even a possibility you'll need a second surgery (sounds to me like there is), a good orthopedist or pod is no longer good enough, as second TTS surgery is much more complicated than the first. Don't want to go into that now, but complications include potentially collapsed nerve bed, excessive scarring, having to repair nerve damage done by previous surgeon, etc, etc. You must see a TTS specialist such as the two I named. I can't stress that enough. Doesn't guarantee surgical success, but increases the odds. Such a specialist will also be more familiar with topical and oral drugs that may help. Sure, it's inconvenient and far away, you may have to wait a few months to see him (actually a good thing since you're just post-op) and there may be insurance issues; it's also the rest of your life we're talking about. If you want to see who you're seeing on the 20th, get an MRI through him, and then go to the TTS specialist, that's OK too.

1. First step is to get that MRI, both the films and the written report. It is such a disappointment to wait two months to see a big-name doc only to be scheduled for an MRI after that and then have to wait again for another appointment when the doc can look at the MRI on the spot and see what he needs to know. So do it first if possible (that lump may be compelling enough to authorize it if there's red tape). Also get copies of the written report of your first surgeon's TTS surgery (and even the PF surgery). Not sure if a nerve conduction test is the right thing now so soon after surgery; this can probably wait for the doc to decide.

2. Go to big-name TTS guy, taking MRI and reports with you. I doubt he's going to encourage another surgery so soon after the first, unless he's convinced that previous surgery was all wrong (even then, you may want to wait as long as you can). See what he says. At least you will understand where you're holding.

3. In the meantime, try some drugs to help with the pain and discomfort. This can come from big-name doc, but doesn't have to wait for him. Given your tingling and shooting, Neurontin is worth a try. You need someone to tell you what dosage to take. There are other oral drugs too. Next, topical drugs, consisting of various mixtures of drugs such as amitryptyline, ketamine, ketaprofen, gabapentin, etc. There is a drug store in Florida, called Custom Meds (352) 341-1212 and (800) 226-2023, that sells three different topical prescription drugs: Neuropathy Gel for tingling, Formula 5 for numbness/burning, and one other for shooting/stabbing pain. So if your doc doesn't know where to get it, you have a phone no. (Sammarco for sure will know about these drugs, and should have free samples of each to try, cheaper than paying and trying for nothing.) You smear a drop or two over the affected area every 3 hours or so as needed, and it can give partial temporary relief. I found only the first to work for me (about a 35-40% reduction in pain), but everyone's different. Cost around $45, which I paid for myself and got reimbursed later by my dinky HMO for all but $10 of it. I'm not going to lie, but drugs often don't work for TTS, or are of only limited value. But worth a try.

Follow the plan if you can and get back to us. Tammie, hugs and kisses. I really mean it.

--------

Re: oh

CArmen H on 12/04/01 at 07:46 (066060)

No...bartending is high volume work running running running!
Which none of us can do it seems....sigh.....oh well. We have each other right??
:-)

Re: OK, here goes

Tammie on 12/04/01 at 10:21 (066076)

Ok Elliott u have my attention , as u did not say I would have to quit my job . If I give u my email can we talk (email removed) I feel like awful for using all the heel board space or at least move this to another section. Also I have people who may read this and i dont know if I want them knowing everything about me. And Elliott when I offer a hug or a kiss it is always given with my heart it is not that mushy unfeeling saying. Just so u know I really am not transparent there. Thank u for really meaning it it means a lot to me ! I feel like maybe there is a hope somewhere, and I feel as tho finally someone really might understand the whole picture here.

Re: oh

Carole C on 12/04/01 at 17:57 (066132)

I had some misconceptions due to the way bartenders are sometimes portrayed on TV. I thought all they did was just mix a couple of things together and add a cute little tiny straw to make a drink, and put it on a cocktail napkin and set it on the counter. Well, that and also talking to people. I didn't realize there was any running involved! Oh well.

It's amazing how people sometimes have preconceptions of jobs they aren't familiar with. People sometimes think that because I am an oceanographer, I have an active outdoorsy sea-going job. Not so! I have the ideal job for someone with PF (though I went to sea more when I was younger and in school).

Carole C

Re: oh

wendyn on 12/04/01 at 18:57 (066137)

Carole, you should just come and visit me...we could hang out in bars and do research!

Re: oh

Carole C on 12/04/01 at 20:22 (066148)

Sounds like fun! I am often curious about bars, but would feel kind of out of place just walking into one by myself and ordering a diet Coke. LOL

Carole

Re: To Elliott, Re: RSD

Janet C on 12/04/01 at 20:56 (066157)

RSD (Reflex Sympathetic Dystrophy) a.k.a. CRPS (Chronic Regional Pain Syndrome) is actually a cluster of symptoms. A syndrome is a disease that has many parts to it; each symptom represents a piece that by itself may be unrecognizable. Only when put together into a 'symptom complex' is the picture of the disease apparent.

There are two major branches of the nervous system in the body: the voluntary nervous system and the autonomic nervous system. The voluntary nervous system can be divided into motor nerves (which move muscles) and sensory nerves (which transmit the sensation of pain, pressure, temperature, etc.). In the autonomic nervous system, the division is between sympathetic and parasympathetic nerves. The sympathetic fibers cross the midline outside the spinal cord, which explains why the symptoms of RSD can cross from one leg or one arm to the other. Also, the fact that the sympathetic chain exists along the entire spinal cord explains why the symptoms may spread from one arm to a leg on the same side.

At any given time, the symptoms associated with RSD may change. One month, a patient may have a swollen limb, overgrowth of hair or nails, and discolored skin. The next month, the patient may have hair loss, heat in a limb that had previously been cold (or vice versa). Not all patients will have all of the symptoms. RSD has been often been called a 'chameleon disease' because the symptoms can change so rapidly and so profoundly.

One of the best ways to differentiate a patient with RSD from one suffering from a nerve entrapment syndrome is to determine whether or not the affected limb is extremely sensitive to temperature. Patients with nerve entrapment syndrome very often do not have exquisite sensitivity to temperature, while RSD patients very often do suffer from extreme sensitivity to either heat or cold.

Since early diagnosis and treatment is essential to provide a cure for RSD, the appropriate use of diagnostic studies is important. Any delay in treatment will result in a disorder that is resistant to treatment and can become permanent. Some of the diagnostic tests for RSD include: the Sympathetic Nerve Blocks, Thermography, A Three Phase Bone Scan, and EMG Nerve Conduction Tests.

I was dx'ed with RSD about a year and a half ago, by having the Lumbar Sympathetic Nerve Blocks that Laurie is now getting. The LSNB's are used not only as a diagnostic tool, but also as a treatment for the pain of RSD. They are based on blocking the Sympathetic Ganglion, which is the cluster of Sympathetic Nerves outside the spinal cord. These types of blocks, if done on a repetitive basis early in the course of the disease, can put the disease into remission. I understand that if the patient gets some relief from them, then they do have Sympathetically Maintained Pain.

A well-educated Dr. taking very careful notes and observations of your symptoms also helps to diagnose it. One common symptom that I have is that the skin temperature of my feet usually registers around 70 degrees at my Dr's appts. I experience constant, intense, burning and ice cold pain that never goes away. I have extreme sensitivity; and the slightest touch of the skin on my legs or feet can bring agony. It has become very uncomfortable for me to wear pants, because the skin on my legs feels like it's crawling when clothing touches it. It's also extremely painful for my feet to touch the mattress, and even the covers feel like they're putting intense pressure on my skin. I need to keep my feet elevated above my heart most of the time, or they will turn deep purple, swell up badly, and feel like they're going to explode. My hands and arms are now experiencing similar symptoms as well. They're bitter cold, they ache deep in the muscles and bones, and it hurts me to bend my left arm at the elbow. I want to avoid any movement at all of my affected limbs, and I feel very protective of them. I also experience a shin-splint type of pain, and I have related sciatic nerve pain, that travels from my lumbar spine, through my hips, and is swollen and inflamed down each leg. My hips hurt me so much that it often wakes me when I turn over on my sides in the middle of the night.

Not just driving, but also riding in a car has become very painful as every little bump in the road causes roars of pain through my nervous system. I am also extremely sensitive to loud noises, which often sends my pain escalating. The pain comes over me, in times of flare-ups, giving me small convulsions, and muscle spasms. I often have sweats and then chills, and I get inexplicable rashes and bruises. The pain often brings with it waves of nausea, and I also suffer with insomnia; the pain keeps me awake because I'm unable to get comfortable.

I have to use a wheelchair now, and I stay in bed most all the time. I believe that stress can increase the pain, as can eating unhealthy foods, such as sweets, coffee, salt, and junk food. Drinking lots of water is essential. And I also use a small heating pad on the areas that hurt the most, which gives me some relief.

I'm sorry this was so long, but I hope that I have answered your questions.

Best wishes always, Janet

Re: To Elliott, Re: RSD

wendyn on 12/04/01 at 21:02 (066159)

Very informative Janet....and actually reminds me of something.

When my pain was bad - if I was exposed to a sudden noise or scare, I actually felt sudden intense pain. I had forgotten all about it till you mentioned it.

Re: oh

wendyn on 12/04/01 at 21:05 (066162)

Eeew...always avoid walking into a bar by yourself. Unless you are meeting a table full of people.

You will attract attention you may not want.

Carole - you come up for Stampede and I'll take you to some bars. You can have diet coke if you want!

Re: RSD

Janet C on 12/04/01 at 21:11 (066164)

Thank you Wendy. I was embarressed to mention this strange symptom to anyone, until I read it was a common problem for those with RSD. Thank goodness for the Internet! I no longer feel so alone and misunderstood.

All the best ~ Janet

Re: oh

Carole C on 12/04/01 at 21:44 (066165)

Bars were just not made for a 53 year old overweight greying overly intellectual woman like me with PF, who doesn't drink or smoke, to walk into alone. I agree! And although I hate to generalize, I am sure than if I walked in alone and got any attention at all it would be of the unwelcome type.

Stampede? what is that? Sounds like something in Fort Worth, maybe. I'm in New Orleans, and there is a bar on every corner here (and several between) but I've never been in any of them.

Carole

Re: RSD

wendyn on 12/04/01 at 22:01 (066167)

Actually Janet, from all the reading I ever did on RSD - I never even read about it.

The few times it happened to me, I seriously wondered if I was losing my mind.

I think it's been a long time - maybe more than a year since it happened. But I remember one time vividly where a car pulled in front of me while driving and pain shot through my whole body - right into my toes and finger tips - it was like a huge electric shock.

I don't think I ever told anyone about it....it sounded too crazy.

Re: oh

wendyn on 12/04/01 at 22:04 (066168)

I live in Calgary, Alberta Canada - the Stampede is an annual 10 day long event that includes a huge rodeo, fare grounds exhibition, and plenty of parties, special events at the bars, lots of tourists etc.

It is one of the only times that I know of where it is socially acceptable to be quite corked in the middle of the day. Because, well it's Stampede you know....

Thank God it's only once a year.

Re: oh

BrianG on 12/04/01 at 22:10 (066169)

Carole, they are all good looking at 2am :*)
There are a couple wild bartender movies out there. One is the Tom Cruise flick, and the other is 'Cyote Ugly'. A rocking good time. If there's anything like that at Stampede, I'm coming along too. I used to work at a funky little, local rodeo in Kona, Hawaii. I also saw the PBR (Professional Bull Riders) a couple years ago. Real Men ride Bulls, and crazy men too, hahahahaaa.

So, when is Stampede? The PBR has had the Finals live from LasVegas the past couple of weekends. Cowboys rock!

Shit, I miss my REAL life !!! :*(
BCG

Re: oh - ceanography

Julie on 12/05/01 at 03:32 (066178)

Carole, will you tell us more about what you do? I'm fascinated by the idea of oceanography but have no idea what oceanographers actually do. (I've got the ocean on my mind lately - since Nancy moved to within spitting distance of the Atlantic.)

Perhaps start a new 'oceanography' thread on the Social board? This one is getting rather out of hand.

Re: oh - ceanography

Carole C on 12/05/01 at 06:26 (066183)

OK, I'm headed over to the social board to talk about my job. See you there! :)

Carole

Re: thanks; appreciate it (nm)

elliott on 12/05/01 at 08:27 (066190)

.

Re: Janet

BarbaraTX on 12/05/01 at 11:14 (066201)

This sounds miserable beyond belief. Are you doning anything for treatment right now? What is your prognosis for the future? I was wondering how RSD is eventually resolved? B.

Re: oh

Carole C on 12/05/01 at 17:45 (066255)

Neat! That sounds like a lot of fun. Some day before I get too old, I plan to visit Canada for the first time. If I do, I'll be sure not to miss Stampede! It will be easy to spot me; I may be the only sober person there. (grin)

Carole

Re: oh

Carole C on 12/05/01 at 17:47 (066256)

LOL! Brian, I'll bet you are a lot of fun in real life. :)

Carole

Re: could u explain please I need help

elliott on 12/01/01 at 18:58 (065856)

Neuritis is nerve dysfunction secondary to inflammation of the nerve tissue. I guess tibial neuritis means neuritis of the (posterior) tibial nerve, i.e. the main TTS nerve. You just had a TTS release, didn't you?

PT tenosynovitis is inflammation of the sheath encasing the posterior tibial tendon. That sheath helps the tendon glide properly when walking. If necessary, there is a surgery which sort of cleans out the inflammation (I had it as part of my TTS release in my right foot, but I think I regret it). It is possible it will resolve with rest, walking boot cast, proper shoes, NSAIDS, etc. The tenosynovitis may be an early indication of posterior tibial tendon dysfunction, which, left alone, could worsen to the point where you can't walk too well and more serious surgery (tendon transfer or bone fusion) is necessary. As a possibly relevant aside, tenosynovitis is one cause of TTS, apparently because the inflammation on the tendon takes up space and presses on the nerve.

Tammie, can you summarize (briefly :-)) what your symptoms were pre-surgery, what surgery you had and what was found at surgery, and what your symptoms are now post-surgery? Just these things. (You can leave out the hugs and kisses. :-))

Did you have an MRI? If yes, get a copy of the report and post its contents here. If you didn't, just get that MRI--you need it (you can't rely on a script for that), and then post its contents here. And don't hestitate or feel guilty about going to other doctors. Maybe an orthopedist who has experience with both TTS and posterior tib dysfunction would be a good idea.

Re: elliott

Tammie on 12/01/01 at 21:03 (065868)

Ok I will try. First I had the spur and pf release in april, symptoms then were heel pain could not put weight on at all walked totaly on toes. Arch pain and some electrical feelings that would go to big toe. First morning pain and after rest. Took several anti inflams, orthodics,iced ,pt ,cortisone shots, Taped new shoes.

Ok after that surgery things were some what better, could now put weight on heel and foot, some lateral pain I think outside of foot right.Still allot of the tingling feelings and some jolts that would progress down to my large toe, inside ankle area thru heel arch area. I get like a hot feeling in foot and a throbbing sensation in the arch to heel.(all this is to the inner ankle side and under.Night time is the worse for symptoms seems as the day progresses the tingling and the jolts along with the throbbing get extreamly worse . I try to go to sleep and the pain is real I cannot sleep and when I do fall asleep I often wake with a jolt that certainly makes me know it is there, then will throb untill I cannot stand it or sleep or anything till It settles down or I take something like ultram and it will let me sleep for a few hrs. It seems to be a all day type feeling but getting worse later in day. At times I feel as tho someone stuck me with a hot machetee and left it in.There is a numbness on the inner side of ankle about a inch or so below the ankle bone which goes under foot along that nerve area. It is not totaly numb tho it sometimes has the nervy feel.if u follow that line the lump comes and it is very painful and has progressed more so. This is what I am feeling since the tts surgery which was done aug 30 .

I am having allot of trouble walking that toe walk is back along with a terrible limp when I try to walk flat, I have always had flat feet no arch.Sometimes as I walk I feel as tho it is ripping inside it will stop me dead in tracks for a min to catch a breath if u know what I mean. That is when i am tired and have been going to long and that is when things get worse. I have not had a MRI, or nerve testing. I will ahve to be refered by the dr. for insurance, I do have a appt. in dec with another dr. Ok I tryed to keep this brief I thank u for the explanation thank u much.

I am sorry I forgot to say the tts surgery was not what people have described here the incision was small on the side of ankle about 2 inches I would guess, and a small incision on bottom of foot I believe camera inc? He told my husband and showed him pics he took where he said the nerve was compressed into a ligment with scar tissue around it he had to cut I believe I may have misunderstood now , but that he had to cut part of ligment to get it released? I am not to smart on this ok, I am sorry I get flustered and get lost quick . Simple is best for me.I get hung up on technical terms and miss the rest.So what do u think now , Am I totaly nuts or can this really be this painful? No one would ever understand but I usually am a very strong person with a high pain thresh hold this has wimped me out to a whiny snivling baby. I need help.

Re: Tammie, you've got to get that MRI

elliott on 12/01/01 at 22:40 (065878)

Don't worry about sounding like a wimp. You're in a lot of pain. TTS pain can make anyone with a high pain threshhold into a whiny sniveling wimp; don't feel guilty at all about that. I was there not too long ago myself, and it ain't fun.

After reading your post, I'm a little unclear about what, if any, change you had in your nervy symptoms pre- and post-TTS release. If you'd like to elaborate on that, fine. I presume the ligament you're talking about is the laciniate ligament--also called the flexor retinaculum--which is always cut during any initial TTS surgery to give the nerve room to move; nothing special about that. Not sure why your incision is so small; it should be more like 4'. Not sure what your doc did with all that camera stuff. I don't like the description of his surgery, but what do I know?

Your nervy symptoms sound like classic severe TTS symptoms. Couldn't be more obvious. That lump may be a mass pressing on the nerve and causing the symptoms. You have to know what that is. An MRI likely will say what that is and if anything else is going on. It is standard procedure to get an MRI before TTS surgery to see what possibly is causing the TTS (e.g. heel spur, tenosynovitis, etc.) so that they can be repaired as well at surgery and increase the odds of success. You need an MRI, and you need it now. You've got to get your primary or whoever to OK it pronto. Cry and scream at them, but get it. If ever it was warranted, this is sucha case.

I think you may need to see some big-name TTS people to straighten this out. Where do you live? There are a few big specialists in my city. If you need to fly here, maybe I can pick you up from the airport and take you there.

Sometimes things get worse post-surgery before they get better, so you don't want to rush into another surgery until you're sure. Maybe things will settle down. There are some topical drugs that can give you some partial relief, if you can get your hands on them.

Besides a nerve conduction test (which will probably just confirm what you're already complaining about, and anyway is a little less useful post-surgery), the first step is an MRI. Whatever doctors you eventually go to, they'll all need to see that same MRI and its written report, a copy of which you can get from the doc who requested it or from the MRI place a week or so after the test. If at all possible, get a copy from the MRI place of the actual films to take with you. They gave me mine on the spot.

GET THAT MRI NOW.

Real sorry for the pain you're suffering. Try and hang in there.

Re: Tammie, you've got to get that MRI

DR Zuckerman on 12/02/01 at 07:12 (065889)

Man ,

Can't be any more descriptive. Couldn't of answered this any better. Dr. Elliot you are now an honary heelspurs.com doctor. Keep up the great work

Re: wow! thanks!

elliott on 12/02/01 at 08:04 (065895)

I've been working hard for just such a title. Does honorary heelspurs.com doctor satisfy Richard C.Ped's requirements of need-to-know foot care professional? I just gots to know what's behind that shower curtain! :-)

Re: could u explain please I need help

Laurie R on 12/02/01 at 10:57 (065900)

Dear Tammie, Did your doctor tell you where you have tenosynivitis ? I sure know how painful it is . I have it in my FHL tendon .... They found out when I had the tenogram done . I have the films here and you can see it . My Pod told me it is like glue in the outer part of the tendon .. Elliott explained it really well.... It is the outer cover of the tendon . How does your doctor know you have tenosynivitis ??

I can't remember ,have you have a MRI yet ?? My tednosynivitis also showned up on my MRI ....

My heart really goes out to you . Tammie you have been through so much with your feet .. I wish I could say something to make you feel better. Just know I am also just a email away .. Also I know you love your job . That has to be so hard to hear you better think about doing something else.

I was told I can NEVER go back to bartending ever . It took me a long time to realize I can't . I thought for a long time I would be able to someday , but now I know I can't .. My focus now is to just get somewhat better ... It has been a long road for me with some pretty big bumps along the way , but I try so hard to stay positive , but you know I have my times where I feel like it is never going to get better.....

Keep the faith and I know you have a lot on your mind , I am praying for you ...

Much love to you Tammie , Laurie R

Re: Tammie, you've got to get that MRI

Tammie on 12/02/01 at 12:24 (065907)

Thank u very much for the help I really mean it ! I want to tell more about the surgery, he had told me that the outer incision was much smaller then the inner one in fact he stressed that to me as I had said once about how much pain for such a small incision. He told me with the modern ways of operating they dont always need to make a large incision on the outside . Now I dont know what u make about this . As for pre op and post op changes, I feel that some of thease symtoms were there from the very begining back when I first had the pf and spur done, he kept saying that he thought the first surgery would help the secondary stuff which he had called tarsal tunnel. He really did not want to do any surgery on the nerve area unless absoulutely needed he stated at that time. So thus we did his way, which all thru healing of first and continuing the nervy stuff kept up and getting more painful.

Now I did not know if it was because I was not getting rest as I had so much pain I was not getting much sleep, or if it was really getting worse. It boiled and finally he said time to think about the surgery for the tts. Ok done it and now I would say if honest with myself, That things got worse when I returned to work. I hate to admit this I really do, but working anywheres from 9 to 10 hrs a day and well I am one who does not sit unless my body just wont allow me to move. I am being serious about this. Now I feel as tho I am back to square one and maybe a bit worse . He asks me % from before surgery, I kinda I know this is bad but I tell him better then is really the case, I told him about 50%, not true. But I know if I tell him really he will not let me work at all and he will tell me I will have to find another dr. cause I wont listen .

I am sorry I am getting myself into a mess and am so darn frustrated and tired of pain, but I also need to work I have bills to! Plus how do I pay for dr. if I am not working? My husband has his own high medical bills also.I feel as tho life is closing in on me and I am feeling a bit desperate and very frightened at what I might really be doing to myself.I was really thinking I am crazy that this cannot really be this painful that people are right when they tell me I am being a big baby. I am ready to try and find some help.I see a dr. on the 20 of dec I can maybe get a referral for a mri what are they and what should I expect? I am not frightened of pain as what at this point is a little more? But I would like to know in advance what I should expect. Thank u again please dont tell me I am a fool I already know this , I am ready to listen.

Re: Tammie, you've got to get that MRI

Julie on 12/02/01 at 15:59 (065914)

Tammie, no-one should tell you you're being a big baby, and if they do, you shouldn't listen! You're in pain, and the pain is real. We all believe you, so please believe it yourself, and get whatever help and take whatever steps you can to deal with it.

Everyone's prayers are with you. You've had a terrible time!

Re: Tammie, you've got to get that MRI

Tammie on 12/02/01 at 16:36 (065919)

Thank u , but it is the old saying if u are told something often enough it soon gives u doubts about yourself. So u understand why it feels that way. I do Thank all of you for being so very special in my life and understanding , This is sure been a really long road and I am glad I have you all with me ! I would have gotton really lost without you all.I am only sorry that you all have to feel the pain also! Thank you again for the kind words! I have been glad to see you back again Julie!

Re: Tammie, you've got to get that MRI

elliott on 12/03/01 at 00:45 (065958)

Not sure what your doc is talking about with that smaller outer incison. TTS release, dealing with teensy-weensy nerves, is so delicate that it does not really lend itself to a smaller incision on the outside; they have to cut the entire laciniate ligament (whose roof starts well above the ankle) as well as follow the course of the nerve and its immediate branches, at least one being lower down past the ankle, to see if they're clear. They gotta see all that with their eyes. I know some big TTS names, and all do that bigger incision. I may recall having seen some article talking about what you describe, but in any case, you already had the surgery, so let's not dwell on that.

MRI (magnetic resonance imaging) takes pictures of the tissue inside you (unlike xrays or bone scans, which are limited primarily to bone). It is expensive, but it can be crucial. Hopefully your insurance will cover it. There is a foot-type MRI where just your foot is enclosed and you sit outside and read a magazine (but you have to make extra sure you don't mistakenly leave your credit cards in your pocket when entering its range, as they can de-magnetize). More typical is an all-purpose MRI, where you lie down and they slide you into something looking like a half-cylinder (cut the long way, so when standing at the front of it, you see a semicircle on the outside--sort of looks like the matter-anti-matter pod that Scotty of Star Trek would have to climb into). You will be in the MRI room alone (no reason for the technician to get constantly radiated), and the tech talks to you by microphone. For an MRI of your foot, your head till about your waist will remain outside the device (unlike for an MRI of your back, where you're slid totally in). Your foot has to remain still while they take the pictures. The machine clangs very loudly, and when the tech says just a few more minutes and we're done, it's a lie that means around another 45 minutes to go. :-) Overall, this test does not hurt at all. Keeping your foot still or up against the surface may be a tad uncomfortable depending on your foot problems, but for most is no big deal. Now if one is claustrophobic and wants to panic, well... On a pain scale of 1 to 10, I give it a 0. So don't worry about it.

Tammie, where do you live?

Re: Tammie, you've got to get that MRI

Janet C on 12/03/01 at 02:12 (065961)

Dear Tammie,

You have been given some excellent advice so far, but I wanted to add my two cent's worth...

I was dx'ed with heel spurs a little over ten years ago. How I wish I had the support and knowledge from this Web site back then!!! I also had a plantar fasciotomy, both heel spurs removed, and a tarsal tunnel release on both feet, so I think I can REALLY relate to the pain that you are feeling!

Unfortunately, I also found it extremely difficult to stay down; as a mother of three, I constantly pushed myself. And like Laurie, I also worked as a bartender, at not just one but two jobs, seven days a week, to help support our family. Because my husband became sick with a terminal illness, I didn't think I had much choice.

I now have RSD as a result of the nerve damage, and it has spread from my feet, up my legs, into my hips and lower back, and now is affecting my arms. I am now 100% permanently disabled, and have to use a wheelchair. The pain is far worse than it ever was, and I continue to slowly lose my independence. For instance - just last year, I was driving a half hour trip twice a week, although it was quite painful. Now I need to take a taxi cab to my Dr's appts. 15 min. away.

Through the years we have had to rely on free Med Ins available from the state for families with lower incomes. We also had to declare bankruptcy just last year, after living off of our credit cards for as long as possible. I still have a WC case pending, although it has been over five years since I was able to work, and my husband and I are still fighting for our SSDI benefits. Although it has been a long and difficult struggle, I have confidence that we will win, some day.

I am writing you and telling you all these personal details because I want you to know that you are at a point now, when you still can make choices to help reverse the damage. I wish that I could prevent just one person from making the same mistakes that I did. At the time, I had no idea of the severe consequences of my actions. PLEASE try to understand that the nerve damage can and will get MUCH WORSE, if you continue to work on your feet all day long! If you must work, please try to find some sort of desk job. Even if you have to accept a decrease in pay, consider the alternative that I have described.

My very best wishes to you, always ~ Janet

Re: Tammie, please listen to Elliott and Janet

Julie on 12/03/01 at 05:39 (065964)

Dear Tammie

I understand what you say: that if you're told something often enough you begin to doubt yourself and even the reality of your pain. I was trying to put some weight on the other side of that see-saw. The voices you hear and the hurtful, disbelieving things that are said in 'real life' are louder and seem realer than the ones you 'hear' on your computer screen, but we're real too, and really and truly, we all believe you. We know you're in great pain. And we know you're not a wimp, and you're not a baby. You're still the strong person you once thought you were, and that strength will see you through.

Now you need to use that strength to make some decisions about the future. Some of them, the ones to do with the professional help you need, are easier to make than others: get an MRI, and get at least one more specialist view. Elliott has given you clear explanations and excellent advice, and has even offered to take you to a top TTS specialist - a kind offer you could surely take him up on: I'm sure he means it.

Janet has given you good advice too, from her experience and from her heart. It was brave and kind of her. It's difficult for you to hear, because it's about your work which you love so much, but it may be the most important decision you'll ever have to make. I feel sure that Janet is right in telling you the same thing that your pod has told you. I know how painful it is for you to hear that you are likely to get worse and do permanent nerve damage if you continue to do work that keeps you on your feet. But you really have to think about it now, because working on your feet is hurting you.

It's a pretty clear-cut question of putting two and two together and accepting the answer. Having followed your story for almost a year, I really don't like to think that in another year you'll be in a worse state of damage and pain than you are now because you couldn't accept the facts now.

You're already one of the most compassionate people I know, and it's hard to see how you could be more so, but you know as well as I that the pain you go through makes you even more sensitive to the pain others go through. So I've absolutely no doubt that this long, painful experience will bear fruit later on in your work and in your life, in ways you cannot foresee. Please be hopeful and look forward to all the help you're going to be able to give others, even though you don't know right now how that's going to happen.

My thoughts and prayers are with you - and in your next posts I would like to hear what steps you've decided to take towards healing.

Love and blessings

Julie

Re: RSD

elliott on 12/03/01 at 10:03 (065975)

Sorry for your condition. Could you (and Laurie R, if you're reading this) explain what symptoms you feel as part of RSD, why it goes into the arms, how RSD is diagnosed, what can be done for it? Thanks.

--------

Re: It's time to shi*, or get off the pot !!

BrianG on 12/03/01 at 10:59 (065976)

Hi Tammy,

Ellott is correct about getting the MRI. It's absolutely painless, but on the other hand it's quite expensive. I think you have a decision to make here. First, I think that you should read Janet's post 5 or 6 times before deciding anything. It is one of the the most compelling posts I have ever read about why we should all take care of our feet before it's too late.

If you decide that you just can't stop working, no matter what the consequences, I woldn't even bother with the MRI's, Neurologists, 2nds opinions, none of it. Why waste your money if you don't want to help yourself. Please find a competent, compassionate pain management specialist who will give you enough pain meds to continue on with your job until you are crippled.

I'm sorry for sounding so harsh, but just remember, I continue to pray for you everyday.

BCG

Re: It's time to shi*, or get off the pot !!

Tammie on 12/03/01 at 15:59 (066002)

Brian , Yes you are right . Thank you for showing your friendship I do appreciate it always. I guess I dont deserve to be here this is not for me I am sorry . I just can't accept this as a final ending . Take care and I wish you the best of luck . Dont waste your prayers on me as as you have said I am just not ready to give into this life.Please send your prayers for those more in need and those willing to change there life for there feet. Thanks and take care and my prayers go out to you and all.

Re: Tammie, you've got to get that MRI

Tammie on 12/03/01 at 16:04 (066003)

I live in a very small northeastern area of Ohio. But I think maybe someone is right I just dont think I am ready to give in to this final dx and give up my life for my feet. So maybe it is a waste of the dr.s time and effort. You are a very smart man and i do appreciate all of your knowledge I really do. My hope is that u continue to help those here that are open to lisitening and wanting to change there lives. I want to heel but I want life also and I am not willing to give up what I love . If I have to drag myself around i will.I thought I was making the best choice by contacting another dr. for a look but maybe I will be wasting there time also. Life just is not worth living for me if I can not do any thing that I love so I guess that is my answer. Thank u and I do hope for your recovery thru all of this. Keep up the good work here on the board!

Re: Tammie, you've got to get that MRI

Tammie on 12/03/01 at 16:07 (066004)

Thank u for sharing . Unfortuantly I just have a very hard time believing this could be my potential problem but if it is I guess I deserve what ever happens. Thank u for taking the time to offer your thoughts and advice. I am sorry for the pain you have I truly am and my hopes and prayers for you are with u always. May God shine upon your heart always!

Re: Tammie, please listen to Elliott and Janet

Tammie on 12/03/01 at 16:11 (066005)

Thank u Julie, No u do not want to hear what steps are planned ! But thank u for the care and effort. I guess there are some of us who well just cannot change. I will not bother anymore as I finally realize I just do not belong here. Maybe i will never belong anywhere. I am just not ready to accept all of this.I feel as tho I have been given a type of death sentence, and not sure how to handle it. I am having trouble coping with all of this . I dont think I want to anymore. Take care and good to see you back there allot of people here who have missed u !

Re: Tammie, we care

Carole C on 12/03/01 at 16:29 (066007)

Tammie, life is worth living.

It's just necessary sometimes to take care of yourself for a limited period of time, so that you can continue living your life as you want to for many many years to follow.

Hang in there! And do try to get all the help you can find, and try to help yourself as much as you feel able to do, too. Try to be your own best friend, and tell yourself what you might tell your best friend if she was faced with this. I am so sorry that you are in all this pain, and I know how rugged it is to try to deal with things when you are hurting like this! I sincerely hope that things get better for you soon.

Carole C.

Re: bartending

Carole C on 12/03/01 at 16:41 (066008)

I have never been a bartender, and actually I have hardly ever been in a bar, but isn't that the type of thing that Tammie might be able to do in a wheelchair for a short time while her feet heel? Could she reach high enough to do this?

If not, how about going on disability temporarily? She needs to earn a living and I can certainly relate to that. There is no Santa Claus.

I'm no more a lawyer than a bartender. Some of you probably know all about this stuff and could tell us if this is something she could pursue.

Carole C

Re: oh

Carole C on 12/03/01 at 16:45 (066009)

Oh... re-reading all these posts, I'm not sure if Tammie is a bartender or what. I hope her job is something that could be done from a wheelchair though.

Re: Tammie, think again

Julie on 12/03/01 at 16:49 (066011)

Tammie, I don't believe you. Not for a moment. You're in pain, unhappy and angry and that's why you're saying this. But try to think of it this way. If you go on working now, the time is going to come when you're going to have to give up the work you love, probably forever. You will be too disabled to do it. If you back off now, and focus your considerable energies and determination on healing, there is a good chance that you will be able to work as you want to work again. Maybe even without pain.

Wouldn't it be worth a try?

Oh - and you can change. Everyone can, and what's more, everyone does, whether they like it or not. The only question is how. And it's up to you to decide that. Please make an intelligent decision!

And yes, I do want to hear about it. And about your progress towards full healing.

Re: Sorry for being harsh

BrianG on 12/03/01 at 16:53 (066012)

Tammie, none of my prayers for you were waisted, no matter what you may think today. You always told me how strong you were, and now your ready to throw in the towel? Doesn't sound like the Tammie I know. I urge you to continue to look for help, where ever that might be. It's obvious, I am no expert, for I am like Janet. We both worked well beyond when we should have. I just don't want to see you go down the same path. Please do whatever it takes.

BCG

Re: Tammie, see if we care

elliott on 12/03/01 at 17:18 (066014)

Trying to use some reverse psychology. :-)

Hard to tell if you're hinting at suicide or just chucking all the advice and saying goodbye. Giving up doesn't sound like what you're about. I for one didn't say you have to stop what you're doing for life, although sometimes that can happen (let's hope not). Those saying so are just offering advice and warnings in case that need be. It's one thing to declare that you're just going to go on as if nothing's stopping you, but you might find very shortly down the road that you just can't do so, maybe can't walk at all, or that you can't bear the pain. At the least, you need short-term rest.

Give it a chance to rest and get better, get prescription drugs--both oral and topical--to help you get through (I can tell you more about these if you'll listen). But go see a big doc anyway. You can always delay a decision, but being informed is a good thing. A second surgery, if and when you feel it has come to that, might give you a second chance. That's all I'm saying, and the decision would be yours and yours alone to make, as there are risks.

Ohio? Lucky lucky lucky lucky lucky lucky break! There are some leading TTS docs in Ohio. Stephen Conti, a foot/ankle orthopedist, I believe has been bouncing around between Cincinnati and Cleveland the last several years, I think now in Cleveland. He is a WORLD giant, especially in posterior tibial tendon dysfunction, but also has extensive TTS surgical exposure. Another is GJ Sammarco, Sr., also a bona fide giant in TTS, and a colleague of the famous Baxter (ask his office when calling to make sure he's the one). Forget the schlock doctors. Go to one of these two. (I know there are loads of high-quality TTS pods in Ohio as well; some Oriental guy with a one-syllable short name that escapes me, as well as others; I'm sure the pods here know of them.) But get that MRI first, then go see one of these docs, even if you have to wait months for an appointment. Just do it! With a little luck, the rest of your life, you'll just do it!

----------

Re: Elliott Talk

Tammie on 12/03/01 at 21:17 (066032)

I am listening to your advice, I am trying very hard to begin somewhere. I have a appt. on the 20 of dec for a start. I am not going to do anything stupid. Reverse psychology huh well dont even try it I am ok just some bad days. Now i am ready to hear u . No promises tho .

Re: oh

wendyn on 12/03/01 at 21:24 (066033)

Laurie was the bartender. Tammie works as a nurse (or nurses aide?).

I don't think you could ever bartend sitting down.

Re: OK, here goes

elliott on 12/03/01 at 22:56 (066043)

First of all, if your foot hurts more and more by just standing on it or working, you've got to temporarily stop or slow down enough, as you might do permanent damage that could have been avoided with temporary rest. We don't all heal at the same rate post-surgery. How would you feel if you could've returned in a few months but did yourself in permanently because you didn't give it a little rest? We're not talking about forever at this point.

I don't know whom you're seeing on the 20th, but if there is even a possibility you'll need a second surgery (sounds to me like there is), a good orthopedist or pod is no longer good enough, as second TTS surgery is much more complicated than the first. Don't want to go into that now, but complications include potentially collapsed nerve bed, excessive scarring, having to repair nerve damage done by previous surgeon, etc, etc. You must see a TTS specialist such as the two I named. I can't stress that enough. Doesn't guarantee surgical success, but increases the odds. Such a specialist will also be more familiar with topical and oral drugs that may help. Sure, it's inconvenient and far away, you may have to wait a few months to see him (actually a good thing since you're just post-op) and there may be insurance issues; it's also the rest of your life we're talking about. If you want to see who you're seeing on the 20th, get an MRI through him, and then go to the TTS specialist, that's OK too.

1. First step is to get that MRI, both the films and the written report. It is such a disappointment to wait two months to see a big-name doc only to be scheduled for an MRI after that and then have to wait again for another appointment when the doc can look at the MRI on the spot and see what he needs to know. So do it first if possible (that lump may be compelling enough to authorize it if there's red tape). Also get copies of the written report of your first surgeon's TTS surgery (and even the PF surgery). Not sure if a nerve conduction test is the right thing now so soon after surgery; this can probably wait for the doc to decide.

2. Go to big-name TTS guy, taking MRI and reports with you. I doubt he's going to encourage another surgery so soon after the first, unless he's convinced that previous surgery was all wrong (even then, you may want to wait as long as you can). See what he says. At least you will understand where you're holding.

3. In the meantime, try some drugs to help with the pain and discomfort. This can come from big-name doc, but doesn't have to wait for him. Given your tingling and shooting, Neurontin is worth a try. You need someone to tell you what dosage to take. There are other oral drugs too. Next, topical drugs, consisting of various mixtures of drugs such as amitryptyline, ketamine, ketaprofen, gabapentin, etc. There is a drug store in Florida, called Custom Meds (352) 341-1212 and (800) 226-2023, that sells three different topical prescription drugs: Neuropathy Gel for tingling, Formula 5 for numbness/burning, and one other for shooting/stabbing pain. So if your doc doesn't know where to get it, you have a phone no. (Sammarco for sure will know about these drugs, and should have free samples of each to try, cheaper than paying and trying for nothing.) You smear a drop or two over the affected area every 3 hours or so as needed, and it can give partial temporary relief. I found only the first to work for me (about a 35-40% reduction in pain), but everyone's different. Cost around $45, which I paid for myself and got reimbursed later by my dinky HMO for all but $10 of it. I'm not going to lie, but drugs often don't work for TTS, or are of only limited value. But worth a try.

Follow the plan if you can and get back to us. Tammie, hugs and kisses. I really mean it.

--------

Re: oh

CArmen H on 12/04/01 at 07:46 (066060)

No...bartending is high volume work running running running!
Which none of us can do it seems....sigh.....oh well. We have each other right??
:-)

Re: OK, here goes

Tammie on 12/04/01 at 10:21 (066076)

Ok Elliott u have my attention , as u did not say I would have to quit my job . If I give u my email can we talk (email removed) I feel like awful for using all the heel board space or at least move this to another section. Also I have people who may read this and i dont know if I want them knowing everything about me. And Elliott when I offer a hug or a kiss it is always given with my heart it is not that mushy unfeeling saying. Just so u know I really am not transparent there. Thank u for really meaning it it means a lot to me ! I feel like maybe there is a hope somewhere, and I feel as tho finally someone really might understand the whole picture here.

Re: oh

Carole C on 12/04/01 at 17:57 (066132)

I had some misconceptions due to the way bartenders are sometimes portrayed on TV. I thought all they did was just mix a couple of things together and add a cute little tiny straw to make a drink, and put it on a cocktail napkin and set it on the counter. Well, that and also talking to people. I didn't realize there was any running involved! Oh well.

It's amazing how people sometimes have preconceptions of jobs they aren't familiar with. People sometimes think that because I am an oceanographer, I have an active outdoorsy sea-going job. Not so! I have the ideal job for someone with PF (though I went to sea more when I was younger and in school).

Carole C

Re: oh

wendyn on 12/04/01 at 18:57 (066137)

Carole, you should just come and visit me...we could hang out in bars and do research!

Re: oh

Carole C on 12/04/01 at 20:22 (066148)

Sounds like fun! I am often curious about bars, but would feel kind of out of place just walking into one by myself and ordering a diet Coke. LOL

Carole

Re: To Elliott, Re: RSD

Janet C on 12/04/01 at 20:56 (066157)

RSD (Reflex Sympathetic Dystrophy) a.k.a. CRPS (Chronic Regional Pain Syndrome) is actually a cluster of symptoms. A syndrome is a disease that has many parts to it; each symptom represents a piece that by itself may be unrecognizable. Only when put together into a 'symptom complex' is the picture of the disease apparent.

There are two major branches of the nervous system in the body: the voluntary nervous system and the autonomic nervous system. The voluntary nervous system can be divided into motor nerves (which move muscles) and sensory nerves (which transmit the sensation of pain, pressure, temperature, etc.). In the autonomic nervous system, the division is between sympathetic and parasympathetic nerves. The sympathetic fibers cross the midline outside the spinal cord, which explains why the symptoms of RSD can cross from one leg or one arm to the other. Also, the fact that the sympathetic chain exists along the entire spinal cord explains why the symptoms may spread from one arm to a leg on the same side.

At any given time, the symptoms associated with RSD may change. One month, a patient may have a swollen limb, overgrowth of hair or nails, and discolored skin. The next month, the patient may have hair loss, heat in a limb that had previously been cold (or vice versa). Not all patients will have all of the symptoms. RSD has been often been called a 'chameleon disease' because the symptoms can change so rapidly and so profoundly.

One of the best ways to differentiate a patient with RSD from one suffering from a nerve entrapment syndrome is to determine whether or not the affected limb is extremely sensitive to temperature. Patients with nerve entrapment syndrome very often do not have exquisite sensitivity to temperature, while RSD patients very often do suffer from extreme sensitivity to either heat or cold.

Since early diagnosis and treatment is essential to provide a cure for RSD, the appropriate use of diagnostic studies is important. Any delay in treatment will result in a disorder that is resistant to treatment and can become permanent. Some of the diagnostic tests for RSD include: the Sympathetic Nerve Blocks, Thermography, A Three Phase Bone Scan, and EMG Nerve Conduction Tests.

I was dx'ed with RSD about a year and a half ago, by having the Lumbar Sympathetic Nerve Blocks that Laurie is now getting. The LSNB's are used not only as a diagnostic tool, but also as a treatment for the pain of RSD. They are based on blocking the Sympathetic Ganglion, which is the cluster of Sympathetic Nerves outside the spinal cord. These types of blocks, if done on a repetitive basis early in the course of the disease, can put the disease into remission. I understand that if the patient gets some relief from them, then they do have Sympathetically Maintained Pain.

A well-educated Dr. taking very careful notes and observations of your symptoms also helps to diagnose it. One common symptom that I have is that the skin temperature of my feet usually registers around 70 degrees at my Dr's appts. I experience constant, intense, burning and ice cold pain that never goes away. I have extreme sensitivity; and the slightest touch of the skin on my legs or feet can bring agony. It has become very uncomfortable for me to wear pants, because the skin on my legs feels like it's crawling when clothing touches it. It's also extremely painful for my feet to touch the mattress, and even the covers feel like they're putting intense pressure on my skin. I need to keep my feet elevated above my heart most of the time, or they will turn deep purple, swell up badly, and feel like they're going to explode. My hands and arms are now experiencing similar symptoms as well. They're bitter cold, they ache deep in the muscles and bones, and it hurts me to bend my left arm at the elbow. I want to avoid any movement at all of my affected limbs, and I feel very protective of them. I also experience a shin-splint type of pain, and I have related sciatic nerve pain, that travels from my lumbar spine, through my hips, and is swollen and inflamed down each leg. My hips hurt me so much that it often wakes me when I turn over on my sides in the middle of the night.

Not just driving, but also riding in a car has become very painful as every little bump in the road causes roars of pain through my nervous system. I am also extremely sensitive to loud noises, which often sends my pain escalating. The pain comes over me, in times of flare-ups, giving me small convulsions, and muscle spasms. I often have sweats and then chills, and I get inexplicable rashes and bruises. The pain often brings with it waves of nausea, and I also suffer with insomnia; the pain keeps me awake because I'm unable to get comfortable.

I have to use a wheelchair now, and I stay in bed most all the time. I believe that stress can increase the pain, as can eating unhealthy foods, such as sweets, coffee, salt, and junk food. Drinking lots of water is essential. And I also use a small heating pad on the areas that hurt the most, which gives me some relief.

I'm sorry this was so long, but I hope that I have answered your questions.

Best wishes always, Janet

Re: To Elliott, Re: RSD

wendyn on 12/04/01 at 21:02 (066159)

Very informative Janet....and actually reminds me of something.

When my pain was bad - if I was exposed to a sudden noise or scare, I actually felt sudden intense pain. I had forgotten all about it till you mentioned it.

Re: oh

wendyn on 12/04/01 at 21:05 (066162)

Eeew...always avoid walking into a bar by yourself. Unless you are meeting a table full of people.

You will attract attention you may not want.

Carole - you come up for Stampede and I'll take you to some bars. You can have diet coke if you want!

Re: RSD

Janet C on 12/04/01 at 21:11 (066164)

Thank you Wendy. I was embarressed to mention this strange symptom to anyone, until I read it was a common problem for those with RSD. Thank goodness for the Internet! I no longer feel so alone and misunderstood.

All the best ~ Janet

Re: oh

Carole C on 12/04/01 at 21:44 (066165)

Bars were just not made for a 53 year old overweight greying overly intellectual woman like me with PF, who doesn't drink or smoke, to walk into alone. I agree! And although I hate to generalize, I am sure than if I walked in alone and got any attention at all it would be of the unwelcome type.

Stampede? what is that? Sounds like something in Fort Worth, maybe. I'm in New Orleans, and there is a bar on every corner here (and several between) but I've never been in any of them.

Carole

Re: RSD

wendyn on 12/04/01 at 22:01 (066167)

Actually Janet, from all the reading I ever did on RSD - I never even read about it.

The few times it happened to me, I seriously wondered if I was losing my mind.

I think it's been a long time - maybe more than a year since it happened. But I remember one time vividly where a car pulled in front of me while driving and pain shot through my whole body - right into my toes and finger tips - it was like a huge electric shock.

I don't think I ever told anyone about it....it sounded too crazy.

Re: oh

wendyn on 12/04/01 at 22:04 (066168)

I live in Calgary, Alberta Canada - the Stampede is an annual 10 day long event that includes a huge rodeo, fare grounds exhibition, and plenty of parties, special events at the bars, lots of tourists etc.

It is one of the only times that I know of where it is socially acceptable to be quite corked in the middle of the day. Because, well it's Stampede you know....

Thank God it's only once a year.

Re: oh

BrianG on 12/04/01 at 22:10 (066169)

Carole, they are all good looking at 2am :*)
There are a couple wild bartender movies out there. One is the Tom Cruise flick, and the other is 'Cyote Ugly'. A rocking good time. If there's anything like that at Stampede, I'm coming along too. I used to work at a funky little, local rodeo in Kona, Hawaii. I also saw the PBR (Professional Bull Riders) a couple years ago. Real Men ride Bulls, and crazy men too, hahahahaaa.

So, when is Stampede? The PBR has had the Finals live from LasVegas the past couple of weekends. Cowboys rock!

Shit, I miss my REAL life !!! :*(
BCG

Re: oh - ceanography

Julie on 12/05/01 at 03:32 (066178)

Carole, will you tell us more about what you do? I'm fascinated by the idea of oceanography but have no idea what oceanographers actually do. (I've got the ocean on my mind lately - since Nancy moved to within spitting distance of the Atlantic.)

Perhaps start a new 'oceanography' thread on the Social board? This one is getting rather out of hand.

Re: oh - ceanography

Carole C on 12/05/01 at 06:26 (066183)

OK, I'm headed over to the social board to talk about my job. See you there! :)

Carole

Re: thanks; appreciate it (nm)

elliott on 12/05/01 at 08:27 (066190)

.

Re: Janet

BarbaraTX on 12/05/01 at 11:14 (066201)

This sounds miserable beyond belief. Are you doning anything for treatment right now? What is your prognosis for the future? I was wondering how RSD is eventually resolved? B.

Re: oh

Carole C on 12/05/01 at 17:45 (066255)

Neat! That sounds like a lot of fun. Some day before I get too old, I plan to visit Canada for the first time. If I do, I'll be sure not to miss Stampede! It will be easy to spot me; I may be the only sober person there. (grin)

Carole

Re: oh

Carole C on 12/05/01 at 17:47 (066256)

LOL! Brian, I'll bet you are a lot of fun in real life. :)

Carole