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Travelling to Europe with TTS and PF

Posted by Sharon W on 3/05/02 at 18:29 (075769)

I'll be travelling to Spain with my husband later this week; it's a 25th anniversary trip, planned about 10 years ago. This will be my first major trip since PF and TTS became part of my life.

Does anyone have any suggestions fo how to maximize my ability to go sightseeing, etc, without overdoing it and ending up in lots of pain? If someone has found useful strategies for this situation, I could sure use some advice! I don't want to end up hanging out in our hotel room all the time, I want to explore Madrid!

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/05/02 at 21:03 (075779)

Sharon,

I was probably at my worse around 18 months ago when I had to go on a trip to London, and Scotland for 2 1/2 weeks. My pod made these incredibly comfortable plaztozote orthotics so I could walk. They took pressure off of everything. They were bulky, so I stuck them in a pair of big cross trainers. They were very soft, yet supportive, but have lousy durability, and only hold their support for a couple of weeks at most. So he made me two pairs for the trip. I managed to stay on my feet the entire day with them every day. By the second week I was hurting more, so I taped my feet with the orthotics, and increased all my medications. I didn't know I had TTS at the time, so unfortunately I didn't have nerve meds. I iced every night in the Hotel. By the end of the trip, my feet were finished, but at least I got through the vacation, and enjoyed it.

If you already have comfortable orthotics, then just bring some athletic tape that you should be able to use with your orthotics. It will give you extra support. It seems the compression helps. Has your pod showed you how to tape? Also, bring extra strong pain-killers. I suggest narcotics. Bring an ice bag, that you can fill from the ice machines while you're there. I brought an ace bandage to hold the ice bag. I also brought an ice pack with velcro to stick in the little tiny freezer of the hotel refrigerator in the room, but not all hotels have refrigerators. Take frequest rest. Sit down whenever you get a chance, and ice when ever you can.

The neurontin would help if you change your mind about it. You should at least bring some with in case you get really bad nerve shooting pains. You could combine all these meds if needed, even with vioxx.

Another alternative would be to rent a wheelchair for certain days. Some people did that on the HS board when they went to Disney World. Also, take a lot of Bus tours, boat rides, taxis, etc, and sit around in nice little cafes.

Donna

Re: By all means, bring your meds

BrianG on 3/05/02 at 22:31 (075792)

Just a comment about bringing pain meds (narcotics) overseas. Bring them in the ORIGINAL container, most important. I'd also carry a photo copy of my perscription. I might even double check with customs. But, people do it every day, and I wouldn't let any negativity (9-11) stop me from doing what is legal. Good luck

BrianG

PS Your doctor may even give you some extra 'breakthrough' pain meds. It's not an uncommon request.
And tape, don't forget to tape!

Re: Brian & Donna SL -- Re: Bringing meds

Sharon W on 3/06/02 at 11:30 (075827)

I guess I didn't explain very well. Neurontin is a prescription med and I don't HAVE it yet -- although I could probably guy it over the counter in Spain. (My pod said she would write me one after the NCV tests were done.) I don't have narcotics, either -- at least, none that have been prescribed to me within the past year. There ARE probably a lot of things I could just buy over the counter at a pharmacy in Madrid -- not narcotics, but other things; my friend Mirta says it's pretty much the same way there now as it was when we all lived in Chile. I'm not sure whether I would have a hassle bringing them back IN to the U.S., though. I know customs is inspecting MUCH more closely than they used to, before 9/11. Does anyone know exactly what the rules are about that, these days? (I bet Neurontin is a lot CHEAPER in Spain!)

Using ice is more like what I meant by 'strategies'. Although, strangely, heat usually feels better to my foot than ice, unless I'm having that 'burning' feeling we all know so well...

Anyway, thanks for answering. And bringing an ice bag along is a very good idea; I'll do that.

-- Sharon

Re: Travelling to Europe with TTS and PF

Sharon W on 3/06/02 at 12:02 (075830)

Donna,

I think it's too late to get new orthotics made, although those soft ones DO sound wonderful!! And yes, I know how to tape my foot -- the pod did it for me the first time, and I kept it up until the orthotics were ready. I will try that and see if it, combined with the orthotics, is more helpful than the orthotics alone. I was even thinking of bringing along an ace bandage to add more compression around the ankle -- maybe that would help with the varicose vein.

As for 'medicines' -- I went into the problem with prescription meds in another message (see Brian & Donna SL:). I did point out to my pod last week that I was going on this trip to Spain. She said if the pain got worse I could come in and she would go ahead and give me the 3rd steroid shot. (She had decided not to do it because she wanted to see the results of the NCV test first, but I couldn't even get an appointment to see the neurologist for a MONTH.) But that makes no sense anyway, because if the pain gets worse I will be in SPAIN! I do NOT think my pod would write a narcotic for breakthrough pain if I called her office; as I said before, I don't even think she quite believes me about the level of pain this thing gets up to. (Maybe if the NCV tests show nerve damage, she will.)

My best friend is handicapped and uses scooters all the time, but I doubt if such things are readily available in Madrid or in the Canary Islands. Atleast, once we get to the Canary Islands we will be with our friends and we won't have to worry about taxis, etc. I intend to walk as little as possible, but I'm sure it will still be more than my foot can handle without triggering those shooting pains I hate so much.

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/06/02 at 13:00 (075836)

Sharon,

I don't know why your pod would recommend a steroid shot which would definitly affect the ncv test, but not give you meds that would 'not' affect the test including neurontin. I undertand she declined at the last minute to not do the injection, because of the test, but too many steroid shots can also do damage to tissue anyway, are very invasive, and they should't be used for just pain control when a safer alternative is available. A lot of my info about the ncv test and meds, etc., comes from one of the top pods in the country who was head of the surgical unit with 30 years of experience, and also headed the special problems clinic at one of the top podiatry schools in the country. Also from other MD specialist, and doctors who perform ncv test.

I know I wouldn't want to see a doctor that did not believe me about pain. My docs know how terrible foot pain can be regardless if it shows up on a test, or not, and wouldn't hesitate for a minute in giving me something to relieve the pain. As I mentioned before you can have TTS, without a positive ncv test. Regardless what's the difference? If you are in pain that's what these drugs are for. You sound like a mature responsible, professional woman, and she's treating you like a child, or some type of drug addict if she refuses them. Didn't you say you were a nurse?

I understand you are on some type of HMO, and it's not as easy to just walk out, and go to another doctor without a referral. Especially at the last minute like this. My plan allows me to go to whomever I want on my own. I don't know if you asked your pod yet for pain meds, so I'll give her the benefit of the doubt, but if she refused to give them to me, I'd dump her like a hot potato. I'll bet she wouldn't let herself, or a familiy member suffer. Would your family doctor give you any? It would be a shame to ruin such a nice trip that took so long to plan. Especially for your 25h anniversary.

I also wouldn't let anyone who didn't believe in pain control to do any invasive procedure on me, or treat me very long. People have developed RSD because of situations like this.

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/06/02 at 18:23 (075863)

Donna,

I was having a bunch of shooting pain after lunch today (I'd been on my feet more than usual, trying to get ready for the trip)so I decided, 'That's enough, I'm going to call my pod and say I need to see her right away before my trip tomorrow. Donna is right; I DO need pain meds.' But my pod wasn't working today; her baby is in the hospital. And she was already overbooked for tomorrow, but they could fit me in to see another young pod from the same practice.

OK, I was desperate, I said yes. She didn't want to give me pain meds, said it would only encourage me to overuse the foot and possibly injure it. I had to beg and plead and agree to use a walking cast (boot) but I did finally get a scrip for Ultram. That's the first time I've ever really ASKED for pain meds, and it wasn't easy.

My problem is that I'm stoic, and I have no talent for inducing empathy. Pain embarasses me and I hide it as much as I possibly can. Even when the pod pokes, I don't cry or scream or yell or jerk away, I just say 'yes' if she asks me, 'Does that hurt?'

Anyway, hopefully that will be enough to get me through the trip...

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/07/02 at 05:51 (075886)

Hi Sharon,

Good For You! You shouldn't have had to beg for pain meds though. I'm so annoyed at this it make me want to scream. These pods seem absolutely ignorant. How did they obtain their degree, from some correspondence course from off the back of a match book? I've read about some doctors, and pods like this before on this board, and they should be taken out, and shot. Seriously this can be dangerous, and it's almost unethical. Either they don't understand the severity of pain that TTS can cause, because they haven't treated many people with this, or maybe they have a drug problem themeselves. A decent doctor would never make you feel like that.
There are good, and bad doctors, dpms, etc., just like any other profession.

I hope you are going to get another pod, and try to see a couple of other MD's when you get back. At least you got something. It's unfortunate you were not able to get the neurontin. This is not proper care in my opinion. You should document everything.

When I first started with my physiatrist, he was actually pushing all these meds on me, and I didn't want to take them at first. I mentioned to you before he's also a pain mgt specialist, and has seen what has happened to people in situations like this. I had been in pain for a very long time before I came to see him, and it was spreading. I had been treating with a very ignorant pod for quite a while. Not only did he not know I had TTS, he never gave me any meds. I found out that I suffered needlessly. I hate for anyone else to have go through what I did for no good reason except absolute negligence, ignorance, or both.

Thank god I listened to this physiatrist, because I was heading towards RSD, and was in a chonic pain situation already, and didn't even know it. Now I need very little meds, and only take a 1/2 a vioxx, and the one Nortriptyline at night. I haven't needed any neurontin lately. The longer you delay the harder it is to beat this, even if you treat the oringinal cause.

I don't think you can do any damage unless you had a fracture. If it's just the nerves they will just get a little more irritated that's all. Make sure the cast isn't too tight. That would be a disaster for the nerves. It may also cause other problems. Only wear it if you really need it.

I don't know why you feel the need to hide pain. You shouldn't have to induce empathy to receive pain meds from any doctor anyway. Just telling them it hurts should be enough. It will only do you harm. I gave you the links to those articles for a very good reason, and I hope you had a chance to read them.

When are you leaving?

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/07/02 at 06:18 (075887)

Donna,

You might have been amused by the coversation between me and the pod. I thought it condescending of her, to say that I would injure myself further if I had pain meds. [The last thing in the world I want to do is 'injure myself further' -- believe me! We will be taking taxis just to walk 3 or 4 blocks, which is NOT something we would ordinarily do. I would not be walking barefoot on the beach and jumping and stomping!] Anyway, I told her, 'It's a vacation, and I will be on my feet regardless. The only question is whether I am happily exploring Spain, or MISERABLE doing it.'

I leave this afternoon. Wish me luck?

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/07/02 at 06:50 (075888)

Hi Sharon,

I can't believe I'm still up. It's almost 4:30 am in CA, but I'm glad I'm having a chance to wish you a good, safe, wonderful trip.

You should have slapped this pod silly when she said that. ha ha, I would have asked her if she's been injecting cortisone in her brain. That's after I got the prescription, and was half way out the door.

Maybe you can find neurontin over the counter. I know I shouldn't be doing this, because I'm not an MD, but if things get bad, and they have them start out with 100 to 200 mg the first few nights at bedtime only, and then see how you do at 100 mg 2 x a day, and then at night do 100 to 200mg at once, totallying 300 to 400mg. You could take more if you needed. It's a very safe drug, but might make you a little drowsy at first. It needs some time to get in your system. This is such a tiny dose, so don't worry.

Also you could see a doctor there if you need to. The generic name is GABAPENTIN in case they are not familiar with neurontin. Hopefully the ultram will be enough, but if the shooting nervy pain gets bad, get the neurontin.

Have a great time.!!

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/07/02 at 07:29 (075889)

Donna,

I don't suppose you'll read this -- sounds like we're waking up in Texas at the same time you're finally getting to bed -- but I thought you might enjoy it anyway. I almost NEVER get angry enough to do something like this, but I was stone-cold angry THIS time; I had made a VERY reasonable request and I should NOT have had to grovel!

The pod I saw yesterday (who was, thank God, NOT my regular pod -- I didn't like her and she made me VERY mad with that condescension)didn't ENTIRELY get by with treating me like that. The appointment was basically over and she thought it was a good time for chit-chat. (I didn't agree, since I was basically ready to wring her neck...) Anyway, she asked why I had waited until the day before my trip to go to my pod for treatment if I was 'having so much difficulty'.
I said, 'I was in here LAST WEEK!'
She said, 'That's true... but what happened TODAY, that made you decide to come in?'
I said, 'I was having shooting pains and got into a panic about how much pain I would probably be in on my trip. I TOLD you that.'
'What were you doing before the shooting pains started?'
'Housework, getting ready for my trip. I wanted to get the house in shape, because my college daughter will be here while we're gone and she's coming here with her new boyfriend, he's bringing her home.'
'Do you like him?'
'I haven't met him yet. She seems pretty serious about him, though. I like almost everything I've heard about him -- except for one thing.'
'What's that?'
'Both of his parents are doctors.'
'What's the problem with THAT?'
'Nothing, right now -- but if she ends up marrying this guy, they'll be her IN-LAWS...'

I gess I should mention that this pod works in the same practice with her pod husband.
She decided that was a good time to exit the room...

-- Sharon

Re: Travelling to Europe with TTS and PF

Sharon W on 3/18/02 at 10:08 (076716)

Donna,

Are you out of town, yourself? I haven't noticed any new posts from you.

Anyway, I'm back, and Spain was lovely. We saw almost everything we wanted to see -- even took in a bullfight! (I don't think I would ever want to do that one AGAIN, but it was something to do ONCE that tells me a lot about the Spanish culture.)

Thanks so much for all your advice -- and for encouraging me to ask for pain meds. I was glad I did. I actually only had to use them 3 times, though; that new cast (a pneumatic walker, the kind with the air bladders inside to put compression on the leg/ankle and massage it as I walk) works really well. Maybe that's because the varicose vein is at least a big part of my problem -- I don't know. As you say, there may be various factors involved, and I'll probably know more after seeing the neurologist -- but I am convinced that varicose vein is a major issue. The problem is, I don't see how a cast could possibly HEAL a varicose vein, just make it FEEL better while it's on my leg...

I have definitely decided that if surgery is necessary I will have another pod do it, the guy who's certified for foot & ankle surgery and has 40 years' experience (instead of four!)

How are YOU feeling? Have you been back to your physiatrist lately?

-- Sharon

Re: Welcom back ! Re: Travelling to Europe with TTS and PF

Donna SL on 3/18/02 at 14:06 (076739)

Hi Sharon,

Welcome back! I'm glad you made it back safe, and sound.

I'm still in town, but have been very busy the last week, or so.

I'm so glad you enjoyed the trip, and were able to get around. I was wondering if you were going to see a bullfight. I saw one in Mexico city, and didn't realize how horrible it was, and swore I'd never go to one again. It seemed exciting with the crowds, the matadors, etc. until they started torturing, and killing the bulls. It's so cruel. I agree it's something you should see once though.

Thanks for asking how I'm doing. I saw my physiatrist this week, for some acupuncture on my back, but not on the feet. They have been feeling really good the last couple of weeks, so he didn't treat them, and only wants to see me every 3-4 weeks now. I'm keeping my fingers crossed tbey stay that way.

I also saw a rheumatologist this week to make sure that all these problems over the last year, or so weren't caused by some type of auto immune condition even though I'm feeling much better. I had made this appointment months ago. My physiatrist didn't think it was necessary, but I went anyway, because I'm still not 100% back to the way I was before this started. The rheumatologist also said it can take a lot of time for symptoms to totally disappear, because this condition didn't develop over night. As a precaution though she ran tons of sophisticated blood test that also included extensive thyroid testing. I'm seeing her this week for the results. Have you ever seen a rheumatologist?

Are you wearing the cast all the time, or just when you need it? Be careful if you are, because it can cause muscle weakness, and require physical therapy after wearing it for some time. Also, make sure you keep active. If there is any type of chronic pain situation going on activity is more critical than ever even if it involves just swimming, and biking to keep things from getting worse. Wearing the cast probably helps the pain, because by keeping pressure off the foot, and ankle structures, is giving the nerves a chance to rest. Some people recover from TTS just by wearing a cast, but make sure you are doing exercises, or having some form of PT while you are wearing it. My pod, and physiatrist were only considering a cast as a last resort, because of the many months of PT required after, and other possible complications, both neurological, and otherwise that could result from wearing it. Unless there is a bad fracture, or a severely torn ligament, etc., cast are not advisable as the first line of treatment. Even when it was finally discovered that I had an osteochondral injury of the talor dome (tiny compression type fracture in the ankle area) for some time a couple of years ago I wasn't casted, because they felt the cast would hinder healing. A cast in this case is usually only recommended if the fracture is caught early.

When are you having the NCV test? Have you made an appointment with a vascular specialist yet? Regardless if it is from a varicose vein, or something else the last thing you want to do is consider surgery unless all conservative methods are tried even if the ncv test is positive. Also all systemic causes need to be ruled out. You should see the more experienced pod regardless, (along with other specialist) for a thorough exam, and to take over your treatment, but don't let him talk you into any surgery at this point. Hopefully he won't be ignorant on treating pain like your current podiatrist.

Is this neurologist just doing a ncv test, or is he/she going to do a complete neurological workup too? Sometimes if you are sent for a test that is all they will do, unless you request it. Also, ask how much experience in TTS, and foot and ankle problems they have. A lot don't take much interest in this. When I was first diagnosed with TTS I went to a neurologist, who once he ruled out that I didn't have anything seriously wrong with me neurological wise just told me to get cortisone shots, and if that didn't work, I would need surgery. Of course I did neither. He was totally ignorant on neuropathic pain too, and only prescribed vioxx. Keep demanding the right to find knowlegable doctors.

Again, I'm so happy to hear you were able to enjoy the trip. Please keep me posted.

Donna

Re: Casts and TTS

Sharon W on 3/18/02 at 17:03 (076757)

Donna,

What do you mean when you say your feet have been 'feeling really good' lately? You said you aren't 100% back to the way you started... Do you still have shooting pains now and then? Does your PF still hurt, first thing in the morning or after you've been on your feet? Do you ever get burning soles, or tingling arches? Is the 1/2 Vioxx the ONLY thing you ever have to take for pain anymore??

Nope, I haven't seen a rheumatologist. In fact, it hadn't occured to me; there's really no reason to think I have arthritis.

In theory, I'm supposed to wear the cast except when I sleep, or bathe. In real life, though, I CAN'T wear it when I DRIVE -- that would be DANGEROUS -- and if I'm just running a 10-minute errand I usually don't take the time to pull off my shoe, put on the cast, inflate the cast, run the errand, come back to the car, remove the cast, deflate it, and change back to my tennis shoe before I drive home and put my cast back on! I am probably not getting full benefits from the cast that way, but at the same time, I imagine I am less likely to have trouble with muscle atrophy than if I never took it off. And the cast actually HELPS me to be more active, because without it I think twice before even walking across the room!

I really don't expect to 'recover' from TTS after wearing this cast. I'm FASCINATED by your success, for obvious reasons, but I don't expect my own problem to ever go away completely. To begin with, I obviously don't have the medical resources that you do. We have kids in college and I can't work anymore so if our insurance won't pay, I really can't consider it, whatever it is.

My internet server is probably about to time out on me again; I'll finish in another post.

-- Sharon

Re: Welcom back ! Re: Travelling to Europe with TTS and PF

Sharon W on 3/18/02 at 18:26 (076769)

Donna,

Even if I had made up my mind to find a new pod right away, this wouldn't be the right time to do it -- at least, NOT until the results of those neuro tests come back. But I will see my family Dr. again on April 21st, and I will discuss this with her, see whether SHE thinks I should change pods, and ask her for a referral to a vascular specialist to check out that varicose vein and find out if I have any others.

I really don't know WHAT the neurologist will do. My pod said she was sending me to him for nerve conductions tests, and commented that 'he might decide to do some other tests, too'. (If he gives me a chance for input, which tests do you think I should ask him about?) A friend told me that this particular neurologist doesn't even DO the nerve conduction tests himself, he sends patients on to someone else and then schedules them to come back & see him for the results. I wasn't exactly thrilled to hear that; I would MUCH rather have the person interpereting the results be the SAME Dr. who performed the tests!

It's ironic that insurance WILL pay $10,000 or more for an operation with no better than a 50% chance of improving TTS in the long run, but they will NOT pay for less invasive methods like ART or accupuncture or anything like that. I DID check for a central Texas practicioner of ART that does lower body work, but the closest one is 78 miles away. I e-mailed him, anyway, before I left on my trip, but he's never responded. So I guess ART is out, for me. My pod likes iontophoresis; she was saying she might refer me for it, depending on what the neuro tests show. But our insurance wouldn't pay for THAT, either...

Actually, you and my pod seem to AGREE about quite a few things. She says she wouldn't even CONSIDER surgery until after all the usual 'conservative treatments' have been tried & found inadequate, and even THEN she probably wouldn't recommend it unless I'm pretty much in agony 24/7 and therefore really don't have much to lose! She doesn't like steriod injections much, either; she has an absolute limit of 3 per year. And she WASN'T the one who put me in the walking cast and made me beg for pain meds -- that was her partner. I don't know whether she'll be happy about the cast or not; I guess i'll find out when I see her again, April 11th. She has never mentioned immobilization to me, so she may agree with you on THAT point, as well!

-- Sharon

Re: Casts and TTS

Donna SL on 3/18/02 at 19:38 (076777)

Hi Sharon,

By feeling really good I mean I have had almost zero pain in my feet, ankles, etc., except for one, or two days last week after I over did it on the Nordic track. I was told to start at 10 to 15 minutes, and ended up doing 45 minutes. The pain was only in the rim of the heels, and some other minor spots, but it went away, and in less than 2 days. Also, my feet feel much stronger lately. Its been a long time since I've experienced that horrible stabbing electrical pain, and the other symptoms you mentioned above. Over the last 2 months I've had only minor pain in the rest of my feet, and ankles when I did a lot of walking. The only really troublesome areas left was the bad rim heel pain if I stood, or walked for more then 3-4 hours, and some minor pain in my right arch, and elsewhere at times. But the last few big walks I've taken over the last few weeks I haven't even had that. It's weird like it just dissapeared. It's too soon to know yet for sure that's why I said I'm holding my breath. My doctor said just take one week at a time. I'm still expecting some downs.

As i mentioned before, I do have other problems with my back, a peroneal injury, and ankle injury that are not totally resolved yet, so I have other things going on besides the feet. That's why I can't say I'm 100% yet. Some days I might feel a little weaker, and my back will bother me, or I'll get some weird burning in my legs, and on occassion in the feet, but it's different then TTS pain. It's more radicular pain, related to the disc injuries.

If any of these areas act up then I'll take one neurontin and I'm fine. I use the topical cream on my feet that I told you about every time I go out. I'm still taking one Nortriptyline at dinner time, but next time I see my pnysiatrist, I'm going to ask if I can switch to a non tri-cyclic anti-depressant, because I'm having trouble loosing weight. When I'm home, I don't even need a 1/2 a vioxx, except if my back hurts. I've been taking it as a preventative measure for my feet when I go out, and do a lot of walking.

I have an appointment with a big shot world renowned pain mgt doctor at a major University hospital this Friday. A lot of research on pain mgt used around the world comes from this clinic. I had made that appointment almost 3 months ago when I still wasn't feeling that great, and my physiatrist had encouraged me to see him. It takes that long to get an appoinment with him. I'm going to keep the appointment anyway since I waited so long, and also gather any info in case some of the symptoms return again. If I learn anything new I'll let you know.

As far as rheumatologist I hadn't gone to one before, because I thought they were only for arthritis. They do much more, and investigate all kinds of auto immune things, and other things that could have gone wrong with the system, and caused foot, and back problems. They also know a lot about the thyroid. She tested things like thyroid antibodies, and all kinds of other stuff, my regular doctor never checked for on a regular physical. The rheumatologist was so fascinated with my recovery so far, she took the name of my chiro, and physiatrist (who's not even taking new patient now) for some of her patients.

I have told people before if they don't have insurance then beg, borrow, and steal to get the proper conservative treatment. I was fortunate enough to have excellent insurance, and other financial means, but I would have mortgaged a house if I had too to resolve this the way I did. I've still had thousands of dollars in co-pays. It may mean forgoing some other things for the moment. Most doctor, and chiro appointments, PT, etc., should be paid for on you insurance anyway. Even if ART, and acupuncture weren't covered, and you had to spend between $5,000.00 to $10,000.00 to get better, it's not a horrendous sum of money, and it's worth for you to have a life, and be out of pain. People have spent that on ESWT treatments, bad orthotics, etc. ESWT isn't even an option for TTS. Who know's, your TTS pain may be due to something entirely different, and once that's treated the TTS pain will resolve itself. That's why investigating for vascular problems, polyneuropathy, etc., is so important.

At one point I never thought I was going to recover from this, and I'm still scared to say I totally am yet, but if I can get to this point in 10 short months, there is no reason you shouldn't be able to. It just takes a lot of time, patience. You should feel at least 50% better, or more, in less than half that time though.

I just noticed your next post. I didn't have a chance to read it well, but will later, because i'm getting ready to go out in a while. Did you call the ART institute, or just look on the website? Sometimes they aren't all listed there. Iontopheresis won't relieve nerve entrapment. It may take a little swelling down, but that's all, but in general it's usually a big waste. You could give it a try. Also, who is doing the ncv test, the neurologist, or a technician? Maybe the other pod would refer you to a better testing center.

Also, I don't know if it's a good idea to wait that long to ask your doctor about a vascular specialist. Does she know what's going on? If not, just in case I would call asap to get this checked sooner to make sure this is not a dangerous situation.

Bye for now,

Donna

Re: Travelling to Europe with TTS and PF

Donna SL on 3/05/02 at 21:03 (075779)

Sharon,

I was probably at my worse around 18 months ago when I had to go on a trip to London, and Scotland for 2 1/2 weeks. My pod made these incredibly comfortable plaztozote orthotics so I could walk. They took pressure off of everything. They were bulky, so I stuck them in a pair of big cross trainers. They were very soft, yet supportive, but have lousy durability, and only hold their support for a couple of weeks at most. So he made me two pairs for the trip. I managed to stay on my feet the entire day with them every day. By the second week I was hurting more, so I taped my feet with the orthotics, and increased all my medications. I didn't know I had TTS at the time, so unfortunately I didn't have nerve meds. I iced every night in the Hotel. By the end of the trip, my feet were finished, but at least I got through the vacation, and enjoyed it.

If you already have comfortable orthotics, then just bring some athletic tape that you should be able to use with your orthotics. It will give you extra support. It seems the compression helps. Has your pod showed you how to tape? Also, bring extra strong pain-killers. I suggest narcotics. Bring an ice bag, that you can fill from the ice machines while you're there. I brought an ace bandage to hold the ice bag. I also brought an ice pack with velcro to stick in the little tiny freezer of the hotel refrigerator in the room, but not all hotels have refrigerators. Take frequest rest. Sit down whenever you get a chance, and ice when ever you can.

The neurontin would help if you change your mind about it. You should at least bring some with in case you get really bad nerve shooting pains. You could combine all these meds if needed, even with vioxx.

Another alternative would be to rent a wheelchair for certain days. Some people did that on the HS board when they went to Disney World. Also, take a lot of Bus tours, boat rides, taxis, etc, and sit around in nice little cafes.

Donna

Re: By all means, bring your meds

BrianG on 3/05/02 at 22:31 (075792)

Just a comment about bringing pain meds (narcotics) overseas. Bring them in the ORIGINAL container, most important. I'd also carry a photo copy of my perscription. I might even double check with customs. But, people do it every day, and I wouldn't let any negativity (9-11) stop me from doing what is legal. Good luck

BrianG

PS Your doctor may even give you some extra 'breakthrough' pain meds. It's not an uncommon request.
And tape, don't forget to tape!

Re: Brian & Donna SL -- Re: Bringing meds

Sharon W on 3/06/02 at 11:30 (075827)

I guess I didn't explain very well. Neurontin is a prescription med and I don't HAVE it yet -- although I could probably guy it over the counter in Spain. (My pod said she would write me one after the NCV tests were done.) I don't have narcotics, either -- at least, none that have been prescribed to me within the past year. There ARE probably a lot of things I could just buy over the counter at a pharmacy in Madrid -- not narcotics, but other things; my friend Mirta says it's pretty much the same way there now as it was when we all lived in Chile. I'm not sure whether I would have a hassle bringing them back IN to the U.S., though. I know customs is inspecting MUCH more closely than they used to, before 9/11. Does anyone know exactly what the rules are about that, these days? (I bet Neurontin is a lot CHEAPER in Spain!)

Using ice is more like what I meant by 'strategies'. Although, strangely, heat usually feels better to my foot than ice, unless I'm having that 'burning' feeling we all know so well...

Anyway, thanks for answering. And bringing an ice bag along is a very good idea; I'll do that.

-- Sharon

Re: Travelling to Europe with TTS and PF

Sharon W on 3/06/02 at 12:02 (075830)

Donna,

I think it's too late to get new orthotics made, although those soft ones DO sound wonderful!! And yes, I know how to tape my foot -- the pod did it for me the first time, and I kept it up until the orthotics were ready. I will try that and see if it, combined with the orthotics, is more helpful than the orthotics alone. I was even thinking of bringing along an ace bandage to add more compression around the ankle -- maybe that would help with the varicose vein.

As for 'medicines' -- I went into the problem with prescription meds in another message (see Brian & Donna SL:). I did point out to my pod last week that I was going on this trip to Spain. She said if the pain got worse I could come in and she would go ahead and give me the 3rd steroid shot. (She had decided not to do it because she wanted to see the results of the NCV test first, but I couldn't even get an appointment to see the neurologist for a MONTH.) But that makes no sense anyway, because if the pain gets worse I will be in SPAIN! I do NOT think my pod would write a narcotic for breakthrough pain if I called her office; as I said before, I don't even think she quite believes me about the level of pain this thing gets up to. (Maybe if the NCV tests show nerve damage, she will.)

My best friend is handicapped and uses scooters all the time, but I doubt if such things are readily available in Madrid or in the Canary Islands. Atleast, once we get to the Canary Islands we will be with our friends and we won't have to worry about taxis, etc. I intend to walk as little as possible, but I'm sure it will still be more than my foot can handle without triggering those shooting pains I hate so much.

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/06/02 at 13:00 (075836)

Sharon,

I don't know why your pod would recommend a steroid shot which would definitly affect the ncv test, but not give you meds that would 'not' affect the test including neurontin. I undertand she declined at the last minute to not do the injection, because of the test, but too many steroid shots can also do damage to tissue anyway, are very invasive, and they should't be used for just pain control when a safer alternative is available. A lot of my info about the ncv test and meds, etc., comes from one of the top pods in the country who was head of the surgical unit with 30 years of experience, and also headed the special problems clinic at one of the top podiatry schools in the country. Also from other MD specialist, and doctors who perform ncv test.

I know I wouldn't want to see a doctor that did not believe me about pain. My docs know how terrible foot pain can be regardless if it shows up on a test, or not, and wouldn't hesitate for a minute in giving me something to relieve the pain. As I mentioned before you can have TTS, without a positive ncv test. Regardless what's the difference? If you are in pain that's what these drugs are for. You sound like a mature responsible, professional woman, and she's treating you like a child, or some type of drug addict if she refuses them. Didn't you say you were a nurse?

I understand you are on some type of HMO, and it's not as easy to just walk out, and go to another doctor without a referral. Especially at the last minute like this. My plan allows me to go to whomever I want on my own. I don't know if you asked your pod yet for pain meds, so I'll give her the benefit of the doubt, but if she refused to give them to me, I'd dump her like a hot potato. I'll bet she wouldn't let herself, or a familiy member suffer. Would your family doctor give you any? It would be a shame to ruin such a nice trip that took so long to plan. Especially for your 25h anniversary.

I also wouldn't let anyone who didn't believe in pain control to do any invasive procedure on me, or treat me very long. People have developed RSD because of situations like this.

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/06/02 at 18:23 (075863)

Donna,

I was having a bunch of shooting pain after lunch today (I'd been on my feet more than usual, trying to get ready for the trip)so I decided, 'That's enough, I'm going to call my pod and say I need to see her right away before my trip tomorrow. Donna is right; I DO need pain meds.' But my pod wasn't working today; her baby is in the hospital. And she was already overbooked for tomorrow, but they could fit me in to see another young pod from the same practice.

OK, I was desperate, I said yes. She didn't want to give me pain meds, said it would only encourage me to overuse the foot and possibly injure it. I had to beg and plead and agree to use a walking cast (boot) but I did finally get a scrip for Ultram. That's the first time I've ever really ASKED for pain meds, and it wasn't easy.

My problem is that I'm stoic, and I have no talent for inducing empathy. Pain embarasses me and I hide it as much as I possibly can. Even when the pod pokes, I don't cry or scream or yell or jerk away, I just say 'yes' if she asks me, 'Does that hurt?'

Anyway, hopefully that will be enough to get me through the trip...

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/07/02 at 05:51 (075886)

Hi Sharon,

Good For You! You shouldn't have had to beg for pain meds though. I'm so annoyed at this it make me want to scream. These pods seem absolutely ignorant. How did they obtain their degree, from some correspondence course from off the back of a match book? I've read about some doctors, and pods like this before on this board, and they should be taken out, and shot. Seriously this can be dangerous, and it's almost unethical. Either they don't understand the severity of pain that TTS can cause, because they haven't treated many people with this, or maybe they have a drug problem themeselves. A decent doctor would never make you feel like that.
There are good, and bad doctors, dpms, etc., just like any other profession.

I hope you are going to get another pod, and try to see a couple of other MD's when you get back. At least you got something. It's unfortunate you were not able to get the neurontin. This is not proper care in my opinion. You should document everything.

When I first started with my physiatrist, he was actually pushing all these meds on me, and I didn't want to take them at first. I mentioned to you before he's also a pain mgt specialist, and has seen what has happened to people in situations like this. I had been in pain for a very long time before I came to see him, and it was spreading. I had been treating with a very ignorant pod for quite a while. Not only did he not know I had TTS, he never gave me any meds. I found out that I suffered needlessly. I hate for anyone else to have go through what I did for no good reason except absolute negligence, ignorance, or both.

Thank god I listened to this physiatrist, because I was heading towards RSD, and was in a chonic pain situation already, and didn't even know it. Now I need very little meds, and only take a 1/2 a vioxx, and the one Nortriptyline at night. I haven't needed any neurontin lately. The longer you delay the harder it is to beat this, even if you treat the oringinal cause.

I don't think you can do any damage unless you had a fracture. If it's just the nerves they will just get a little more irritated that's all. Make sure the cast isn't too tight. That would be a disaster for the nerves. It may also cause other problems. Only wear it if you really need it.

I don't know why you feel the need to hide pain. You shouldn't have to induce empathy to receive pain meds from any doctor anyway. Just telling them it hurts should be enough. It will only do you harm. I gave you the links to those articles for a very good reason, and I hope you had a chance to read them.

When are you leaving?

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/07/02 at 06:18 (075887)

Donna,

You might have been amused by the coversation between me and the pod. I thought it condescending of her, to say that I would injure myself further if I had pain meds. [The last thing in the world I want to do is 'injure myself further' -- believe me! We will be taking taxis just to walk 3 or 4 blocks, which is NOT something we would ordinarily do. I would not be walking barefoot on the beach and jumping and stomping!] Anyway, I told her, 'It's a vacation, and I will be on my feet regardless. The only question is whether I am happily exploring Spain, or MISERABLE doing it.'

I leave this afternoon. Wish me luck?

-- Sharon

Re: Travelling to Europe with TTS and PF

Donna SL on 3/07/02 at 06:50 (075888)

Hi Sharon,

I can't believe I'm still up. It's almost 4:30 am in CA, but I'm glad I'm having a chance to wish you a good, safe, wonderful trip.

You should have slapped this pod silly when she said that. ha ha, I would have asked her if she's been injecting cortisone in her brain. That's after I got the prescription, and was half way out the door.

Maybe you can find neurontin over the counter. I know I shouldn't be doing this, because I'm not an MD, but if things get bad, and they have them start out with 100 to 200 mg the first few nights at bedtime only, and then see how you do at 100 mg 2 x a day, and then at night do 100 to 200mg at once, totallying 300 to 400mg. You could take more if you needed. It's a very safe drug, but might make you a little drowsy at first. It needs some time to get in your system. This is such a tiny dose, so don't worry.

Also you could see a doctor there if you need to. The generic name is GABAPENTIN in case they are not familiar with neurontin. Hopefully the ultram will be enough, but if the shooting nervy pain gets bad, get the neurontin.

Have a great time.!!

Donna

Re: Travelling to Europe with TTS and PF

Sharon W on 3/07/02 at 07:29 (075889)

Donna,

I don't suppose you'll read this -- sounds like we're waking up in Texas at the same time you're finally getting to bed -- but I thought you might enjoy it anyway. I almost NEVER get angry enough to do something like this, but I was stone-cold angry THIS time; I had made a VERY reasonable request and I should NOT have had to grovel!

The pod I saw yesterday (who was, thank God, NOT my regular pod -- I didn't like her and she made me VERY mad with that condescension)didn't ENTIRELY get by with treating me like that. The appointment was basically over and she thought it was a good time for chit-chat. (I didn't agree, since I was basically ready to wring her neck...) Anyway, she asked why I had waited until the day before my trip to go to my pod for treatment if I was 'having so much difficulty'.
I said, 'I was in here LAST WEEK!'
She said, 'That's true... but what happened TODAY, that made you decide to come in?'
I said, 'I was having shooting pains and got into a panic about how much pain I would probably be in on my trip. I TOLD you that.'
'What were you doing before the shooting pains started?'
'Housework, getting ready for my trip. I wanted to get the house in shape, because my college daughter will be here while we're gone and she's coming here with her new boyfriend, he's bringing her home.'
'Do you like him?'
'I haven't met him yet. She seems pretty serious about him, though. I like almost everything I've heard about him -- except for one thing.'
'What's that?'
'Both of his parents are doctors.'
'What's the problem with THAT?'
'Nothing, right now -- but if she ends up marrying this guy, they'll be her IN-LAWS...'

I gess I should mention that this pod works in the same practice with her pod husband.
She decided that was a good time to exit the room...

-- Sharon

Re: Travelling to Europe with TTS and PF

Sharon W on 3/18/02 at 10:08 (076716)

Donna,

Are you out of town, yourself? I haven't noticed any new posts from you.

Anyway, I'm back, and Spain was lovely. We saw almost everything we wanted to see -- even took in a bullfight! (I don't think I would ever want to do that one AGAIN, but it was something to do ONCE that tells me a lot about the Spanish culture.)

Thanks so much for all your advice -- and for encouraging me to ask for pain meds. I was glad I did. I actually only had to use them 3 times, though; that new cast (a pneumatic walker, the kind with the air bladders inside to put compression on the leg/ankle and massage it as I walk) works really well. Maybe that's because the varicose vein is at least a big part of my problem -- I don't know. As you say, there may be various factors involved, and I'll probably know more after seeing the neurologist -- but I am convinced that varicose vein is a major issue. The problem is, I don't see how a cast could possibly HEAL a varicose vein, just make it FEEL better while it's on my leg...

I have definitely decided that if surgery is necessary I will have another pod do it, the guy who's certified for foot & ankle surgery and has 40 years' experience (instead of four!)

How are YOU feeling? Have you been back to your physiatrist lately?

-- Sharon

Re: Welcom back ! Re: Travelling to Europe with TTS and PF

Donna SL on 3/18/02 at 14:06 (076739)

Hi Sharon,

Welcome back! I'm glad you made it back safe, and sound.

I'm still in town, but have been very busy the last week, or so.

I'm so glad you enjoyed the trip, and were able to get around. I was wondering if you were going to see a bullfight. I saw one in Mexico city, and didn't realize how horrible it was, and swore I'd never go to one again. It seemed exciting with the crowds, the matadors, etc. until they started torturing, and killing the bulls. It's so cruel. I agree it's something you should see once though.

Thanks for asking how I'm doing. I saw my physiatrist this week, for some acupuncture on my back, but not on the feet. They have been feeling really good the last couple of weeks, so he didn't treat them, and only wants to see me every 3-4 weeks now. I'm keeping my fingers crossed tbey stay that way.

I also saw a rheumatologist this week to make sure that all these problems over the last year, or so weren't caused by some type of auto immune condition even though I'm feeling much better. I had made this appointment months ago. My physiatrist didn't think it was necessary, but I went anyway, because I'm still not 100% back to the way I was before this started. The rheumatologist also said it can take a lot of time for symptoms to totally disappear, because this condition didn't develop over night. As a precaution though she ran tons of sophisticated blood test that also included extensive thyroid testing. I'm seeing her this week for the results. Have you ever seen a rheumatologist?

Are you wearing the cast all the time, or just when you need it? Be careful if you are, because it can cause muscle weakness, and require physical therapy after wearing it for some time. Also, make sure you keep active. If there is any type of chronic pain situation going on activity is more critical than ever even if it involves just swimming, and biking to keep things from getting worse. Wearing the cast probably helps the pain, because by keeping pressure off the foot, and ankle structures, is giving the nerves a chance to rest. Some people recover from TTS just by wearing a cast, but make sure you are doing exercises, or having some form of PT while you are wearing it. My pod, and physiatrist were only considering a cast as a last resort, because of the many months of PT required after, and other possible complications, both neurological, and otherwise that could result from wearing it. Unless there is a bad fracture, or a severely torn ligament, etc., cast are not advisable as the first line of treatment. Even when it was finally discovered that I had an osteochondral injury of the talor dome (tiny compression type fracture in the ankle area) for some time a couple of years ago I wasn't casted, because they felt the cast would hinder healing. A cast in this case is usually only recommended if the fracture is caught early.

When are you having the NCV test? Have you made an appointment with a vascular specialist yet? Regardless if it is from a varicose vein, or something else the last thing you want to do is consider surgery unless all conservative methods are tried even if the ncv test is positive. Also all systemic causes need to be ruled out. You should see the more experienced pod regardless, (along with other specialist) for a thorough exam, and to take over your treatment, but don't let him talk you into any surgery at this point. Hopefully he won't be ignorant on treating pain like your current podiatrist.

Is this neurologist just doing a ncv test, or is he/she going to do a complete neurological workup too? Sometimes if you are sent for a test that is all they will do, unless you request it. Also, ask how much experience in TTS, and foot and ankle problems they have. A lot don't take much interest in this. When I was first diagnosed with TTS I went to a neurologist, who once he ruled out that I didn't have anything seriously wrong with me neurological wise just told me to get cortisone shots, and if that didn't work, I would need surgery. Of course I did neither. He was totally ignorant on neuropathic pain too, and only prescribed vioxx. Keep demanding the right to find knowlegable doctors.

Again, I'm so happy to hear you were able to enjoy the trip. Please keep me posted.

Donna

Re: Casts and TTS

Sharon W on 3/18/02 at 17:03 (076757)

Donna,

What do you mean when you say your feet have been 'feeling really good' lately? You said you aren't 100% back to the way you started... Do you still have shooting pains now and then? Does your PF still hurt, first thing in the morning or after you've been on your feet? Do you ever get burning soles, or tingling arches? Is the 1/2 Vioxx the ONLY thing you ever have to take for pain anymore??

Nope, I haven't seen a rheumatologist. In fact, it hadn't occured to me; there's really no reason to think I have arthritis.

In theory, I'm supposed to wear the cast except when I sleep, or bathe. In real life, though, I CAN'T wear it when I DRIVE -- that would be DANGEROUS -- and if I'm just running a 10-minute errand I usually don't take the time to pull off my shoe, put on the cast, inflate the cast, run the errand, come back to the car, remove the cast, deflate it, and change back to my tennis shoe before I drive home and put my cast back on! I am probably not getting full benefits from the cast that way, but at the same time, I imagine I am less likely to have trouble with muscle atrophy than if I never took it off. And the cast actually HELPS me to be more active, because without it I think twice before even walking across the room!

I really don't expect to 'recover' from TTS after wearing this cast. I'm FASCINATED by your success, for obvious reasons, but I don't expect my own problem to ever go away completely. To begin with, I obviously don't have the medical resources that you do. We have kids in college and I can't work anymore so if our insurance won't pay, I really can't consider it, whatever it is.

My internet server is probably about to time out on me again; I'll finish in another post.

-- Sharon

Re: Welcom back ! Re: Travelling to Europe with TTS and PF

Sharon W on 3/18/02 at 18:26 (076769)

Donna,

Even if I had made up my mind to find a new pod right away, this wouldn't be the right time to do it -- at least, NOT until the results of those neuro tests come back. But I will see my family Dr. again on April 21st, and I will discuss this with her, see whether SHE thinks I should change pods, and ask her for a referral to a vascular specialist to check out that varicose vein and find out if I have any others.

I really don't know WHAT the neurologist will do. My pod said she was sending me to him for nerve conductions tests, and commented that 'he might decide to do some other tests, too'. (If he gives me a chance for input, which tests do you think I should ask him about?) A friend told me that this particular neurologist doesn't even DO the nerve conduction tests himself, he sends patients on to someone else and then schedules them to come back & see him for the results. I wasn't exactly thrilled to hear that; I would MUCH rather have the person interpereting the results be the SAME Dr. who performed the tests!

It's ironic that insurance WILL pay $10,000 or more for an operation with no better than a 50% chance of improving TTS in the long run, but they will NOT pay for less invasive methods like ART or accupuncture or anything like that. I DID check for a central Texas practicioner of ART that does lower body work, but the closest one is 78 miles away. I e-mailed him, anyway, before I left on my trip, but he's never responded. So I guess ART is out, for me. My pod likes iontophoresis; she was saying she might refer me for it, depending on what the neuro tests show. But our insurance wouldn't pay for THAT, either...

Actually, you and my pod seem to AGREE about quite a few things. She says she wouldn't even CONSIDER surgery until after all the usual 'conservative treatments' have been tried & found inadequate, and even THEN she probably wouldn't recommend it unless I'm pretty much in agony 24/7 and therefore really don't have much to lose! She doesn't like steriod injections much, either; she has an absolute limit of 3 per year. And she WASN'T the one who put me in the walking cast and made me beg for pain meds -- that was her partner. I don't know whether she'll be happy about the cast or not; I guess i'll find out when I see her again, April 11th. She has never mentioned immobilization to me, so she may agree with you on THAT point, as well!

-- Sharon

Re: Casts and TTS

Donna SL on 3/18/02 at 19:38 (076777)

Hi Sharon,

By feeling really good I mean I have had almost zero pain in my feet, ankles, etc., except for one, or two days last week after I over did it on the Nordic track. I was told to start at 10 to 15 minutes, and ended up doing 45 minutes. The pain was only in the rim of the heels, and some other minor spots, but it went away, and in less than 2 days. Also, my feet feel much stronger lately. Its been a long time since I've experienced that horrible stabbing electrical pain, and the other symptoms you mentioned above. Over the last 2 months I've had only minor pain in the rest of my feet, and ankles when I did a lot of walking. The only really troublesome areas left was the bad rim heel pain if I stood, or walked for more then 3-4 hours, and some minor pain in my right arch, and elsewhere at times. But the last few big walks I've taken over the last few weeks I haven't even had that. It's weird like it just dissapeared. It's too soon to know yet for sure that's why I said I'm holding my breath. My doctor said just take one week at a time. I'm still expecting some downs.

As i mentioned before, I do have other problems with my back, a peroneal injury, and ankle injury that are not totally resolved yet, so I have other things going on besides the feet. That's why I can't say I'm 100% yet. Some days I might feel a little weaker, and my back will bother me, or I'll get some weird burning in my legs, and on occassion in the feet, but it's different then TTS pain. It's more radicular pain, related to the disc injuries.

If any of these areas act up then I'll take one neurontin and I'm fine. I use the topical cream on my feet that I told you about every time I go out. I'm still taking one Nortriptyline at dinner time, but next time I see my pnysiatrist, I'm going to ask if I can switch to a non tri-cyclic anti-depressant, because I'm having trouble loosing weight. When I'm home, I don't even need a 1/2 a vioxx, except if my back hurts. I've been taking it as a preventative measure for my feet when I go out, and do a lot of walking.

I have an appointment with a big shot world renowned pain mgt doctor at a major University hospital this Friday. A lot of research on pain mgt used around the world comes from this clinic. I had made that appointment almost 3 months ago when I still wasn't feeling that great, and my physiatrist had encouraged me to see him. It takes that long to get an appoinment with him. I'm going to keep the appointment anyway since I waited so long, and also gather any info in case some of the symptoms return again. If I learn anything new I'll let you know.

As far as rheumatologist I hadn't gone to one before, because I thought they were only for arthritis. They do much more, and investigate all kinds of auto immune things, and other things that could have gone wrong with the system, and caused foot, and back problems. They also know a lot about the thyroid. She tested things like thyroid antibodies, and all kinds of other stuff, my regular doctor never checked for on a regular physical. The rheumatologist was so fascinated with my recovery so far, she took the name of my chiro, and physiatrist (who's not even taking new patient now) for some of her patients.

I have told people before if they don't have insurance then beg, borrow, and steal to get the proper conservative treatment. I was fortunate enough to have excellent insurance, and other financial means, but I would have mortgaged a house if I had too to resolve this the way I did. I've still had thousands of dollars in co-pays. It may mean forgoing some other things for the moment. Most doctor, and chiro appointments, PT, etc., should be paid for on you insurance anyway. Even if ART, and acupuncture weren't covered, and you had to spend between $5,000.00 to $10,000.00 to get better, it's not a horrendous sum of money, and it's worth for you to have a life, and be out of pain. People have spent that on ESWT treatments, bad orthotics, etc. ESWT isn't even an option for TTS. Who know's, your TTS pain may be due to something entirely different, and once that's treated the TTS pain will resolve itself. That's why investigating for vascular problems, polyneuropathy, etc., is so important.

At one point I never thought I was going to recover from this, and I'm still scared to say I totally am yet, but if I can get to this point in 10 short months, there is no reason you shouldn't be able to. It just takes a lot of time, patience. You should feel at least 50% better, or more, in less than half that time though.

I just noticed your next post. I didn't have a chance to read it well, but will later, because i'm getting ready to go out in a while. Did you call the ART institute, or just look on the website? Sometimes they aren't all listed there. Iontopheresis won't relieve nerve entrapment. It may take a little swelling down, but that's all, but in general it's usually a big waste. You could give it a try. Also, who is doing the ncv test, the neurologist, or a technician? Maybe the other pod would refer you to a better testing center.

Also, I don't know if it's a good idea to wait that long to ask your doctor about a vascular specialist. Does she know what's going on? If not, just in case I would call asap to get this checked sooner to make sure this is not a dangerous situation.

Bye for now,

Donna