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please help, post op pain

Posted by Jean M on 3/23/02 at 15:33 (077320)

Hi,
I had surgery for ptt. At my first post op follow up yesterday the Dr. told me that the PTT tendon was not that bad at all but another tendon (FDL) I think, had an area that had a lot of scar tissue around it and there was also a nerve that appeared to be stuck in some scar tissue too. He cleaned up the tendon area and the nerve as well. I had the post-op splint removed and have and air cast boot now. I am still non-weight bearing and begin therapy next week. Here is my question, since having the new boot I have been getting pulsating pain around the incision area as well as what I would describe as zingers that shoot through the same area. The area where the incision is and the arch are numb as well as the big toe (the doc thought it was caused by pressure on a nerve from the splint) this is not the nerve he worked on. He said the one he worked on was would show numbness in the second and third toes. Anyway, sorry to be so long-winded, I have this new pain if the boot is on or off and is worse than any post op pain i have experienced. It gets extremely worse if I do not keep it elevated. I have removed the boot to see if it is causing pressure but it doesnt help. I have also tried icing the area with icecubes in a bag. The surges of pain are quite intense and almost unbearable. I am hoping that this is just part of the healing and it will go away soon, but any input is appreciated. I hate to call and be a pest if this is just part of the normal healing. I am just not sure since it was never this bad before. Thank you for your assistance. The pain starts above the ankle and shoots towards the front of the foot.

Re: please help, post op pain

Ed Davis, DPM on 3/23/02 at 16:14 (077323)

Was your surgery for PTTD? You did not state when the surgery was done but it sounds like it is early in the post-op course so elevation and ice to control the edema is still very important. The throbbing comes from swelling.

An anti-inflammatory prescription to control the swelling and inflammation may be helpful. Also make sure you have an adequate number of pain meds and they are of adequate strength. Things will gradually get better and better.
Ed

Re: please help, post op pain

Jean M on 3/23/02 at 17:42 (077334)

yes it was for pttd but the post tib tendon only had a minimal amount of scar tissue, it was another tendond FDL I think that had so much scar tissue around it. He cleaned this tendon and also a nerve that was trapped in scar tissue too. The surgery was March 12 and the pain had been tolerable and controled with pain meds up till yesterday. I am keeping it elevated and iced but it really seems to react on its own as far as pain. It can be near frozen and hurt like mad or can be in the boot and do the same thing. The pain meds at this point are not helping at all. A sharp shooting pain as well as throbbing like nothing I experienced when in the splint. I am very limited as far as movement in the boot like the splint but it is more uncomfortable. I don't know if I am just getting more sensitive or if it is the change from one to the other but I have really noticed a significant difference just since yesterday and not so much for the better. I know there will be a significant healing time, what concerns me is that it was better before this and I was not sure if this is something that should go unchecked. Thank you for you assistance. I will continue with icing every hour and see if it helps. I will try an anti-inflamatory as well.

Re: please help, post op pain

Crystal S on 3/23/02 at 20:53 (077347)

Hi Jean,
This sounds like the normal pain in the early days after foot surgery.Definitely keep using the ice and elevation.Stay off of your foot as much as possible and ask for some different pain meds.I had a PF release and heel spur surgery in October and the pain meds that they sent me home with didn't do crap for the pain.I called my doctor and got some stronger meds and it helped.I will tell you this though.Do not wait until you are hurting to take your pain meds.Take them every few hours as directed by your doc.The reason for this is if you let the pain get really bad before you take something then it is much harder to control and it takes longer.I hope I helped.I hope you get better soon.

Crystal

Re: Call tomorrow, and ask the Service to contact him

BrianG on 3/23/02 at 22:46 (077359)

Hi Jean,

Yes, your body can become accomidated to surgical pain quite quickly, if your pain meds are not strong enough. Try to keep a list of how the pain is effecting you. The more detailed it is, the easier it may be to get stronger pain meds. Don't feel like you have to suffer needlessly. There are pain meds out there that can help you. If your surgeon still refuses, you can always ask your primary doctor, to help you for the next week or two.

You probably already know that it's not right, or legal, to be be getting pain meds from more than one doctor. Be very honest with the doctor who will help you. Let him know that you won't go 'doctor shopping' I wish you luck, this is a touchy subject, but we are making progress! Good luck

BrianG

PS Don't let him tell you that you shouldn't have pain at this tme. Pain is like healing, we are all different. You may also need a little something to help you to sleep, which is important. Some people take Zanax, or Valium for a few weeks.

Re: please help, post op pain

Ed Davis, DPM on 3/23/02 at 16:14 (077323)

Was your surgery for PTTD? You did not state when the surgery was done but it sounds like it is early in the post-op course so elevation and ice to control the edema is still very important. The throbbing comes from swelling.

An anti-inflammatory prescription to control the swelling and inflammation may be helpful. Also make sure you have an adequate number of pain meds and they are of adequate strength. Things will gradually get better and better.
Ed

Re: please help, post op pain

Jean M on 3/23/02 at 17:42 (077334)

yes it was for pttd but the post tib tendon only had a minimal amount of scar tissue, it was another tendond FDL I think that had so much scar tissue around it. He cleaned this tendon and also a nerve that was trapped in scar tissue too. The surgery was March 12 and the pain had been tolerable and controled with pain meds up till yesterday. I am keeping it elevated and iced but it really seems to react on its own as far as pain. It can be near frozen and hurt like mad or can be in the boot and do the same thing. The pain meds at this point are not helping at all. A sharp shooting pain as well as throbbing like nothing I experienced when in the splint. I am very limited as far as movement in the boot like the splint but it is more uncomfortable. I don't know if I am just getting more sensitive or if it is the change from one to the other but I have really noticed a significant difference just since yesterday and not so much for the better. I know there will be a significant healing time, what concerns me is that it was better before this and I was not sure if this is something that should go unchecked. Thank you for you assistance. I will continue with icing every hour and see if it helps. I will try an anti-inflamatory as well.

Re: please help, post op pain

Crystal S on 3/23/02 at 20:53 (077347)

Hi Jean,
This sounds like the normal pain in the early days after foot surgery.Definitely keep using the ice and elevation.Stay off of your foot as much as possible and ask for some different pain meds.I had a PF release and heel spur surgery in October and the pain meds that they sent me home with didn't do crap for the pain.I called my doctor and got some stronger meds and it helped.I will tell you this though.Do not wait until you are hurting to take your pain meds.Take them every few hours as directed by your doc.The reason for this is if you let the pain get really bad before you take something then it is much harder to control and it takes longer.I hope I helped.I hope you get better soon.

Crystal

Re: Call tomorrow, and ask the Service to contact him

BrianG on 3/23/02 at 22:46 (077359)

Hi Jean,

Yes, your body can become accomidated to surgical pain quite quickly, if your pain meds are not strong enough. Try to keep a list of how the pain is effecting you. The more detailed it is, the easier it may be to get stronger pain meds. Don't feel like you have to suffer needlessly. There are pain meds out there that can help you. If your surgeon still refuses, you can always ask your primary doctor, to help you for the next week or two.

You probably already know that it's not right, or legal, to be be getting pain meds from more than one doctor. Be very honest with the doctor who will help you. Let him know that you won't go 'doctor shopping' I wish you luck, this is a touchy subject, but we are making progress! Good luck

BrianG

PS Don't let him tell you that you shouldn't have pain at this tme. Pain is like healing, we are all different. You may also need a little something to help you to sleep, which is important. Some people take Zanax, or Valium for a few weeks.