Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Curious bilateral symptoms

Posted by Lara T on 3/30/02 at 10:39 (078035)

I have a curious set of symptoms to my TTS, and I wonder if it's a clue to cause/treatment. So far the best explanation I've heard is 'the body is a complicated computer, who knows?'

In any case, my TTS has always expressed itself in both feet at what feels like exactly the same symptoms and intensity. While I understand the body is generally bilateral, I also know it isn't perfectly bilateral, and it struck me strange. When I was first given compression socks, the doctor only had one in his office so he put it on one foot (the one that had the worse readings on the NCV (I think) study. I went home and BOTH feet got better - to the same extent. I then did a 'scientific experiment' and changed the foot the sock was on and BOTH feet got worse. So I quit that experiment and put it back on the foot that got relief. I now where socks on both feet because it makes sense - unlike the above which makes no sense.

IN my various trips for another opinion I went to an orthopod (who was doing research on TTS) and asked him about the symptoms - he told me it was probably a placebo effect and in my head. This guy had shown other symptoms of having a 'god-complex' and being an arrogant jerk, so I didn't go on with the discussion - but seems to me the placebo effect (which research is now indicating isn't nearly as effective or widespread as once believed) works because people expect it to work (like an aspirin), whereas, trust me, I never thought a sock on one foot would relieve symptoms in both feet! But back to my story. This guy did get me thinking how I could prove him wrong, and I came up with the following experiement.

Whenever I take a shower, I get what I call a 'red sock' on my ankle. Presumably, it's the blood rushing in to the area where the compression sock has been presumably slowing down the blood flow. It's not painful or serious and doesn't bother me. I got to thinking, if there is something in the body that treatment of one foot affects both feet, then if I wear a sock only on the one foot, the 'red sock' should appear on both feet after a shower. So I wore a sock on one foot for two days, took a shower, and sure enough, I had 'red socks' on both feet. I tried it for another day, thinking maybe it was just holdover from when I socks on both feet, but on the third day I still had 'red socks' on both feet. I even had my husband come in and judge whether he saw 'red socks' to be sure I wasn't seeing what I wanted/expected to see.

Unforunately (or more likely fortunately) I never went back to the orthopod who told me it was a placebo effect to get an explanation. I did see another orthopod after that who thought it curious too - no explanation either.

My best explanation is it has something to do with the same phenomenon that results in improvement to muscles on both sides of the body when the patient weight lifts with one hand. I was told about this by a microbio friend, so I can't give much more details or references than that, but presumably has something to do with the bilateral nature of the body.

I've come to believe that I will probably die with TTS - probably not much worse, or much better, than I have it right now. But I still hope maybe something will come along so I periodically get renewed energy to explore things that still don't make sense.

Re: Curious bilateral symptoms

Sharon W on 3/30/02 at 11:26 (078042)

Lara,

Wow, that IS weird! I can't explain it either, but maybe one of the DPMs can.

Sorry; sounds like you're having a bad day. I can understand your pessimism when you say, 'I will probably die with TTS'. Sometimes I feel that way, too. It is SO disappointing, every time you try something new and, even though it may seem at first like it's going to work, you end up being back where you started from! Sometimes I ask myself, 'WHY do I even bother with all of these treatments, if nothing does any good anyway?' But there really is no way to just give up, I HAVE to keep trying...

That sounds like depression, and perhaps it is. But that pessimistic attitude usually only appears when I'm hurting, and disappears when I'm not. On a morning like this, when I'm not feeling my TTS, it's the easiest thing in the world to put that out of my mind; it's ALMOST like I don't have TTS at all!

-- Sharon

Re: Curious bilateral symptoms

Lara T on 3/30/02 at 12:31 (078046)

SHARONE WROTE: Sorry; sounds like you're having a bad day. I can understand your pessimism when you say, 'I will probably die with TTS'.

Thanks. Actually, I'm just being more prosaic and accepting than a bad day. As long as I have my compression socks, I've learned how to manage my TTS for the most part, learned how to get back on track when I've mismanaged it, generally know where my limits are (although I learn more as time goes on) and have a generally nice life, although I miss my tennis most. I can do a little exercise (limited options of what kind of exercises, and takes 10 minutes to put all the paraphanalia on my feet(!) but I have the time & it's enough to please the gynecologist's concern for osteoporosis) when other aging creaks aren't impacting on my life, although doing exercise probably limits me doing other things. I've kind of learned I have so many steps in a day - but there are enough steps to lead a good life - and after that I have to take reserves out of the 'bank' I can do that for a few days before the account runs out, then I have to replenish the account with LARGE amounts of rest and other relatively non-invasive treatments that take time but aren't particularly difficult or obnoxious. Life goes on. I figure I'm lucky that my TTS can be managed so that I can do most of the things I want, and have a good life.

My big concern is what if my arthritis gets bad like my grandmother and I can't put on the compression socks (sometimes you have to fight with them!), or things like that. But at the moment I haven't even had arthritis symptoms in my hands for a few years, and treatments keep getting better for that too. For the moment I'm fine and I keep my eyes and ears open for new developments in the treatment of TTS - I figure there is still much to learn and something might change in the next 5-30 years, time I figure to be around for. I'd love to be rid of it, but I have a nice life with it. It's even forced me in some interesting directions I probably wouldn't otherwise have tried (e.g. I now take art lessons instead of tennis and am enjoying it very much - although I have far more interest than talent).

Thanks for the thoughts. I imagine we're all members of this club we'd rather not be eligible for.

Re: Curious bilateral symptoms - P.S.

Lara T on 3/30/02 at 12:40 (078048)

This got cut off of the last post, responding to Sharon:
I hope you have more days when you can forget about it than otherwise. I sometimes forget how lousy it was for a couple of years before I got a diagnosis and effective treatment!. There were days I was such a *** I wasn't fit for human companionship. I would bite off the head of perfect strangers and when attending community meetings - you can imagine what my family put up with! But you're right, when things are going better, you sometimes forget how lousy it can be.

Re: about arthritis

Carole C in NOLA on 3/31/02 at 08:52 (078090)

Lara, I don't have TTS but I have arthritis (and PF), and I want to encourage you not to worry about arthritis preventing you from putting on your compression socks later on. First, it's a 'what if' worry, and may never happen. And second, if and when you do get arthritis, you don't yet know what joints might be involved and you don't yet know how you might or might not respond to all the wonderful new medications that have come out in the past few years.

One thing about arthritis meds that I have learned from the arthritis message boards, is that most people have to try 4-5 different ones before they find the one that works for them; there is no one arthritis med that's great for everyone. It's very individual, even for people with the same type of arthritis. My rheumatologist put me on Relafen at first, and it did absolutely nothing but upset my stomach. However, I'm one of the lucky few whose arthritis responds quite well to Celebrex, and who seems to get no side effects whatsoever from it. My 92-year-old Mom's arthritis didn't respond to Celebrex at all but she seems to do well with Vioxx which is also a Cox-2 inhibitor and apparently very similar to Celebrex. So, you can never tell. Some people don't do well on these new Cox-2 inhibitors but do well on other arthritis meds.

Some rheumatologists don't understand that individuals respond so differently to arthritis meds, just like some foot doctors don't understand that wall stretches and stair stretches can be so harmful to patients with PF. This is what I would call 'message board wisdom', but as far as I can tell it's worthwhile information. I had to nearly beat my (quite eminent) rheumatologist over the head to get him to try a second medication for me when the first didn't work, but I'm glad I did.

When I was in my teens and 20's, I had a passion for playing piano. I used to worry quite a lot about not being able to play piano when I was over 30 due to arthritis that I might later get in my finger joints like my Mom. I even looked into computer generated music for that reason (no slight task in the late sixties). I'm 53, and though I have substantial arthritis of several kinds, my arthritis has yet to invade my fingers to any noticeable extent. Thank heavens!!! However I don't play piano because my interests have changed. I guess what I'm saying to you and to everyone else is that you never know what the future will bring when it comes to arthritis.

Carole C

Re: PS

Carole C in NOLA on 3/31/02 at 08:56 (078091)

Re-reading your post, you probably already know all this about arthritis! Oh well. Anyway, it bears repeating for others who might read it.

Carole C

Re: Red sock

wendyn on 3/31/02 at 16:58 (078114)

Lara - by 'red sock' - do you mean that your feet turn red sort of in a sock pattern?

I have never heard of this before from showering, but I have noticed it in my case. You are the first person who has mentioned it.

If we are talking about the same thing...I notice after showering at the gym that my feet - esp the tops and up my ankles turn very bright red.

This is worse if I've been on the bike. It doesn't happen if I don't shower (say after a yoga day) and I've never noticed this happening at home.

Weird.

I have always chalked it up to RSD - since I have been diagnosed with that and told that it is what causes the color changes in my feet.

Re: Red sock

Lara T on 3/31/02 at 18:07 (078117)

I think we are talking about the same thing with the 'red sock'. Basically, the skin is redder than the surrounding skin in the area of the 'sock' - because blood is rushing to the area I assume.

In my case, I've assumed it's because of my 'compression sock' (that's really an anklet). - so it goes from around my arch to a couple inches above my ankle.

I only notice it when I wear the anklet. I imagine it's there when I wear the knee sock variety - but since it's my entire leg, and the knee makes a more natural line anyway, I don't notice as much - or might not have looked - it wasn't part of my 'scientific experiment'.

Re: Red sock

wendyn on 3/31/02 at 18:14 (078118)

Lara - I don't wear compression socks...so that can't be the cause in my case. Have you ever tried going without them and seeing if you still get the red feet?

Do you get red feet any other time?

I sometimes get very red hot puffy feet in the evenings. It is always associated with A LOT of pain. (The red after the shower does not come with any type of pain - and it is a different, patchy red - not an 'all red')

I tried to take a picture of this recently, but I don't have the film developed yet.

Re: Red sock

Lara T on 3/31/02 at 18:36 (078120)

yea - part of the 'experiment' was to carefully watch when I don't wear compression socks too- then it's jsut ordinary. After a hot bath I'm red regardless of whether I wear socks, but it's fairly uniform (and I think I've heard it described as blotchy - probably what you referred to as 'patchy').

I don't get red feet any other time and as with you, the 'red sock' from the shower doesn't cause any pain).

In case someone is confused, the 'anklet' compresion socks do not have toes (I wear regular socks or stockings over them), so the 'red sock' pattern from my mid-arch to slightly above my ankle is very distinctive and matches my anklet compression sock.

Re: Red sock

susie on 4/01/02 at 09:48 (078150)

Lara, I also get the reddness after a shower. No pain with it just bright red shinny skin. I did take a picture of it and showed
it to my Dr and he said bad ciculation from temp changes. Mine doesnt happen every time I think it depends on how much I have been on my feet that day or exercice ect. So I dont have any answers but I know exactly what you are talking about..
I dont wear compression socks now but I did for 6months and had it then too. Susie

Re: Curious bilateral symptoms

Ed Davis, DPM on 4/03/02 at 22:32 (078446)

Lara:
What type of diagnostic testing have you had so far? A couple of possibilties come to mind: 1)varicosities which fill up during dependency can increase pressure within the tarsal tunnel, 2) TTS can be postion dependent, pronation of the foot, often more prevalent without shoegear, can increase pressure within the TT.
Ed

Re: Curious bilateral symptoms

LaJeT ViouN on 4/09/02 at 14:48 (078942)

I've had x-rays, PT, rest, & blood work. Originally I was diagnosed with just PF and put on NSAIDS. The TTS diagnosis was initially made by a sports podiatrist with an interest in TTS after listening to my history. He sent me to a neurologist (I had a NCV test I think) which confirmed the diagnosis. Since then I've seen a few more orthopods and no one has questioned the TTS diagnosis.

The curious part isn't the red sock. I assume most anyone who wears a compression sock, whether they have TTS, or varicose veins, something else, or nothing at all and wear the sock for kicks, will have a 'red sock' after taking a shower. The curious part is that if I wear the sock on my right foot, both feet will get a red sock! I didn't try the opposite (sock on left foot) because my history is that a compression sock on my right foot makes both feet feel better, but a compression sock on my left foot doesn't help either foot - so I didn't feel like doing a three day experiment going without a sock on my right foot.

The NCV test came back as delayed messaging on both feet, but more pronounced on the right foot.

Re: Curious bilateral symptoms

Lara T. on 4/09/02 at 15:22 (078948)

In case someone is confused, my mailbox is LaJeT ViouN, and I'm on vacation and typed in LaJeT ViouN instead of Lara T by accident, thinking I had to sign in or something. It's the same person.

Re: Curious bilateral symptoms

Sharon W on 3/30/02 at 11:26 (078042)

Lara,

Wow, that IS weird! I can't explain it either, but maybe one of the DPMs can.

Sorry; sounds like you're having a bad day. I can understand your pessimism when you say, 'I will probably die with TTS'. Sometimes I feel that way, too. It is SO disappointing, every time you try something new and, even though it may seem at first like it's going to work, you end up being back where you started from! Sometimes I ask myself, 'WHY do I even bother with all of these treatments, if nothing does any good anyway?' But there really is no way to just give up, I HAVE to keep trying...

That sounds like depression, and perhaps it is. But that pessimistic attitude usually only appears when I'm hurting, and disappears when I'm not. On a morning like this, when I'm not feeling my TTS, it's the easiest thing in the world to put that out of my mind; it's ALMOST like I don't have TTS at all!

-- Sharon

Re: Curious bilateral symptoms

Lara T on 3/30/02 at 12:31 (078046)

SHARONE WROTE: Sorry; sounds like you're having a bad day. I can understand your pessimism when you say, 'I will probably die with TTS'.

Thanks. Actually, I'm just being more prosaic and accepting than a bad day. As long as I have my compression socks, I've learned how to manage my TTS for the most part, learned how to get back on track when I've mismanaged it, generally know where my limits are (although I learn more as time goes on) and have a generally nice life, although I miss my tennis most. I can do a little exercise (limited options of what kind of exercises, and takes 10 minutes to put all the paraphanalia on my feet(!) but I have the time & it's enough to please the gynecologist's concern for osteoporosis) when other aging creaks aren't impacting on my life, although doing exercise probably limits me doing other things. I've kind of learned I have so many steps in a day - but there are enough steps to lead a good life - and after that I have to take reserves out of the 'bank' I can do that for a few days before the account runs out, then I have to replenish the account with LARGE amounts of rest and other relatively non-invasive treatments that take time but aren't particularly difficult or obnoxious. Life goes on. I figure I'm lucky that my TTS can be managed so that I can do most of the things I want, and have a good life.

My big concern is what if my arthritis gets bad like my grandmother and I can't put on the compression socks (sometimes you have to fight with them!), or things like that. But at the moment I haven't even had arthritis symptoms in my hands for a few years, and treatments keep getting better for that too. For the moment I'm fine and I keep my eyes and ears open for new developments in the treatment of TTS - I figure there is still much to learn and something might change in the next 5-30 years, time I figure to be around for. I'd love to be rid of it, but I have a nice life with it. It's even forced me in some interesting directions I probably wouldn't otherwise have tried (e.g. I now take art lessons instead of tennis and am enjoying it very much - although I have far more interest than talent).

Thanks for the thoughts. I imagine we're all members of this club we'd rather not be eligible for.

Re: Curious bilateral symptoms - P.S.

Lara T on 3/30/02 at 12:40 (078048)

This got cut off of the last post, responding to Sharon:
I hope you have more days when you can forget about it than otherwise. I sometimes forget how lousy it was for a couple of years before I got a diagnosis and effective treatment!. There were days I was such a *** I wasn't fit for human companionship. I would bite off the head of perfect strangers and when attending community meetings - you can imagine what my family put up with! But you're right, when things are going better, you sometimes forget how lousy it can be.

Re: about arthritis

Carole C in NOLA on 3/31/02 at 08:52 (078090)

Lara, I don't have TTS but I have arthritis (and PF), and I want to encourage you not to worry about arthritis preventing you from putting on your compression socks later on. First, it's a 'what if' worry, and may never happen. And second, if and when you do get arthritis, you don't yet know what joints might be involved and you don't yet know how you might or might not respond to all the wonderful new medications that have come out in the past few years.

One thing about arthritis meds that I have learned from the arthritis message boards, is that most people have to try 4-5 different ones before they find the one that works for them; there is no one arthritis med that's great for everyone. It's very individual, even for people with the same type of arthritis. My rheumatologist put me on Relafen at first, and it did absolutely nothing but upset my stomach. However, I'm one of the lucky few whose arthritis responds quite well to Celebrex, and who seems to get no side effects whatsoever from it. My 92-year-old Mom's arthritis didn't respond to Celebrex at all but she seems to do well with Vioxx which is also a Cox-2 inhibitor and apparently very similar to Celebrex. So, you can never tell. Some people don't do well on these new Cox-2 inhibitors but do well on other arthritis meds.

Some rheumatologists don't understand that individuals respond so differently to arthritis meds, just like some foot doctors don't understand that wall stretches and stair stretches can be so harmful to patients with PF. This is what I would call 'message board wisdom', but as far as I can tell it's worthwhile information. I had to nearly beat my (quite eminent) rheumatologist over the head to get him to try a second medication for me when the first didn't work, but I'm glad I did.

When I was in my teens and 20's, I had a passion for playing piano. I used to worry quite a lot about not being able to play piano when I was over 30 due to arthritis that I might later get in my finger joints like my Mom. I even looked into computer generated music for that reason (no slight task in the late sixties). I'm 53, and though I have substantial arthritis of several kinds, my arthritis has yet to invade my fingers to any noticeable extent. Thank heavens!!! However I don't play piano because my interests have changed. I guess what I'm saying to you and to everyone else is that you never know what the future will bring when it comes to arthritis.

Carole C

Re: PS

Carole C in NOLA on 3/31/02 at 08:56 (078091)

Re-reading your post, you probably already know all this about arthritis! Oh well. Anyway, it bears repeating for others who might read it.

Carole C

Re: Red sock

wendyn on 3/31/02 at 16:58 (078114)

Lara - by 'red sock' - do you mean that your feet turn red sort of in a sock pattern?

I have never heard of this before from showering, but I have noticed it in my case. You are the first person who has mentioned it.

If we are talking about the same thing...I notice after showering at the gym that my feet - esp the tops and up my ankles turn very bright red.

This is worse if I've been on the bike. It doesn't happen if I don't shower (say after a yoga day) and I've never noticed this happening at home.

Weird.

I have always chalked it up to RSD - since I have been diagnosed with that and told that it is what causes the color changes in my feet.

Re: Red sock

Lara T on 3/31/02 at 18:07 (078117)

I think we are talking about the same thing with the 'red sock'. Basically, the skin is redder than the surrounding skin in the area of the 'sock' - because blood is rushing to the area I assume.

In my case, I've assumed it's because of my 'compression sock' (that's really an anklet). - so it goes from around my arch to a couple inches above my ankle.

I only notice it when I wear the anklet. I imagine it's there when I wear the knee sock variety - but since it's my entire leg, and the knee makes a more natural line anyway, I don't notice as much - or might not have looked - it wasn't part of my 'scientific experiment'.

Re: Red sock

wendyn on 3/31/02 at 18:14 (078118)

Lara - I don't wear compression socks...so that can't be the cause in my case. Have you ever tried going without them and seeing if you still get the red feet?

Do you get red feet any other time?

I sometimes get very red hot puffy feet in the evenings. It is always associated with A LOT of pain. (The red after the shower does not come with any type of pain - and it is a different, patchy red - not an 'all red')

I tried to take a picture of this recently, but I don't have the film developed yet.

Re: Red sock

Lara T on 3/31/02 at 18:36 (078120)

yea - part of the 'experiment' was to carefully watch when I don't wear compression socks too- then it's jsut ordinary. After a hot bath I'm red regardless of whether I wear socks, but it's fairly uniform (and I think I've heard it described as blotchy - probably what you referred to as 'patchy').

I don't get red feet any other time and as with you, the 'red sock' from the shower doesn't cause any pain).

In case someone is confused, the 'anklet' compresion socks do not have toes (I wear regular socks or stockings over them), so the 'red sock' pattern from my mid-arch to slightly above my ankle is very distinctive and matches my anklet compression sock.

Re: Red sock

susie on 4/01/02 at 09:48 (078150)

Lara, I also get the reddness after a shower. No pain with it just bright red shinny skin. I did take a picture of it and showed
it to my Dr and he said bad ciculation from temp changes. Mine doesnt happen every time I think it depends on how much I have been on my feet that day or exercice ect. So I dont have any answers but I know exactly what you are talking about..
I dont wear compression socks now but I did for 6months and had it then too. Susie

Re: Curious bilateral symptoms

Ed Davis, DPM on 4/03/02 at 22:32 (078446)

Lara:
What type of diagnostic testing have you had so far? A couple of possibilties come to mind: 1)varicosities which fill up during dependency can increase pressure within the tarsal tunnel, 2) TTS can be postion dependent, pronation of the foot, often more prevalent without shoegear, can increase pressure within the TT.
Ed

Re: Curious bilateral symptoms

LaJeT ViouN on 4/09/02 at 14:48 (078942)

I've had x-rays, PT, rest, & blood work. Originally I was diagnosed with just PF and put on NSAIDS. The TTS diagnosis was initially made by a sports podiatrist with an interest in TTS after listening to my history. He sent me to a neurologist (I had a NCV test I think) which confirmed the diagnosis. Since then I've seen a few more orthopods and no one has questioned the TTS diagnosis.

The curious part isn't the red sock. I assume most anyone who wears a compression sock, whether they have TTS, or varicose veins, something else, or nothing at all and wear the sock for kicks, will have a 'red sock' after taking a shower. The curious part is that if I wear the sock on my right foot, both feet will get a red sock! I didn't try the opposite (sock on left foot) because my history is that a compression sock on my right foot makes both feet feel better, but a compression sock on my left foot doesn't help either foot - so I didn't feel like doing a three day experiment going without a sock on my right foot.

The NCV test came back as delayed messaging on both feet, but more pronounced on the right foot.

Re: Curious bilateral symptoms

Lara T. on 4/09/02 at 15:22 (078948)

In case someone is confused, my mailbox is LaJeT ViouN, and I'm on vacation and typed in LaJeT ViouN instead of Lara T by accident, thinking I had to sign in or something. It's the same person.