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

Surgery Option???

Posted by Donna on 5/07/02 at 17:59 (082880)

Hello. I was diagnosed with PF in both feet about 3 years ago. I have tried all the conservative treatments with little success. My left foot seems to be worse than my right foot. My doctor put me in a hard cast about a week ago on my left foot because I had a lot of inflammation and terrible pain. I could hardly walk. It doesn't seem to be helping a lot -in fact, some days it actually hurts worse than ever!! At my last visit, he told me that if this didn't work my other option would be surgery. At this point I am willing to go for this because I can't stand this pain anymore. My question is, after reading these boards I am getting mixed info as to whether to go with the open surgery or the endoscopic version. It seems to me that more people have better success with the open version. I have not discussed this with my dr. yet because until I found this site, I have been very ignorant of this condition and basically just did what the dr. told me to do. I do have a list of questions I want to ask when I go back to see him on May 17 but I thought some advice from people who have been there would really help me. Any advice anyone can give would be great. Thanks!!!

Re: Surgery Option???

DR Zuckerman on 5/07/02 at 18:38 (082892)

Hi

When it comes to plantar fascia foot surgery and heel spur excision I like the minimial incsion foot surgery approache. It is down from the bottom where there are no major nerves. The use of a fluroscope makes the removal of the bone spur easly and quick. No matter what procedure you pick there is always the risk of infection, failure and pain that is greater then when you started. Our practice used the revolutionary ESWT non-invasive procedure. Please investigate this procedure before any foot surgery is undertaken. We have done in the past three years over one thousand procedure that work and have stood the test of time . Feel free to ask any questions that you may have about ESWT, foot surgery and or heel pain

Re: Surgery Option???

john h on 5/08/02 at 11:36 (083046)

I would pass on the endoscopic Donna.

Re: Surgery Option???

Kevin I on 5/08/02 at 12:19 (083060)

Donna, My doctor recommended the open PF release, he personally has had a better success rate. I won't be able to give my personal opinion on the open procedure for many months though. My doctor did recommend the ESWT before any surgery that Dr. Z mentioned at first until I had a nerve test which showed signs of neuropathy in my lower legs and feet, hence the TTS surgery at the same time. After the nerve problem surfaced he nixed the ESWT treatment as a possibilty. Besides, my insurance didn't cover it anyway. Good Luck to you!!

Re: Surgery Option???

Donna on 5/08/02 at 16:48 (083111)

Thanks for all the comments guys! Kevin, my insurance won't cover EWST either so I guess that is really not an option right now. I haven't had any nerve tests done yet although at my last visit I did mention to the dr. that I was having some sharp pains run from my heel up through the back of my calf. The dr. noted that but didn't say much of anything about it. Do you think I should be concerned about that? Like I said earlier, I feel dumb sometimes when I go to the dr. and they ask for my symptoms and when I tell them, they don't say anything about it. Maybe I should ask more questions, huh? I'm really leaning towards the open procedure should they tell me surgery is next in line. I've heard way too many bad things about the other. How confusing all this is!!!!

Re: Surgery Option???

Sharon W on 5/09/02 at 01:46 (083160)

Donna,

Sharp pains that run from your heel up the the back of your calf could very very well be a nerve problem. If it continues, be sure to continue to report it to the Dr. - every single time. And perhaps you should ask about a referral to a neurologist for tests.

I know what you mean about 'feeling dumb sometimes' when you go to the Dr. and tell them your symptoms and they don't say anything. That drives me up the wall, too! Sometimes I ask, 'what could cause that to happen, Dr?' but the response is usually some kind of an evasion. I would MUCH rather hear 'I don't know' or 'I haven't quite got it figured out yet'; at least that's HONEST.

-- Sharon

Re: Surgery Option???

Donna on 5/09/02 at 05:38 (083185)

Thanks Sharon! It's nice to know that I'm not really dumb you know??!! Actually, I did do something very dumb last night. I had to go shopping for a birthday present for a friend and there were no wheelchairs available at the mall I went to. I made it to 2 stores (very near one another) before I had to give up. I ended up with no birthday present and very painful feet! I have a hard walking cast on my left foot and noticed when I got home and put my feet up that I messed up the cast on the bottom. So I guess its a trip back to the dr. to get it fixed today. What a pain!! I am so tired of this. I could hardly get out of bed this morning because it hurt so bad!! Sorry to moan, but I have a feeling this is not going to be a good day. I do still have occasional flare ups of sharp shooting pain up the backs of my calves so I will mention it again when I go today. Who knows if it will do any good or not. I am so frustrated!! Thanks again for your wonderful advice. Hope you have a good day! Take care.

Re: Surgery Option???

michelec on 5/09/02 at 18:45 (083286)

Hi Donna,

I had Open PF release on April 19th. You may have read my previous posts. I have had no complications since surgery. Very little pain at all. I was out of the cast and walking in less than 3 weeks! I'm not walking very gracefully yet and I use one crutch sometimes but I have no pain and very little swelling. I am very pleased with the open procedure. My doc feels that endoscopic has a limited field of vision and may not be a success. That is why he recommended and I chose the open.

Like you, I suffered since 2000 with this. I got tired of waiting for all the other treatments to work. None of them did - they only provided temporary relief. I wish you all the luck in your decision.

Re: Surgery Option???

Kevin I on 5/10/02 at 13:08 (083431)

Michele: Did you go straight into your shoes after he removed your cast? How much of your day is spent on your feet? Your recovery has been great so far and I hope you continue down that path. I'm curious because I'm about 11 days behind you (surgery 5/1) and due to get my stitches out and splint off on 5/20. Fortunately, I'm off my feet for 60-70% of a work day where I can prop my foot up and ice it if I need too.

Re: Surgery Option???

michelec on 5/10/02 at 16:13 (083453)

Kevin,

I have been very fortunate. I have had no major swelling. I could wear sneakers and slip on shoes immediately but my favorites are my birkenstock sandals so that's what I've been wearing mostly. I only had swelling on the inside of my foot, near the arch -- right above the incision. I haven't had to keep it elevated either. I have had physical therapy twice so far. I do the exercises they recommend each day. I haven't been up walking around too much though. I'm averaging around 6,000 steps a day (I have been wearing a pedometer for a wellness program I am in) -- which works out to about 1/2 mile. That's about 1/2 of the amount I was walking prior to surgery. I still am not comfortable putting weight on the foot so I walk mostly on the ball of my foot. I find it easier to go up and down steps than walking on flat surfaces which seems weird but I think it's because the way I position my foot. Good luck with your recovery.

Re: Delay the surgery, if it's PF

BrianG on 5/10/02 at 17:40 (083459)

Hi Donna,

One more suggestion. If you are diagnosed with only PF, try to hold off on the surgery as long as possible. At this moment, ESWT is your best bet, with none of the surgical problems. Once you are cut, there is no going back! I know you wouldn't be happy if the surgery failed, and you had more pain than before you started. It can happen.

I would start to look at where some of the ESWT locations are, in your area, maybe in Canada also. It's only a matter of time before more and more insurance companies start paying for this procedure. If the pain is too much, why not look into daily pain meds for the next year, or so. That should give you enough time to locate an ESWT treatment you can afford. It's like all new technologies, the prices will come down, or I'll eat my cap. Yuk, fish guts!!!! hahahaaaa

Of course, if you have nerve type problems, it will probably eliminate you from ESWT. Ths diagnosis is very important, go to 2 or 3 doctors, if necessary. Good luck

BrianG

Re: Surgery Option???

DR Zuckerman on 5/07/02 at 18:38 (082892)

Hi

When it comes to plantar fascia foot surgery and heel spur excision I like the minimial incsion foot surgery approache. It is down from the bottom where there are no major nerves. The use of a fluroscope makes the removal of the bone spur easly and quick. No matter what procedure you pick there is always the risk of infection, failure and pain that is greater then when you started. Our practice used the revolutionary ESWT non-invasive procedure. Please investigate this procedure before any foot surgery is undertaken. We have done in the past three years over one thousand procedure that work and have stood the test of time . Feel free to ask any questions that you may have about ESWT, foot surgery and or heel pain

Re: Surgery Option???

john h on 5/08/02 at 11:36 (083046)

I would pass on the endoscopic Donna.

Re: Surgery Option???

Kevin I on 5/08/02 at 12:19 (083060)

Donna, My doctor recommended the open PF release, he personally has had a better success rate. I won't be able to give my personal opinion on the open procedure for many months though. My doctor did recommend the ESWT before any surgery that Dr. Z mentioned at first until I had a nerve test which showed signs of neuropathy in my lower legs and feet, hence the TTS surgery at the same time. After the nerve problem surfaced he nixed the ESWT treatment as a possibilty. Besides, my insurance didn't cover it anyway. Good Luck to you!!

Re: Surgery Option???

Donna on 5/08/02 at 16:48 (083111)

Thanks for all the comments guys! Kevin, my insurance won't cover EWST either so I guess that is really not an option right now. I haven't had any nerve tests done yet although at my last visit I did mention to the dr. that I was having some sharp pains run from my heel up through the back of my calf. The dr. noted that but didn't say much of anything about it. Do you think I should be concerned about that? Like I said earlier, I feel dumb sometimes when I go to the dr. and they ask for my symptoms and when I tell them, they don't say anything about it. Maybe I should ask more questions, huh? I'm really leaning towards the open procedure should they tell me surgery is next in line. I've heard way too many bad things about the other. How confusing all this is!!!!

Re: Surgery Option???

Sharon W on 5/09/02 at 01:46 (083160)

Donna,

Sharp pains that run from your heel up the the back of your calf could very very well be a nerve problem. If it continues, be sure to continue to report it to the Dr. - every single time. And perhaps you should ask about a referral to a neurologist for tests.

I know what you mean about 'feeling dumb sometimes' when you go to the Dr. and tell them your symptoms and they don't say anything. That drives me up the wall, too! Sometimes I ask, 'what could cause that to happen, Dr?' but the response is usually some kind of an evasion. I would MUCH rather hear 'I don't know' or 'I haven't quite got it figured out yet'; at least that's HONEST.

-- Sharon

Re: Surgery Option???

Donna on 5/09/02 at 05:38 (083185)

Thanks Sharon! It's nice to know that I'm not really dumb you know??!! Actually, I did do something very dumb last night. I had to go shopping for a birthday present for a friend and there were no wheelchairs available at the mall I went to. I made it to 2 stores (very near one another) before I had to give up. I ended up with no birthday present and very painful feet! I have a hard walking cast on my left foot and noticed when I got home and put my feet up that I messed up the cast on the bottom. So I guess its a trip back to the dr. to get it fixed today. What a pain!! I am so tired of this. I could hardly get out of bed this morning because it hurt so bad!! Sorry to moan, but I have a feeling this is not going to be a good day. I do still have occasional flare ups of sharp shooting pain up the backs of my calves so I will mention it again when I go today. Who knows if it will do any good or not. I am so frustrated!! Thanks again for your wonderful advice. Hope you have a good day! Take care.

Re: Surgery Option???

michelec on 5/09/02 at 18:45 (083286)

Hi Donna,

I had Open PF release on April 19th. You may have read my previous posts. I have had no complications since surgery. Very little pain at all. I was out of the cast and walking in less than 3 weeks! I'm not walking very gracefully yet and I use one crutch sometimes but I have no pain and very little swelling. I am very pleased with the open procedure. My doc feels that endoscopic has a limited field of vision and may not be a success. That is why he recommended and I chose the open.

Like you, I suffered since 2000 with this. I got tired of waiting for all the other treatments to work. None of them did - they only provided temporary relief. I wish you all the luck in your decision.

Re: Surgery Option???

Kevin I on 5/10/02 at 13:08 (083431)

Michele: Did you go straight into your shoes after he removed your cast? How much of your day is spent on your feet? Your recovery has been great so far and I hope you continue down that path. I'm curious because I'm about 11 days behind you (surgery 5/1) and due to get my stitches out and splint off on 5/20. Fortunately, I'm off my feet for 60-70% of a work day where I can prop my foot up and ice it if I need too.

Re: Surgery Option???

michelec on 5/10/02 at 16:13 (083453)

Kevin,

I have been very fortunate. I have had no major swelling. I could wear sneakers and slip on shoes immediately but my favorites are my birkenstock sandals so that's what I've been wearing mostly. I only had swelling on the inside of my foot, near the arch -- right above the incision. I haven't had to keep it elevated either. I have had physical therapy twice so far. I do the exercises they recommend each day. I haven't been up walking around too much though. I'm averaging around 6,000 steps a day (I have been wearing a pedometer for a wellness program I am in) -- which works out to about 1/2 mile. That's about 1/2 of the amount I was walking prior to surgery. I still am not comfortable putting weight on the foot so I walk mostly on the ball of my foot. I find it easier to go up and down steps than walking on flat surfaces which seems weird but I think it's because the way I position my foot. Good luck with your recovery.

Re: Delay the surgery, if it's PF

BrianG on 5/10/02 at 17:40 (083459)

Hi Donna,

One more suggestion. If you are diagnosed with only PF, try to hold off on the surgery as long as possible. At this moment, ESWT is your best bet, with none of the surgical problems. Once you are cut, there is no going back! I know you wouldn't be happy if the surgery failed, and you had more pain than before you started. It can happen.

I would start to look at where some of the ESWT locations are, in your area, maybe in Canada also. It's only a matter of time before more and more insurance companies start paying for this procedure. If the pain is too much, why not look into daily pain meds for the next year, or so. That should give you enough time to locate an ESWT treatment you can afford. It's like all new technologies, the prices will come down, or I'll eat my cap. Yuk, fish guts!!!! hahahaaaa

Of course, if you have nerve type problems, it will probably eliminate you from ESWT. Ths diagnosis is very important, go to 2 or 3 doctors, if necessary. Good luck

BrianG