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surgery scheduled

Posted by kay on 6/04/02 at 13:34 (086272)

i will be having open foot surgery for plantar fasciitis on june 18th. i have tried everything else that my insurance will cover, including somethings that they don't cover. my orthepedic says there is only a 50% chance of improvement of my pain with the surgery. and that it will take at least 6 months to recoup from this surgery. i am really afraid that the surgery won't help and i'll have to live with this pain the rest of my life. not to mention i will not be able to go back to work.
kay

Re: surgery scheduled

Ed Davis, DPM on 6/04/02 at 22:07 (086322)

Kay:

It is your body. Can you accept a 50% success rate and the consequences that can follow? I certainly could not if it was my foot.

What modalities, specifically have been performed for this problem?
Ed

Re: surgery scheduled

Joe S on 6/04/02 at 23:50 (086335)

Kay, the success rate for an open plantar fasciotomy is greater than 50%. It runs upwards of 80%. Conservative management (stretching, orthotics, injections etc) runs around 85-90%. I can count the number of open procedures that I've done in the last year on one hand. I have done 3 open plantar fasciotomies in the last year. I see approximately 35 patients per day. Out of those I would say a good 5-6 patients are heel pain patients. I'm sure the other podiatrists on this board would agree. Most people get better without surgery. If you have exhausted all forms of conservative care, then surgery is the next step be it an open fasciotomy, ESWT or an EPF. Personally I don't like the EPF's. Personally I try to get you better conservatively first. Maybe you should get a second opinion just to see if there are any other treatment options available. Not all orthopedists are foot specialists. Some are very good. Some not so good. The same holds true for podiatrists. However, I would bet that a busy, well trained podiatrist probably sees far more cases of plantar fasciitis than most orthopods do in a week. I do. I work in an orthopedic practice. They don't see any foot stuff. They send it to me. The last open procedure I performed was about two months ago. The lady had suffered with plantar fasciitis for 3 years. Shipped around to different docs who injected her, put her into orthotics, night splints, physical therapy. Well she came to me and related that I can't continue with this pain. All forms of conservative care had been failed. We attempted to get her approved for ESWT to no avail. United HealthCare would not pay for it. We opted for an open plantar fasciotomy. The procedure took approximately 30minutes. She was made nonweightbearing for 2-3 weeks. Sutures were removed on day 15 or 16. She wore a post op shoe for 1 week and then transitioned into her running shoe at 4 weeks post op. She is doing extremely well. Her pain level went from a continual 9/10 to about a 2/3. She wears her orthotics and to date has not developed any lateral pain. There are horror stories associated with surgery. I believe if you read any of my other comments regarding surgery I have addressed them at some point. Most failures are due to improper diagnosis. Not all heel pain is plantar fasciitis. Sometimes, during surgery, the plantar fascia may not be cut. This ultimately ends in failure because nothing was done to alleviate the stress on the calcaneus (heel bone). And last but not least, this is an elective surgery. You have to be ready to undergo the procedure. If you are scared or hesitant, then you should probably not have it done. Alot of doctors will try and talk you out of this procedure. Some will try to talk you into it. You have to make an informed decision about your healthcare. You will know when you're ready for the surgery. Believe me. You will know.

Re: surgery scheduled

wendyn on 6/05/02 at 07:11 (086341)

This makes a lot of sense to me...the 'When you're ready you'll know'. I had bunions surgery abou 10 years ago, and I KNEW that I absolutely could not continue the way things were going.

Re: surgery scheduled

kay on 6/05/02 at 12:20 (086375)

can i accept 50%? what choice do i have? i've had this problem since i was 19 (46 now)and have been through everything!!!! except ossatron,,,,no money, no insurance coverage for it. i had the endoscopic surgery 6 years ago. this last year has been hell for me trying to work. i've taken so many pain pills trying to stay employed. the pain has gotten so bad i am desperate. i cannot even fix a meal or go to the grocery without the pain being so bad that i think i can't deal with another day.
can i accept 50%? what choice do i have? i am grasping for straws here. he says only 50% because i have had surgery before and it was unsuccessful. i also have fibromyalgia which i basically ignore since the pain in my back, hips and arms are nothing compared to my feet pain. thoughts of dying come to mind. does that tell you how desperate i am?
kay

Re: surgery scheduled

kay on 6/05/02 at 12:29 (086378)

i guess i should list what i have had done for my feet. new shoes, orthodics,physical therapy,cort.injections,stretching,NSAID drugs,ultrasound therapy,,antidepressants,endoscopic surgery,and casting. i think thats it. its been a long time and i am tired of this pain. i can't work, we will most likely have to sell our house we built 3 years ago because i can't work. sick pay is about half of what i normally make working and it will be cut again by half in september.
kay

Re: surgery scheduled

Tonya R. on 6/05/02 at 15:58 (086392)

Kay, I just wanted to say that I greatly sympathize and relate to what you are saying, experiencing and feeling. Although, i do believe that the success rate of the surgery is a bit more than 50%, but nothing would have a 100% guarantee. Knowing this, on May 9th I chose to have the open plantar fascia release. I had been in treatment for several years. Nothing worked, and laugh as some may, I seriously thought i would be better off if someone cut my right foot off. I have suffered with PF in both, but the right was worse. Yes, this surgery is an elective surgery, but for me even a mere 50% chance of improvement is better than the 100% pain I would have by not having the surgery done. Therefore, I feel that in some cases it is a necessity. By all means, if you are not comfortable with the probability of improvement, DON'T DO IT. I just feel that some of people who have posted on this board have been seen as throwing in the towel, plopping their foot up, and saying 'Go ahead Doc, cut away'. I know in my instance that was not the case, as I am sure it has not been in yours. That being said, I really wish you luck on the 18th. I hope you get the relief that you are seeking. God only knows how daily, constant pain can wear someone down. Not to mention the impact it has on ones family life.

Re: surgery scheduled

kay on 6/05/02 at 16:03 (086393)

thanks tonya, i hope your surgery helped you. i am to the point that i have to do something. surgery is the only thing left. i have to do it. i only hope to god it helps. please keep this board updated on your progress as i will be right here behind you with mine. hopefully we will have good news to share and bring hope to the hopeless, which is how i have felt for sometime now. i am seeing my regular family doctor tuesday and i am asking for some antidepressants. i believe i really need them. a day doesn't go by that i dont burst into uncontrollable tears.
thanks again.
kay

Re: surgery scheduled

Tonya R. on 6/05/02 at 16:07 (086395)

Kay, hang in there. I will pray for you. There are a lot of understanding people who do read and respond to these posts. I'm sure I speak for all of us when I say we are here for you.

Re: surgery scheduled

Sharon W on 6/05/02 at 17:16 (086408)

Kay,

I understand 'desperate,' I'm feeling pretty desperate myself. I'm also planning to have surgery (although it is for TTS and not PF) and I'm ALREADY at the end of my rope with it, after a year of treatments that just haven't worked for me. I do have PF too, though, I truly can't IMAGINE what it would be like, fighting a bad case of PF for 27 YEARS!!!

It sounds to me like you have a point, you really have NO choice but to try surgery, even if there's really only a 50% chance of success. I think there does come a point where you really have no choice but to GO FOR IT --I mean, you CAN'T give up on treatment, because the pain won't LET you do that!

Yes, antidepressants WILL probably help -- in fact, if they give you something like Elavil, it might even help relieve some of your PAIN!

Hang in there, Kay, we're all here for you.

-- Sharon

-- Sharon

Re: surgery scheduled

kay on 6/05/02 at 18:41 (086430)

hi sharon thanks for your words. i also forgot to mention that the doc says i have some nerve problems too. so when i seen the papers it said surgery for P.F. & T.T. so i am assuming tarsel tunnel also.
i took elavil for my fibro last year and the only thing it did for me was make me gain weight. i'm going to ask about welbutrin because i heard it doesn't have all the side effects.
thanks
kay

Re: surgery scheduled

Laurie R on 6/05/02 at 19:09 (086436)

Hi Kay , Kay , I am one that waited a while before surgery . I am now 4 weeks post opp . I had a PF release Open and a TTS relase and my tendons cleaned out and my Pod removed a groth on the bottom of my foot. We went back and forth on wheather I should have the surgery or not . I am so gald I did . I also have RSD , so both of my doctors were very careful before my surgery . I have also been going for spinel injections to help control the RSD .

It is up to you and only you if you should have surgery . I like you suffered for way to long . I have not been able to work now for almost three years . I would love part of my life back .

I wish only the best for you . Not everyone believes in surgery nor does every surgery come out right . I feel you have to weigh out everything then make your choice ....

My best to you Kay , Laurie R

Re: surgery scheduled

Barbara S on 6/05/02 at 19:27 (086438)

Hi Kay
Barbara S. here. I had EPF surgery at the end of Nov. It did not work,my foot only got worse. I have been off of work Since a week after surgery. I only put up with my pain for 1-1/2yrs I can't imagine going through that type of pain for as long as you have.
I also Have fibromyalgia diagnosed in 1994 after several yrs of pain.
My Pod knew I had Fibro. so he thought at first it was just taking me longer to recover,so kept me off my foot for 1 month. I was still in alot of pain. He then ordered a MRI. This showed that everything had healed in relation to EPF surgery. Nothing else showed on the MRI. He then told me that he thought I had TTS and sent me to a Neurologist for an EMG. This test showed positive for TTS. First he tired a steriod type shot, no relief. He then suggested surgery and referred me to an ortho surgeon,as he said the surgeon had done more TTS Surgery and felt I would be in better hands. He, himself had only done a couple TTS Surgery and he felt mine would be difficult. He was right. I have a 7-8inch incision starting under my foot up around my ankle and 2 inches above my ankle up my leg. I am 6wks post op and only able to put slight weight on my foot. My Heel and ankle area are always swollen and the rest of my foot and toes swell up as the day goes on and are constantly burning and prickly.
I am now going to therapy 3 times a week. I think they are trying to push me too fast. I will be talking about this with her tomorrow. I haven't gotten paid for 5 of the 6 months I have been off. I've worked for Ameritech for over 25yrs., and my disability has been denied for the first 5 months. THey have paid me for 1 month from the date of my TTS surgery,but then stopped on May 22nd. I just found out today that they have now approved me til June 7th. I don't see my Doc until the 18th of June. I guess the PT will have to send them another report.
I have hired an attorney to deal with Ameritech and if I have to I will take more vacation time before I'll go back to work too early. See they don't consider my inability do drive a part of disability. Take a bus call a cab. I have a 25 min drive one way and that is if there are no traffic problems.
I take welbutrin. I feel it helps somewhat,but I still have days that I cry because I get so frustrated that I cannot do anything. I have a wheelchair at home that helps me get around as I have knee and back problems also. If it wasn't for the wheelchair I think things would be worse.
I have also said maybe it would be better to have my foot amputated. MY husband says don't be so foolish and I've said back to him you put up with this pain then.
If it wasn't for the kind encouraging words from people on this board I would really be more down and out. So keep reading and posting and hopefully this will give you strength to go on.
Take care and God Bless us. Barbara S.

Re: surgery scheduled

Ed Davis, DPM on 6/05/02 at 21:05 (086448)

You have had this problem for a long time -- too long. Have you had other opinions in order to better ascertain the cause of the problem and be sure it actually is PF? Is the current surgeon planning an open procedure?
Ed

Re: surgery scheduled

Ed Davis, DPM on 6/05/02 at 21:06 (086449)

PS If it definitely is PF, one option is Canadian ESWT. The cost at the Sonocur center in Vancouver, BC is $750 Canadian ($535 US) for 3 treatments.
Ed

Re: surgery scheduled

Missy B on 6/05/02 at 23:12 (086467)

Hi Kay,
I have read your posts and can tell you that I have been there before you. I suffered on and off for 6 years with heel pain and was diagnosed with PF and TT. Like you, I tried all the non-invasive treatments, but nothing really helped. I was to the point of sometimes dragging my leg because I did not want to put my weight on it. When my nerve conduction study came back a glaring positive for TT, I knew it was time to make the decision for surgery.
I am now 19 weeks post PF/TT release surgery, and I can tell you, that as of right now, I am not sorry I had it done. Compared to the pain I suffered before my surgery, I consider myself 80% better. I still have some residual PF soreness, and my foot does still ache sometimes, but at least now I can work a full day and not come home in tears. I get my new custom orthotics on 6/10 and my pod hopes these will help relieve the soreness I am still experiencing.
My pod, as well as other patients, have told me it may take up to a year before we will know the final outcome. Last January, that seemed like a long time, but here it is June already. And while I still rest my foot a great deal in the evenings, I am now starting to become more active.
You sound as if you have really tried to find an answer outside of surgery. But for each of us, there comes the time when we must decide what we think is our best course of action. My pod was very honest about the complications that could arise and that there was no guarantee the surgery would work. However, at 54 years of age, I decided that I was too young to sit out the rest of my life and therefore I opted for surgery.
My advice to you would be to try and find the best doctor you can for whatever procedure you need performed. Make sure he explains everything to you in terms you can understand and don't be afraid to ask him questions, no matter how silly you might think they are. If he won't communicate with you, consider finding another doctor.
Once you have the surgery, plan on Rest and more Rest. My recovery may have been slower than some who have posted here, but it has been encouraging so far. Do not let anyone rush you, not even your doctor - LISTEN to your foot, as it will be the best indicator as to how you are doing. Many of us here have had some physical therapy to aid in the recovery process - it may be a little rough at first, but in the long run it may be helpful.
And don't forget that you will always find support, suggestions, or just a ear that listens when you visit these boards. Many of us have posted our post-op progress, and you can learn a lot just by reading our previous notes - but remember, we are all individuals and we all heal at our own pace, so do not base your time table for recovery on what you read here. Let your foot lead the way, so to speak.
And remember, your online family will always be here for you.
Good Luck in the weeks ahead; keep us posted. I will be thinking of you and hoping that all goes well for you on 6/18. Missy B.

Re: surgery scheduled

kay on 6/06/02 at 10:10 (086510)

yes i've had another opionion when i had my first surgery. (endoscopic)
i can barely make ends meet as it is. there is no money for the ossatron procedure. my doc will be preforming the open surgery. he says that it will not be a total release as the tendon is there for a reason. he will also be cleaning out the nerve area.
kay

Re: surgery scheduled

john h on 6/06/02 at 10:24 (086513)

Kay: you always still have ESWT to fall back on and I am sorry you cannot have this before you try surgery. At some point insurance will probably start picking up on ESWT. Your doctor is being very conservative with his 50% chance of success. I have read numbers of 65%-80% success. So much depends on your doctor. I am glad to hear it is open surgery. Is it by chance Minimal Invasive Surgery? Time is another great healer. Facts are a lot of people are cured from PF with surgery even though some few are made worse.Just be patient after surgery and know you will be looking at 3 months to one year for a full recovery. It is less than 30 minutes to do the surgery and I really never experienced any pain to speak of so do not worry about the surgery

Re: surgery scheduled

J. King on 6/06/02 at 12:43 (086540)

Barbara S

And people believe that PF or TTS is just a minor problem!!!! I have severe PF and I know what it is like to be so frustrated about not being able to walk without pain. I have had this disease for many years and it has caused me disability as well. I just don't understand how these surgeons can be so anxious to cut when the outcome can be so bad for the patient. Doctors are supposed to 'do no harm' above all else.

Re: surgery scheduled

J. King on 6/06/02 at 12:45 (086541)

The thing is will be surgery make you worse??? How big a gamble can you afford to take with your body? I can walk a little now. I don't know what I would do if I could not walk at all>

Re: surgery scheduled

kay on 6/06/02 at 21:45 (086616)

my endoscopic surgery that i had 6years ago did leave me a little worse. but i have to try something. i do not want to live like this. this is some kind of a nightmare for me. i try to fix supper and i am in so much pain i could cry. i have to try something. surgery is my only option left. if it doesn't work i don't know what i'll do. either become a drug addict or kill myself....just joking....about killing myself....not about becoming a drug addict.
thanks for all the comments. i'll keep you all updated on any progress.
kay

Re: surgery scheduled

john h on 6/07/02 at 09:09 (086649)

J King: My biggest concern when I decided on surgery was not will it cure me but will it make me worse. I told this to the Doctor and he was very straight forward with his answers. Being and ortopedic foot and ankle surgeons in his late 40's he had performed a number of PF releases or actually the Baxter Procedure which I guess technically is not a PF release. I told him if the procedure did not work I had no problem with that I just did not want to be worse. I was not worse and somewhat better but not as better as I wanted. Ultimately I chose the Baxter Procedure because it was much less likely to cause further foot complicatons.

Re: surgery scheduled

J. King on 6/07/02 at 16:53 (086706)

John H

That is exactly my concern. I am crippled up enough as it is without being made worse. I had an operation on my wrist and now it is worse. I have severe pain in my neck and shoulder but I resist surgery because of the fear that it will be worse. I have had so many second opinions on this stuff that I have grown cautious since the opinions don't agree. As long as I am not in acute pain I am o.k. not happy but o.k.

Re: surgery scheduled

J. King on 6/07/02 at 17:00 (086708)

Kay

I have the same feelings about my disabilities and am frustrated about prognosis. I figure that if I tried to kill myself with my luck I would just wound myself. I did become habituated to narcotics for a while. Not a good solution. What happens is that you have to take more and more dope to get the pain relief. It has an effect on your mind and emotions and will make you feel worse ultimately. I am going to pain management clinic Monday. Chronic pain is a field that needs a lot of work. I recommend psychiatic help because without it I would be in more trouble than I already.

Re: You do have a choice !!!

BrianG on 6/07/02 at 18:06 (086712)

Hi Kay,

This has been quite the post, hasn't it! I have one more suggestion, if you decide not to go ahead with the surgery. Get a referrel to a pain management specialist. It will buy you some time, possibly years!!! Don't look at it as dope, addiction, or any of the other derogatory things attributed to addicts. It has been proven that less than 1% of the people who take narcotics for pain management, will become addicted. That is pretty good odds to me, considering that this next surgery could leave you in worse condition than you are currantly in. I really think that within a couple yeras, ESWT will be available to everyone who needs it. Isn't it worth the wait, to possibly have a much safer type of treatment?

If you do go with the surgery, good luck.

BrianG

Re: You do have a choice !!!

kay on 6/07/02 at 19:51 (086727)

brian thanks for your thoughts, but i am set for surgery. if it doesn't work i'll know i gave it my best shot. with narcotic type drugs no matter how low the dose i do not do well with. i could never work on those drugs.

i have been to a pain management clinic before, about 5 years ago. i am in much greater pain now than i was then. when i say i am in pain i am not kidding. i have worked with pain for a long time....for some reason this last 6 months my feet have gotten so much worse. loading the dish washer for 5 minutes kills me. all i can do anymore is sit on my butt. i hate it.
kay

Re: You do have a choice !!!

BrianG on 6/07/02 at 20:38 (086729)

Hi Kay,

Alot has changed in the last 5 years, in chronic pain management. New drugs have been approved, new combinations are being tried. But I know, you have your mind made up.....good luck

BrianG

Re: surgery scheduled

Carmon S. on 6/08/02 at 00:24 (086746)

Hi Kay,
I had Open PF release done on my right foot February 8th 2002. I will be 4 months post - op tomorrow!!!! Yippee. I totally understand your desperation and your concerns. Personally I know that this surgery has helped my right foot. I no longer have the intense pain that once was unbearable. My shooting pains and cramps have subsided. Although it is still tender and I am working thru the scar tissue it is so much better.
I would do it again in a heartbeat and as a matter of fact I am scheduled to have open release for my left foot on June 18th as well!! You and I will be going in on the same day (I will send you positive thoughts).
My doctor also told me that my sucess rate would be around 50% and I said no, I am going to get 60 or 70%!!! This is where a positive attitude can help to carry you thru. My opinion is that even though you have been told that you may have a 50% sucess rate try not to focus on that alone. Everyone is individual and our bodies heal differently. Plantar fasciitis is sometimes really a mystery. I think that for the most part longitudinal studies have not been done to compare the various efficiancy of treatments (or if they have they are vague).
I was at the end of my rope just like you and I took that chance.....it was right for me. It is your foot (feet) and you need to do what you feel is a reasonable next step. I wish you all of the luck in the world and will be thinking of you on the 18th. Takecare.

Re: surgery scheduled

john h on 6/08/02 at 09:03 (086763)

if your shoulder and neck pain is caused by cervical compression that problem is treated very successfully by surgery. I had two levels in the neck fused 20 years ago and I got an instant cure which has never bothered me since and i can not notice any loss of range of neck motion. usaually that problems will only get worse. i have not read of any of these going bad although grafts can not take sometimes. i know at least 4 people who have had this surgery and like me all were instantly cured. this is an easy diagnosis and much easier to deal with than low back pain.

Re: You do have a choice !!!

john h on 6/08/02 at 09:04 (086764)

My prayers are with you Kay.

Re: surgery scheduled

michelec on 6/10/02 at 18:49 (087014)

Hi Kay,

It's been a while since I've posted. I had open release on April 19th. I have recovered tremendously. I am currently going for reflexology treatments twice a week to help with the scar tissue. In my opinion, it works better than physical therapy. The reflexologist works the scar much more than than PT's. My pain is virtually gone. I do strengthening exercises every day because I 've noticed that my ankle and foot seem to become weak -- I always had weak ankles. The only time I have pain is if I walk too much on it. Only being 7 weeks post-op, I can't walk for miles at a time but that's to be expected. I went to the beach this weekend and walked more than I had been and my foot was tired, not painful afterwards. It sounds to me like you have tried everything else out there. I'm sure everyone's physical condition is different -- you have suffered with it much longer than I (3 years). But I don't regret having the surgery. I wish you the best of luck. My thoughts and prayers are with you.

Re: surgery scheduled

kay on 6/10/02 at 20:00 (087019)

its post like your i need to read. i have to get my mind set in the right direction. can you tell me more about this reflexology? i have never heard of it. what is it?
kay

Re: surgery scheduled

john h on 6/11/02 at 11:05 (087100)

J King: With all the stress you are under it is no wonder your neck and shoulders hurt. Reading your post almost makes my neck and shoulders hurt.I would get x-rays or an mri on my neck as compression problems in this area are easily diagnosed and you need to know if your neck/shoulder problems are disc related or stress related. Both are very treatable. I went with conservative treatment on my neck for 7 months (PT,NSAIDS,Stretching the neck with a water filled bag on a pulley hanging on my door). One day the pain became so excructating that I called the Doctor and told him I could no longer tolerate it that if surgery was an option I did not care about risk or anything. I had surgery 2 days later and after 21 years have never had a neck or shoulder pain again. I had two disc fragments that were floating in my spinal canal. When one would lodge against a nerve it was lights out. Fusions in the neck are very successful. Much more so than low back surgery. Do find out the diagnosis and not go on suffering needlessly.

Re: You do have a choice !!!

john h on 6/11/02 at 11:07 (087101)

I am with Brian on this one Kay but it is your body,your life and ultimately your decision. Good luck and God bless.

Re: surgery scheduled

john h on 6/11/02 at 11:15 (087105)

I had reflexology and was set back a month with very severe pain. Reflexology following foot surgery should be very carefully discussed with your surgeon. There are reflexologist and there are reflexologist. The theory is that you can help problems in various part os the body by massaging various points on your feet. Sort of like accupuncture without needles. Some reflexologist use very stong pressure which would seem to me to be of some concern if you have just recently had surgery. Definitely ask your doc on this one.

Re: Kays surgery

peter f on 12/13/02 at 08:27 (102899)

Does anyone know how Kay got on with her surgery on June 18th-I've just read her heartbreaking posts and would love to think it has helped

Re: surgery scheduled

Ed Davis, DPM on 6/04/02 at 22:07 (086322)

Kay:

It is your body. Can you accept a 50% success rate and the consequences that can follow? I certainly could not if it was my foot.

What modalities, specifically have been performed for this problem?
Ed

Re: surgery scheduled

Joe S on 6/04/02 at 23:50 (086335)

Kay, the success rate for an open plantar fasciotomy is greater than 50%. It runs upwards of 80%. Conservative management (stretching, orthotics, injections etc) runs around 85-90%. I can count the number of open procedures that I've done in the last year on one hand. I have done 3 open plantar fasciotomies in the last year. I see approximately 35 patients per day. Out of those I would say a good 5-6 patients are heel pain patients. I'm sure the other podiatrists on this board would agree. Most people get better without surgery. If you have exhausted all forms of conservative care, then surgery is the next step be it an open fasciotomy, ESWT or an EPF. Personally I don't like the EPF's. Personally I try to get you better conservatively first. Maybe you should get a second opinion just to see if there are any other treatment options available. Not all orthopedists are foot specialists. Some are very good. Some not so good. The same holds true for podiatrists. However, I would bet that a busy, well trained podiatrist probably sees far more cases of plantar fasciitis than most orthopods do in a week. I do. I work in an orthopedic practice. They don't see any foot stuff. They send it to me. The last open procedure I performed was about two months ago. The lady had suffered with plantar fasciitis for 3 years. Shipped around to different docs who injected her, put her into orthotics, night splints, physical therapy. Well she came to me and related that I can't continue with this pain. All forms of conservative care had been failed. We attempted to get her approved for ESWT to no avail. United HealthCare would not pay for it. We opted for an open plantar fasciotomy. The procedure took approximately 30minutes. She was made nonweightbearing for 2-3 weeks. Sutures were removed on day 15 or 16. She wore a post op shoe for 1 week and then transitioned into her running shoe at 4 weeks post op. She is doing extremely well. Her pain level went from a continual 9/10 to about a 2/3. She wears her orthotics and to date has not developed any lateral pain. There are horror stories associated with surgery. I believe if you read any of my other comments regarding surgery I have addressed them at some point. Most failures are due to improper diagnosis. Not all heel pain is plantar fasciitis. Sometimes, during surgery, the plantar fascia may not be cut. This ultimately ends in failure because nothing was done to alleviate the stress on the calcaneus (heel bone). And last but not least, this is an elective surgery. You have to be ready to undergo the procedure. If you are scared or hesitant, then you should probably not have it done. Alot of doctors will try and talk you out of this procedure. Some will try to talk you into it. You have to make an informed decision about your healthcare. You will know when you're ready for the surgery. Believe me. You will know.

Re: surgery scheduled

wendyn on 6/05/02 at 07:11 (086341)

This makes a lot of sense to me...the 'When you're ready you'll know'. I had bunions surgery abou 10 years ago, and I KNEW that I absolutely could not continue the way things were going.

Re: surgery scheduled

kay on 6/05/02 at 12:20 (086375)

can i accept 50%? what choice do i have? i've had this problem since i was 19 (46 now)and have been through everything!!!! except ossatron,,,,no money, no insurance coverage for it. i had the endoscopic surgery 6 years ago. this last year has been hell for me trying to work. i've taken so many pain pills trying to stay employed. the pain has gotten so bad i am desperate. i cannot even fix a meal or go to the grocery without the pain being so bad that i think i can't deal with another day.
can i accept 50%? what choice do i have? i am grasping for straws here. he says only 50% because i have had surgery before and it was unsuccessful. i also have fibromyalgia which i basically ignore since the pain in my back, hips and arms are nothing compared to my feet pain. thoughts of dying come to mind. does that tell you how desperate i am?
kay

Re: surgery scheduled

kay on 6/05/02 at 12:29 (086378)

i guess i should list what i have had done for my feet. new shoes, orthodics,physical therapy,cort.injections,stretching,NSAID drugs,ultrasound therapy,,antidepressants,endoscopic surgery,and casting. i think thats it. its been a long time and i am tired of this pain. i can't work, we will most likely have to sell our house we built 3 years ago because i can't work. sick pay is about half of what i normally make working and it will be cut again by half in september.
kay

Re: surgery scheduled

Tonya R. on 6/05/02 at 15:58 (086392)

Kay, I just wanted to say that I greatly sympathize and relate to what you are saying, experiencing and feeling. Although, i do believe that the success rate of the surgery is a bit more than 50%, but nothing would have a 100% guarantee. Knowing this, on May 9th I chose to have the open plantar fascia release. I had been in treatment for several years. Nothing worked, and laugh as some may, I seriously thought i would be better off if someone cut my right foot off. I have suffered with PF in both, but the right was worse. Yes, this surgery is an elective surgery, but for me even a mere 50% chance of improvement is better than the 100% pain I would have by not having the surgery done. Therefore, I feel that in some cases it is a necessity. By all means, if you are not comfortable with the probability of improvement, DON'T DO IT. I just feel that some of people who have posted on this board have been seen as throwing in the towel, plopping their foot up, and saying 'Go ahead Doc, cut away'. I know in my instance that was not the case, as I am sure it has not been in yours. That being said, I really wish you luck on the 18th. I hope you get the relief that you are seeking. God only knows how daily, constant pain can wear someone down. Not to mention the impact it has on ones family life.

Re: surgery scheduled

kay on 6/05/02 at 16:03 (086393)

thanks tonya, i hope your surgery helped you. i am to the point that i have to do something. surgery is the only thing left. i have to do it. i only hope to god it helps. please keep this board updated on your progress as i will be right here behind you with mine. hopefully we will have good news to share and bring hope to the hopeless, which is how i have felt for sometime now. i am seeing my regular family doctor tuesday and i am asking for some antidepressants. i believe i really need them. a day doesn't go by that i dont burst into uncontrollable tears.
thanks again.
kay

Re: surgery scheduled

Tonya R. on 6/05/02 at 16:07 (086395)

Kay, hang in there. I will pray for you. There are a lot of understanding people who do read and respond to these posts. I'm sure I speak for all of us when I say we are here for you.

Re: surgery scheduled

Sharon W on 6/05/02 at 17:16 (086408)

Kay,

I understand 'desperate,' I'm feeling pretty desperate myself. I'm also planning to have surgery (although it is for TTS and not PF) and I'm ALREADY at the end of my rope with it, after a year of treatments that just haven't worked for me. I do have PF too, though, I truly can't IMAGINE what it would be like, fighting a bad case of PF for 27 YEARS!!!

It sounds to me like you have a point, you really have NO choice but to try surgery, even if there's really only a 50% chance of success. I think there does come a point where you really have no choice but to GO FOR IT --I mean, you CAN'T give up on treatment, because the pain won't LET you do that!

Yes, antidepressants WILL probably help -- in fact, if they give you something like Elavil, it might even help relieve some of your PAIN!

Hang in there, Kay, we're all here for you.

-- Sharon

-- Sharon

Re: surgery scheduled

kay on 6/05/02 at 18:41 (086430)

hi sharon thanks for your words. i also forgot to mention that the doc says i have some nerve problems too. so when i seen the papers it said surgery for P.F. & T.T. so i am assuming tarsel tunnel also.
i took elavil for my fibro last year and the only thing it did for me was make me gain weight. i'm going to ask about welbutrin because i heard it doesn't have all the side effects.
thanks
kay

Re: surgery scheduled

Laurie R on 6/05/02 at 19:09 (086436)

Hi Kay , Kay , I am one that waited a while before surgery . I am now 4 weeks post opp . I had a PF release Open and a TTS relase and my tendons cleaned out and my Pod removed a groth on the bottom of my foot. We went back and forth on wheather I should have the surgery or not . I am so gald I did . I also have RSD , so both of my doctors were very careful before my surgery . I have also been going for spinel injections to help control the RSD .

It is up to you and only you if you should have surgery . I like you suffered for way to long . I have not been able to work now for almost three years . I would love part of my life back .

I wish only the best for you . Not everyone believes in surgery nor does every surgery come out right . I feel you have to weigh out everything then make your choice ....

My best to you Kay , Laurie R

Re: surgery scheduled

Barbara S on 6/05/02 at 19:27 (086438)

Hi Kay
Barbara S. here. I had EPF surgery at the end of Nov. It did not work,my foot only got worse. I have been off of work Since a week after surgery. I only put up with my pain for 1-1/2yrs I can't imagine going through that type of pain for as long as you have.
I also Have fibromyalgia diagnosed in 1994 after several yrs of pain.
My Pod knew I had Fibro. so he thought at first it was just taking me longer to recover,so kept me off my foot for 1 month. I was still in alot of pain. He then ordered a MRI. This showed that everything had healed in relation to EPF surgery. Nothing else showed on the MRI. He then told me that he thought I had TTS and sent me to a Neurologist for an EMG. This test showed positive for TTS. First he tired a steriod type shot, no relief. He then suggested surgery and referred me to an ortho surgeon,as he said the surgeon had done more TTS Surgery and felt I would be in better hands. He, himself had only done a couple TTS Surgery and he felt mine would be difficult. He was right. I have a 7-8inch incision starting under my foot up around my ankle and 2 inches above my ankle up my leg. I am 6wks post op and only able to put slight weight on my foot. My Heel and ankle area are always swollen and the rest of my foot and toes swell up as the day goes on and are constantly burning and prickly.
I am now going to therapy 3 times a week. I think they are trying to push me too fast. I will be talking about this with her tomorrow. I haven't gotten paid for 5 of the 6 months I have been off. I've worked for Ameritech for over 25yrs., and my disability has been denied for the first 5 months. THey have paid me for 1 month from the date of my TTS surgery,but then stopped on May 22nd. I just found out today that they have now approved me til June 7th. I don't see my Doc until the 18th of June. I guess the PT will have to send them another report.
I have hired an attorney to deal with Ameritech and if I have to I will take more vacation time before I'll go back to work too early. See they don't consider my inability do drive a part of disability. Take a bus call a cab. I have a 25 min drive one way and that is if there are no traffic problems.
I take welbutrin. I feel it helps somewhat,but I still have days that I cry because I get so frustrated that I cannot do anything. I have a wheelchair at home that helps me get around as I have knee and back problems also. If it wasn't for the wheelchair I think things would be worse.
I have also said maybe it would be better to have my foot amputated. MY husband says don't be so foolish and I've said back to him you put up with this pain then.
If it wasn't for the kind encouraging words from people on this board I would really be more down and out. So keep reading and posting and hopefully this will give you strength to go on.
Take care and God Bless us. Barbara S.

Re: surgery scheduled

Ed Davis, DPM on 6/05/02 at 21:05 (086448)

You have had this problem for a long time -- too long. Have you had other opinions in order to better ascertain the cause of the problem and be sure it actually is PF? Is the current surgeon planning an open procedure?
Ed

Re: surgery scheduled

Ed Davis, DPM on 6/05/02 at 21:06 (086449)

PS If it definitely is PF, one option is Canadian ESWT. The cost at the Sonocur center in Vancouver, BC is $750 Canadian ($535 US) for 3 treatments.
Ed

Re: surgery scheduled

Missy B on 6/05/02 at 23:12 (086467)

Hi Kay,
I have read your posts and can tell you that I have been there before you. I suffered on and off for 6 years with heel pain and was diagnosed with PF and TT. Like you, I tried all the non-invasive treatments, but nothing really helped. I was to the point of sometimes dragging my leg because I did not want to put my weight on it. When my nerve conduction study came back a glaring positive for TT, I knew it was time to make the decision for surgery.
I am now 19 weeks post PF/TT release surgery, and I can tell you, that as of right now, I am not sorry I had it done. Compared to the pain I suffered before my surgery, I consider myself 80% better. I still have some residual PF soreness, and my foot does still ache sometimes, but at least now I can work a full day and not come home in tears. I get my new custom orthotics on 6/10 and my pod hopes these will help relieve the soreness I am still experiencing.
My pod, as well as other patients, have told me it may take up to a year before we will know the final outcome. Last January, that seemed like a long time, but here it is June already. And while I still rest my foot a great deal in the evenings, I am now starting to become more active.
You sound as if you have really tried to find an answer outside of surgery. But for each of us, there comes the time when we must decide what we think is our best course of action. My pod was very honest about the complications that could arise and that there was no guarantee the surgery would work. However, at 54 years of age, I decided that I was too young to sit out the rest of my life and therefore I opted for surgery.
My advice to you would be to try and find the best doctor you can for whatever procedure you need performed. Make sure he explains everything to you in terms you can understand and don't be afraid to ask him questions, no matter how silly you might think they are. If he won't communicate with you, consider finding another doctor.
Once you have the surgery, plan on Rest and more Rest. My recovery may have been slower than some who have posted here, but it has been encouraging so far. Do not let anyone rush you, not even your doctor - LISTEN to your foot, as it will be the best indicator as to how you are doing. Many of us here have had some physical therapy to aid in the recovery process - it may be a little rough at first, but in the long run it may be helpful.
And don't forget that you will always find support, suggestions, or just a ear that listens when you visit these boards. Many of us have posted our post-op progress, and you can learn a lot just by reading our previous notes - but remember, we are all individuals and we all heal at our own pace, so do not base your time table for recovery on what you read here. Let your foot lead the way, so to speak.
And remember, your online family will always be here for you.
Good Luck in the weeks ahead; keep us posted. I will be thinking of you and hoping that all goes well for you on 6/18. Missy B.

Re: surgery scheduled

kay on 6/06/02 at 10:10 (086510)

yes i've had another opionion when i had my first surgery. (endoscopic)
i can barely make ends meet as it is. there is no money for the ossatron procedure. my doc will be preforming the open surgery. he says that it will not be a total release as the tendon is there for a reason. he will also be cleaning out the nerve area.
kay

Re: surgery scheduled

john h on 6/06/02 at 10:24 (086513)

Kay: you always still have ESWT to fall back on and I am sorry you cannot have this before you try surgery. At some point insurance will probably start picking up on ESWT. Your doctor is being very conservative with his 50% chance of success. I have read numbers of 65%-80% success. So much depends on your doctor. I am glad to hear it is open surgery. Is it by chance Minimal Invasive Surgery? Time is another great healer. Facts are a lot of people are cured from PF with surgery even though some few are made worse.Just be patient after surgery and know you will be looking at 3 months to one year for a full recovery. It is less than 30 minutes to do the surgery and I really never experienced any pain to speak of so do not worry about the surgery

Re: surgery scheduled

J. King on 6/06/02 at 12:43 (086540)

Barbara S

And people believe that PF or TTS is just a minor problem!!!! I have severe PF and I know what it is like to be so frustrated about not being able to walk without pain. I have had this disease for many years and it has caused me disability as well. I just don't understand how these surgeons can be so anxious to cut when the outcome can be so bad for the patient. Doctors are supposed to 'do no harm' above all else.

Re: surgery scheduled

J. King on 6/06/02 at 12:45 (086541)

The thing is will be surgery make you worse??? How big a gamble can you afford to take with your body? I can walk a little now. I don't know what I would do if I could not walk at all>

Re: surgery scheduled

kay on 6/06/02 at 21:45 (086616)

my endoscopic surgery that i had 6years ago did leave me a little worse. but i have to try something. i do not want to live like this. this is some kind of a nightmare for me. i try to fix supper and i am in so much pain i could cry. i have to try something. surgery is my only option left. if it doesn't work i don't know what i'll do. either become a drug addict or kill myself....just joking....about killing myself....not about becoming a drug addict.
thanks for all the comments. i'll keep you all updated on any progress.
kay

Re: surgery scheduled

john h on 6/07/02 at 09:09 (086649)

J King: My biggest concern when I decided on surgery was not will it cure me but will it make me worse. I told this to the Doctor and he was very straight forward with his answers. Being and ortopedic foot and ankle surgeons in his late 40's he had performed a number of PF releases or actually the Baxter Procedure which I guess technically is not a PF release. I told him if the procedure did not work I had no problem with that I just did not want to be worse. I was not worse and somewhat better but not as better as I wanted. Ultimately I chose the Baxter Procedure because it was much less likely to cause further foot complicatons.

Re: surgery scheduled

J. King on 6/07/02 at 16:53 (086706)

John H

That is exactly my concern. I am crippled up enough as it is without being made worse. I had an operation on my wrist and now it is worse. I have severe pain in my neck and shoulder but I resist surgery because of the fear that it will be worse. I have had so many second opinions on this stuff that I have grown cautious since the opinions don't agree. As long as I am not in acute pain I am o.k. not happy but o.k.

Re: surgery scheduled

J. King on 6/07/02 at 17:00 (086708)

Kay

I have the same feelings about my disabilities and am frustrated about prognosis. I figure that if I tried to kill myself with my luck I would just wound myself. I did become habituated to narcotics for a while. Not a good solution. What happens is that you have to take more and more dope to get the pain relief. It has an effect on your mind and emotions and will make you feel worse ultimately. I am going to pain management clinic Monday. Chronic pain is a field that needs a lot of work. I recommend psychiatic help because without it I would be in more trouble than I already.

Re: You do have a choice !!!

BrianG on 6/07/02 at 18:06 (086712)

Hi Kay,

This has been quite the post, hasn't it! I have one more suggestion, if you decide not to go ahead with the surgery. Get a referrel to a pain management specialist. It will buy you some time, possibly years!!! Don't look at it as dope, addiction, or any of the other derogatory things attributed to addicts. It has been proven that less than 1% of the people who take narcotics for pain management, will become addicted. That is pretty good odds to me, considering that this next surgery could leave you in worse condition than you are currantly in. I really think that within a couple yeras, ESWT will be available to everyone who needs it. Isn't it worth the wait, to possibly have a much safer type of treatment?

If you do go with the surgery, good luck.

BrianG

Re: You do have a choice !!!

kay on 6/07/02 at 19:51 (086727)

brian thanks for your thoughts, but i am set for surgery. if it doesn't work i'll know i gave it my best shot. with narcotic type drugs no matter how low the dose i do not do well with. i could never work on those drugs.

i have been to a pain management clinic before, about 5 years ago. i am in much greater pain now than i was then. when i say i am in pain i am not kidding. i have worked with pain for a long time....for some reason this last 6 months my feet have gotten so much worse. loading the dish washer for 5 minutes kills me. all i can do anymore is sit on my butt. i hate it.
kay

Re: You do have a choice !!!

BrianG on 6/07/02 at 20:38 (086729)

Hi Kay,

Alot has changed in the last 5 years, in chronic pain management. New drugs have been approved, new combinations are being tried. But I know, you have your mind made up.....good luck

BrianG

Re: surgery scheduled

Carmon S. on 6/08/02 at 00:24 (086746)

Hi Kay,
I had Open PF release done on my right foot February 8th 2002. I will be 4 months post - op tomorrow!!!! Yippee. I totally understand your desperation and your concerns. Personally I know that this surgery has helped my right foot. I no longer have the intense pain that once was unbearable. My shooting pains and cramps have subsided. Although it is still tender and I am working thru the scar tissue it is so much better.
I would do it again in a heartbeat and as a matter of fact I am scheduled to have open release for my left foot on June 18th as well!! You and I will be going in on the same day (I will send you positive thoughts).
My doctor also told me that my sucess rate would be around 50% and I said no, I am going to get 60 or 70%!!! This is where a positive attitude can help to carry you thru. My opinion is that even though you have been told that you may have a 50% sucess rate try not to focus on that alone. Everyone is individual and our bodies heal differently. Plantar fasciitis is sometimes really a mystery. I think that for the most part longitudinal studies have not been done to compare the various efficiancy of treatments (or if they have they are vague).
I was at the end of my rope just like you and I took that chance.....it was right for me. It is your foot (feet) and you need to do what you feel is a reasonable next step. I wish you all of the luck in the world and will be thinking of you on the 18th. Takecare.

Re: surgery scheduled

john h on 6/08/02 at 09:03 (086763)

if your shoulder and neck pain is caused by cervical compression that problem is treated very successfully by surgery. I had two levels in the neck fused 20 years ago and I got an instant cure which has never bothered me since and i can not notice any loss of range of neck motion. usaually that problems will only get worse. i have not read of any of these going bad although grafts can not take sometimes. i know at least 4 people who have had this surgery and like me all were instantly cured. this is an easy diagnosis and much easier to deal with than low back pain.

Re: You do have a choice !!!

john h on 6/08/02 at 09:04 (086764)

My prayers are with you Kay.

Re: surgery scheduled

michelec on 6/10/02 at 18:49 (087014)

Hi Kay,

It's been a while since I've posted. I had open release on April 19th. I have recovered tremendously. I am currently going for reflexology treatments twice a week to help with the scar tissue. In my opinion, it works better than physical therapy. The reflexologist works the scar much more than than PT's. My pain is virtually gone. I do strengthening exercises every day because I 've noticed that my ankle and foot seem to become weak -- I always had weak ankles. The only time I have pain is if I walk too much on it. Only being 7 weeks post-op, I can't walk for miles at a time but that's to be expected. I went to the beach this weekend and walked more than I had been and my foot was tired, not painful afterwards. It sounds to me like you have tried everything else out there. I'm sure everyone's physical condition is different -- you have suffered with it much longer than I (3 years). But I don't regret having the surgery. I wish you the best of luck. My thoughts and prayers are with you.

Re: surgery scheduled

kay on 6/10/02 at 20:00 (087019)

its post like your i need to read. i have to get my mind set in the right direction. can you tell me more about this reflexology? i have never heard of it. what is it?
kay

Re: surgery scheduled

john h on 6/11/02 at 11:05 (087100)

J King: With all the stress you are under it is no wonder your neck and shoulders hurt. Reading your post almost makes my neck and shoulders hurt.I would get x-rays or an mri on my neck as compression problems in this area are easily diagnosed and you need to know if your neck/shoulder problems are disc related or stress related. Both are very treatable. I went with conservative treatment on my neck for 7 months (PT,NSAIDS,Stretching the neck with a water filled bag on a pulley hanging on my door). One day the pain became so excructating that I called the Doctor and told him I could no longer tolerate it that if surgery was an option I did not care about risk or anything. I had surgery 2 days later and after 21 years have never had a neck or shoulder pain again. I had two disc fragments that were floating in my spinal canal. When one would lodge against a nerve it was lights out. Fusions in the neck are very successful. Much more so than low back surgery. Do find out the diagnosis and not go on suffering needlessly.

Re: You do have a choice !!!

john h on 6/11/02 at 11:07 (087101)

I am with Brian on this one Kay but it is your body,your life and ultimately your decision. Good luck and God bless.

Re: surgery scheduled

john h on 6/11/02 at 11:15 (087105)

I had reflexology and was set back a month with very severe pain. Reflexology following foot surgery should be very carefully discussed with your surgeon. There are reflexologist and there are reflexologist. The theory is that you can help problems in various part os the body by massaging various points on your feet. Sort of like accupuncture without needles. Some reflexologist use very stong pressure which would seem to me to be of some concern if you have just recently had surgery. Definitely ask your doc on this one.

Re: Kays surgery

peter f on 12/13/02 at 08:27 (102899)

Does anyone know how Kay got on with her surgery on June 18th-I've just read her heartbreaking posts and would love to think it has helped