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DR: What's my next 'step'??

Posted by Shirley W on 10/11/02 at 21:00 (097360)

My PF started 1 year ago, gradually becoming worse. I went to a POD, who after a painful push on my heels, gave me a shot in each foot, and cast me for orthotics. I have quite high arches. Orthotics #1: did not help at all, arch support almost nonexistent. Returned for recast = Ortho #2: looks like a 3 yr old made them. Left foot so high and angled that I can't wear it without a popping (shoe, ortho, or foot?? who can tell). Right foot arch is again very low, not helpful. Orthos are picked up, as though at a drive thru window, no checking to see if they fit or not. Just try them for 2-3 weeks then call if they don't help. VERY disgusted and mad, and HURTING. Don't go back for several months. Have bought good shoes, read the heelspurs site all the time to learn more, never go barefoot, even wear shoes in the shower. After several months, went back to POD, maybe 3rd times the charm?? Without casting, he sends pr #2 back with instructions to remake them in 'soft version'. This pr is like walking on a speed bump. My arches hurt terrible. I have tried to walk on my toes at times. I am almost in tears when the day is over (I stand all day), but after taking them off and resting abit at nite, my feet don't hurt quite as bad. But I can't bear the thought of putting them on again tomorrow. I want to cut my feet off and walk on the stubs. What would you tell me my next step would be? What is best for high arches?

Re: DR: What's my next 'step'??

Julie on 10/12/02 at 04:36 (097367)

Shirley, I'm not a doctor, but I do think your next step should be to cut your losses with this podiatrist and find another. You might also see if you can't get a refund for these misconceived and poorly made orthotics.

Do you really have to stand all day? That is one of the most frequent contributory cause of PF, and one of the very worst things for it. Presumably it's your occupation that demands it - would it be possible to ask for a switch to sit-down duties?

You say you read this website for information - I hope you've read the heel pain book and not just the message boards?

Re: DR: What's my next 'step'??

Mar on 10/12/02 at 08:07 (097375)

Shirley --

I understand your frustration and pain. I have had PF for almost a year now and I am in constant, exteme pain when standing or walking. The popping sounds like the orthotic does not fit in the shoe. I had that when I tried to put my sport ortho in a nonsneaker. It just wouldn;t work without the popping. I have 2 pairs of hard orthotics that I can't wear and my softer ones that I wear everyday in sneakers. They don;t take the pain away, but it is better than without them. I certainly agree that it is time to find a new pod and get it right. He may be able to adjust your soft orthos rather than make a 4th pair. A fellow sufferer who has thought about cutting off the feet as well, as horrible a thought as that is! Hope you find relief soon -- Mar

Re: DR: What's my next 'step'??

Carole C in NOLA on 10/14/02 at 09:15 (097466)

Good orthotics should feel better than not wearing them, after you've broken them in for a couple of weeks. Did you break them in slowly, starting with just an hour or two and then increasing the time by no more than an hour each day? You can do this in the evenings, to start with.

If you already broke them in like this, and they still hurt after a couple of weeks, then I doubt they would feel any better later on.

Birkenstock shoes are often helpful, especially for those with high arches. Like orthotics, they need to be broken in gradually.

I agree with Julie, that you should get a different Pod and try to temporarily switch to a sitting down job if you can. Icing your feet every night, and doing gentle non-weightbearing stretches should also be part of your routine.

Have you tried taping? There's a discussion of it in the heel pain book, with illustrations of how to do it.

Good luck to you and don't give up hope.

Carole C

Re: Thanks for all your responses.. it helps

Shirley W on 10/14/02 at 20:27 (097493)

Yes, I have read the heel pain book, but went over it again to refresh when you mentioned it again. Always good to jog the old gray matter. I do tape occasionally, and might more often if it will help. I also ice, and roll a ball under my feet, etc. Unfortunately, my job does not allow me the option of sitting, except at lunch. So I will have to stand regargless, and I use a 2' foam type mat to stand on. I wear the new inserts for a couple hours a day, then switch to the old ones. I have to wear black shoes to work, and they must be closed in, so I am currently wearing a new pair of NB. Haven't checked lately if Birks come in something closed in and in black, so I will continue to check around. But I do read here on the boards to learn all I can from others, and I really appreciate all the responses to my queries. I fortunately am not as bad on weekends, as I am not on my feet but off and on--- Sundays is family day, with meals and relaxing, and Mondays is whatever I want--errands and such. but nothing where I am constantly on my feet, so the pain is not nearly as noticable. So I REALLY look forward to my weekends. Well, I will keep looking for the 'cure for the week' and will pass it along if I find it. Thanks to you all------------:)

Re: Thanks for all your responses.. it helps

nancy s. on 10/14/02 at 20:33 (097494)

hello shirley,

do your shoes have to be all the way closed in, or just the toes and major front part? because boston birks are nearly closed in -- just not at the very back. they're my best friends.

i don't know your case (and i'm not a doc), but i hope you'll be open to the possibility of changing jobs if your feet are in a bad way. standing all day could make this condition chronic, and then there'll be no choice. i'm not trying to scare you -- just encouraging you to be realistic. it took me a while to get realistic, and i'd give a lot to go back and do it differently.

best of luck to you.
nancy

Re: Thanks for all your responses.. it helps

Julie on 10/15/02 at 01:31 (097508)

Hi Shirley

Let's do a little creative thinking. Could you describe your job and responsibilities to us? Maybe we can help you think of one or two crafty ways of getting round the standing problem. There's absolutely no doubt that the way you spend your working days is obstructing your healing - it's not just a side issue, it may be THE issue. And it could, long term, mean that your PF became chronic and disabling. So let's try to think of some way of minimizing your time on your feet.

All the best,

Julie

Re: Thanks for all your responses.. it helps

Carole C in NOLA on 10/15/02 at 13:20 (097546)

I agree with Julie and Nancy, and also want to suggest that even wearing Birkenstocks whenever you aren't at work might help at least some.

Carole c

Re: Thanks for all your responses.. it helps

Shirley W on 10/15/02 at 20:40 (097575)

Well, I work at a service counter, waiting on customers all day. We have a very busy office, with usually all four counters manned. I stand on a 2'x3' foam mat, and probably 75% of my day is in this area, but often turning to the side for forms, etc. A stool or 'chair' is absolutely a no-no, and really would not be practical from a logistics point of view. I would have to move it constantly to get to the forms, then move it out of the way to get to the cash drawer, for each customer. That is if it was allowed, which it is not. I am about 4 years away from retirement, and believe me, after 33 years here I am not about to look for another job. Could never find one so secure, with good pay and great benefits. This is all I have done since high school, and it is all I know. I have tried to think of things to change at work, and there isn't any. Another guy I work next to has the same problem (but he's young, tall, and thin). I will just keep searching to find what will help ease the situation. I noticed today an ad in the paper for a new shockwave therapy machine that is new in the area (approved by FDA) for those not repoonding to treatment for 6 mos or more. May check that out and see if my ins. will cover if I am eligible. Will let you know on that one. Well, thanks.

Re: Thanks for all your responses.. it helps

Julie on 10/16/02 at 03:32 (097597)

Shirley, thanks for the explanation. This is certainly a tough one! Of course you don't want to leave your job after 33 years in it when you're only four years away from retirement with, I expect, a good pension waiting for you.

But those four years are going to seem awfully long if your feet keep hurting - and I'm concerned about how those feet are going to limit your pleasure in retirement when that great day comes.

I do see that a stool wouldn't work. What about this as a line of thought? In most organizations there are 'backroom' administrative sit-down jobs. Could you speak to your employer/line manager and arrange to get transferred to one of those (assuming they exist)? In fact - HAVE you spoken to him/her about your problem?

I really hope something like that will be possible. It will, of course, require you to be perhaps more assertive than you may be used to being. But if you think there's any possibility of it turning up trumps - go for it.

And while you're still on your feet, I would suggest you apply tape. If you haven't already investigated taping, I think you would find it a real help in reducing the ongoing pain. There are instructions and illustrations in part 2 of the heel pain book. I used the simplest of the suggested techniques - two strips of tape connecting the ball of the foot with the heel. If you've tried it but didn't find it helpful, there could be several reasons - the tape itself, the way you applied it, the tension, etc. Try again and come here for advice if you need it.

Investigate Nancy's Boston Birks, and take Carole's suggestion of wearing Birks at home. I'm assuming you ice your feet to reduce inflammation whenever you get the chance?

That's about all I can think of at the moment. Oh - except, find another podiatrist!

Good luck and let us know how you fare.

Re: Shirley re ESWT

Julie on 10/16/02 at 03:34 (097598)

I meant to say also that you can investigate ESWT (the treatment you referred to in your post) on this board. Extracorporeal Shock Wave Treatment is non-invasive and has a good success rate. Read the ESWT message board, and also the section on ESWT. And Dr Z has an information pack that he can send you - you can email him (I think there's a link at the top of the Dr board).

Re: Thanks for all your responses.. it helps

Shirley W on 10/16/02 at 20:44 (097678)

You all have been hard at work thinking of ways to help me! Whew! Thanks a lot--- but unfortunately there is not an area to be transferred to in the 'backroom' or sit down jobs available here. Before I got this postition, I worked the graveyard shift. The 'sit down' positions were really lean positions. Take a stool about crotch height, tilt the seat upward, then you can lean on it with your feet resting on a slanted footrest. --Not really what you call sitting--just leaning, but still on your feet. So, thanks for all the suggestions. I am fairly direct. I think as I age, I know more than I did when I was younger and am not as intimidated by things as much. One thing I tried today, which seemed to help-- I took my inserts from the sports injury store (these have been modified by them as much as they could, and work the best) and I added more padding in the arch area. I bought a pack of self stick 'Ball of Foot' cushions, trimmed them, and stuck them on top of my inserts. So far they worked great, tho the pain is not eliminated, it was a great day, all things considered. Thanks for all your input, I will keep you posted and I will look into those Birks, Carol. I have been looking at that footprints.com site for some time, and I may just try it out for some winter shoes.----

Re: Thanks for all your responses.. it helps

Julie on 10/17/02 at 08:44 (097718)

Shirley, best of luck.

Re: DR: What's my next 'step'??

Julie on 10/12/02 at 04:36 (097367)

Shirley, I'm not a doctor, but I do think your next step should be to cut your losses with this podiatrist and find another. You might also see if you can't get a refund for these misconceived and poorly made orthotics.

Do you really have to stand all day? That is one of the most frequent contributory cause of PF, and one of the very worst things for it. Presumably it's your occupation that demands it - would it be possible to ask for a switch to sit-down duties?

You say you read this website for information - I hope you've read the heel pain book and not just the message boards?

Re: DR: What's my next 'step'??

Mar on 10/12/02 at 08:07 (097375)

Shirley --

I understand your frustration and pain. I have had PF for almost a year now and I am in constant, exteme pain when standing or walking. The popping sounds like the orthotic does not fit in the shoe. I had that when I tried to put my sport ortho in a nonsneaker. It just wouldn;t work without the popping. I have 2 pairs of hard orthotics that I can't wear and my softer ones that I wear everyday in sneakers. They don;t take the pain away, but it is better than without them. I certainly agree that it is time to find a new pod and get it right. He may be able to adjust your soft orthos rather than make a 4th pair. A fellow sufferer who has thought about cutting off the feet as well, as horrible a thought as that is! Hope you find relief soon -- Mar

Re: DR: What's my next 'step'??

Carole C in NOLA on 10/14/02 at 09:15 (097466)

Good orthotics should feel better than not wearing them, after you've broken them in for a couple of weeks. Did you break them in slowly, starting with just an hour or two and then increasing the time by no more than an hour each day? You can do this in the evenings, to start with.

If you already broke them in like this, and they still hurt after a couple of weeks, then I doubt they would feel any better later on.

Birkenstock shoes are often helpful, especially for those with high arches. Like orthotics, they need to be broken in gradually.

I agree with Julie, that you should get a different Pod and try to temporarily switch to a sitting down job if you can. Icing your feet every night, and doing gentle non-weightbearing stretches should also be part of your routine.

Have you tried taping? There's a discussion of it in the heel pain book, with illustrations of how to do it.

Good luck to you and don't give up hope.

Carole C

Re: Thanks for all your responses.. it helps

Shirley W on 10/14/02 at 20:27 (097493)

Yes, I have read the heel pain book, but went over it again to refresh when you mentioned it again. Always good to jog the old gray matter. I do tape occasionally, and might more often if it will help. I also ice, and roll a ball under my feet, etc. Unfortunately, my job does not allow me the option of sitting, except at lunch. So I will have to stand regargless, and I use a 2' foam type mat to stand on. I wear the new inserts for a couple hours a day, then switch to the old ones. I have to wear black shoes to work, and they must be closed in, so I am currently wearing a new pair of NB. Haven't checked lately if Birks come in something closed in and in black, so I will continue to check around. But I do read here on the boards to learn all I can from others, and I really appreciate all the responses to my queries. I fortunately am not as bad on weekends, as I am not on my feet but off and on--- Sundays is family day, with meals and relaxing, and Mondays is whatever I want--errands and such. but nothing where I am constantly on my feet, so the pain is not nearly as noticable. So I REALLY look forward to my weekends. Well, I will keep looking for the 'cure for the week' and will pass it along if I find it. Thanks to you all------------:)

Re: Thanks for all your responses.. it helps

nancy s. on 10/14/02 at 20:33 (097494)

hello shirley,

do your shoes have to be all the way closed in, or just the toes and major front part? because boston birks are nearly closed in -- just not at the very back. they're my best friends.

i don't know your case (and i'm not a doc), but i hope you'll be open to the possibility of changing jobs if your feet are in a bad way. standing all day could make this condition chronic, and then there'll be no choice. i'm not trying to scare you -- just encouraging you to be realistic. it took me a while to get realistic, and i'd give a lot to go back and do it differently.

best of luck to you.
nancy

Re: Thanks for all your responses.. it helps

Julie on 10/15/02 at 01:31 (097508)

Hi Shirley

Let's do a little creative thinking. Could you describe your job and responsibilities to us? Maybe we can help you think of one or two crafty ways of getting round the standing problem. There's absolutely no doubt that the way you spend your working days is obstructing your healing - it's not just a side issue, it may be THE issue. And it could, long term, mean that your PF became chronic and disabling. So let's try to think of some way of minimizing your time on your feet.

All the best,

Julie

Re: Thanks for all your responses.. it helps

Carole C in NOLA on 10/15/02 at 13:20 (097546)

I agree with Julie and Nancy, and also want to suggest that even wearing Birkenstocks whenever you aren't at work might help at least some.

Carole c

Re: Thanks for all your responses.. it helps

Shirley W on 10/15/02 at 20:40 (097575)

Well, I work at a service counter, waiting on customers all day. We have a very busy office, with usually all four counters manned. I stand on a 2'x3' foam mat, and probably 75% of my day is in this area, but often turning to the side for forms, etc. A stool or 'chair' is absolutely a no-no, and really would not be practical from a logistics point of view. I would have to move it constantly to get to the forms, then move it out of the way to get to the cash drawer, for each customer. That is if it was allowed, which it is not. I am about 4 years away from retirement, and believe me, after 33 years here I am not about to look for another job. Could never find one so secure, with good pay and great benefits. This is all I have done since high school, and it is all I know. I have tried to think of things to change at work, and there isn't any. Another guy I work next to has the same problem (but he's young, tall, and thin). I will just keep searching to find what will help ease the situation. I noticed today an ad in the paper for a new shockwave therapy machine that is new in the area (approved by FDA) for those not repoonding to treatment for 6 mos or more. May check that out and see if my ins. will cover if I am eligible. Will let you know on that one. Well, thanks.

Re: Thanks for all your responses.. it helps

Julie on 10/16/02 at 03:32 (097597)

Shirley, thanks for the explanation. This is certainly a tough one! Of course you don't want to leave your job after 33 years in it when you're only four years away from retirement with, I expect, a good pension waiting for you.

But those four years are going to seem awfully long if your feet keep hurting - and I'm concerned about how those feet are going to limit your pleasure in retirement when that great day comes.

I do see that a stool wouldn't work. What about this as a line of thought? In most organizations there are 'backroom' administrative sit-down jobs. Could you speak to your employer/line manager and arrange to get transferred to one of those (assuming they exist)? In fact - HAVE you spoken to him/her about your problem?

I really hope something like that will be possible. It will, of course, require you to be perhaps more assertive than you may be used to being. But if you think there's any possibility of it turning up trumps - go for it.

And while you're still on your feet, I would suggest you apply tape. If you haven't already investigated taping, I think you would find it a real help in reducing the ongoing pain. There are instructions and illustrations in part 2 of the heel pain book. I used the simplest of the suggested techniques - two strips of tape connecting the ball of the foot with the heel. If you've tried it but didn't find it helpful, there could be several reasons - the tape itself, the way you applied it, the tension, etc. Try again and come here for advice if you need it.

Investigate Nancy's Boston Birks, and take Carole's suggestion of wearing Birks at home. I'm assuming you ice your feet to reduce inflammation whenever you get the chance?

That's about all I can think of at the moment. Oh - except, find another podiatrist!

Good luck and let us know how you fare.

Re: Shirley re ESWT

Julie on 10/16/02 at 03:34 (097598)

I meant to say also that you can investigate ESWT (the treatment you referred to in your post) on this board. Extracorporeal Shock Wave Treatment is non-invasive and has a good success rate. Read the ESWT message board, and also the section on ESWT. And Dr Z has an information pack that he can send you - you can email him (I think there's a link at the top of the Dr board).

Re: Thanks for all your responses.. it helps

Shirley W on 10/16/02 at 20:44 (097678)

You all have been hard at work thinking of ways to help me! Whew! Thanks a lot--- but unfortunately there is not an area to be transferred to in the 'backroom' or sit down jobs available here. Before I got this postition, I worked the graveyard shift. The 'sit down' positions were really lean positions. Take a stool about crotch height, tilt the seat upward, then you can lean on it with your feet resting on a slanted footrest. --Not really what you call sitting--just leaning, but still on your feet. So, thanks for all the suggestions. I am fairly direct. I think as I age, I know more than I did when I was younger and am not as intimidated by things as much. One thing I tried today, which seemed to help-- I took my inserts from the sports injury store (these have been modified by them as much as they could, and work the best) and I added more padding in the arch area. I bought a pack of self stick 'Ball of Foot' cushions, trimmed them, and stuck them on top of my inserts. So far they worked great, tho the pain is not eliminated, it was a great day, all things considered. Thanks for all your input, I will keep you posted and I will look into those Birks, Carol. I have been looking at that footprints.com site for some time, and I may just try it out for some winter shoes.----

Re: Thanks for all your responses.. it helps

Julie on 10/17/02 at 08:44 (097718)

Shirley, best of luck.