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Doctors: HOW do you get diagnosed

Posted by Ginger S. on 10/15/02 at 16:21 (097558)

Hi! I'm a newbie to the board, and you all seem so very knowledgeable about this that I thought I'd ask a question.
If you don't want the history, skip down to 'MY QUESTION'

My HISTORY:
I have been to about five or six different doctors. Ever since I was sixteen, I've had terrible pain in my right foot. I'm VERY flat-footed and I have always worked retail (which has been a sheer hell) except for two years ago when I had to quit. I teach school now, which offers me better flexibility (I CAN sit when the pain is too bad), but the pain is bad. I also have the shooting electrical pains (which are so bad they make me jump as if I'm being electrocuted on my foot) and numbness in some of my toes.

I have been diagnosed with heel spurs, bursitis, flat feet (doh!), and PF. I have been told to exercise (which HURTS), soak my feet, wrap them with tape (which helps a LITTLE), take cortisone shots (I had five and they did NOTHING--the next day the pain was there) and wear orthotics (they help a little). I've taken Vioxx, Oruvail (?), Ibuprofin and Tylenol. The Vioxx helps the best, but I wish I could get off taking ANYTHING. Looks like Doctors would treat the problem, not the symptoms.

I have had MRI's, CT's (with contrast--which was like a weird thing that they did to TRY and see if they could tell what's wrong) and even a arteriogram which they did to look at the blood vessels in my foot to see if there was some sort of lesion growing down there because I have a birthmark on the bottom of that foot (which is NO WHERE NEAR the spot near the ankle where I'm having the pain). All of that did nothing; the doctor said they couldn't figure out what the problem was. He told me after all those tests to go home and walk. I cried so hard, because I'd gotten my hopes up that we'd finally figure this thing out. I was just dashed.

MY QUESTION:
The person that got me started looking at Tarsal Tunnel was a Physical Therapist. He explained it to me and it made sense for all my symptoms. The thing is, I can't get a doctor to diagnose me. It seems that if I ask them to look into that idea, they will NOT do it (I tried that with the doctor that did all those tests.) The other doctors whom I didn't mention it to just said basically, 'here's some drugs, get out of my face.'

So here's my question (I'm sorry it's gone on so long, but I just wanted to make sure you got as much info as possible.)

***HOW do you get a doctor who will do his job and diagnose you? Are there certain things about your doctors that clued you into the fact that this was the right guy to help you out? Are their certain tests I can ask for? What should I be doing to get the help I need?***

I sympathize with your struggles and I hope that all of us find some kind of relief one day.
Thanks for all your help!
Ginger S.

Re: Doctors: HOW do you get diagnosed

Ellen F. on 10/15/02 at 19:00 (097566)

I was diagnosed by podiatrist that thought i had it related to symptoms, then he sent me for Nerve Conduction Study and EMG. they can take readings of the various nerves in your feet and legs and determine if you have TTS. i feel for you, i've only had symptoms for about 2 yrs. ,started with aching and painful to numb toes on both feet worse on right. never gave it a thought for anything but my shoes were too tight, then....oh well now being told have TTS in both feet. it really is true when your feet hurt you are miserable all over. this is a good place to come and learn, i have found out so much about 'conservative' treatments , etc. everyone is very nice and helpful. don't give up, find someone to help you, definetly have the nerve studies done.

Re: here's how

elliott on 10/15/02 at 19:48 (097572)

You go to better doctors if you can. One should be competent enough to be suspicious of TTS if that's what it is. They (orthopedist, pod) can then possibly refer you to a neurologist to conduct a nerve conduction test, as Ellen said, which might add evidence to the diagnosis.

Can you describe your symptoms in greater detail (exactly where your pain is, i.e. which part of foot/ankle, which side, what kind of pain it is, where it radiates to, what brings it on, etc.)? The more descriptive, the better.

Can you say where you live? Maybe someone here can recommend a doc.

[]

Re: here's how

Ginger S. on 10/16/02 at 17:50 (097664)

SURE!

I have pain along the spot on the bottom of my foot in front of the heel area (which I hear is the place that PF foot pain usually is). It's NOT ever pain of the heel. I don't think it's PF though, because I NEVER have pain in the morning, it's better after rest, and I have electrical shocks. Sometimes it's a burning pain (like today!) and then sometimes I get these SHOCKS that feel like electrical impulses on the inside of my foot (not the bottom of the foot but the SIDE) up near the ankle. It's so sharp it makes me JUMP! There's some kind of pain every day, although some days are better than others. Sometimes my toes go numb, and the pain travels up my foot to there most of the time. It's like it starts under the ankle on the bottom of my foot and works all the way up to my toes.

Standing in one spot really drives it crazy. The cold weather is bad on it, but the standing thing is the real kicker that sends the pain over the edge. I'd have days in retail where I'd go home crying. If I'm sitting, for a while, I don't feel a lot of pain. I'm 29 now, so I've been suffering with this pain for years. Should I just go into a podiatrist's office and tell him he MUST reccomend me for a nerve conduction test? NONE of my podiatrists/orthopedists seem to want to even THINK about that. They try EVERYTHING but that, but everything hasn't worked so far. The times I've brought the idea up, they seem to not hear me. :o(

The bad thing is, I use my left foot to compensate for the right and I'm starting to have the same type symptoms underneath that area that's the inside ankle. No shocks in the other foot yet, but the burning pain is there. Sigh.

I hope I've been helpful... if you need more details, please let me know.
I am from Georgia. Athens, Atlanta and Augusta are easy for me to get to. Augusta is the closest and best alternative, but I'm willing to try ANYTHING. If anyone could reccommend someone, I'd be VERY GRATEFUL!!!!

Thanks to all for any help!!!!!!!!!!!
:o) Ginger

Re: here's how

elliott on 10/16/02 at 21:48 (097691)

It sure sounds like TTS. I don't know what your insurance restrictions are, but you have to go to a doc who has experience with it. Can you get a doc, even your primary, to refer you to a neurologist/electromyographer for NCV/EMG testing? Then ask that office for a copy of the report/results, and take that with you to the ortho or pod with hands-on surgical experience with TTS.

Did you try change of shoes and orthotics, by the way? No point rushing into a risky surgery if this will help.

There is an ortho, a TTS pro, in Birmingham, Alabama named J. S. Gould. Is that too far?

[]

Re: PLEASE HELP!!!!!

Ginger S. on 10/17/02 at 17:11 (097766)

YES!
I've changed shoes. I NEVER wear anything like high heels; I only wear shoes with support and I have had two sets of EXPENSIVE custom orthotics.

Thanks. I have a great primary physician that hopefully will refer me for the testing. That'll be my objective over our school break (I'm a teacher). I asked my husband and he said Birmingham AL is not too far.
Can you give me more information on Dr. Gould?

Re: Doctors: HOW do you get diagnosed

Ellen F. on 10/15/02 at 19:00 (097566)

I was diagnosed by podiatrist that thought i had it related to symptoms, then he sent me for Nerve Conduction Study and EMG. they can take readings of the various nerves in your feet and legs and determine if you have TTS. i feel for you, i've only had symptoms for about 2 yrs. ,started with aching and painful to numb toes on both feet worse on right. never gave it a thought for anything but my shoes were too tight, then....oh well now being told have TTS in both feet. it really is true when your feet hurt you are miserable all over. this is a good place to come and learn, i have found out so much about 'conservative' treatments , etc. everyone is very nice and helpful. don't give up, find someone to help you, definetly have the nerve studies done.

Re: here's how

elliott on 10/15/02 at 19:48 (097572)

You go to better doctors if you can. One should be competent enough to be suspicious of TTS if that's what it is. They (orthopedist, pod) can then possibly refer you to a neurologist to conduct a nerve conduction test, as Ellen said, which might add evidence to the diagnosis.

Can you describe your symptoms in greater detail (exactly where your pain is, i.e. which part of foot/ankle, which side, what kind of pain it is, where it radiates to, what brings it on, etc.)? The more descriptive, the better.

Can you say where you live? Maybe someone here can recommend a doc.

[]

Re: here's how

Ginger S. on 10/16/02 at 17:50 (097664)

SURE!

I have pain along the spot on the bottom of my foot in front of the heel area (which I hear is the place that PF foot pain usually is). It's NOT ever pain of the heel. I don't think it's PF though, because I NEVER have pain in the morning, it's better after rest, and I have electrical shocks. Sometimes it's a burning pain (like today!) and then sometimes I get these SHOCKS that feel like electrical impulses on the inside of my foot (not the bottom of the foot but the SIDE) up near the ankle. It's so sharp it makes me JUMP! There's some kind of pain every day, although some days are better than others. Sometimes my toes go numb, and the pain travels up my foot to there most of the time. It's like it starts under the ankle on the bottom of my foot and works all the way up to my toes.

Standing in one spot really drives it crazy. The cold weather is bad on it, but the standing thing is the real kicker that sends the pain over the edge. I'd have days in retail where I'd go home crying. If I'm sitting, for a while, I don't feel a lot of pain. I'm 29 now, so I've been suffering with this pain for years. Should I just go into a podiatrist's office and tell him he MUST reccomend me for a nerve conduction test? NONE of my podiatrists/orthopedists seem to want to even THINK about that. They try EVERYTHING but that, but everything hasn't worked so far. The times I've brought the idea up, they seem to not hear me. :o(

The bad thing is, I use my left foot to compensate for the right and I'm starting to have the same type symptoms underneath that area that's the inside ankle. No shocks in the other foot yet, but the burning pain is there. Sigh.

I hope I've been helpful... if you need more details, please let me know.
I am from Georgia. Athens, Atlanta and Augusta are easy for me to get to. Augusta is the closest and best alternative, but I'm willing to try ANYTHING. If anyone could reccommend someone, I'd be VERY GRATEFUL!!!!

Thanks to all for any help!!!!!!!!!!!
:o) Ginger

Re: here's how

elliott on 10/16/02 at 21:48 (097691)

It sure sounds like TTS. I don't know what your insurance restrictions are, but you have to go to a doc who has experience with it. Can you get a doc, even your primary, to refer you to a neurologist/electromyographer for NCV/EMG testing? Then ask that office for a copy of the report/results, and take that with you to the ortho or pod with hands-on surgical experience with TTS.

Did you try change of shoes and orthotics, by the way? No point rushing into a risky surgery if this will help.

There is an ortho, a TTS pro, in Birmingham, Alabama named J. S. Gould. Is that too far?

[]

Re: PLEASE HELP!!!!!

Ginger S. on 10/17/02 at 17:11 (097766)

YES!
I've changed shoes. I NEVER wear anything like high heels; I only wear shoes with support and I have had two sets of EXPENSIVE custom orthotics.

Thanks. I have a great primary physician that hopefully will refer me for the testing. That'll be my objective over our school break (I'm a teacher). I asked my husband and he said Birmingham AL is not too far.
Can you give me more information on Dr. Gould?